Allegations against people in positions of trust – PiPoT

Partner agency assurance

A multi-agency discussion after an audit of activity at the Executive on 16 September 2021 was convened following a piece of single agency assurance work designed to consider how agencies were effectively discharging the responsibilities in relation to adults in positions of trust and allegations.

The single agency audit activity was completed in May and June and a composite spreadsheet completed and discussed at the Executive in July. That meeting concluded that a further discussion on the findings and key issues would be useful to drawn together the multi-agency aspects and to consider any further action that we would wish to take as a partnership.

Background

As a multi-agency partnership four key issues led us to undertake this assurance activity:

  1. Some learning was taken from a serious case where a staff member was disciplined in the home care sector amid allegations of service user neglect – this led to a discussion on staff mobility in the sector
  2. Awareness raising activity by London ADASS
  3. To provide some important partnership assurance
  4. To learn from each other.

The audit and assurance

The audit activity, see below, provided assurance that all agencies providing universal care and support services had arrangements in place, alongside appropriate policies for dealing with allegations against people in positions of trust.

In our discussions we were confident that such policies created clarity in distinguishing between an allegation against an individual, a concern relating to the quality of care or practice and a formal complaint.

The audit also illustrated clarity, confirmed in the discussions, that risk was appropriately assessed and recorded.

The discussion highlighted those policies extended to anyone working with adults with care and support needs and that this included volunteers.

The partnership was assured and confident in this aspect of audit activity and was confident that the constituent agencies of the partnership had in place proportionate and transparent policies and internal reporting mechanisms.

The discussion therefore focused on a few areas:

  1. Those agencies from whom services were commissioned and contracted.
    It was recognised that many of these agencies are smaller organisations. They are often community or third sector organisations and smaller employers. While there is a degree of confidence that the issue is highlighted in contracts and commissioners use the framework as a clear expectation, it is less clear if this is consistently applied. The discussion highlighted a number of key questions:
    - Are we sufficiently clear in contracting and commissioning arrangements to assure ourselves that there are adequate safe working practice procedures in place in organisations?
    - Are we asking providers to report concerns re staffing issues to commissioners?
  2. Approaches to ‘fitness to practice’ in adults work.
    We discussed the issues of being unable sometimes to substantiate an allegation but of being left with concerns. We explored the use of HR and management support mechanisms. In the main when the individual is a ‘professional‘ we received good assurance of the use of reporting through professional bodies. The issue of the non-professional workforce was acknowledged as more challenging. In these instances, we heard how some agencies were using the Disclosure and Barring Service to offer advice and support and to agree how information that was low level or ‘soft’ intelligence could be collated. We agreed to have some insight from them would be useful.
  3. We discussed gathering data and understanding a collated picture for Ealing.
  4. We discussed the LADO role in children’s services and its applicability in adult services. We agreed to explore this further.

Audit activity: Dealing with allegations against people in positions of trust

Does your organisation have a clear and well understood process to deal with allegations against staff that would be considered a safeguarding allegation?

  • LBE -  There is a policy in place with the principal social worker acting as designated senior manager (similar role to LADO in childrens).
  • WLNHST - Yes, this is included in both the safeguarding adult and children policies. We also have a flowchart to highlight the process.
  • CCG - Yes, via HR policies and practices.
  • LNWUHT - Yes, LNWH have a clear and well understood process to deal with allegations against staff that would be considered a safeguarding allegation.
  • Police - Yes, all investigated either by our local Professional Standards Unit (PSU) or Directorate of Professional Standards (DPS).

Does your organisation escalate and report such incidents, including liaising with ASC/police as appropriate?

  • LBE -  If it is brought to our attention that a member of staff is subject to a PIPoT concern, then there is a policy in place to escalate to relevant agencies. The designated safeguarding manager, assistant director of operations and director of adult social services would make a decision about whether the matter should be referred to the police.
  • WLNHST - Yes, all allegations against staff are reported to the LADO, safeguarding adult concern as appropriate. Police are also notified if appropriate.
  • CCG - Yes, via HR policies and practices.
  • LNWUHT - Yes LNWH report such incidents, including liaising with ASC/police as appropriate. In addition a strategy meeting is convened by safeguarding lead, HR, service manager, complaints lead to delegate an internal investigator and trigger the Trust investigation process.
  • Police - Yes - escalated to central DPS or IOPC depending on threshold of concerns/offence.

Is there a clear process for reporting through governance routes in the organisation?

  • LBE - There is a policy which requires review to ensure that it meets our requirements.
  • WLNHST - Yes, this is highlighted in the flowcharts.
  • CCG - Yes, via quality and HR policies and processes.
  • LNWUHT - Yes, via the Integrated Safeguarding Board, Quality Committee, Trust Board and CCGs via SHOF.
  • Police - Very clear governance routes.

Does your organisation routinely think about fitness to practice and the link to barring?

  • LBE - Social workers and OTs are regulated professionals. Any concerns raised in this manner would immediately be reported to the regulatory bodies for either profession.
  • WLNHST - The Trust has a disciplinary policy, which was reviewed by the safeguarding team and included the interface between safeguarding and the disciplinary policy.
  • CCG - Yes, via HR policies and processes.
  • LNWUHT - Yes.
  • Police - All risk managed by PSU and DPS.

What have been the numbers of allegations against people in positions of trust in the last three years?

  • LBE - 13 where LBE have received an allegation in writing or from Social Work England. Within that number two people had two allegations.
  • WLNHST - This information is shared on our Safeguarding Health Outcomes Frameworks (SHOF) to the Clinical Commissioning Groups (CCGs)/Integrated Care Systems (ICS) that is completed and reported on quarterly. Last year there were three in Ealing.
  • CCG - None in the last three years.
  • LNWUHT - Approximately nine. I recently joined the Trust and so far have reported four cases.
  • Police - Unable to provide this information.

Does your organisation have a lead role similar to the LADO, but for adults?

  • LBE - Pprincipal social worker is the designated senior manager.
  • WLNHST - Yes, this is held by the safeguarding named professional for adults.
  • CCG - Yes.
  • LNWUHT - N/A. NHS Provider Trust refer allegations involving adults to the LA designated officer for adults in adult social care.
  • Police - Various units across the MPS deal with referrals/allegations depending on type of incident.