Allegation Management Flowchart
The Care Act 2014 formalised the expectations on local Safeguarding Adults Boards to establish and agree a framework and process for how allegations against people working with adults with care and support needs (i.e. those in a position of trust) should be notified and responded to.
While the primary focus of Adult Safeguarding work is to safeguard one or more identified adults with care and support and support needs, there will be occasions where a risk or potential risk may be posed by a person who works with adults with care and support needs, but where there is no specific adult at risk identified. Where such concerns are raised about someone who works with adults with care and support needs, it will be necessary for the employer (or student body or voluntary organisation) to assess any potential risk to adults with care and support needs who use their services, and, if necessary, to take action to safeguard those adults.
This document provides an overarching framework on the approach and process to follow when responding to allegations and concerns relating to people who work in a position of trust with adults who have care and support needs.
This document is directed at agencies and individuals who are “relevant partners” as defined in Section 6 of the Care Act 2014, and/or who are members of Cambridgeshire and Peterborough Safeguarding Adults Partnership Board, and those agencies providing universal care and support services.
This document should be read alongside relevant local multi agency policy and procedures and information sharing protocols (see Appendix Eight of the Cambridgeshire and Peterborough Safeguarding Partnership Board’s Multi-agency Policy and Procedures)
If, during either the initial information gathering stage or while working on a PIPOT you become aware that the subject has moved locations but is still in contact with adults with care and support needs, either via employment or volunteering consider your duties under information sharing. Note: Decisions on sharing information must be justifiable and proportionate, based on the potential or actual harm to adults or children at risk and the rationale for decision-making should always be recorded (Care Act 2014: 14.131)
Scope of Policy
A Person in a Position of Trust (PIPOT) is anyone who works or volunteers with adults with care and support needs.
People can be considered to be in a ‘position of trust’ where they are likely to have contact with adults with care and support needs as part of their employment or voluntary work, and
- Where the role carries an expectation of Trust and
- The person is in a position to exercise authority, power, or control over an adult(s) with care and support needs (as perceived by the adult).
This policy must be followed in all cases by the organisation/agency which first becomes aware of a concern, where information (whether current or historical) is identified in connection with:
- The PIPOTs own work / voluntary activity with adults with care and support needs
- The PIPOTs life outside work i.e. concerning adults with care and support needs in the family or social circle
In relation to this process the person in a position of trust will have had an allegation raised that they may pose a risk to adults at risk because they have:
- behaved in a way that has harmed, or may have harmed an adult or child
- possibly committed a criminal offence against, or related to, an adult or child
- behaved towards an adult or child in a way that indicates they may pose a risk of harm to adults with care and support need
- Behaved in a way which questions their ability to provide a service to an adult with care and support needs which must be reviewed e.g. conviction for grievous bodily harm against someone who is not an adult with care and support needs.
(Adapted from Care Act 2014: 14.123)
Children – whilst this Protocol is concerned with potential harm to adults with care and support needs, if the allegation is such that there is a concern that the person may also pose a risk to children, then Children’s Social Care Services must be informed. It is everyone’s duty to refer any current and historical allegations of abuse against children to Children’s Services, whether the alleged perpetrator is a PIPOT or not
What is excluded from this Policy?
The following are excluded from this policy:
If an allegation is made that concerns the actions of a professional, or volunteer which related to alleged abuse or neglect of a person with care and support needs then (i) A Safeguarding Referral should be made and (ii) Consideration by the MASH of a Safeguarding Enquiry (Section 42) to be undertaken. Such an allegation should be dealt with by following the local adult safeguarding policies and procedures.
If the employer is aware of concerns about a staff member, it is their responsibility to manage the risks around this (unless this is also a safeguarding concern-see above), and a PIPOT referral to the local authority is not required.
Where there are complaints about a professional, or volunteer and concerns raised about the quality of practice provided by the person in a position of trust, and these do not pose a specific risk to adults or children. Other relevant bodies and their agency’s procedures should be used to recognise, respond to and resolve these issues, such as complaints or contractual processes.
