4.2 Stage 2: Screening and Initial Decision Making

1. Introduction

Under the Care Act 2014 the local authority is responsible for ensuring that enquiries into cases of abuse and neglect are carried out. Local authorities must make enquiries, or cause others to do so, if they reasonably suspect an adult is experiencing, or at risk of, abuse or neglect.

The local authority response to a safeguarding adults concern will involve:

• information gathering;
• decision making.

Depending on the circumstances, and the adults wishes, this may the be followed by:

• carrying out a safeguarding enquiry;
• taking action / developing a safeguarding plan.

2. Local Authority Actions

On receipt of a concern, the Safeguarding Adults Team will make a decision regarding the most appropriate way to respond. The outcome of the decision may be:

• that on the basis of the information provided, the concern meets the threshold to initiate a safeguarding adults enquiry and therefore the concern becomes a referral (see, The safeguarding duty);
• that it is more appropriate for the concern to be addressed through another process;
• that further information is required in order to make this decision.

The purpose of the safeguarding enquiry is to decide whether or not the local authority or another organisation, or person, should do something to help and protect the adult.

An enquiry can range from a conversation prior to initiating a formal enquiry with the adult, through to a more formal multi-agency plan or course of action.  Where the adult lacks mental capacity or has substantial difficulty in understanding the enquiry, discussions will take place with their representative or advocate.

Whatever the course of action decided, practitioners should record details of the concern, including the adult’s views and wishes, any immediate action which has been taken (with reasons).

2.1 Purpose of the Enquiry

The purpose of the enquiry is to decide whether or not the local authority (or another organisation, or person), should act in order to help and protect the adult.

The scope of any enquiry, who leads it and its nature, and how long it takes, will depend on individual circumstances. It will usually start with asking the adult their view and wishes, which will often determine the next steps to take. Everyone involved in an enquiry will focus on improving the adult’s well-being and work
together to that shared aim.

If the local authority decides that it would be more appropriate for another organisation to make the enquiry, for example a care provider, the local authority should be clear about required timescales, the need to know the outcomes of the enquiry and what action will follow if this is not done.

2.1.1 Involving the adult in enquiries

Action that is taken as a result of an enquiry should reflect the adult‘s wishes wherever possible, as stated by them or by their advocate. If they do not have mental capacity, the outcome should be in their best interests and proportionate to the level of concern.

The adult should always be involved from the beginning of the enquiry, unless 
there are exceptional circumstances that would increase the risk of abuse. If the adult has substantial difficulty in being involved, and where there is no one appropriate to support them, then the local authority must arrange for an independent advocate to represent them (see Independent Advocacy).

2.1.2 Professional roles and responsibilities in enquiries

Professionals and other staff need to handle safeguarding enquiries in a sensitive and skilled manner to ensure any potential distress to the adult is minimised.

It is likely that the majority of safeguarding enquiries will require the input and supervision of a social worker, particularly more complex situations.

Social workers involved in enquiries should support the adult to realise the outcomes they want and to reach a resolution or recovery.

Whilst work with the adult usually requires the input of a social worker, other professionals may be involved who have specialist skills and knowledge. For example, health professionals should undertake enquiries and treatment plans relating to medicines management or pressure sores.

3. Information Gathering

3.1 Who to consult

(Information Gathering Diagram, Chapter 14, Care and Support Statutory Guidance).

The adult’s carer and / or family should also be involved, where appropriate, and where it would not put the adult at any further risk of abuse or neglect.

After the information gathering and consultation stage, if the issue cannot be resolved or the adult remains at risk of abuse or neglect (actual or suspected), the local authority’s duty to enquire (under section 42) continues until it decides what action is necessary to protect the adult and by whom and it can ensure that this action has been taken.

3.2 Principles for decision making

The following principles should be applied during the decision making process:

• empowerment: presumption of person led decisions and informed consent;
• prevention: it is better to take action before harm occurs;
• proportionate and least intrusive response appropriate to the risk presented;
• protection: support and representation for those in greatest need;
• partnership: local solutions through services working with their communities;
• communities: have a part to play in preventing, detecting and reporting neglect and abuse;
• accountability and transparency in delivering safeguarding;
• feeding back whenever possible.

3.3 Decision making diagrams

4. Mental Capacity

For information about assessing mental capacity see Section 3, Assessing Mental Capacity, Mental Capacity.

4.1 When the adult does not have mental capacity

Where there is concern that the adult may not have mental capacity to make relevant decisions regarding the safeguarding enquiry, it is important that their capacity is appropriately assessed as soon as possible. It may be that, with appropriate support, the adult can make their own decisions.

If the assessment concludes that the adult does not have the mental capacity to make decisions related to the enquiry, feedback will be given to them and anyone who is acting in their best interests (for example, their attorney or court appointed deputy), unless they are implicated in the allegation.

If the person has no suitable family or friend who can be consulted regarding their best interests, an independent advocate should be instructed.

4.2 When the Adult has Capacity

If the adult has mental capacity to make decisions about their safety, consideration must be given to:

• finding out from them what is happening;
• talking to them about their concerns;
• carrying out a risk assessment with them to find out if they understand the risks and what help they may need to support them to reduce the risk if that is what they want;
• being satisfied that their ability to make an informed decision is not being undermined by the harm they are experiencing and is not affected by intimidation, misuse of authority or undue influence, pressure or exploitation if they decline assistance;
• reassuring them that they will be involved and supported in all relevant decisions and actions that are taken to protect them, and informing them that in certain circumstances action will have to be taken even if they disagree (for example, if a child or another adult is also at risk of harm).