5.4 Working in partnership with providers

A shared goal between all parties is that adults can expect to receive a safe, quality service. Integral to the effectiveness of partnerships is the need to work in a transparent and open way. It is not the intention of this policy and procedures to be punitive in its dealings with providers but to implement quality and safeguarding principles by supporting and giving a helpful steer when concerns arise, to assist providers in getting back on track. Open dialogue can only be achieved where there is trust and a willingness on all parties to work together.

The rules of natural justice should be observed, and where there are organisational concerns, enquiries or investigations should be based on evidence and a thorough assessment.

Providers should underpin their own policies and procedures with the six safeguarding principles. They should empower adults to fully participate in how services are run by creating a culture of dignity and respect. Providers’ policies should comply with this overarching Policy and Procedures.

Providers are accountable to adults using their services and commissioners for meeting the expected standard of care agreed in individual care plans, contracts and commissions. They are expected to have a robust quality assurance framework in place that evidences commitment to prevention and early intervention. Such commitments are about recognising potential abuse and learning from past situations to inform better practice. Undertaking regular staff training, supervision and appraisals, self-audits and making changes as a result, reduces the risk of matters escalating to safeguarding action. Providers should publish an open and transparent complaint procedure with the assurance of no retribution; and offer ways of gaining customer feedback which supports empowerment and quality assurance. Independent advocacy and regular service user/carer/patient led meetings are equally important to ensuring that services are influenced by adults who use them. CQC gives guidance for providers to ensure the quality and safety of their services.

Providers have a duty of care to protect adults at risk and meet safeguarding standards; this can be evidenced where there is a clear commitment to protection in their policy and procedures that is observed in practice. See SCIE Policies and procedures review.

Action taken in response to safeguarding should always be proportionate with the least intrusive response that will effectively manage risk.

5.4.1 Commissioning support to Providers

In turn commissioning organisations should offer support and guidance where it is asked for or identified through constructive dialogue. Provider Forums are a constructive mechanism for sharing best practice, and identifying areas of risk. Transparency and information sharing, as per the following example Care Provider Forums Central Bedfordshire Council which demonstrates effective partnership working and mutual benefits.

5.4.2 Multiple Care Provision

Where providers support adults in or from a number of different establishments within the same locality, care should be taken that one establishment is not seen in isolation. This is to ensure that any failings are not endemic and embedded in corporate cultures and systems. This may impact on the capacity and capability of the provider to implement agreed improvements, but ensures that improvements are made on firm, sustainable foundations.

5.4.3 Duty of Candour

The Francis Report recommended the development of a culture of openness, transparency and candour in all organisations providing care and support.

Service providers must comply with the duty of candour, meaning providers must be open and transparent with service users about their care and treatment, including when it goes wrong. (Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 20)

The duty is part of the fundamental standard requirements for all providers. It applies to all NHS trusts, foundation trusts and special health authorities from October 2014 and for all other service providers or registered managers from April 2015.

5.4.4 Natural Justice

The principles of natural justice concern procedural fairness and ensure a fair decision is reached by objective decision making. Where there are concerns about quality or safety these should be evidenced, and parties provided with information and opportunity to take action to address concerns.

5.4.5 Workers who raise concerns within their organisations (whistleblowing)

Each organisation must have its own whistleblowing policy and provide staff with protection from victimisation or detriment when genuine concerns have been raised about malpractice.

See Public Concern at Work, the whistleblowing charity. 

5.4.6 Allegations against people in a position of trust

 This section is under development.

5.4.7 Criminal investigations

Although the Local Authority has the lead role in making enquiries or requesting others to do so, where criminal activity is suspected, early involvement of the police is essential. Police investigations should be coordinated with the Local Authority who may support other actions, but should always be police led. 

5.4.8 Suspension of staff pending Section 42 Enquiry outcomes

In the event that staff are suspended, adult safeguarding processes should consider how it can dovetail any agreed disciplinary processes. It should be borne in mind that a provider concerns process may feed into HR processes, but the provider concerns process in itself cannot determine outcomes for staff under employment laws. There must be a robust procedure for managing the re-integration of staff into the workplace. See you HR department for further advice.

5.4.9 People who fund their own care

People, who arrange their own care and support may not be known to either the Local Authority or its partners. In order to safeguard them and meet the duty of care to offer protection to all people who are in need of care and support and unable to protect themselves (the majority of people living in a care setting), providers are required to work with the Local Authority and its partners to ensure that information and advice is readily available and that information is shared when requested.

5.4.10 Adults at risk who cause harm

Where the person alleged to cause harm is also an adult at risk, the safety and wellbeing of both the adult at risk and the person alleged to have caused harm needs to be addressed separately. In most cases this can be considered through the Section 42 enquiry. The least intrusive action should be taken to support adults using the service. The provider is responsible for ensuring that actions are taken that support the person alleged to have caused harm in consultation and collaboration with commissioners, and the safety and wellbeing of other adults using the service. Commissioners are responsible for ensuring that the service meets the assessed needs of adults and that regular reviews are carried out to ensure this.