Key roles and responsibilities
The Care Act, Statutory Guidance sets out the responsibilities of employers:
- The local authority’s relevant partners, as set out in Section 6 (7) of the Care Act, and those providing universal care and support services, should have clear policies in line with those from the safeguarding adults board for dealing with allegations against people who work, in either a paid or unpaid capacity, with adults with care and support needs (Section 14.120)
- Where such concerns are raised about someone who works with adults with care and support needs, it will be necessary for the employer (or student body or voluntary organisation) to assess any potential risk to adults with care and support needs who use their services, and, if necessary, to take action to safeguard those adults (Section 14.122)
- Employers, student bodies and voluntary organisations should have clear procedures in place setting out the process, including timescales, for investigation and what support and advice will be available to individuals against whom allegations have been made (Section 14.126)
- Employers, student bodies and voluntary organisations should have their own sources of advice (including legal advice) in place for dealing with such concerns (Section 14.126)
- …action necessary to address the welfare of adults with care and support needs should be taken without delay and in a coordinated manner, to prevent the need for further safeguarding in future (Section 14.128)
- If an organisation [permanently] removes an individual (paid worker or unpaid volunteer) from work with an adult with care and support needs (or would have, had the person not left first) because the person poses a risk of harm to adults, the organisation must make a referral to the Disclosure and Barring Service. It is an offence to fail to make a referral without good reason (Section 14.127. Italics comment added)
Each organisation must therefore ensure they have policies and procedures in place that enable them to respond to concerns about people in positions of trust. This must include arrangements for raising concerns to the local authority in accordance with the multi-agency safeguarding adults’ policy and procedures where this is appropriate; as well as the management of concerns within their own organisation.
Employers and student bodies are responsible for working with the person in a position of trust to understand the issues, assess any risk in the context of their service; and take appropriate actions that safeguard people who use their services. This will include supporting the person in position of trust to understand the process being followed and decisions reached in accordance with the organisations policies.
Only an employer has the power to suspend an employee, redeploy them or make other changes to their working arrangements, and so must be responsible and accountable for the decisions reached. Actions taken should take into account their own internal policies and procedures, their responsibilities to provide safe services, and employment law.
According to the nature of the concerns raised, an employer/volunteers organisation/student body may also have a responsibility to inform overseeing bodies according to their requirements, such as:
- Care Quality Commission (CQC)
- Charities Commission
- Commissioning bodies
- Disclosure and Barring Service (DBS)
- Professional bodies
The Cambridgeshire and Peterborough Safeguarding Adults Partnership recommend that within each agency a specific point of contact or specialist professional has the lead for PIPOT inquires and guidance. Having a designated PIPOT lead would support single agency policies / procedures and adherence to the multi-agency guidance as set out below.
The information owner
The CPSPB partner agency (or service provider they commission) who first becomes aware of an allegation or concern will be the Primary Data Controller, or owner of the information.
The owner of the information relating to the concern or allegation is expected to:
- consider if the information indicates any immediate risk management actions are needed, or referrals into adult or children safeguarding processes if the criteria is met. Risk assessment must be completed to reflect the discussion and identified risks.
- consider whether the allegation or concern indicates a criminal offence has occurred or may occur – if so, the allegation or concern must be reported to the police (early liaison with police should take place to agree on next steps and to avoid contamination of evidence – if a criminal investigation is required this may take primacy over an agency or organisation’s internal investigation)
- refer to the relevant Local Authority LADO where the information indicates the person also works with and could pose a risk of harm to children
- make a decision whether the information should be disclosed to the person in a position of trust’s employer
- When making a decision, consider any known history of conduct (when making a decision), complaints, cautions or convictions that may be relevant to the potential risk
- If disclosing, manage this disclosure in line with legal and best practice requirements for information sharing. The Care and Support Statutory Guidance states that local authority’s relevant partners, and agencies providing universal care and support services should have clear policies in line with those from the safeguarding adults board to deal with this area of activity. Some agencies may have well established protocols for sharing information in these types of circumstance – such as the Common Law Police Disclosure process – whereas other agencies may not deal with these issues on a frequent basis and may need to have senior management oversight, and gain legal advice as required, on a case-by-case basis.
