Plan & Review Stage 3: Multi-Agency Adult Safeguarding Planning Meeting Guidance
1. What is the purpose of a Multi-Agency Adult Safeguarding Planning Meeting?
The overarching purpose of a Multi-Agency Adult Safeguarding Planning Meeting is to bring together all of the relevant stakeholders, so that information and intelligence can be shared to determine what the appropriate actions should be to “sufficiently reduce, or remove the risk to the adult” (although it may also be appropriate for this to 'remain' in some circumstances).
This is a shift in terminology and emphasis away from trying to 'substantiate' reports of abuse, which can become combative between professionals and agencies, detracting from the efforts to improve the adult's wellbeing and safety.
See: Multi-Agency Adult Safeguarding Planning Meeting Form (Word) Multi-Agency Adult Safeguarding Planning Meeting Form (Pdf)
2. When might a Multi-Agency Adult Safeguarding Planning Meeting be needed?
A Planning Meeting may not be necessary in relation to all Section 42 Safeguarding Enquiries, but the following points should be used to help determine if one is required:
- Where the health and safety of the adult is, or maybe compromised, and a detailed (or initial) safeguarding plan is required.
- Where there have been previous Safeguarding Concerns and the issues have been repeated, and or, the risks are more acute than previously thought.
- Where multiple agencies (including providers) are needed in providing support and or protection, and there is a need to co-ordinate actions.
- In organisational or institutional cases where other adults are at risk of abuse or neglect. This may include where issues have affected residents of other Local Authorities.
- Where the abuse involved a member of staff/volunteer (position of trust), and this brings into question the safety of other adults, and or the service.
- Where there is the potential for parallel or overlapping criminal investigations by Police. In some instances a Planning Meeting may be required at short notice (1 day) following on from the initial Safeguarding Enquiries, if the issues identified place the adult at significant risk of harm, otherwise this should be arranged within 5 working days of a decision being made that one is necessary. With this in mind the following points made under each of the six Safeguarding Principles should be followed to ensure that Planning Meetings are utilised effectively and consistently. The objectives of a Safeguarding Enquiry are laid out on page 70 of the London Multi-Agency Safeguarding Policy and Procedures.
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Safeguarding Principle - Empowerment
What does this mean for the professionals: Adults are encouraged to make their own decisions and are provided with support and information.
What does this mean for the adult: "I am consulted about the outcomes I want from the safeguarding process and these directly inform what happens".……………………………………………………………………………………………………………………………………………
The practitioner who is setting up and chairing a Planning Meeting (see section 3) must ensure that the adult’s views, wishes and opinions are effectively represented, and conduct the meeting in an appropriate manner, using appropriate adaptations if required, allowing for the full participation of the adult and or their representative(s).
2.1 If the adult does wish to attend the following points must be born in mind:
- The adult can bring someone to support them at the meeting. This might be a family member, friend or an Advocate (see section 3.2 of the London Multi-Agency Safeguarding Policy and Procedures), and or a legal representative.
- The meeting is about the adult and their views and wishes. The Chair of the meeting must ensure these are heard and listened to by everyone else.
- The meeting may need to decide what actions need to be taken, and by who, to make the adult safer and improve their wellbeing. This will be a group decision and the adult’s views will form part of this decision.
- A Safeguarding Plan may be agreed - this is about how the adult wants to be supported to be safe. Decisions about the adult’s welfare or care will need to be agreed with them.
- If the adult has been assessed as not having mental capacity to make a particular decision at that time, then it will need to be made in their ‘best interests’, and their views, wishes, feelings and beliefs must still be taken into account. Such decisions must be made in line with the Mental Capacity Act 2005 (Mental capacity should be carefully considered during every safeguarding enquiry- see section 3.1 of the London Multi-Agency Safeguarding Policy and Procedures.
- Think about how you ask questions and how you can improve your understanding of a person's life circumstances: Lewisham Safeguarding Adults Board - Professional Curiosity
2.2 If the adult does not wish to attend they may:
- Give their views in writing, or
- Ask someone to attend on their behalf, for example an advocate, friend or family member, or
- Ask the Safeguarding worker or Safeguarding Adults Manager to pass on their views.
Local Government Association - Making Safeguarding Personal Toolkit ………………………………………………………………………………………………………………………………………….
Safeguarding Principle - Prevention
What does this mean for the professionals: Strategies are developed to prevent abuse and neglect that promotes resilience and self-determination.
What does this mean for the adult: "I am provided with easily understood information about what abuse is, how to recognise the signs and what I can do to seek help". ……………………………………………………………………………………………………………………………………………
2.3 The Planning Meeting should consider:
- The longer-term ongoing support the adult will need.
- What learning can be shared across agencies to help prevent further re-occurrences. This is also linked to Section 44 of the Care Act 2014 - if the criteria for a Safeguarding Adults Review (SAR) is met.
- If a referral to the Provider Concerns Process should be made (see sections 5.7 & 5.8 of the London Multi-Agency Safeguarding Policy and Procedures)
- What training or education is needed to help prevent further re-occurrences of abuse.
