4.2 Stage 2: Screening and Initial Decision Making

1. What is a Referral?

A referral is the direct reporting of an allegation, concern or disclosure of harm, neglect or abuse to the Adult Social Care Team in Trafford Council using the Trafford Adult Social Care Online Portal.

A referral begins a process of assessing the level of harm experienced, gathering facts, assessment of the allegation / concern, assessment of the adult’s needs and a risk assessment to decide whether the statutory safeguarding adult duty applies.

Where possible and / or appropriate this should be done in consultation with the referrer and any relevant organisations. The decision about whether the safeguarding adults procedures apply must be made on the same working day or within 24 hours of the referral reaching the appropriate health or social care team during normal operating hours.

Out of hours, the responsibility for this decision will fall to the Trafford Adult Social Care Emergency Duty Team (see Contact) and will be made on the same day the referral is received. Where the referral meets the criteria, as described in Stage 1: Initial Safeguarding Actions, Trafford Council, must make or cause an enquiry to be made under Section 42 of the Care Act 2014.

2. Where to Refer and how to make a Referral

Staff and volunteers from all agencies should make referrals, using the Trafford Adult Social Care Online Portal.

If members of the public or relatives, friends, neighbours or representatives have concerns, they should also report these using the Trafford Adult Social Care Online Portal.

2.1 Contacting the police

In an emergency staff should call the police on 999.

For a non-emergency police response staff should dial 101.

If the referring person or the Trafford Adult Social Care reasonably believes a crime has been or may have been committed, they should refer immediately to the police unless the adult involved has mental capacity, does not want a report made and there are no overriding public or vital interest issues. The police may also be contacted later, if more information becomes available and it becomes apparent that a crime has been committed.

3. Receiving a Referral and Checking the Information

On receipt of a referral, the Trafford Adult Social Care will take the following action.

• Check that all of the necessary information is included on the referral form. Necessary information is a level of information that will enable the receiving team to be able to immediately and effectively screen the referral. The safeguarding concern will be screened against the three statutory criteria (see Section 1, What is a Concern? Stage 1: Initial Safeguarding Actions).
• It must be identified if the person has consented to the referral and / or if the person lacks capacity to make a decision about the referral. If the latter applies it must be determined who has assessed the person’s capacity to decide, and made the best interest decision to raise the concern and on which date.
• Initial contact is to be made with the adult (where safe / appropriate to do so) to establish their views and to obtain and record the outcomes they wish to achieve from the safeguarding process. Immediate safety concerns need to be considered.
• Some suggested questions for consideration:
  • Are there any immediate safety issues?
  • Type of harm? If there are any injuries, has treatment been sought? If so, GP, health care practitioner views?
  • Any children or other adults at risk or experiencing abuse or neglect?
  • Are there wider public interest concerns/alleged perpetrator in a position of trust?
  • Where did the abuse take place? Is it Trafford to lead on the enquiry?
  • Any witnesses?
  • Is the alleged perpetrator still in contact with the person?
  • What are the adult’s health and social care needs?
  • What action has already been taken?
  • If this the first referral of this nature or similar? Are there other adults / residents with similar concerns?

It must be identified at this time if the adult has the mental capacity / substantial difficulty to engage in the safeguarding process. A decision now needs to be made to determine if the three safeguarding statutory criteria are met, and the adult:

• has needs for care and support (whether or not the local authority is meeting any of those needs);
• is experiencing, or at risk of, abuse or neglect;
• as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.

Decision making will take into account the information gathered including: consent, immediate safety concerns and the actions taken by the care provider / other agencies. Trafford Adult Social Care will then reach a decision how best to proceed by applying the three following local authority outcomes.

3.1 No Safeguarding Response

This outcome can be recorded where:

• the person does not meet any of the three safeguarding eligibility conditions;
• the referral is inappropriate or malicious (for example an ambulance report where a person has become physically unwell as a direct result of a natural condition)
• consent has not been provided for the local authority to make further enquiries and there are no wider public interest matters or concerns regarding the person’s decision making ability;
• the person has been signposted to other agencies, for example, NHS, Department for Work and Pensions (DWP) etc.

Even if no safeguarding response is required, the local authority retains a duty to offer advice / guidance (including financial advice, see Information and Advice chapter). All decisions and actions need to be recorded on the adult’s electronic case file, with reasons.

3.2 Other Safeguarding Response

This outcome can be recorded in the following:

• this is a concern where there is not a s42 enquiry duty, (the person does not meet all of the statutory safeguarding criteria) but it is believed that it is proportionate to carry out an enquiry to enable the local authority to promote the person’s wellbeing and support a preventative agenda. Examples include:
  • it has been determined that the person is not at risk / experiencing abuse as a health professional has provided evidence that the injury is consistent with an accident and there are no wider concerns regarding others the person is in contact with;
  • consent has not been provided for the local authority to make further enquiries and there are no wider public interest matters or concerns regarding the person’s decision making ability, but advice and guidance is requested.

The local authority still retains a duty to offer advice and / or guidance. This may be:

• an assessment of need;
• carer’s assessment;
• alert to the CQC;
• formal complaint;
• direct work with the family;
• referral to partner organisations;
• 1:1 intervention with the person.

The person considered to be at risk and / or their representative / the referrer is informed of the recorded outcome and advised that should further concerns regarding this person / organisation should be brought to the local authority’s attention, then this concern may be reconsidered to inform future decision making.