- Where a disclosure is made, notify the relevant service commissioners and regulatory agencies,
- Record the information and decisions clearly, including the rationale for any decision made.
- Records should be maintained in line with internal agency record keeping policies and requirements.
Employers, student bodies, or voluntary organisations
Employers, student bodies and voluntary organisations/agencies should have clear procedures in place that are consistent with this PIPOT framework setting out the process, including timescales, for investigation and what support and advice will be available to individuals against whom allegations have been made. Any allegation against people who work with adults should be reported immediately to a senior manager within the organisation/agency. Employers, student bodies and voluntary organisations/agencies should have their own policies and procedures (including legal advice) in place for dealing with such concerns.
Records should be maintained in line with internal agency record keeping policies and requirements.
Once the employer, student body or voluntary organisation/agency has been informed, they are responsible for assessing the risks in the context of their service or organisation. Only the employer has the authority to suspend, redeploy or make other changes to working arrangements.
Any employer, student body, or voluntary organisation who is responsible for a person in a position of trust where there is a concern or allegation raised are expected to:
- respond in individual cases where concerns are raised about people working in a position of trust, ensuring that the risk is assessed, investigated where appropriate through internal employment processes, and that risk management actions are identified and implemented as appropriate to the individual cas
- ensure all adult or child safeguarding concerns that result from a concern about a position of trust are reported in line with the safeguarding referral procedures (i.e. Safeguarding Adult Referral / Child Protection Referral)
- where appropriate, notify and refer to external agencies to the; Care Quality Commission (CQC) (where the person in a position of trust is working or volunteering in a CQC regulated organisation), statutory and other bodies responsible for professional regulation (such as the General Medical Council (GMC), Nursing and Midwifery Council, Social Work England, Independent Office for Police Conduct, The Charity Commission and the Disclosure and Barring Service (DBS)
- provide feedback at regular intervals to the relevant Local Authority (if there is a related safeguarding enquiry) and to their commissioning agency (if they have one)
- ensure the safety and protection of adults with care and support needs is central to their decision making
- share information in line with these procedures where it is known the person in a position of trust also has other employment or voluntary work with adults with care and support needs or children
- record the information and decisions clearly, including the rationale for any decision made
If an organisation/agency removes an individual (paid worker or unpaid volunteer) from work with an adult with care and support needs (or would have, had the person not left first) because the person poses a risk of harm to adults, the organisation must make a referral to the Disclosure and Barring Service. It is an offence to fail to make a referral without good reason.
At the conclusion of any position of trust inquiries, consider if the findings demonstrate evidence of a theme or pattern in the context of past and historic position of trust concerns; identify potential themes or system wide issues within the organisation/agency; and ensure that appropriate action is taken by their organisation/agency so that learning from past events is applied to reduce the risk of harm to adults with care and support needs in the future.
Support for the ‘person in a position of trust’
Where concerns have been raised that a person in a position of trust may pose a risk to people with care and support needs, the experience is likely to be very stressful for them. Alongside the duty of care towards the adult at risk, there must be a duty of care to the employee, volunteer or student concerned.
The employer/voluntary/student body will need to provide support to minimise stress associated with the process, this may need to include where possible:
- the individual has the right to be informed of the allegation
- support for the person to understand the procedures being followed
- the right to contact their union representative at any point – should they have one
- updates on developments
- the opportunity to respond to allegations/concerns
- support to raise questions or concerns about their circumstances
- occupational health / mental health support available within the employee / volunteer’s own organisation
There may be limitations on the amount of information that can be shared at a particular time in order not to prejudice any enquiry/investigation or place any adult or child at risk. There may also be occasions where there is a need to agree changes to the Person’s working arrangements or to the support provided.
