Consent to make a safeguarding referral

Consent to make a safeguarding referral

 Consent to make a safeguarding referral is a highly contentious issue that is often misconstrued. I am going to unpick this from a practitioner’s perspective. Making safeguarding personal asks us to discover what the persons own definition of safe and well (In the circumstances presented) would look like. The practitioner will need to find out what safe and well means to the person, because every person’s definition will be based upon their experiences, values and personal ethics. We should not impose our own definition of safe and well upon the person.

 If I approach you and tell you that I want to keep you safe, to safeguard you, it is likely that your initial thoughts would be that you would be controlled by me, you would not be allowed to make your own choices or take risks. This is not ‘safeguarding’ and so the question, 'What makes you feel safe and well and how can I support you to achieve this?' must be asked. What are your expectations of me and others, if we are to help you to achieve this? What would ‘safe and well’ look like for you if we have done our job well? We can not predict what safe and well means and therefore we can not and should not need to assess a persons capacity to consent to a safeguarding referral because this would mean imposing a set of ‘safe’ characteristics to the assessment. If we to ask you what safe and well means for you and then tell you that I want to help you achieve this, why would you decline the offer?

Any intervention with the individual should never present further danger to the person and the enquiry process will consider each outcome identified by the person and where there is doubt about a persons ability to make a choice regarding an outcome, a specific capacity assessment will take place with appropriate advocacy. This is true person-centred work .

 If there is reasonable suspicion of coercive and controlling behaviours, then further work is required to determine the persons own autonomous decision making, or to protect the person where they are too afraid to act autonomously. No one can choose to take actions that harm others or place others at risk and therefore the safeguarding enquiry must explore any of these possibilities. No one can choose to commit a crime, these must be reported to the Police.  Information may be shared with relevant bodies, however, where a competent adult explicitly refuses any supporting intervention, this should normally be respected.

Exceptions to this may be where a criminal offence may have taken place or where there may be a significant risk of harm to a third party. If, for example, there may be an abusive adult in a position of authority in relation to other vulnerable adults [sic], it may be appropriate to breach confidentiality and disclose information to an appropriate authority. Where a criminal offence is suspected it may also be necessary to take legal advice.

Ongoing support should also be offered. Because an adult initially refuses the offer of assistance he or she should not therefore be lost to or abandoned by relevant services. The situation should be monitored and the individual informed that she or he can take up the offer of assistance at any time.  

Care Act

A local authority must co-operate with each of its relevant partners, and each relevant partner must co-operate with the authority, in the exercise of—

(a)their respective functions relating to adults with needs for care and support,

(b)their respective functions relating to carers, and

(c)functions of theirs the exercise of which is relevant to functions referred to in paragraph (a) or (b).

The duties under subsections (1) to (4) are to be performed for the following purposes in particular—

(a)promoting the well-being of adults with needs for care and support and of carers in the authority’s area,

(b)improving the quality of care and support for adults and support for carers provided in the authority’s area (including the outcomes that are achieved from such provision),

(c)smoothing the transition to the system provided for by this Part for persons in relation to whom functions under sections 58 to 65 are exercisable,

(d)protecting adults with needs for care and support who are experiencing, or are at risk of, abuse or neglect, and

(e)identifying lessons to be learned from cases where adults with needs for care and support have experienced serious abuse or neglect and applying those lessons to future cases.

 Guidance

The need to protect people from abuse and neglect.

In any activity which a local authority undertakes, it should consider how to ensure that the

person is and remains protected from abuse or neglect. This is not confined only to safeguarding issues, but should be a general principle applied in every case including with those who self-neglect.

 Where the local authorities identifies that an adult is experiencing, or is at risk of experiencing, abuse or neglect. Where the adult who is or is at risk of abuse or neglect has capacity and is still refusing an assessment, local authorities must undertake an assessment so far as possible and document this. They should continue to keep in contact with the adult and carry out an assessment if the adult changes their mind, and asks them to do so.

Conclusion

Initial contact will be to establish the persons own definition of safe and well and to provide assurance that as long as this is an informed autonomous decision where there are no risks to others or criminal activities responses will comply with their wishes and expected outcomes within lawful boundaries. Information can be shared with the Local Authority to conduct enquiries to rule these things out, but any response in relation to the capacitated adult must be compliant with their wishes. Where there is concern that an adult does not understand enough to make a specific decision / decisions the enquiry process will explore their understanding of safe and well and their understanding of the consequences of each chosen action. This will be coordinated via an identified appropriate lead coordinator. Lawful responses should also be explored across agencies and underpinned by the Human Rights Act.