Escalation procedure

Effective working together depends on an open and honest approach to relationships between agencies. Problem resolution is an integral part of professional co-operation in a multi-agency approach to safeguard adults.

Occasionally situations arise when workers within one agency feel that the actions, inaction or decisions of another agency do not adequately safeguard an adult. Such situations have been highlighted in a number of case reviews. This interagency policy defines the process for resolving such professional differences and should be read alongside the local adult safeguarding procedures and relevant internal policies on escalating matters in dispute.

Disagreements can arise in a number of areas, but are most likely to arise around:

• levels of need
• roles and responsibilities
• the need for action
• the progress of plans and communication.

Where professionals consider that the practice of other professionals is placing adult at risk of harm, they must be assertive, act swiftly and ensure that they challenge the relevant professionals in line with this policy.

• The safety of individual adult is the paramount consideration in any professional activity.
• Resolution should be sought within the shortest timescale possible to ensure the adult is protected.
• As a guide, professionals should attempt to resolve differences through discussion within one working week or a timescale that protects the adult from harm (whichever is shortest).
• Disagreements should be resolved at the earliest possible opportunity.

If an adult is thought to be at immediate harm, the designated safeguarding lead in your agency should be informed immediately.

Any worker who feels that a decision is not safe or is inappropriate should initially consult their supervisor/manager to clarify their thinking, if required. Those concerned should be able to evidence the nature and source of the concerns and must keep a record of all discussions.

Individuals may wish to refer to this policy for their organisation to clarify the approach required.

Concerns relating to decisions, suspected wrongdoing or dangers at work within an agency, should be raised in line with each agencies' policies for dealing with such matters, including but not limited to those setting out the arrangements for 'whistleblowing'.

It is important that practitioners feel empowered and supported within their agencies to challenge aspects of practice that they do not feel are in the best interests of the adult. When trying to resolve a difference of professional opinion or concern about practice practitioners should work within the following principles:

• The safety and wellbeing of the adult is paramount, and should they be considered to be at significant risk the Community Access Team should be contacted.
• Keeping the adult at the centre of all professional discussions.
• Ensuring that the right conversations are had with the right people at the right time, taking place face to face where possible.
• Challenges must be resolved in a timely manner.
• Concerns, actions, responses and outcomes must be recorded.

Difference of opinion or concerns about practice between practitioners and agencies can arise at any stage in the safeguarding process and between any of the agencies involved. This procedure is to ensure partner agencies have a quick and straightforward means of resolving any concerns, in order to safeguard the welfare of adults.

Effective working together depends on resolving different professional perspectives to the satisfaction of workers and agencies, and a belief in a genuine partnership and joint working to safeguard adults. Problem resolution is an integral part of professional cooperation and joint working to safeguard adults. Professional challenge can be positive, it demonstrates that professionals are willing to consider different perspectives and escalate matters that they do not feel will result in positive outcomes for the adult. It is only dysfunctional if not resolved in a constructive and timely fashion.

Stages of resolution

Stage one: Discuss with the other worker

Those individuals who are unable to reach an agreement should have a discussion to resolve the problem. This discussion must take place as soon as possible and could be a telephone conversation or a 'face to face' meeting. It should be recognised that differences in status and/or experience may affect the confidence of some workers to pursue this if they are not supported by their respective agency.

Stage two: Escalate to line manager

If the problem is not resolved, the worker should contact their immediate supervisor/manager within their own agency who should have a discussion with the equivalent supervisor/manager in the other agency.

If the case involves an adult who is already subject to an adult safeguarding plan, prior to any dispute, then this should be brought to the attention of the safeguarding lead with responsibility for that plan.

Stage three: Escalate to senior managers

If the problem cannot be resolved at Stage Two, then the supervisor/manager should report the situation to their respective manager or named/designated lead for safeguarding. These two managers must attempt to resolve the professional differences through discussion.

If the disagreement cannot be resolves at this stage, then the expectation is that escalation should continue through the appropriate tiers of management within each organisation until the matter is resolved. The respective agency members of the Cheshire West and Chester Local Safeguarding Adults Board (LSAB) should be engaged in seeking resolution before the case is ultimately raised with the Chair of the LSAB.

If either agency involved in the escalation does not have direct representation then this should be referred to the LSAB business unit, who will arrange proxy representation on the resolution panel.

Stage four: Resolution by the LSAB chair

If it has not been possible to resolve the professional differences between the agencies concerned (and after the LSAB agency members have been involved), the matter should then, as a very last resort, be referred by the agency concerned to the Chair of the LSAB, via the LSAB Board Manager. The chair may then either seek to resolve the issue directly with their relevant senior managers, or convene a Resolution Panel.

The agency raising the dispute must e-mail the details through to the LSAB Board Manager who will raise the matter with the chair at: LSAB@cheshirewestandchester.gov.uk

Any Resolution Panel must be compose of senior officers from three agencies who are members of the LSAB. The senior officers should, as far as practicable, include the agencies engaged in the escalation process.

The Panel will receive representations from those involved in the dispute and will collectively resolve the professional differences concerned, by the application of relevant legislation, policy and best practice. The welfare of the individual and their views will be the primary concern, in line with the principles of Making Safeguarding Personal.

Additional notes

At all stages of the process, actions and decisions must be recorded in writing within the adult's records and shared with relevant personnel, which should include the worker who raised the initial concern.

At all steps of the process decisions should be taken in a timely way and shared with the relevant professional who is involved with the service user(s).

Details of the disagreement, the decisions taken, and the outcomes must be recorded on the Adult's file.

Senior managers should ensure there is a system in place within agencies to evidence and report on all escalations at steps two - four.

Step one (day 1) - take action within 24 hours of concern arising

When concern regarding practice or decision-making by a professional/agency arises initial attempts should be made between workers to resolve the issue. If resolution cannot be achieved professionals must escalate to the safeguarding lead and/or team manager in their organisation.

Step two (no later than day 3, to be concluded by day 9)

The line manager/safeguarding lead should discuss the concerns/response with their opposite manager in the other agency. If resolution cannot be achieved professionals must notify their senior managers.

Step three (no later than day 9, to be concluded no later than day 14)

The senior manager will escalate to the LSAB Board Representative who will arrange a meeting to seek resolution. If agreement cannot be achieved the matter should be brought to the attention of the LSAB Board Manager who will refer the matter to the LSAB Chair.

Step four (no later than day 16, to be concluded by day 21)

The LSAB Chair will seek written representation, and may request a meeting with those involved. The LSAB Chair will make a recommendation on the most appropriate way to proceed and communicate this within five days of notification.