If the Person is a member of a union or professional association or network s/he should be advised that they may wish to seek support from that organisation. The Person may also wish to seek independent advice regarding employment issues. Such advice and support should be supplementary to that provided by the employer.
Consent and involvement of a person in a position of trust
Unless wholly impractical, before disclosing information to another employer, volunteer manager or student body, there is a need to consult with the person whose information is to be shared. This will give them the opportunity to respond to the concerns and make representation on the need to share the information.
If it is assessed as justified and necessary for the employer to be informed of the concerns/allegations, the person in a position of trust may wish to inform their employer/volunteer organisations/student body themselves.
If this is the case, their wish should be respected but it will still be necessary to contact the employer/volunteer organisation/student body subsequently to check that relevant information has actually been passed on. It should be made clear to that person in a position of trust that this is required.
Multi-Agency Safeguarding Hub (MASH) – Advice
The MASH may be consulted to consider the wellbeing of the subject and discuss risk management under the multi-agency PIPOT Guidance. However, please remember if making a safeguarding referral consent from the adult at risk should be gained prior to submitting safeguarding concerns.
Adults at Risk Safeguarding Concern
Where there is any abuse or suspicion of abuse that relates to a relevant adult at risk, the concern must be reported to the relevant Multi-Agency Safeguarding Hub (MASH) by using the online referral form (for Cambridgeshire), telephone or secure email using the adult safeguarding referral form which can be found at: Concerned? | Cambridgeshire and Peterborough Safeguarding Partnership Board (safeguardingcambspeterborough.org.uk)
Customer Service Contact Details for Safeguarding Referrals for Adults At Risk:
- Cambridgeshire County Council
- Safeguarding Adults referral form – Cambridgeshire County Council
- Phone: 0345 045 5202 (9am to 5pm Monday to Friday)
- Peterborough City Council –
In an emergency, outside office hours, if someone is in danger and unable to protect themselves or cannot remain in the community without immediate intervention telephone 01733 234 724 and / or dial 999
Child Protection Concern
If there are concerns that a child is at risk of significant harm, then an immediate report must be made to the Children’s Multi-Agency Safeguarding Hub.
- Cambridgeshire County Council: Make a professional referral to Cambridgeshire County Council Children’s Services – Cambridgeshire County Council
- Peterborough City Council: Make a professional referral to Peterborough City Council Children’s Services
In urgent situations out of office hours the referral should be made to the emergency duty team (out of hours) on 01733 234724
Local Authority Designated Officer – Children
In circumstances where adults that are engaged in regulated activity with children, and have harmed or may have harmed a child, this should be referred to the Local Authority Designated Officer
- Cambridgeshire County Council LADO
- Email LADO@cambridgeshire.gov.uk
- Phone 01223 727967
- Peterborough City Council LADO
- Email: LADO@peterborough.gov.uk
- Phone: 01733 864038
7 Minute Briefing: People in Position of Trust relating to Adults at Risk – Safeguarding Adults National Network
Appendix A: Referrals to Professional Bodies
If the person is registered with a professional body and there are concerns about their fitness to practice, the employer/volunteer manager must refer to the professional body’s published guidance and consider the need to raise the concern with that professional body.
A professional body has a range of options where appropriate, these usually include suspending the person from practice, de-registering them or imposing conditions of practice that the person must work under. Some of the principal organisations are:
- Nursing and Midwifery Council (nmc-uk.org)
- Health and Care Professions Council (hpc-uk.org)
- General Medical Council (gmc-uk.org)
- General Optical Society (optical.org)
- General Dental Society (gdc-uk.org)
- General Chiropractic Council (gcc-uk.org)
- Royal Pharmaceutical Society of Great Britain (rpsgb.org.uk)
- General Osteopathic Council (osteopathy.org.uk)
- Care Quality Commission (cqc.org.uk/)
- Independent Office for Police Conduct (policeconduct.gov.uk/)
- Social Work England (socialworkengland.org.uk/)
- Charity Commission (www.gov.uk/government/organisations/charity-commission)
- Ofsted Office for Standards in Education, Children’s Services & Skills (www.gov.uk/government/organisations/ofsted)
Each professional registration body:
- Maintains a public register of qualified workers
- Sets standards for conduct, performance, and ethics
- Considers allegations of misconduct, lack of competence or unfitness to practice
- Makes decisions as to whether a registered worker can practice
Notification of a professional body is the responsibility of the employer. Where this action has been agreed with the organisation’s nominated safeguarding lead, confirmation should be provided to them that the action has been completed. As the responsible authority for adult safeguarding, the local authority has the power to make a referral where the relevant criteria have been met and should do so where it is necessary to ensure an appropriate referral has been made.
