Strategy meetings/ discussions: key considerations

Timescales

A strategy discussion/meeting usually precedes any action to protect. It must take place within 7 working days of the conclusion of the s126 enquiries, but if immediate action is necessary, to protect the adult at risk and/or other adults at risk or children, it should precede this action and be undertaken in a manner which does not delay the necessary action. Good practice, however, would advise that the first strategy discussion/meeting should happen as soon as is practically possible especially where a criminal offence is suspected

For example: a young woman with a learning disability has alleged sexual assault by a family member. The opinion of the professionals is that an urgent medical examination is required, and the woman is able to consent to this. Arrangements are made to support the woman to attend the Sexual Abuse Referral Centre that day to undertake a police interview and medical examination to gather and secure evidence.

Person-Centred Strategy Discussions/ Meetings

Adults at risk have the right to give or withhold their consent to all aspects of their possible involvement in adult safeguarding unless it has been assessed that they do not have the mental capacity to make these decisions.

If an adult at risk does not have the mental capacity to make this decision, a best interest decision must be made that reflects the best interests of the person and the wider public interest.

The strategy discussion/meeting must check if the adult at risk has consented to the s126 enquiries or if there are grounds for overriding a decision to withhold consent. This may require direct contact to be arranged with the adult at risk to determine their wishes.

Strategy discussions/meetings are professional meetings. However, a decision should be made as to who will liaise with the adult at risk and their family about process and decisions reached.

It is crucial that the enquiries or investigations are fair and objective and any decisions about safeguarding arrangements are made in partnership with the adult at risk. To achieve this:

• Every effort should be made to explain the purpose of the enquiries and investigations to the adult at risk using appropriate communication methods;
• Any concerns the adult at risk has about the process are recognised and where possible addressed;
• Their views as to what they would like to happen are sought;
• The personal outcomes they wish to achieve are recognised.

Participation in strategy discussion/ meetings

When deciding who should be involved in strategy meetings and discussions practitioners should use their professional judgement, based on the information gained to date.

At a minimum the following should be included:

• appropriate personnel with responsibility for adult protection in police and social services;
• the practitioner making the report;
• practitioners from services working with the adult at risk, their family and carers;
• a doctor from the service who has/may be providing a medical examination.

The engagement of other practitioners will depend on the individual nature of the case but may include:

• day-centre staff;
• any key agencies working with the adult at risk and/or providing services including the third sector;
• advocates working with the adult at risk;
• medical and health staff;
• regulatory bodies, as relevant to the circumstances;
• representative from the local authority legal services if legal proceedings are being considered.

The staff involved in the discussion should be authorised to make decisions on behalf of their agency.

Chairing

The strategy discussion/meeting should be chaired the lead/delegated lead co-ordinator who has the authority and expertise to chair these discussions/meetings.

The chair should ensure:

• focus on the adult at risk’s safety, care and support needs and actual and potential risk of abuse and or neglect;
• establish tasks and actions to be taken: who, why and when;
• clarify roles and responsibilities of organisations in terms of best use of skills, expertise and resources;
• identify any issues regarding co-operation and communication;
• determine what information is shared with the adult at risk, their carers and family (if the police are involved in consultation with them);
• record and ensure actions are carried out or any changes are made in consultation with them.

The discussion/meeting should be held in line with national and local procedures.

The chair decides who will receive a record of the discussion/meeting.

The chair should identify who will participate in further assessments and investigations. For example, tissue viability nurses, police.

The agenda

The practitioners participating in the strategy discussion should consider:

1. The adult at risk

• the report/disclosure;
• the perceived vulnerability of the adult at risk, including their mental capacity in relation to the allegation(s);
• the consent of the adult at risk and his/her wishes with respect to any outcomes;
• the nature and extent of the alleged abusive act(s);
• when the alleged abuse took place;
• whether the alleged abuse was an isolated incident or may continue;
• the impact upon the adult at risk;
• the risk of repeated abuse;
• whether other adults and children may be at risk, whether the child protection procedures should also be triggered;
• if the abuse or neglect is alleged to have been committed by a practitioner, any actions that need to be taken to reduce the risks posed must be noted and agreed;
• the nature, apparent seriousness and urgency of the alleged abuse i.e. assess the risks and take immediate or emergency action if this is needed and has not been done.

2. Evidential issues

• Consider police requirements:
• There may be a need to secure and preserve evidence, e.g. obtaining photographic evidence;
• An immediate interview of the adult at risk or other may be required and if so for what purpose and by whom.
• Whether a medical examination of the abused adult at risk is necessary.

3. Perpetrator issues

• establish if the alleged perpetrator is an adult at risk;
• whether there are any ongoing care issues. This may require contact with the HR department of the alleged perpetrator’s employer;
• the possible intent of the perpetrator;
• the potential illegality of the perpetrator’s actions.

4. Actions

• the immediate safety, care and support needs of the adult at risk;
• how they will be met;
• will there be an investigation (criminal or other);
• monitoring to ensure adult at risk protected from further abuse and neglect.

5. Other issues

• options available outside adult safeguarding procedures, including consideration of referrals into MAPPA, MARAC and/or child protection;
• whether, in cases of poor practices and standards in regulated or commissioned services, an investigation is needed, or an alternative approach is required.

This requires those engaged to:

• share all available information;
• determine the course of action required and timescales set for those actions to be carried out;
• agree on any subsequent assessment process;
• establish the way information about the strategy discussion is to be shared with the adult at risk and by whom. (consideration should be given as to whether information sharing may place the adult at risk of abuse and/or jeopardise police investigations into any alleged offence(s));
• identify the needs of other adults and children at risk who may be in contact with alleged abusers.

Recording the strategy discussion/ meeting and decisions

A record must be taken of the strategy discussion/meeting and saved with the case notes. This recording as a minimum should include:

• A list of attendees/participants and apologies received;
• A record of the discussion and decisions taken;
• Those party to the discussions;
• A list of action points and their purpose;
• Agreed timescales for actions including assessments;
• The persons responsible for carrying out identified actions;
• The agreed mechanism and timescale for sharing the outcome of any designated actions and determining next steps;
• Agreed mechanisms to escalate concerns and timescales for the completion of agreed actions;
• Whether a medical examination is required.

Any information shared, all decisions reached, and the basis for those decisions, must be clearly recorded and circulated within one working day to all parties relevant to the discussion.