Contracted services

Promoting well-being and safeguarding adults against abuse and neglect is an integral part of the commissioning and contracts processes.

Where a private, voluntary or independent organisation is commissioned to provide services on behalf of a statutory organisation, the agreement under which the arrangements are made should require that the private or voluntary organisation concerned takes into account the safeguarding requirements placed upon the commissioning body.

This means that there is a duty on Oxfordshire County Council and other statutory bodies to ensure that any organisation commissioned by them for the provision of services to adults at risk of abuse have regard for standard six of the ADASS Adult Safeguarding Improvement Tool

 

Commissioner Responsibilities

Commissioners should have in place a range of processes to ensure service users receive good quality and safe care. They must assure themselves that a provider is capable and competent in responding to allegations of abuse or neglect, including having robust processes in place to investigate the actions of members of staff.

Commissioners should encourage an open culture around safeguarding, working in partnership with providers to ensure the best outcome for the adult. Commissioners will be transparent and proportionate in any decisions and actions taken to safeguarding service users and specifically it will place service users’ well-being, quality of life and safety at the centre of all commissioning activity by:

  1. Regularly assuring themselves of the safety and effectiveness of the services commissioned.
  2. Responding promptly and robustly to concerns about possible abuse or neglect arising in regulated care and support settings, adopting a person-led and outcome-focused approach.
  3. Making available a continuum of responses in order to ensure responses are proportionate to the nature and level of concerns raised and that these are undertaken by the appropriate body or organisation.
  4. Request the provider to lead a section 42 enquiry when the concern relates to the actions or conduct of staff. However, the local authority will have to satisfy itself that the provider’s response has been sufficient to deal with the safeguarding issue and, if not, to undertake any enquiry of its own and any appropriate follow up action (e.g. referral to CQC, professional regulators). There may be circumstances when it is inappropriate or unsafe for the provider to lead a section 42 enquiry. For example, this could be a serious conflict of interest on the part of the employer, concerns having been raised about non-effective past enquiries or serious, multiple concerns, or a matter that requires investigation by the police.
  5. Maintaining up-to-date, accurate information on all safeguarding adults concerns arising in regulated care settings to ensure informed decision making and risk assessment.
  6. Clearly document any actions or decisions taken under safeguarding adults arrangements.
  7. Make decisions to suspend and/or terminate a placement(s) independently of any enforcement action CQC may be taking and/or criminal justice action that may be in progress.
  8. Ensuring that appropriate processes are in place to respond swiftly and appropriately in the event of a home closure.

 

Provider Responsibilities

There is an expectation that commissioned and grant funded services must have in place a range of processes to enable them to meet their duty of care to safeguard their service users. In addition to providing high quality and safe care, service providers are expected to:

  1. Have an up-to-date clear internal adult safeguarding policy and procedure consistent with the local policies and procedures of the Oxfordshire Safeguarding Adults Board and ensure all staff are aware of, and can act on concerns and allegations in accordance with the policy.
  2. Have clear care governance arrangements in place to prevent abuse or neglect and that allegations of abuse, neglect or misconduct are responded to, including having robust processes in place to investigate the actions of members of staff. This includes working to correct abuse or neglect in their organisation and protect the adult from further harm as soon as possible. The local authority must be informed as well as the CQC and also the CCG where the latter is the commissioner.
  3. Have robust reporting mechanisms from the point of care to the senior management/Board and from the management/Board to the point of care to proactively monitor the risk of abuse and neglect in the care setting.
  4. Adopt robust recruitment and employment practices, with checkable references, checkable ID, and appropriate DBS checks in place at the commencement of employment. Also ensuring all Job Descriptions include a clear statement on the responsibility to prevent abuse and neglect and to report concerns and that that disciplinary procedures are compatible with the responsibility to protect adults at risk of abuse or neglect.
  5. Ensure all staff receive training on the nature of abuse and neglect, recognising the signs and how to report concerns, the Mental Capacity Act, Deprivation of Liberty Safeguards, and the Prevent Agenda (commensurate with their roles and responsibilities).
  6. Have a whistle blowing policy to enable staff to raise concerns outside their own chain of line management, including outside their organisation to the local authority where necessary.
  7. Have robust mechanisms for service users, relatives and visitors to raise concerns including how to make a complaint and the contact number for the local safeguarding adults team and ensuring where necessary, all service users are supported by an advocate.
  8. Ensure staff governed by professional regulation, understand how their professional standards and requirements underpin their organisational roles to prevent, recognise and respond to abuse and neglect.
  9. Lead (at the request of the local authority) a section 42 enquiry providing any additional support the adult may need. This may be when the safeguarding enquiry relates to the conduct or actions of a staff member. Information relating to the action taken and what the outcome is must be made available to the local authority in line with s67 or s68 Care Act 2014. Fully cooperate with section 42 safeguarding enquiries being made by or on behalf of the local authority and to provide access to premises, staff and service users and relatives (including people funding their own care). Records should also be made available any independent advocate supporting the adult.
  10. Report allegations against staff to the Designated Safeguarding Adults Manager for their sector or the Safeguarding Adults Lead in their organisation. Ensure that the person who is alleged to have cause harm is appropriately informed and supported during the process and that information, advice and support is provided to the adult(s) harmed or their representative.