Adult Safeguarding: Sharing Information
Sharing the right information, at the right time, with the right people, is fundamental to good practice in safeguarding adults.
Frontline staff and volunteers should always report safeguarding concerns in line with their organisation’s policy. Policies should be clear about how confidential information should be shared between departments in the same organisation.
For Safeguarding purposes sensitive or personal information sometimes needs to be shared between the Local Authority and its safeguarding partners (including GP’s, health, the police, service providers, housing, regulators and the Office of the Public Guardian). This may include information about individuals who are at risk, service providers or those who may pose a risk to others. It aims to enable partners to share information appropriately and lawfully in order to improve the speed and quality of safeguarding responses.
The Care Act emphasises the need to empower people, to balance choice and control for individuals against preventing harm and reducing risk, and to respond proportionately to safeguarding concerns. The Act deals with the role of the safeguarding adults board’s (SAB’s) in sharing strategic information to improve local safeguarding practice. Section 45 ‘the supply of information’ covers the responsibilities of others to comply with requests for information from the safeguarding adults board.
Sharing information between organisations as part of day-to-day safeguarding practice is already covered in the common law duty of confidentiality, the Data Protection Act, the Human Rights Act and the Crime and Disorder Act. The Mental Capacity Act is also relevant as all those coming into contact with adults with care and support needs should be able to assess whether someone has the mental capacity to make a decision concerning risk, safety or sharing information.
Why do we need to share adult safeguarding information?
Organisations need to share safeguarding information with the right people at the right time to:
- Prevent death or serious harm,
- Coordinate effective and efficient responses,
- Enable early interventions to prevent the escalation of risk,
- Prevent abuse and harm that may increase the need for care and support,
- Maintain and improve good practice in safeguarding adults,
- Reveal patterns of abuse that were previously undetected and that could identify others at risk of abuse,
- Identify low-level concerns that may reveal people at risk of abuse,
- Help people to access the right kind of support to reduce risk and promote wellbeing,
- Help identify people who may pose a risk to others and, where possible, work to reduce offending behaviour,
- Reduce organisational risk and protect reputation.
False perceptions about needing evidence or consent to share safeguarding information
Some frontline staff and managers can be over-cautious about sharing personal information, particularly if it is against the wishes of the individual concerned. They may also be mistaken about needing hard evidence or consent to share information. The risk of sharing information is often perceived as higher than it actually is. It is important that staff consider the risks of not sharing safeguarding information when making decisions.
How to address false perceptions
- Raise awareness about responsibilities to share information (profession- or work role-specific guidance may help),
- Encourage consideration of the risks of not sharing information,
- Brief staff and volunteers on the basic principles of confidentiality and data protection,
- Improve understanding of the Mental Capacity Act,
- Provide a contact number for staff and volunteers to raise concerns,
- Be clear in procedures about when to raise a safeguarding concern,
- Assure staff and volunteers that they do not necessarily need to have evidence to raise a concern.
Complex networks between safeguarding partner agencies
The local authority has the lead responsibility for safeguarding adults with care and support needs, and the police and the NHS also have clear safeguarding duties under the Care Act 2014. Clinical commissioning groups and the police will often have different geographical boundaries and different IT systems. Housing and social care providers will also provide services across boundaries. This makes sharing information complex in practice.
The Care Act 2014 (Section 6 ) places duties on the local authority and its partners to cooperate in the exercise of their functions relevant to care and support including those to protect adults. The safeguarding adults board should ensure that it ‘has the involvement of all partners necessary to effectively carry out its duties’.
Sharing information to prevent abuse and neglect
Sharing information between organisations about known or suspected risks may help to prevent abuse taking place. The safeguarding adults board has a key role to play in sharing information and intelligence on both local and national threats and risks. The board’s annual report must provide information about any safeguarding adults reviews. This can include learning to inform future prevention strategies. Designated adult safeguarding managers ‘should also have a role in highlighting the extent to which their own organisation prevents abuse and neglect taking place’.
What if a person does not want you to share their information?
Frontline workers and volunteers should always share safeguarding concerns in line with their organisation’s policy, usually with their line manager or safeguarding lead in the first instance, except in emergency situations. As long as it does not increase the risk to the individual, the member of staff should explain to them that it is their duty to share their concern with their manager. The safeguarding principle of proportionality should underpin decisions about sharing information without consent, and decisions should be on a case-by-case basis.
Individuals may not give their consent to the sharing of safeguarding information for a number of reasons. For example, they may be frightened of reprisals, they may fear losing control, they may not trust social services or other partners or they may fear that their relationship with the abuser will be damaged. Reassurance and appropriate support along with gentle persuasion may help to change their view on whether it is best to share information.
If a person refuses intervention to support them with a safeguarding concern, or requests that information about them is not shared with other safeguarding partners, their wishes should be respected. However, there are a number of circumstances where the practitioner can reasonably override such a decision, including:
- The person lacks the mental capacity to make that decision – this must be properly explored and recorded in line with the Mental Capacity Act,
- Other people are, or may be, at risk, including children sharing the information could prevent a crime,
- The alleged abuser has care and support needs and may also be at risk,
- A serious crime has been committed staff are implicated,
- The person has the mental capacity to make that decision but they may be under duress or being coerced,
- The risk is unreasonably high and meets the criteria for a multi-agency risk assessment conference referral,
- A court order or other legal authority has requested the information.
