Safeguarding Adults Resolving Professional Differences (Escalation Policy)

Introduction

Effective working together depends on an open approach and honest relationships between agencies. Problem solving and resolution is an integral part of professional co-operation and joint working to safeguard adults at risk.

Transparency, openness and a willingness to understand and respect individual and agency views are a core aspect of multi-agency / inter-agency working. However, there may be occasions where individuals / agencies disagree on how best to keep adults at risk safe and promote their welfare.

Disagreements can arise in a number of areas, but are most likely to arise around:

• Perceived levels of risk
• Levels of need and whether a concern has met the threshold for a service or intervention
• Roles and responsibilities
• Level or quality of communication/ information sharing
• Provision of services
• Action or lack of action progressing plans
• Cases being / not being stepped up or down and / or closed

The Cambridgeshire & Peterborough Executive Safeguarding Partnership Board is clear that there must be respectful challenge whenever a professional or agency has a concern about the action or inaction of another. The aim must be to resolve a professional disagreement at the earliest possible stage, always keeping in mind that the adult at risk’s safety and welfare is paramount.

If an adult is thought to be at immediate risk of harm, all should respond as required by the SAB and individual agency policies and procedures.

Any worker who feels that a decision is not safe, or is inappropriate, can initially consult their supervisor / manager to clarify their thinking, if required. They should be able to evidence the nature and source of the concerns and should keep a record of all discussions.

Concerns relating to decisions, suspected wrongdoing or dangers at work within an agency, should be raised in line with each agency’s policies for dealing with such matters, including, but not limited to, those setting out the arrangements for ‘whistleblowing’.

Where a dispute involves a complaint about the behaviour or professional conduct of a worker, this should be reported in line with the Safeguarding Adults Board, Managing Concerns About People in Positions of Trust (PIPOT) procedure, or the agency’s whistleblowing / complaints procedure.

Key Principles

• The adult at risk’s safety and welfare should be the key focus at all times and any dispute between individuals / agencies should never leave an adult at risk unprotected
• It is the responsibility of all professionals to be assertive and to present a respectful challenge to the actions and decisions of other agencies where they believe there is evidence to suggest that the adult at risk’s safety or development may be compromised
• A culture of professional challenge can be developed and facilitated through consistent communication and information sharing between agencies and within clear plans for adults at risk. Professionals should know who in the multi-agency network is involved with the adult
• Individuals /agencies should not be defensive when challenged and must always be prepared to review decisions and plans with an open mind and revise decisions in light of the new information
• Differences of opinion should be resolved at the earliest stage and within the shortest timescale possible to ensure that the adult is protected

NOTE: If an adult is thought to be at imminent risk of harm, the matter should be referred immediately to the Police/Social Care to decide what action to take to safeguard/protect them whilst the dispute is being resolved.

Resolving Differences of Opinion; Stages of Resolution

Stage One: Discussion between workers

The people who disagree should have a discussion to try to resolve the problem. This discussion must take place as soon as possible and could be a telephone conversation or a face to face meeting. It should be recognised that differences in status and /or experience may affect the confidence of some workers to pursue this unsupported.

Stage Two: Discussion between Line Managers

If the problem is not resolved and concerns remain, the worker should contact their supervisor / line manager / safeguarding lead within their own agency to consider the issue raised, what outcome they would like to achieve and how differences can be addressed.

The line manager should contact their respective counterpart to try to negotiate an agreed way forward. This could involve a professionals meeting if deemed appropriate.

Stage Three: Discussion between Operational/Senior Managers

If the issue is not resolved at stage two, the supervisor/ line manager reports to their manager or named/ lead safeguarding representative. These two senior managers of both individuals/organisations must liaise and attempt to resolve the professional differences through discussion.

If there remains disagreement, escalation continues through the appropriate tiers of management in each organisation until the matter is resolved.

Stage Four: Resolution by Cambridgeshire and Peterborough Executive Safeguarding Partnership Board

If there is no resolution, and having exhausted all other routes, the matter should be escalated to the Chair of the Cambridgeshire and Peterborough Executive Safeguarding Partnership Board. The escalation to CPESPB should be made via the Head of Service (for each individual/agency) to the Head of Service for the Safeguarding Partnership Board. They will then liaise with the Chair of the Executive Safeguarding Partnership Board.

The Chair will convene a Resolution Panel, membership will consist of a senior officer from the three agencies, LA, Police and ICB.

The Panel will receive representations from those involved in the dispute and will collectively resolve the professional differences concerned.

Additional Note:

1. At each stage professionals must ensure that appropriate records are made in the adult at risk’s case records. This should include the concern, action taken to resolve, agreed actions from resolution process, timescales and the outcome. This should be clear, evidenced and factual.

Appendix 1: Escalation procedure flowchart