This process, which should be undertaken in advance of the face-to-face, includes gathering information from systems held within the Local authority and in conversations held with other professionals including GP’s and the police where appropriate, who know, or have some involvement with the Adult at Risk.
An initial risk screening will have been commenced, as part of screening the concern consideration will have been given to –
- Level of threat to the person at risk’s physical or mental well-being
- The nature/extent of the abusive acts
- Whether the abuse was a one off event or part of a long standing relationship or pattern
- The impact of the abuse on the adult and their independence
- The intent of the alleged source of harm – Is this a potential hate/mate crime
- The risk of the abuse being repeated to the Adult at Risk, other adults or children. (Consider a risk assessment and referral to services if appropriate) (risk to other adults may result in an enquiry without the consent of the adult)
- The risk that harm would result or impact of harm escalate if no action was taken
- The incident involves a regulated service provider (inform Care Quality Commission and Contracts) (in these cases we may progress the enquiry without the consent of the adult)
- The concern involves a commissioned service not regulated by CQC
- Do the allegations involve “persons in position of trust” (workers or volunteers) (we may progress an enquiry without the consent of the adult)
- A crime has been committed
Ideally in advance of the face to face meeting you will need to have answered all of these questions to support a realistic discussion with the adult about their perception of the risks and consequences and based on the information shared that you maybe required to go against their wishes and give the reasons to them WHY you need to take this action. (I.e. public interest, others at risk)
You will need to record any evidence as to why you have not been able to access relevant information in advance of the meeting if you are not able to do so and if an agency/organisations is or remains unwilling to share information please notify the Safeguarding Adults Office.
In advance of the meeting with the Adult at Risk the worker(s) will need to balance this information in context to produce a proportionate and balanced approach to the risk(s)
Some of the areas that it would be helpful to consider include -
- Capacity of the adult – always start with a presumption of capacity – however it is essential to consider the impact of coercion/control (domestic violence) and duress – Mental Capacity Act
- Their current, or if they now lack capacity (previous), their views on the risks in their lives. When you meet with then this may change
- The risks in context – of family member i.e. taking £30 per week may not result in any harm and the adult may be willing to pay this to guarantee contact with the family. Even if the loss of money is resulting in harm, the adult still may be willing to support family continuing to have access to the money to maintain an otherwise positive relationship
- Has the adult a long history of abusive relationships (low self esteem/self worth), their perception of risk/abuse is very different from other adults
- Has the adult a negative history on contact with statutory services – will this reduce the chances of them accessing support and help
- Are they able to demonstrate that they can and will protect themselves if the situation continues to deteriorate
- Has the adult any positive influences in their life – family, friends, organisations who can support the adult to reduce or remove the risks
- Has the adult got the necessary information/skills to access help or to remove themselves from the source of harm
- Have they a history of agreeing to action and then being unable or unwilling to deliver on these commitments
Mapping these out under each broad risk area will assist your conversation with the adult, their family or advocate/IMCA andsupport you in rating the risks as high, medium or low.
The risk should be reviewed regularly throughout the Section 42 enquiry and recorded on the relevant SA forms.