Safeguarding adults - overview and update report

Report: 6
Date: 8 July 2010
By: Assistant Commissioner Territorial Policing on behalf of the Commissioner

Summary

This report provides members with an overview of the strategic vision and current MPS policies and procedures relating to Safeguarding Adults.

A. Recommendation

That the report be noted.

B. Supporting information

1. Safeguarding Adults at Risk (SAAR) in its current form is a relatively new business area for the Metropolitan Police Service (MPS). The MPS SAAR policy and Standard Operating Procedure (SOP) was published on 10 June 2009. It sets out clear guidelines for staff when dealing with any adult victim of crime who falls within the scope of the policy and who may be “at risk”. The Policy clearly relates to victims, the needs of adults other wise in the criminal justice system as perpetrators are dealt with by Police and Criminal Evidence Act (PACE, Sec C Annex E). The purpose of this policy is to:

• Ensure the safety and protection of adults at risk by providing quality service to service users whether as employees, colleagues, victims, witnesses, strategic partners, etc.
• To hold perpetrators of abuse accountable for their actions. Where criminal proceedings are deemed inappropriate, to work with partnership agencies and identify courses of action.
• To work in effective partnership with other agencies to safeguard adults at risk.

2. The MPS is resolute in its commitment to tackling all forms of crimes against “adults at risk”. Every member of the community deserves protection from exploitation and abuse by those entrusted with their care and the people they should be able to rely on them to keep them safe. The SAAR policy outlines the MPS’ bespoke guidance to the identification, support and care to adults at risk. It gives clear guidance to police officers and staff about the multi agency investigative approach necessary to arrest and bring perpetrators to justice for crimes committed.

3. The scope of the policy incorporates: Adults at Risk who experience abuse or have been subject to a crime that has been perpetrated on them by a person in a position of authority, or where there is an expectation of trust, or who has been providing them with care either in a care setting (e.g. care home, hospital) or in their own home or where an MPS crime manager has particular concerns about the risk to or vulnerability of the victim or the impact of the incident on the community.

4. The policy seeks to professionalise and improve the quality of service delivery to adults at risk of or suspected of being the victims of abuse/crime. It provides a corporate approach across the MPS to the identification and management of SAAR incidents, by issuing clear instructions to staff ensuring that everyone understands their roles and responsibilities. The policy also seeks to develop good practice relating to the prevention and detection of crime. It ensures that the MPS is legally compliant and is intended to increase the level of victim safety, response, reporting, prosecution and monitoring of cases.

5. The MPS policy uses the National Health Service (NHS) definition of a ‘vulnerable adult’ which is set out in the Department of Health “No Secrets” document as follows:

“A person aged 18 years or over who is in need of community care services or may be at risk of abuse by reason of mental or other disability, age or illness and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation”

6. The MPS has continued to demonstrate its commitment to improving the recognition and investigation of crimes against adults “at risk”. The MPS strives to continually provide improved bespoke victim care and support by working in partnership with Governmental, Statutory and strategic Non-Government Organisations (NGOs) e.g. Home Office, CPS, NHS, Local Authorities, London Adult Protection Network, Action on Elder Abuse.

7. The MPS uses the SAAR SOP as best practice, when dealing with an adult believed to be “at risk” who falls outside the scope of the SAAR policy. This adult will also be dealt with in accordance with the Department of Health ‘No Secrets’ guidance (i.e. they must be referred into Local Authority Safeguarding Adult procedures). The policy is also used in tandem and in support of other MPS documents such as the Domestic Violence (DV) and Honour Based Violence (HBV) policies.

8. In 2009 there was a National review of the current multi agency guidance set out within the “No Secrets” document. The MPS played a key role in the development of the initial consultation document and the subsequent nationwide consultation. As a result of the review, in January 2010 HM Government stated its plan to introduce legislation to make Safeguarding Boards a statutory requirement for local authorities and partners. This was to be outlined in late 2010. The intention of the coalition government and timescales are yet to be confirmed.