Appendix B: Referrals to the Disclosure and Barring Service (DBS)
The Disclosure and Barring Service – GOV.UK (www.gov.uk) can bar a person unsuitable to work with vulnerable people, including children, from working in regulated activity in the future. If a person is barred it becomes an offence for an organisation to knowingly engage that person in regulated activity.
Employers and volunteer managers of people working in ‘regulated activity’ have a legal duty to make referrals to the Disclosure and Barring Service in certain circumstances. The local authority also has a power to make a referral and should do where it is necessary to ensure the appropriate referral has been made. Regulated activity is work (both paid and unpaid) with children or vulnerable adults that meets certain criteria. In relation to vulnerable adults, regulated activity in broad terms includes activities involved in:
- Providing health care
- Providing personal care
- Providing social work
- Providing assistance with cash, bills and/or shopping
- Providing assistance in the conduct of personal affairs
- Conveying the person
There is a duty placed on regulated activity providers and personnel suppliers to make a DBS referral in circumstances where they have permanently removed a person from ‘activity’ through dismissal or permanent transfer (or would have if the person had not left, resigned, retired, or been made redundant); because the person has:
- Been cautioned or convicted for a relevant offence; or
- Engaged in relevant conduct in relation to children and/or vulnerable adults [i.e. an action or inaction (neglect) that has harmed a child or vulnerable adult or put them at risk of harm]; or
- Satisfied the Harm Test in relation to children and/or vulnerable adults [i.e. there has been no relevant conduct (i.e. no action or inaction) but a risk of harm to a child or vulnerable adult still exists.
It is also possible to make a referral where this legal duty has not been met. For example, where there are strong concerns, but the evidence is not sufficient to justify dismissing or removing the person from working with children or vulnerable adults. Such a referral would need to be compliant with relevant employment and data protection laws.
Where the need for a referral to the Disclosure and Barring Scheme (DBS) has been agreed with the organisation’s nominated safeguarding lead, confirmation should be provided to them that the action has been completed. As the responsible authority for adult safeguarding, the local authority has the power to make a referral where the ‘person in a position of trust’ is employed in another organisation and should do so where it is necessary to ensure an appropriate referral has been made.
The full up-to-date guidance and definitions must be referred to when deciding whether to make a Disclosure and Barring Service referral. For further information contact the Disclosure and Barring Service (DBS)
7 Minute Briefing: Disclosure and Barring Service (DBS) – Safeguarding Adults National Network
Appendix C – Case Examples
The case studies below are designed to help practitioners understand and navigate through the PIPOT guidance. The illustrations are not exhaustive and not intended to be a definitive response to a potential PIPOT situation – but are available to help the practitioner think about how to apply the process in different situations.
Case Example One
Mary is subject to child protection enquiries for the neglect of her six children who are all under 12 years of age. The level of child neglect is significant and includes severe malnutrition and failing to seek medical help when two of her children became ill. During the investigation Mary discloses that she is a support worker at a local residential home for adults with learning disabilities. She works four nights each week.
Children’s Social Services and the Police are the Information Holders. Both agencies consider whether they have a duty to make a disclosure to Mary’s employer.
- In the first instance they speak to the Mary about their concerns regarding her working with adults at risk and the current child protection investigation. Mary agrees to speak to her manager about the situation.
- A follow up call to the employer was made by the social worker and they confirmed that Mary had told her manager.