If none of the above apply and the decision is not to share safeguarding information with other safeguarding partners, or not to intervene to safeguard the person:
- Support the person to weigh up the risks and benefits of different options,
- Ensure they are aware of the level of risk and possible outcomes,
- Offer to arrange for them to have an advocate or peer supporter,
- Offer support for them to build confidence and self-esteem if necessary,
- Agree on and record the level of risk the person is taking,
- Record the reasons for not intervening or sharing information,
- Regularly review the situation,
- Try to build trust and use gentle persuasion to enable the person to better protect themselves.
If it is necessary to share information outside the organisation:
- Explore the reasons for the person’s objections – what are they worried about?
- Explain the concern and why you think it is important to share the information,
- Tell the person who you would like to share the information with and why,
- Explain the benefits, to them or others, of sharing information – could they access better help and support?
- Discuss the consequences of not sharing the information – could someone come to harm?
- Reassure them that the information will not be shared with anyone who does not need to know,
- Reassure them that they are not alone and that support is available to them.
If the person cannot be persuaded to give their consent then, unless it is considered dangerous to do so, it should be explained to them that the information will be shared without consent. The reasons should be given and recorded.
If it is not clear that information should be shared outside the organisation, a conversation can be had with safeguarding partners in the police or local authority without disclosing the identity of the person in the first instance. They can then advise on whether full disclosure is necessary without the consent of the person concerned.
It is very important that the risk of sharing information is also considered. In some cases, such as domestic violence or hate crime, it is possible that sharing information could increase the risk to the individual. Safeguarding partners need to work jointly to provide advice, support and protection to the individual in order to minimise the possibility of worsening the relationship or triggering retribution from the abuser.
What if a safeguarding partner is reluctant to share information?
There are only a limited number of circumstances where it would be acceptable not to share information pertinent to safeguarding with relevant safeguarding partners. These would be where the person involved has the mental capacity to make the decision and does not want their information shared and:
- Nobody else is at risk,
- No serious crime has been or may be committed,
- The alleged abuser has no care and support needs,
- No staff are implicated,
- No coercion or duress is suspected,
- The public interest served by disclosure does not outweigh the public interest served by protecting confidentiality,
- The risk is not high enough to warrant a multi-agency risk assessment conference referral,
- No other legal authority has requested the information.
Safeguarding adults boards set clear policies for dealing with conflict on information sharing. If there is continued reluctance from one partner to share information on a safeguarding concern the matter would be referred to the board. It can then consider whether the concern warrants a request, under Clause 45 of the Care Act, for the ‘supply of information’. Then the reluctant party would only have grounds for refusal if it would be ‘incompatible with their own duties or have an adverse effect on the exercise of their functions’.
Codes of Practice
In England Care workers are not registered but there is a Voluntary Code of Practice, this is based on the principles of protecting the public by promoting best practice. It will ensure that you are ‘working to standard’, providing high quality, compassionate healthcare, care and support. The Code describes the standards of conduct, behaviour and attitude that the public and people who use health and care services should expect. You are responsible for, and have a duty of care to ensure that your conduct does not fall below the standards detailed in the Code. Nothing that you do, or omit to do, should harm the safety and wellbeing of people who use health and care services, and the public.
As a Healthcare Support Worker or Adult Social Care Worker in England you must:
- Be accountable by making sure you can answer for your actions or omissions.
- Promote and uphold the privacy, dignity, rights, health and wellbeing of people who use health and care services and their carers at all times.
- Work in collaboration with your colleagues to ensure the delivery of high quality, safe and compassionate healthcare, care and support.
- Communicate in an open, and effective way to promote the health, safety and wellbeing of people who use health and care services and their carers.
- Respect a person’s right to confidentiality.
- Strive to improve the quality of healthcare, care and support through continuing professional development.
- Uphold and promote equality, diversity and inclusion.
Standards of Proficiency
Social workers are registered with the Health and Care Professions Council. The Standards of proficiency state that they must:
- Understand the need to protect, safeguard and promote the wellbeing of children, young people and vulnerable adults.
- Be able to recognise and respond appropriately to situations where it is necessary to share information to safeguard service users and carers or others.
Duty of Candour
Regulations under the Care Act place a duty of candour on all service providers registered with the Care Quality Commission from April 2015. The duty:
- Aims to ensure transparency and honesty when things go wrong,
- requires providers to tell the person concerned when something has gone wrong as soon as possible and provide support to them,
- includes giving an apology and keeping the person informed about any further enquiries.
Those commissioning services should consider whether contracts should place an obligation on service providers to share safeguarding information. Any specifications would need to be in line with policy, regulation and the law.
Sharing information on those who may pose a risk to others
The police can keep records on any person known to be a target or perpetrator of abuse and share such information with safeguarding partners for the purposes of protection under Section 115 of the Crime and Disorder Act 1998, and the Data Protection Act 1998, provided that criteria outlined in the legislation are met’. All police forces now have IT systems in place to help identify repeat and vulnerable victims of antisocial behaviour.