Legislation

9. 9. There is a wide range of legislation that can be utilised for the protection of all, but at present there is very little consolidated legislation specifically aimed at the protection of “adults at risk”. The process for responding to allegations involving adults at risk is not based in statute as with “every child matters,” where there is a legal obligation for agencies to share information and work together towards protecting children.

10. 10. Current legislation set out within the Mental Capacity Act (MCA) 2005 which came fully into force on 1 October 2007 was designed to provide a legal basis for providing care and treatment for people aged 16 and over, who lack the mental capacity to give their consent. The Act states 5 basic principles:

The five statutory principles of the Mental Capacity Act 2005

• A person must be assumed to have capacity unless it is established that they lack capacity.
• A person is not to be treated as unable to make a decision unless all practicable steps to help her/him to do so have been taken without success.
• A person is not to be treated as unable to make a decision merely because she/he makes an unwise decision.
• An act done or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in her/his best interests.
• Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action.

11. Section 44 MCA sets out the offences of ill-treatment OR wilful neglect of a person who lacks capacity, by a person who has care of the person or is the recipient of a lasting power of attorney, or an enduring power of attorney created by the person or is a deputy appointed by the court for the person.

Developments

12. A scrutiny of the Crime Reporting Information System (CRIS) by the Community Safety Unit (CSU) Service Delivery Team (SDT) noted disparity between boroughs in the recording of reports involving adults at risk, specifically in respect of flagging accuracy and in recording victims’ disabilities, needs or requirements. A consultation process was initiated to establish the best method of addressing these issues and updates to the CRiS system were introduced on 5 December 2008.

13. The update improved the way MPS staff record details of victims, informants and witnesses in relation to:

• Disability Description
• Physical Access Needs
• Communication Needs
• Communication Methods
• Personal Care Needs
• Medical Needs

14. Changes also introduced the Carer Abuse - AA flag. This is used to identify an incident/crime relating to an adult at risk who falls within the remit of the SAAR Policy/SOP. Initial teething problems were evident with this flag being used to identify crimes perpetrated against children by care home staff, this was quickly rectified. The need to manually insert flags onto a report was also removed. Flags are now system generated.

15. Once a report has been identified as SAAR it is automatically flagged by the selection of one or more check boxes, this ensures flagging compliance and an ability to scrutinise data. If the report relates to SAAR within a Domestic Violence (DV) scenario, in addition to identifying SAAR, the risk assessment, risk management and 124D completion/supervision is recorded by a system of check boxes.

16. If anyone perceives a victim/witness to have significant needs their details are recorded together with the victim’s disability description, physical access and communication requirements, preferred communication methods, personal care needs and medical needs.

17. There are significant benefits to the updated CRiS system. These include:

• The inputting of data has become more accurate and consistent with specific improvements to the manner in which SAAR crime is recorded.
• Crime types are easier to ‘flag’ and identify
• Targeted communities can be identified
• Disproportionality issues can be identified and addressed
• Victims’ disabilities are accurately recorded
• Disabled victims needs and requirements are identified and addressed
• Risk assessment processes are recorded and evaluated
• Performance gaps are easily identified and addressed
• Compound discrimination issues are recorded and can be identified
• The improved data recording assists in developing strategies and addressing emerging issues
• Opportunities to develop Quality Assurance processes

Supporting Prosecutions and Victims

18. A growing number of cases are coming to the notice of police and partner agencies, it is therefore important to consider all possible avenues of enquiry, and the potential for alleged perpetrators (including spouses, children, paid or unpaid carers) to be guilty of a wide range of offences under legislation including, Offences Against the Person Act, 1861, Sexual Offences Act 2003 (SOA 2003), Domestic Violence Legislation (Domestic Violence Crimes & Victims Act 2004) or Financial protection legislation (Power of Attorney Act 1971, National Assistance Act 1948).

