2. Adult Protection Committee functions
9. Section 42 of the ASP Act states that:
(1) Each council must establish a committee (an "Adult Protection Committee") with the following functions-
(a) to keep under review the procedures and practices of the public bodies and office-holders to which this section applies which relate to the safeguarding of adults at risk present in the council's area (including, in particular, any such procedures and practices which involve co-operation between the council and other public bodies or office-holders to which this section applies),
(b) to give information or advice, or make proposals, to any public body and office-holder to which this section applies on the exercise of functions which relate to the safeguarding of adults at risk present in the council's area,
(c) to make, or assist in or encourage the making of, arrangements for improving the skills and knowledge of officers or employees of the public bodies and office-holders to which this section applies who have responsibilities relating to the safeguarding of adults at risk present in the council's area,
(d) any other function relating to the safeguarding of adults at risk as the Scottish Ministers may by order specify.
(2) In performing its functions, an Adult Protection Committee must have regard to the desirability of improving co-operation between each of the public bodies and office-holders to which this section applies for the purpose of assisting those bodies and office-holders to perform functions in order to safeguard adults at risk present in the council's area.
(3) The public bodies and office-holders to which this section applies are-
(a) the council,
(b) the Care Commission,
(c) the relevant Health Board,
(d) the chief constable of the police force maintained in the council's area,
(e) any other public body or office-holder as the Scottish Ministers may by order specify.
10. In summary, the Act places a duty on councils to set up APCs that will be responsible for monitoring and advising on adult protection procedures, for ensuring appropriate cooperation between agencies and for improving the skills and knowledge of those with a responsibility for the protection of adults at risk.
11. APCs must be established for every council area. There may be different models to deliver this and local authorities should adopt the model that is most appropriate for their area. Where an APC covers more than one council area, each authority will remain accountable for the activities in their own council area. Local authorities are encouraged to work together with their partners to ensure APCs work effectively.
12. APC membership must include representatives of the relevant council(s), NHS Board and relevant Chief Constable. The Care Commission may also nominate a representative, with appropriate skills and knowledge, to be a member of an APC. The establishment of an APC should therefore be planned in consultation with all of these bodies, and any other partners the council wishes to involve. Section 3 below provides guidance on membership.
Procedures and practice
13. One of the main aims of the Act is to improve co-operative working between agencies with responsibility for adult protection. APCs will be responsible for regulating their own procedures. They must also monitor practice and quality relating to the safeguarding of adults at risk and also audit performance of the agencies in the APC area in relation to adult protection. (Council, NHS Board, Police and Care Commission).
14. APCs may therefore wish to develop tools for doing this. These may build on existing policy and practice guidelines, provided they meet the requirements of, and include sufficient explanation of, the Act.
15. To improve cooperative working, APCs will have to ensure that their procedures and practices are both multi-agency and multi-disciplinary. A step process might be useful, addressing:
- referral and initial response
- assessment and risk assessment;
- adult protection conferences and protection planning;
- adult protection care management;
- adult support;
- risk monitoring; and
16. Procedures should also address arrangements for local interagency and intra-professional communication, information sharing and coordination. Similar arrangements should be considered between council areas. It is important for local guidelines that address communications with adults at risk, family members and others. Local guidelines should also be clear about expectations in relation to support services such as advocacy and representation for adults at risk, especially where any intervention is pursued under the Act.
Information, advice and proposals
17. The Act requires APCs to give information or advice to its statutory members on the safeguarding of adults at risk present in the council area(s). This means that APCs will need expertise in standards of adult support and protection, and become knowledgeable about local professional practice and performance management. Monitoring and evaluating local practice will involve data collection and data analysis, including the measurement of outcomes. APCs will therefore need to consider what information systems will have to be in place, what form of regular audit is needed, and what research would be helpful. Over time, APCs will be able to consider practice and performance trends from the information available.
18. The Act does not require APCs to become involved in individual case reviews. APCs have a strategic and monitoring function rather than an operational role and therefore routine case review may well be seen as inappropriate. However, joint consideration of individual cases may help APC members to develop greater joint understanding of service user concerns and professional practice. While there is no duty to do so, APCs are encouraged to evaluate and learn from critical incidents.
Improving skills and knowledge
19. APCs have a duty to make or assist with arrangements for improving the skills and knowledge of the public bodies and office-holders that have responsibilities relating to the safeguarding of adults at risk in their area. A local strategy will therefore be required, recognising the different roles and responsibilities of staff and office holders in statutory, voluntary and private organisations. The Scottish Government has implemented phase 1 of its national training strategy to ensure that sufficient staff are able to fulfil their statutory duties on commencement. Phase 2 looks at training in the longer term.
