Specialist Management Service

Safeguarding Advice for Staff

see think act Safeguarding LogoAdvice

If you identify a potential safeguarding issue and you are unsure of how to proceed, you should refer to Trust policies and have a look at the flowcharts that show what action you should take.  You should always discuss any safeguarding issue with your line manager, and record the outcome of that discussion.

You will find a list of frequently asked questions and answers on this website.

For further advice, you are encouraged to contact either of the Specialist Practitioners at the Safeguarding Team. Usually, they should be able to provide advice over the phone. Alternatively you can use email. The outcome of your enquiry will be recorded on EPEX.

Complex cases are referred to Angela Lacy (Deputy Named Nurse), but in the first instance the Specialist Practitioners will record the details of the case. They are your first point of contact.

For advice out of hours contact the on call manager via switchboard. Alternatively, if you are unsure of how to proceed with any concerns, you can discuss the case with Social Services. Before contacting Social Services for advice, be sure that you are clear about information sharing guidance and policy.

For non-clinical matters and general inquiries, contact Sarah Evason (PA/Secretary) or Suzanne Daniels (Administrative Support)

If for any reason you have difficulty accessing advice from within Mersey Care you can contact Social Services for adult or children services. Urgent cases will warrant direct contact with police or social services

Engagement

Frontline staff are frequently concerned about the impact on 'therapeutic relationships' when following good practice in safeguarding.

  • At point of entry, service users should be informed that their are limits to confidentiality
  • The duty of Mersey Care staff to ensure the wellbeing of service users, children and the public can be summarised: "Clearly, there are times when we need to share information. If you or other people are at risk in any way we would work with other professionals to protect you and others"
  • People can be fearful of social services and other agency involvement. In the majority of cases safeguarding is about reducing the risk of events escalating to a protection issue. Where appropriate, discuss the reasons and benefits of sharing information and safeguarding assessment whilst reducing the stigma associated with 'other people' knowing about a service users mental health problem or fears of 'having my kids taken away'
  • If you are worried about what effect implementing safeguarding procedures will have remember: the safety of the child or victim should always take priority. Discuss the case with your manager or the safeguarding team to work out an effective collaborative strategy.
  • Do not delay in cases where you have reasonable grounds to believe risk of harm is immediate,  imminent or probable.

 See below for collaborative working and consent.

Consent and Sharing Information

You should be prepared to exercise judgement.

Generally, consent should be sought when sharing information outside of NHS health services involved in the care of the service user e.g. when making referrals.

Obtaining consent/agreement for referrals to Social Services can be problematic and in some circumstances might affect a relationship with a  service user. This is not a justification for not seeking agreement.  Likewise, fear of damaging a relationship is no reason for not sharing information when there is a requirement/need to do so.

In non-emergencies, when sharing information without consent the matter should have first been discussed with a manger. If needed, the Safeguarding Team will help you reach a decision on sharing information.

Contrary to popular misconception, information can be shared without consent where:

  • The person has withheld consent and the non-disclosure of  information may lead to significant harm to themselves or others
  • Seeking consent could compromise an investigation and may lead to the person/other persons being at risk of harm
  • The inquiry is urgent, seeking consent will cause delay which may lead to significant harm
  • To prevent or detect a crime
  • Overriding public interest or justification for sharing information
  • The person lacks capacity to consent and the non-disclosure of information may lead to significant harm
  • Seeking consent would pose a risk to the professional involved.

Further guidance can be found in Information Sharing Practitioners Guide, Information Sharing and Mental Health and appendix 3 What To Do If You're Worried A Child Is Being Abused (DoH 2006)  

Capacity

Mental Capacity refers to the ability to make decisions themselves about their own life. Some people have difficulties in making such decisions. This is called ‘lacking capacity’.

Under the Mental Capacity Act (MCA) there are now laws governing who can make decisions on someone else’s behalf, which help to safeguard vulnerable people. To find out more, including who to contact if you are concerned, plus an e-learning tool for professionals please visit the Mental Capacity Act page.

Recording information

CPA (Care Programme Approach)

The Care Programme Approach is the backbone to service provision and risk assessment/management. Staff should ensure that safeguarding information is included is current and is recorded in this documentation. Care plans should be used to record specific interventions such as monitoring risk. 

Common problems include not identifying that potential safeguarding issues have been assessed (even if there are no identified concerns). Occupants of the family home and relationships are not recorded. Ages of children rather than dates of birth are recorded. Not including details of allied professionals.

EPEX supports the CPA. There are specific codes that can assist staff in recording and communicating information

EPEX

Using EPEX codes will improve information sharing and assist in case management.