19. The SAAR policy and SOP promotes the fact that everyone should be afforded equal access to justice. A multi agency approach is taken with Police leading on criminal investigations with other agencies, such as local authorities, Victim Support Scheme or NHS offering victim support.

20. The use of intermediaries and Achieving Best Evidence (ABE) interviews ensures a victim is given the opportunity to give the best evidence they are able to provide. It can help obtain a clear and concise record of events record safety advice and safety plans agreed with victims. Early identification and flagging of SAAR allegations to the CPS is also recommended in the SOP. Early discussions between prosecutors and investigating officers should ensure all possible areas of an allegation are explored.

21. The MPS is in the process of providing bespoke toolkits for investigating officers. An MPS financial crimes toolkit has been developed by SCD6. This particular crime genre is being explored by an Association of Chief Police Officers (ACPO) projects team consisting of police and finance experts working within the City of London. The project is researching how to prevent, identify and investigate financial crimes committed against adults at risk. The vulnerable adult financial abuse awareness campaign is planned for June 2010.

22. There is use of Multi Agency Risk Assessment Conferences (MARAC) in the London Borough of Newham. SAAR cases believed to be high risk are discussed and assessed in a multi-agency forum and effective management put in place. However, due consideration must be given to the sensitivity, complexity and confidentiality of such cases given victims’ notable concerns regarding disclosure. This use of MARAC is being examined with a view to identifying whether it is best practice for further role out.

23. The use of Protection of Vulnerable Adults (POVA), multi agency meetings are used by many boroughs. These forums are used to ensure that agencies adopt a joined up approach to effective risk identification and management for adults who may be at risk.

Training

24. The CSU Service Delivery Team has recently commissioned a Performance Needs Analysis (PNA) to assist the development for the SAAR portfolio. This will identify ways of improving MPS performance and will include identifying training needs and steps that can be taken to ensure a consistent high level of service delivery across the MPS.

25. Current Safeguarding training of MPS staff is mainly generated by the CSU SDT and includes or has included:

• The award winning Hydra recruit training package for probationary constables. This consists of four phases aimed at training student constables in preparation for independent patrol on their future London borough.
• The CSU Service Delivery Team provides specific SAAR input on the CSU course. This course is for all officers from Constable to Inspector.
• Organisational learning and presentations on new or relevant legislation are agenda items at the six weekly Community Safety Unit DI meetings. These products are then disseminated to CSU staff.
• The above is also disseminated directly to CSU staff by VCD through e-mail, briefing notes and guidance documents.
• Input on Public Protection Desk (PPD) course and training days delivered by CSU SDT. The training is specifically aimed at PPD staff as this may be the referral point for outside agencies and early identification of potential offences is crucial.
• Ad Hoc presentations to statutory and non statutory partners, Adult Safeguarding Boards, NHS etc.
• Joint training pilot project developed with Tower Hamlets Adult Services.
• Presentations at conferences - London based and National.
• Joint training seminars titled - Enhanced Victim Care and Obtaining Best Evidence, held at New Scotland Yard, presentations by VCD and partner agencies.
• Two CPS/Police workshops aimed at SAAR awareness and promoting equal access to justice.
• Borough CSU’s have also delivered training joint training to borough Safeguarding Adults Boards and statutory and non statutory partners. This has included SAAR, HBV and DV with a focus on SAAR.

Partnership Working

26. When the MPS initiated the development of the SAAR policy and SOP, a multi agency, joined up approach was taken. A working group was set up to develop and write the policy, which included statutory and non statutory partners and IAG members. This was to capture a wide range of expertise, ensuring the document was, although for Police direction, focused on providing the best possible service for end users. On completion the documents were then disseminated to a wide partnership base for consultation. The Violent Crime Directorate (VCD) has continued to develop strong links within the SAAR portfolio both within London and nationally. Partnership working has included:

• Setting up Multi agency SAAR policy working group - now steering group.
• Developing a National Police Safeguarding network. The MPS and Surrey instigated the South East Regional SAAR steering group, which now sits every 6 months.
• Developing the NHS “No Secrets” consultation.
• Developing the “Pan London” adult protection procedures with Local Authority and NHS.
• Linking with London Safeguarding Adults Network (LASN), ensuring each borough establishes links with their Safeguarding Adults Co-coordinator. VCD sits on the LASN.
• Working with NHS and primary care trusts re. protocols and training.
• Working closely with ACPO Safeguarding lead.