- How information should be recorded and shared in line with the data protection legislation to help prevent further instances of abuse (see section 2.39 of the London Multi-Agency Safeguarding Policy and Procedures.
- Does the adult have the mental capacity to consent to the Safeguarding Enquiry?
- Is there a need to provide statutory advocacy: Advocacy 7 Minute Briefing March 2023
- Is there any possibility that the adult has/ is suffering from any type of coercion, control, threat, duress or pressure from another person(s) which may mean they refuse consent?
- Does mental capacity (including executive capacity) need to be assessed or reviewed? For more information read: Decision Making and Mental Capacity (NICE Guidelines), Supported decision-making toolkit for people with communication difficulties Practicable steps for people with communication difficulties and Oldham SAB's Executive Functioning Guidance
- Give due regard to the adult’s views and wishes, including their desired outcomes, even if Best Interest Decisions have been made linked to the Mental Capacity Act. For more information read: Local Government Association - Making Safeguarding Personal Toolkit including on the six Safeguarding Principles and Alcohol Change UK Cognitive Impairment Guide and Alcohol Change UK How to use legal powers to safeguard highly vulnerable dependent drinkers guide.
- If the adult does have the mental capacity to consent to the Safeguarding Enquiry, but refuses, professionals must be careful that they consider how to keep the adult safe. This may be particularly relevant in domestic abuse cases.
- A Safeguarding Enquiry can still proceed without the adult’s consent if ‘vital’ or ‘public’ interest considerations apply.
- If the adult meets the safeguarding duty/ criteria, and is at risk of significant harm, and it is deemed they do have the mental capacity to refuse consent and to not engage with any Safeguarding Enquiry, then consider seeking legal advice and the use of the Court of Protection, and or Inherent Jurisdiction: 39 Essex Chambers: Guidance on Use of Inherent Jurisdiction.
- See and use the Guidance on Improving our Approach to Adult and Family Engagement which includes an overview of Trauma Informed Practice. A lack of effective engagement should result in an escalation of the risks in some instances and not a closure of the case.
- See and use the Multi-Agency Self-Neglect Policy, Practice Guidance and Procedures. Including consideration of the use of the High-Risk Panel if the Enquiry and Review is not achieving the desired effect in reducing the risk to the adult.
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Safeguarding Principle - Proportionality
What does this mean for the professionals: A proportionate and least intrusive response is made balanced with the level of risk.
What does this mean for the adult: "I am confident professionals will work in my interest and only get involved as much as needed".
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- If the abuse or neglect is unintentional and has arisen because an informal carer is struggling to care for another person. An assessment of both the carer and the adult must be considered in relation to wellbeing principles and duties.
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Safeguarding Principle - Protection
What does this mean for the professionals: Adults are offered ways to protect themselves, and there is a co-ordinated response to safeguarding.
What does this mean for the adult: "I am provided with help and support to report abuse. I am supported to take part to the extent to which I want and to which I am able". ……………………………………………………………………………………………………………………………………………
- The details of the Safeguarding Concern and how this places the adult at risk of abuse or neglect.
- That there is clarity about the type of abuse that has occurred and that this is recorded effectively, considering types of abuse that are particularly under-recorded:
- Organisational Abuse
- Discriminatory Abuse
- Modern Slavery
- Domestic Abuse.
- If an enquiry does take place, that an appropriate risk assessment of the available information is conducted that informs decisions regarding how the investigation will be undertaken, by whom, and by when.
- How a Safeguarding Plan will be delivered to reduce or remove the risk of harm to the adult, and or others.
- Any potential risks to children and young people (or other adults at risk) and agreement on who will arrange a Child Protection referral, where necessary. Refer to the: The Think Family page where you will find the Lewisham Think Family Protocol, the Think Family Practice Guidance and resources.
- The link with other key processes and procedures e.g. personnel issues (including referrals to the Disclosure and Barring Service or a professional or regulatory body); Police investigations; other regulatory processes such as a NHS Serious Incident, and the link to Pressure Ulcer Panels (see section 6).
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Safeguarding Principle - Partnerships
What does this mean for the professionals: Local solutions through services working together within their communities.
What does this mean for the adult: "I am confident that information will be appropriately shared in a way that takes into account its personal and sensitive nature. I am confident that agencies will work together to find the most effective responses for my own situation".
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- How everyone involved in the enquiry will deliver the actions that are agreed as a result of the investigation in a manner consistent with Making Safeguarding Personal principles (MSP) and that the adult’s views and wishes are achieved as agreed.
Local Government Association - Making Safeguarding Personal Toolkit
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Safeguarding Principle - Accountability
What does this mean for the professionals: Accountability and transparency in delivering a safeguarding response.
What does this mean for the adult: "I am clear about the roles and responsibilities of all those involved in the solution to the problem".
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- That arrangements are in place to give feedback to the person raising the Safeguarding Concern if they are not in attendance at the Planning Meeting.