Odd number suffix = child 

Even number = adult

  • Use the code below to record information that you wish to share with colleagues within Mersey Care. (e.g. Seen at home. No indicators of illness impacting on parenting capacity) 

SG1 = Child: safeguarding information (communication/advice with Mersey Care)

SG 2 = Adult: (as above)

  • Use the code below when you communicate and share information with allied agencies. (e.g. With client consent, contacted Ms C Hampson (Health Visitor) and informed her of CRHT involvement). (e.g. Contacted Adult Social Services Liverpool to ascertain if Mr Jones circumstances met criteria for intervention. Spoke to Ms C Hampson, who stated a referral should be made)

SG3 = Child: Information sharing (contacts with other agencies /professionals outside of Mersey Care)

SG4 = Adult (same as above)

  • Use the code below to record actions taken in the course of a referral i.e. Who was contacted and when. When written confirmation was sent. When a response is expected

SG5 = Child referral to Social Services

SG6 = Adult referral to Social Services

  • Use this code to record the purpose and outcome of multi disciplinary/professional meetings and case conferences. Note that interventions should be recorded in appropriate parts of CPA.

SG7 =  Child:Professionals’ meeting/case conference

SG8 = Adult as above

 

Frequently Asked Questions

Q:  When do I need to contact the Safeguarding Team?

  • Safeguarding incidents when the alleged perpetrator is an employee of Mersey Care NHS Trust
  • When you are unsure about your assessment and how to proceed
  • If difficulties arise in sharing information, e.g. consent is withheld by as parent
  • Incidents that constitute significant risk of harm, or wher significant harm has occurred
  • When difficulties in collaborative working with other agencies arise

You do not need to contact the team for 'information only' purposes

Q:  Consent to share information; when do I need to obtain it?

In ideal circumstances, consent to share information should always be obtained.  There are circumstances when confidentiality and obtaining consent to share information is overridden by the level of risk to a child and/or adult.  Assessing whether risk is significant can be difficult.  Use the assessment criteria as a guide.  Examine section 3.5 of Mersey Care Policy & Procedure for Confidentiality and information Sharing.  This identifies exceptional circumstances when information can, or must, be shared.

  • Consider sharing information on a case by case basis
  • Seek advice form a manager before sharing information, unless in an emergency
  • Be clear about the need to share information

Q:  Domestic abuse; what do I do when the victim tells me they are subject to domestic violence, but asks me not to take any action?

  • Obtain as much information as possible, i.e. frequency, degree, duration, perpetrator
  • Determine if it is safe for the victim to remain in, or return, to their home
  • Contact the safeguarding team for advice
  • Outside office hours, you can anonymise details and contact the police for advice

Pregnancy

Any professional who becomes aware that a woman is pregnant and has cause to be concerned that:

  • the mother is failing to meet the health & development of her unborn baby OR
  • that the new-born baby would be at risk of significant harm, OR
  • that the parent(s) would need substantial support to care for the child

should make a referral to Children Social Services as soon as possible.  Other professionals ordinarily involved with the care of the mother and unborn child should be kept informed of circumstances that would impact on their wellbeing (see information sharing).

Circumstances when you should consider referral for a pre-birth assessment:

  • A woman, or couple, with chronic and disabling mental health problems, schizophrenia, affective psychosis, personality disorder, obsessive compulsive disorder and eating disorders;
  • Severe substance/alcohol abuse, this includes women known to be using drugs during pregnancy.  
  • Where domestic abuse/violence is present, a referral must be made to Children's Social Services department. Where domestic abuse/violence has already existed in a relationship, pregnancy may cause its escalation.
  • When the parents’ history suggests that the prospect of the baby being adequately cared for is bleak e.g. a history of early abuse, serious violence, of continued substance abuse unresponsive to treatment or a young couple, living a chaotic lifestyle with no home base, using drugs and alcohol to excess, refusing ante-natal care.
  • A young woman with learning difficulties who is unable to self care appropriately casting doubt on her ability to care for a vulnerable baby.

You can discuss any case with the Safeguarding Team. You can also discuss a case with Social Services without consent providing details are anonymised   

Pre-Birth assessment referral

Some Social Services departments tend to only accept referrals for Pre Birth Assessment  25 weeks plus into pregnancy. But, it is good practice to at least discuss the case at the earliest opportunity and decide if there are currently any indicators causing safeguarding concerns, for the unborn baby. There may be occasion were assessment prior to 25 weeks is appropriate. Record details of any initial discussion with Social Services in patient service in records.

Consent should be obtained from the unborn's mother when making a referral.  There are specific circumstances when consent is not required. If consent is withheld, discuss the case with the Safeguarding Team.

 

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