20. The elements of a local training strategy should address:
- staff working in any sector who need to recognise the signs of harm, neglect or exploitation and require to know when and how to respond, what action to take, including who to report their concerns to, and how they fit into a protection plan;
- the opportunity for staff working in any sector to reach an understanding of the importance of working with people in a way that supports them and promotes their wellbeing and health in the context of the ASP Act;
- staff working in any sector who will be playing a major part in communications, assessments (including about risk, capacity and consent), recording events, decision-making on actions to be taken, and have a major role in the implementation of protection plans, including legal processes;
- staff managing services who will be supervising others in contact with service users, who will be monitoring performance at a local or central level and who may be involved in decision-making in individual cases and chairing adult protection conferences and reviews;
- staff working in the statutory and legal sectors who will be taking a lead role in legal proceedings in relation to adult protection work; and
- staff in other areas of work including advocates in local organisations, members of APCs, regulatory staff within the Care Commission, council clerical/administrative staff who will act as minute takers in adult protection case conferences, guidance staff in secondary schools for those pupils aged 16 to 18 years and lecturing and tutoring staff within local education institutions.
21. It is equally important for people who use services to understand their rights and the supports available to them. APCs may also want to develop a broader communication strategy, encompassing general awareness raising and appropriate training for service users, carers and members of the public. They may also wish to consider asking service users to act as co-workers in delivering such programmes.
22. Any actions undertaken by an APC must have regard to improving cooperation amongst its members. An APC should also have regard to the need for communication and cooperation activities with other APCs.
23. Formal inquiries consistently identify effective communication, information sharing and co-ordination as critical in protecting adults at risk of harm. APCs will have an opportunity to provide a model of joint working by the way they themselves operate, and will require to promote good working relations between agencies and staff working within them. All staff in all sectors will need to understand and accept the absolute necessity of sharing information about adults at risk, and be clear about their roles and responsibilities in supporting those adults.
24. Clear guidance about information sharing should be reflected in procedures for:
- inter-agency referral discussions;
- inquiry and investigation;
- protection planning;
- risk assessment, monitoring and review; and
- any process related to protection orders.
25. APCs will also need to ensure that there are effective arrangements in place for resolving disagreements and disputes between agencies about decisions in individual cases and about their roles and responsibilities.
26. A wide range of statutory services contribute to the protection of adults at risk. It will be important to involve and engage with:
- services for children and families;
- criminal justice services;
- adult services;
- local community and specialist police such as family protection unit staff ;
- homeless services;
- housing services including private providers and homeless services;
- acute hospital services and primary care services, including general practitioners; and
- the prison service.
27. The need to support and protect adults at risk extends to adults within managed and registered care services. Where harm is happening or suspected in these situations, the Care Commission has a responsibility with its regulatory functions through inspection, complaints and enforcement. As with other aspects of practice, APCs will want to ensure a proper understanding of roles and responsibilities between the Care Commission and local agencies through further development of existing Memoranda of Understanding.
28. The duties and powers of the Act relate to adults in all settings who are being harmed or may be being harmed. Within NHS services this includes inpatient, day or other services. These situations will involve health service managers and monitoring bodies, particularly NHS Quality Improvement Scotland. As with registered care services, APCs will want to consider how adult protection work relates to NHS services and to ensure the Act's implementation in relation to these services.
29. The Mental Welfare Commission for Scotland ( MWC) has particular statutory responsibilities in relation to the care and treatment of people with mental disorders, which includes learning disabilities, both in monitoring practice and carrying out inspections and inquiries. APCs will also want to ensure that arrangements are agreed and understood about the relationship between local agencies and the MWC in adult support and protection work. Similar understanding will need to be developed with the Office of the Public Guardian.
Authority and accountability
30. It is important that local Councils, NHS Boards and Police recognise the statutory functions which will be carried by APCs in relation to:
- reviewing procedures and practices;
- improving skills and knowledge;
- improving co-operation;
- providing information and advice; and
- making proposals.
31. APCs will need to be given the authority by local agencies to be able to carry out these functions effectively, and will need lines of accountability to local Councils, NHS Boards and Police. To ensure that appropriate authority is delegated, some pre-existing APC-type arrangements have created direct lines of communication between themselves and local Chief Officers Groups. These usually have membership at Chief Executive and Director level from the Council, NHS and Police.
Child Protection Committees and MAPPA
32. Good practice involves information sharing, communication and coordination between services for adults, children and family services, and criminal justice services. Monitoring and oversight arrangements already exist for Child Protection Committees and Multiagency Public Protection Arrangements ( MAPPA). Whatever local decisions are made, communication and coordination within these Committee arrangements will be necessary.
Adult Protection Unit
33. The Scottish Government's Regulatory Impact Assessment provided to Parliament to accompany the Bill's passage identified the need for adult protection units in each council area, including an Adult Protection co-ordinator, a training post and administrative support. This proposal was made both in recognition of the fact that the work of APCs will need to be serviced and supported, that good joint working will be fundamental to effective implementation, and that joint training will be an important part of that. Adult protection units, as proposed, were also seen as a means by which APCs could link in with local management, information and support systems. They are, therefore, to be the bridge between strategic oversight and front-line operations and should be formed in a manner that would best meet the needs of the local community.
34. The Act empowers the Scottish Ministers to specify other functions for APCs relating to the safeguarding of adults at risk, by statutory order. This is to allow Ministers to respond to practice findings as outlined in the biennial reports.