27.The CSU VCD is currently working in partnership with the Judith Trust, Foreign and Commonwealth Office (FCO) and the Ann Craft Trust to identify and respond to data that suggests there are significant Honour Based Violence (HBV) issues for adults with learning difficulties. Initial findings show that this issue affects genders in a 50-50 % split, where as HBV recorded where learning difficulties are not a factor is split 85% female to 15% male. The age range is also greater for persons with learning difficulties with more victims identified in their late 20’s and 30’s.

28. There are different factors and motivations affecting this particular crime genre for adults with learning difficulties. These include:

• Vulnerability of the subject
• Support needs of the subject
• Capacity issues
• Different coercion factors
• Provision of long term care
• Normalisation of the victim
• Lack of understanding of the learning difficulty

C. Race and equality impact

1. MPS data for reports flagged AA on the Crime Recording Information System (CRiS) has been analysed for Financial Year 09/10.

There were 724 incidents recorded, of these 490 were recorded as crimes. There may be significant under reporting of all crime types. This can be attributed to many factors, ranging from the reporting officer not recognising an allegation as SAAR, to the victim being reticent to report an incident as the perpetrator is in a close relationship with them. The perpetrator could be the primary or only carer and police intervention could mean the loss of that care. All of these concepts are explored within the SAAR policy and SOP. This report explains both the measures that are in place and those that are being put in place to counter under reporting.

2. It should also be noted that there was one murder flagged AA where the victim was over 60. Although there has been a year on year decrease in domestic violence (DV) homicides, the 09/10 MPS DV homicide data shows an increase to eight out of the twenty- four homicides being by sons on elderly mothers. This is being reviewed by the DV Homicide Review Group, which includes the CSU Service Delivery Team.

3. Of the 490 crimes recorded 234 were recorded as offences of violence against the person. Of these, 65 were assaults with injury and 131 common assaults. The age range that recorded the highest number of crimes of violence, 89, was in the over 60’s. The lowest was the 30-39 age range with 13 recorded offences. Crimes of violence also appear to disproportionately affect women, with 143 offences recorded as opposed to 91 against males.

4. Self Classed Ethnicity was not noted in 261 allegations whilst White British was shown for another 126. All other self classed ethnicities were evenly represented.

5. The MPS is cognisant of any adverse impact or disproportionality that may occur as a result of the delivery of its services and as a result, fully embraced the need for engagement and consultation with communities and their informed representatives during the development of the SAAR policy and SOP. Strategic and non-strategic partners, service users and IAG members were key participants of the strategic group and sub groups, providing valuable advice and guidance throughout the development and consultation process.

6. The MPS Diversity and Equalities Strategy 2009-2013 is designed to help ensure inequality and discrimination are tackled and ensure continued service delivery by improvements in the standard of policing, staff awareness of the organisational strategy and by community engagement. The strategy is divided into four distinct themes. These have been considered and are evident in the development of the SAAR policy and SOP.

• Fair and responsive services: delivering efficient and effective policing services that are fair and clearly responsive to the diverse needs of the people we serve.
• Community engagement: enhancing engagement with all communities by listening and responding to their needs.
• Workforce and culture: building and developing a talented workforce and working culture that promotes mutual respect and teamwork in the MPS.
• Governance: monitoring progress, taking responsibility and being accountable for our performance.

