Gathering information
What is causing me to think the individual is at risk of harm?
What do I know?
- Information-gathering should focus on the signs and indicators of possible abuse and or neglect. For example, for those considering reporting a case of an adult at risk it means obtaining sufficient information to decide whether to make a report to social services. For practitioners responding to a report, the purpose of information-gathering is to gain insight into the world of the adult at risk to understand whether they need protection and/or have care and support needs.
- The role and responsibilities of the worker will affect the information they have at their disposal.
- Information gathered should be ‘proportionate’. It should be sufficient to inform decision-making. For example, if there are concerns about an older person in a care home who has pressure ulcers it is not, in the first instance, necessary to obtain information about the family history.
- When gathering information, detail and evidence of concerns about harm should be obtained. For example, ‘inappropriately dressed’ means little. If the information gathered is hearsay or professional opinion this should be made clear.
- The service-user and their carers should have opportunities to provide information about their situation, their wishes and feelings. Communication approaches that promote engagement and information-sharing should be used. For example, asking what language they wish to use; drawing on interpreters and advocates.
- Information gathering and sharing should be in accordance with the EU’s General Data Protection Regulation.
- It should be transparent to the service user and undertaken with the consent of the adult at risk. However, information can be shared without consent if to do so would place the individual or others at increased risk of harm or they do not have the mental capacity under the Mental Capacity Act 2005 to give informed consent.
- Information gathering should not focus merely on gathering evidence to confirm one’s hypothesis. For example, if there are concerns that a young man with a severe learning disability is being emotionally abused by a parent it is important to gather information about both the positive and negative aspects of their relationship.
- Careful consideration should be given to information that is obtained from social media. Whilst this information may be in the public domain, it may not be accurate.
- Record information gathered.
Making sense of the information
What does this information tell me about the adult I consider to be at risk? Does it confirm or refute the hypothesis? Do I need to test further, consult and/ or consider alternative hypothesises?
At this stage, irrespective of the reason for the assessment, there are questions that the practitioner should ask of themselves:
- Do I have enough information to analyse and make a professional judgement? If not, what more do I need? How will I obtain it?
- Have I seen and spoken to the individual? Have I listened to what they have to say and taken their wishes, views and feelings seriously?
- Do I have a clear understanding of the personal outcomes the adult at risk wish to achieve?
- What weight can I give to the information gathered? For example. is the information evidence-based, hearsay or professional opinion?
- Do I need to revise my hypotheses in view of the information obtained and analysed?
- Do I need professional advice and guidance? Who can I contact? (see section on obtaining advice)
Decision-making and planning
What do I need to do, considering my role and responsibilities to protect, care and support the adult at risk? Are immediate actions necessary?
In the same way that the information gathered should be proportionate so should the response.
The following questions should be considered:
- What does the information gathered tell me about risk of harm and protective factors?
- Do I have enough information to make an informed decision about next steps or should I gather more? If so, what do I need to know? Who should I consult?
- What are the wishes of the adult at risk?
- What is required of both carers and practitioners to protect the adult at risk from abuse and neglect when possible without breaching the right to family life? If there are several options, consider the advantages and disadvantages of each. For example, lengthy waiting lists, location, appropriateness of available services.
Action/ Intervention
How will the identified actions - immediate and longer-term - contribute to keeping the person safe and improving the lived experience of the adult or child at risk of harm?
At this stage the 5 ‘Ws’ should be considered. Practitioners and the adult at risk and their family and carers must reach a shared understanding of the following:
- Why interventions are taking place and how they are designed to achieve identified person-centred outcomes
- What interventions will be undertaken to achieve the desired outcomes and the rationale for these interventions. For example, why the parent should attend a parenting programme
- Who is expected to do what? This is essential so that both practitioners and the family understand exactly what is expected of them as part of the intervention and how these actions should achieve the desired outcomes.
- When this will happen. It is useful to agree timescales with measures of progress.
- Where interventions will take place.
Evaluation
Have the agreed person-centred outcomes been achieved? What evidence do we have? If the outcomes have not been achieved what should happen?
These questions are important to ensure presumptions are not made that the risk of harm has reduced without evidence to support this. Practitioners should consider the following:
- Does the adult at risk believe the quality of their lives and their well-being has improved?
- What evidence do we have from the service user and practitioners that the agreed outcomes have been achieved?
- What interventions worked?
- What actions did not contribute to improved outcomes?
- Do we need to revise interventions for this individual?
- What information do we need to assist us make this decision?
- If the outcomes have been achieved should the case by closed? Are other sources of support required to maintain current levels of safety and well-being?
- Does the adult at risk and practitioners share a common understanding of the review conclusions and any additional assessments etc that will be completed because of the evaluation?