All actions should be recorded under the heading ‘Safeguarding Protection Plan’ and the CQC, Commissioning and the person’s GP should be informed.

3.3 Formal section 42 enquiry

This outcome is recorded on the safeguarding episode and should be recorded when all three statutory safeguarding conditions are met.

3.4 Closed by Adult Social Care

This is where there are safeguarding concerns under s42 of the Care Act (where the safeguarding criteria are met), but they do not necessarily require a formal s42 enquiry. The course of action is clear and appropriate action has been taken by the care provider / partner agency and the advice given by the Adult Social Care is sufficient to mitigate further risk / occurrence.

Adult Social Care are satisfied that the information received corroborates information contained in the referral and risks have been mitigated.

The care provider is afforded 24 hours from the time of request for additional / supporting information. If the information is not provided in a timely manner, the enquiry will be referred to the corresponding locality team for follow up / further enquiry and the CQC alerted of Adult Social Care decision making.

The adult and / or their representative / the referrer is informed of the outcome and advised that should further concerns regarding this person / organisation be brought to the local authority’s attention, this concern may be reconsidered to inform future decision making.

The CQC, Commissioning and the person’s GP should be informed of the initial referral and decision making.

All actions should be recorded under the heading ‘Safeguarding Protection Plan’.

Where there are no commissioned services involved, this will result in the referral being passed to the Social Care Team to allocate a suitably qualified enquiry lead to make, or instruct others to make, enquiries.

If the three statutory safeguarding criteria are met and there are commissioned services in place, the course of action is clear; a risk management approach can be applied at the screening stage.

Once the Adult Social Care practitioner is satisfied that they have received sufficient or insufficient information, the concern meets the safeguarding threshold for a formal s 42 enquiry and cannot be safely managed by the Screening Team; it will be referred immediately to the appropriate team or service to make, or cause others to make enquiries. This approach would be required where further exploration and / or a multi-agency approach is required to identify additional information and / or risk mitigation strategies.

All actions taken by Adult Social Care will be recorded as an ‘Interim Safeguarding Protection plan’ and will require regular review through the process to ensure suitability / effectiveness.

The adult and / or their representative / the referrer will be informed of this outcome by Adult Social Care.

Adult Social Care will ensure that all adult safeguarding concerns are processed within 48 hours of receipt. In circumstances where referrals are received after 16:00 hours Monday to Friday, on a Saturday or Sunday all day and on public holidays (all day) the Trafford Emergency Duty Team (see Contact) are responsible for screening and triage of any and all Safeguarding Adults Concerns Referral Forms.

4. Trafford Emergency Duty Team

The Emergency Duty Team (EDT) will screen referrals and determine that:

• all of the necessary information is included on the referral form. Necessary information is a level of information that will enable the EDT to be able to immediately and effectively screen the referral;
• the three statutory criteria will be applied to all safeguarding concerns received by the EDT;
• where there are no immediate safety concerns the safeguarding concern will await processing by Adult Social Care on the next working day;
• where an urgent response if required to safeguard the adult, the EDT will determine the response needed and, where necessary intervene immediately;

Where serious concerns of abuse / neglect are identified, the EDT will contact the senior manager on Call for Trafford Council for further advice Where an adult is referred during the period monitored by the EDT and they are not known to Adult Social Care, the EDT practitioner will create an Electronic Social Care Record for the adult.

The Emergency Duty Team practitioner will make an entry in the Electronic Social Care record of every case referred during the period monitored by them. This entry will include the reason for referral, and their professional opinion following application of the three statutory Section 42 safeguarding criteria:

• no further action is required and the referral can be closed and recorded as information only and passed to the relevant day time team;
• there are no immediate safety concerns for the adult in which case the referral it will await processing by the Adult Social Care on the next working day
• where the s42 duty is engaged and the adult requires an immediate response, EDT will identify and act upon the relevant actions and record this appropriately on the safeguarding episode to ensure accurate follow up by Adult Social Care on the next available working day;
• where serious concerns of abuse and / or neglect are identified, the EDT will contact the senior manager on Call for Trafford Council.

EDT practitioners will be required to mobilise and consider the use of wider community, NHS and other resources when they intervene to protect adults during the hours in which they operate. EDT practitioners will ensure that they have completed the relevant Safeguarding documentation and standard Safeguarding and care management documents before the end of each shift and will send a formal handover to the receiving health or social work team for the next working day to enable continuous, uninterrupted support for the adult.

5. Decision to Move to the Planning Phase

Where the safeguarding concern is referred to the Social Care team, the concern must proceed to the planning phase for further consideration. At this stage there does not have to be a formal meeting, a planning discussion with the senior social worker and / or team manager may be sufficient.

The purpose of a planning meeting is to determine what next steps are required and is usually undertaken in a multi-agency context.

Where wider public interest concerns are indicated, action must be taken under these procedures, even if the adult does not want any action taken. The adult must be informed of this decision, the reason for the decision and reassured that they will not have to contribute to the enquiry if they choose not to. Every effort will be taken to minimise actions which affect them personally without their involvement.

Related Documents

See Local Forms, Letters, Leaflets

• Body map;
• MARAC risk assessment;
• Trafford Adults at Risk Group (TARGet) Referral Form.