7. The aim of the MPS SAAR policy and SOP was to set out clear guidelines for front line responders, supervisors and secondary investigators. It clearly states the need for early identification of an incident involving an adult who may be at risk and the different factors that need to be considered to ensure responsive, proportionate and effective service delivery.

8. The strategic group was mindful that the implementation of the policy should not disadvantage or label any group or person. The term “vulnerable” was excluded, as a person would not automatically be defined as “vulnerable” due to age or disability. The same consideration was also given to the term “at risk”. This is defined as situational risk and not due to a person’s disability or needs.

9. Circumstances were noted where service users may be disadvantaged by the actions taken by police in adherence of the SOP, this would in some instances involve taking steps that might be against the wishes of the victim. An example would be where a son or daughter, who is the sole care provider, assaulted their elderly parent, the policy would see the perpetrator arrested, leaving the victim no care provider. MPS data clearly illustrates that SAAR incidents affects a diverse range of people from different backgrounds; however the MPS recognises that these incidents disproportionately affect disabled and older people. By the nature of the subject and the remit of the policy and SOP there will be significant impact on these particular groups where, intervention by professionals may be seen as unwanted or disproportionate by a victim. A victim may not recognise a risk or may accept a risk due to family relationships or fear of being alone. There should be no disproportionality evident when implementing the policy with regards to gender, ethnicity or Lesbian, Gay, Bisexual and Transgender matters.

10. The multi agency approach promoted in the SAAR policy would ensure that the autonomy and needs of the victim are considered at all times, although decisions may be made by professionals, following a full risk assessment, that may go against the victims wishes. This may especially be the case if, upon assessment, the victim was shown to lack mental capacity.

11. The CSU Service Delivery Team (SDT) are monitoring current MPS data, to ensure consistency in relation to approach, practice and audit and to identify and address gaps in service delivery.

D. Financial implications

1. It is expected the performance needs analysis will identify areas where service delivery can be improved and methods to accomplish this. Any cost implications arising from changes to service delivery will be subject to the MPS business planning and approval processes.

E. Legal implications

1. The legislation relating to safeguarding vulnerable adults is vast but fragmented. Each case must be considered on its own merits to determine the appropriate intervention.

2. This report confirms that the MPS recognise that the delivery of safeguarding vulnerable adults at risk requires strong multi-agency and inclusive partnership working.

3. This report also confirms that the MPS has identified systems, structures and tools that aim to provide better safe guarding for vulnerable adults, where there is a risk of harm or abuse. Developing internal guidance which sets out the responsibilities of all staff to operate within it is also in keeping with the recommendations set out in the Department of Health’s “No Secrets” document, which is considered best practice guidance.

F. Background papers

None

G. Contact details

Report authors: DI Anthea Richards

For information contact:

MPA general: 020 7202 0202
Media enquiries: 020 7202 0217/18

Abbreviations

• ABE Achieving Best Evidence
• ACPO Association of Chief Police Officers
• BME Black Minority Ethnic
• CAADA Community Action against Domestic Abuse
• CRiS Crime Recording Information System
• CSU Community Safety Unit
• DC Detective Constable
• DI Detective Inspector
• DV Domestic Violence
• FCO Foreign and Commonwealth Office
• HBV Honour Based Violence
• LASN London Adult Safeguarding Network
• MARAC Multi Agency Risk Assessment Committee
• MCA Mental Capacity Act
• MPS Metropolitan Police Service
• NGO Non Governmental Organisation
• NHS National Health Service
• NPIA National Policing Improvement Agency
• PNA Performance Needs Analysis
• PND Police National Database
• POVA Protection of Vulnerable Adults
• PPD Public Protection Desk
• SAAR Safeguarding Adults at Risk
• SCD Serious Crime Directorate
• SDT Service Delivery Team
• SEA South East Asian
• SOA Sexual Offences Act 2003
• SOP Standard Operating Procedure
• VCD Violent Crime Directorate
• VSS Victim Support Scheme

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