7.6 Multi Agency Escalation Protocol

1. Introduction

In order to work together effectively to safeguard adults at risk of harm and abuse, practitioners should see professional challenge as part of a ‘healthy’ working relationship. Successful partnership working is reliant upon resolving professional disagreements in a timely manner in order to avoid any potential risks to the adult in question.

The aim of this protocol is to ensure that resolution of any professional disagreement(s) leads to better outcomes for adults and positive partnership working in Trafford.

Accountability and partnership are two of the six key principles identified in the Care Act 2014 which underpin adult safeguarding. Safeguarding is everyone’s business, and all partners have their roles to play in order to safeguard adults. It is important that agencies are accountable for delivering their part of the safeguarding process.

It is recognised that working with adults with care and support needs can be difficult, and involves making important decisions often based on incomplete information and changing circumstances. In most circumstances, agreement between practitioners can be reached, but where there are concerns or disagreements over another professional’s decision making, including their action or perceived lack of action as the case may be, timely professional challenge is paramount as any delay could put adults at further risk.

In order to resolve professional disagreements positively, practitioners should remain respectful of each other at all times, and this should be evidenced in both direct and written communication, and throughout the escalation resolution process.

Disagreements could arise in a number of areas such as:

• Whether a safeguarding concern is reportable or non-reportable.
• Practitioner’s roles and responsibilities.
• Lack of action from an agency; or
• Sooner than expected case closure.

This list is not exhaustive.

This protocol provides practitioners with the steps to raise concerns they have about decisions made by
other professionals or agencies by:

1. Avoiding professional disputes that put adults at further risk or take away focus from the adult.
2. Resolving the difficulties within and between agencies quickly and openly; or
3. Identifying problem areas in working together where there is a lack of clarity and to promote the
   resolution via amendment to protocols and procedures.

Resolution should be sought within the shortest timescale possible to ensure the adult at risk is protected. Disagreements should be resolved at the earliest possible stage, however if an adult is thought to be at risk of immediate harm discretion should be used as to which stage is initiated.

2. Stages of Escalation

2.1 Additional matters to consider

At all stages of the process, actions and decisions must be timely, recorded in writing and shared with relevant personnel, to include the worker who raised the initial concern. In particular, this must include written confirmation between the parties about any agreed outcome of the disagreement, the timescales for responses / actions and how any outstanding issues will be progressed.

Where the disagreement relates to a family member or professional differences in opinion about a best interests decision which is being made for a person who lacks the mental capacity to make that decision themselves, reference should be made to Chapter 15 of the Code of Practice – Mental Capacity Act 2005. Where no consensus of agreement can be reached despite taking all practical steps to do so, then the Court of Protection should be approached.

A clear record should be kept at all stages by all parties. In particular, this must include written confirmation between the parties about the agreed outcome of the dispute and how any outstanding issues will be pursued. This should be documented in the appropriate record system within each individual agency, in accordance with their internal processes.

3. Complex High Risk Cases

Where there are significant and serious areas of disagreement between adult social care, police and health, resulting in polarised views, it can be difficult to reach agreement. Where time pressures, particularly within or about acute health service issues are involved, it is proposed that multi-agency oversight of the case involving senior staff is undertaken early on by convening a round-table discussion or consultation involving senior managers. This group would agree and propose actions to be communicated directly to the operational staff involved. This should seek to resolve the matter promptly or propose how disagreements would be considered and resolved further. The Trafford Multi-Agency Risk Management Framework should be used to address concerns in a multi-agency forum.

4. Concerns about the Practice of Colleagues within your own Organisation

Each agency should have its own clear and accessible policy in respect of ‘whistleblowing’ which should be consulted when there are serious concerns about the practice of a colleague which have not yet been resolved by discussion with the relevant managers. If you have exhausted your organisation’s whistleblowing process you should escalate outside the organisation (see Whistleblowing chapter).

Concerns relating to colleagues in a position of trust believed to pose a risk to adults with care and support needs should be addressed using the Trafford PiPoT Policy, and in line with respective organisational HR processes. Concerns relating to criminal matters must be referred to the police.

5. Wider Learning Points or Gaps in Policies and Procedures

If the process highlights gaps in policies and procedures this will be brought to the attention of the Safeguarding Adults Board Manager or Independent Chair of the Safeguarding Adults Board.

Appendix 1: Multi Agency Escalation Protocol, pdf version

Trafford Strategic Safeguarding Partnership; Safeguarding Adults Multi Agency Escalation Protocol.