The manager shared with the social worker that Mary had worked at the care home for many years and that they had never had any concerns about her work with any of the residents. As a supportive action it was agreed that Mary could transfer from nights to working day shifts and that flexibility be given to her working hours when needed. Additionally, the Manager ensured that the mother never worked alone minimising any further risk.
Case Example Two
A Doctor is arrested for historical child sex offences. The Doctor is employed in an NHS hospital and is arrested by the Police for the alleged historical child sex offences. The doctor works with a range of adults in their role, some of whom will have needs for care and support. The Police consider the ‘adult position of trust’ issues and work alongside the PIPOT guidance.
The Police is the INFORMATION HOLDER and think through whether they have a duty to make a disclosure to the Doctor’s employer.
The Police decide they do need to disclose the information to the NHS Hospital Trust as the employer of the doctor.
- The Police inform the NHS Hospital Trust about the arrest of the Doctor for the alleged historical child sex offences and
- notify the Care Quality Commission as regulator and the Integrated Care Board (ICB) as the commissioner of the hospital trust.
The NHS Hospital Trust acts on the information and decides to suspend the Doctor immediately. Their disciplinary process is placed on hold while the Police investigation progresses.
Case Example Three
John has care and support needs and is a volunteer in a local charity shop serving customers and stock taking. Another volunteer called Lucy, who also has care and support needs, tells the manager that John keeps asking her to go on a date and won’t seem to take ‘No’ for an answer. The Manager of the charity shop is concerned because John started a relationship with another volunteer last year which did not end well with both being upset with each other.
The Charity / Charity Shop Manager is the INFORMATION HOLDER and has to think through whether John’s behaviour is a concern to female adults at risk working within the Charity shop.
- On reflection the Manager decided that this is not a PiPOT concern, and that John is a vulnerable young man who may have issues trying to form relationships with women.
- As a supportive measure the Manager decides to have an informal chat with John about making relationships and to help explain that when Lucy says ‘No’ to having a date with him she really does mean that and for him to stop continuing to pursue and harass her.
Case Example Four
The Police receive information that a local general practitioner had formed a relationship with a patient who had significant mental health issues. The woman alleged that despite her telling her GP that she wanted to end the relationship he has continued to visit her at home and to coerce her into having sexual intercourse. The Police checked with agencies working with the woman to ascertain that she did have care and support needs.
The Police is the INFORMATION HOLDER and think through whether they have a duty to make a disclosure to the Doctor’s employer.
The Police decide that this is a safeguarding matter and make a referral to the MASH and to investigate the case further.
- The MASH progressed the case to a Section 42 enquiry with the Police taking the lead with action to manage the potential risk to others.
- The Police notify the Care Quality Commission as regulator and the Integrated Care Board (ICB) about the allegations.
The General Practitioner was found to be having a coercive relationship with the adult at risk and was suspended from duties pending further investigations from the CQC.
Adult At Risk
Integrated Care Board
Local Authority Designated Officer
Multi-Agency Safeguarding Hub
National Health Service
Person in Position of Trust
Safeguarding Adult Partnership Board
Cambridgeshire and Peterborough Safeguarding Partnership Board – https://www.safeguardingcambspeterborough.org.uk/
- Multi-Agency Policy / Procedures – https://www.safeguardingcambspeterborough.org.uk/download/multi-agency-safeguarding-adult-procedures/
- Safeguarding Adults Partnership Board Training – https://www.safeguardingcambspeterborough.org.uk/home/multi-agency-safeguarding-training/
- Local Authority Designated Officer – LADO (children) – https://www.safeguardingcambspeterborough.org.uk/home/virtual-briefings-sways/what-is-the-lado/
 Relevant partners include NHS bodies, chief officer of the police, relevant provider of probation services, minister of the crown exercising functions in relation to prisons, or social security, employment or training.
 Universal care and support services will include those services available to all, such as leisure and housing services, preventative services, as well as services provided in relation to the care and support needs of adults.