Guidance Twelve - Complex abuse
Introduction
Complex Abuse is defined as:-
"Adult Abuse involving one or more abusers and a number (two or more) of victims. The abusers concerned may act in concert or in isolation, or may use an institutional framework or position to target victims" (DoH 1999 Complex Abuse Investigations).
Complexity will increase by virtue of the number of people and places involved and the period over which the alleged abuse occurred.
A full Safeguarding Assessment relating to a complex abuse situation will be time consuming, resource demanding and will require specialist skills and detailed coordination from Police, Social Care and NHS staff.
- The Complex Abuse Guidance document covers:
- Managing and conducting an investigation (the Safeguarding Assessment);
- Records: Safeguarding/preservation, Access/Information sharing;
- Support to victims and witnesses;
- Handling the media;
- De-brief and closure.
| The full guidance can be found in Appendix 16 - Complex Abuse. |
- Such Safeguarding Assessments will frequently involve a number of agencies and often the Police and the Registering Authority or authorities. Therefore, it is vitally important to ensure that all aspects of the investigation are carefully planned and that the agencies and individual professionals involved are aware of their respective roles and responsibilities;
- A key first step is to recognise when a larger scale assessment is involved. Responsible Managers and agencies receiving Safeguarding Adults’ referrals need to be aware of the possibility that a number of vulnerable adults may be at risk. In some cases, for instance where individual adults across a wide area, or over a period of time, are being abused by a serial abuser or group of abusers, the overall picture may not be so clear;
- It is also important that those receiving safeguarding adults referrals are aware that more than one vulnerable adult may being at risk and a key consideration throughout any assessment is this possibility. Information search activity (e.g. Database checks, consultation with other agencies etc.) should always be undertaken;
- If such a possibility is obvious from the state of a particular investigation as part of the safeguarding assessment, or is suggested as more information becomes available, then the Safeguarding Manager should be informed immediately. When a larger scale enquiry situation is identified the first task should be to identify a Manager to coordinate the overall assessment. This Manager will then be responsible for the overall conduct of the Safeguarding Assessment and ensuring that all relevant agencies are informed and involved. The Manager will also need to inform Senior Agency Managers of the establishing of a major Safeguarding Assessment.
This section aims to provide a checklist or "aide memoir" that should be considered prior to the commencement of such a Safeguarding Assessment and at periodic reviews while it is being conducted. The list is not exhaustive, nor will every issue be relevant to every assessment, but each item should be properly considered, not least to ensure that in planning for the ‘unexpected’ adequate attention is given to the ‘obvious’.
Planning the Safeguarding Assessment
This is a complex task and consideration needs to be given to the following:-
- joint response and decision making;
- ascertain exactly what is to be investigated;
- ascertain what is NOT to be investigated;
- maintain a file of all policy decisions affecting or concerned with the assessment;
- consider the timing of the investigative actions;
- what background enquiries are needed;
- obtain details of those people (staff and adults) affected by the assessment;
- if an establishment or other unit is involved, obtain details of the normal regime;
- maps of area;
- plans of building accommodation.
Management Issues
Effective joint working is essential to ensure that the following take place:
- identify key Managers from all appropriate agencies;
- jointly agree staffing and the location for the assessment;
- agree staffing not directly involved in the assessment;
- ensure that staff involved with the assessment are relieved of other responsibilities;
- identify funding and resourcing for the assessment;
- prepare for medical examinations - staff available and location;
- clarify legal advice arrangements - Criminal Prosecution and Service and County/City Solicitors;
- prepare joint press release/liaise with press offices;
- consider other local and central government agencies, not normally involved;
- plan for security of records;
- thought is given to the need for staff counselling/welfare arrangements and general health and safety issues.
Professional Issues
- Early consideration of the following issues will facilitate the assessment process:
- identify differing agency priorities and goals;
- team building;
- regular briefings: daily for very large scale assessments;
- early contact with non-abusing carers;
- support to referrers;
- legal position and opportunities;
- care arrangement for vulnerable adults;
- implication of any ethnic/religious differences;
- language and communications considerations;
- therapeutic services;
- help-line facility;
- debriefing at conclusion of the assessment;
- handling the press.
Post Assessment
At this stage it is important that the lessons learnt from one larger scale assessment are available to a range of agencies and staff involved in the protection of vulnerable adults.