- How partners are going to monitor and measure the delivery of the agreed actions with MSP in mind.
- Issues relating to inequalities and or potential discrimination are identified and taken account of.
3. Who can convene a Multi-Agency Adult Safeguarding Planning Meeting?
An Enquiry Officer or a Safeguarding Adults Manager from the London Borough of Lewisham (LBL) can convene a Multi-Agency Adult Safeguarding Planning Meeting.
4. Who should attend a Multi-Agency Adult Safeguarding Planning Meeting?
There are a wide range of people who may be required to attend a Planning Meeting, including, but not limited to:
- The adult and or their representative (see 2.1).
- The Safeguarding Adults Manager or their equivalent.
- The Safeguarding Enquiry Officer.
- The person who raised the Safeguarding Concern (if they are a professional).
- Police manager.
- Other criminal justice agencies.
- NHS Trust manager and or relevant specialist.
- GP
- Care Quality Commission.
- Care Provider agency manager.
- Relevant LBL and or South East London (SEL) Integrated Care Board (ICB) Commissioner.
- Quality Assurance or Contracts Officer from LBL and or SEL ICB.
- The person/agency alleged to have caused the harm should have been given the opportunity to submit their representations. If this an agency, then a manager not directly involved in providing care in the case may be invited to attend.
- Any other relevant agency/service representative as deemed appropriate by the person chairing the meeting.
Whoever attends a Planning Meeting should be of sufficient seniority to make decisions within the meeting concerning the organisation’s role and the resources they may contribute to the agreed Safeguarding Plan.
Planning Meetings should be formally recorded and minutes taken, which should be shared with those attending. This should be completed within 5 working days of the Meeting.
5. Practical arrangements
Whilst there is a need to formally record the minutes from Planning Meetings, these should be set up as informally and flexibly as possible to meet the requirements of the adult and or their representative(s), whilst also helping ensure that professionals can contribute when these meetings are being set up at relatively short-notice.
It may be suitable and appropriate to set these meetings up online using video methods, or via telephone, or by being flexible in utilising meeting rooms that are accessible for those involved. Otherwise the chair of the Planning Meeting should consider:
- How to create a comfortable and welcoming environment.
- Whether the adult wishes to have a representative(s) with them and whether they will or should have an active or silent role (legal representative). This should be agreed with the adult, their legal representative and the chair ahead of the Planning Meeting.
- Any communication requirements or other accessibility issues.
- Location of facilities such as refreshments and toilets.
- How breaks will be agreed, if needed.
- Arrangements should the adult require a break or wish to clarify any points covered in the meeting.
- The adult and their representative(s) should not be required to join a room where other attendees have previously gathered, and where possible they should be in the room before other attendees join, having met and had a chance to talk with the chair ahead of the meeting.
- Meetings can also be in multiple parts to make them less intimidating (smaller groups) and more manageable for the adult, and include a separate and wider ‘professionals’ meeting.
- Where the venue is the adult’s own home, consideration should be given to how their home will be treated with respect, and how to maintain confidentiality if others not attending the meeting may also be present in the home.
See: Multi-Agency Adult Safeguarding Planning Meeting Form (Word) Multi-Agency Adult Safeguarding Planning Meeting Form (Pdf)
6. How do Planning Meetings link to Pressure Ulcer Panels and the Provider Concerns process?
6.1 Pressure Ulcer Panels
Any Section 42 Safeguarding Enquiry which has commenced as a result of a pressure ulcer related issue will normally be conducted via one of the two Pressure Ulcer Panels in the Borough of Lewisham, which are both overseen by a senior social work practitioner from within LBL.
If these are routine cases, then a separate Planning Meeting will not be required, unless one or more of the issues listed in section 2 of this guidance are also present in the case.
If a Planning Meeting is deemed to be necessary in relation to a pressure ulcer related case, then one should be convened within 5 working days of a decision being made that one is necessary, even if the case has not been brought to a conclusion by the relevant Pressure Ulcer Panel.
6.2 Provider Concerns
As described in section 2.3, one outcome from a Planning Meeting might be to make a referral to the Provider Concerns process if the criteria for this has been reached. The Planning Meeting may help to identify signs linked to provider concerns, allowing for early supportive actions to be taken by commissioning authorities in supporting social care providers. A referral for the Provider Concerns Process should be made through the applicable Contracts Officer from LBL/ SEL ICB, or through the Head of Safeguarding and Gateway at LBL.
Provider Concern Process Flowchart Oct 2022
Quality, Safeguarding and Provider Concerns Procedure Oct 2022
Provider Concerns Policy and Procedures - Oct 2022
7. Monitoring and review of Planning Meetings
The Operational Lead from LBL will provide operational oversight and monitor all activity linked to the Section 42 Enquiry process, including Planning Meetings, in conjunction with the Service Manager with overall responsibility for adult safeguarding within LBL.
The Service Manager within LBL will provide oversight of Planning Meetings, providing quality assurance to the Lewisham Safeguarding Adults Board through ongoing audit and reporting processes.