CQC Quality Statement
Theme 4 – Leadership: Governance, management and sustainability
We statement
Lancashire County Council has clear responsibilities, roles, systems of accountability and good governance. We use these to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes and we share this securely with others when appropriate.
CONTENTS
1. Introduction
This policy statement sets out the statutory duties placed upon Lancashire County Council in relation to maintaining, securing and sharing records and other information whenever a complaint or allegation of abuse is made.
2. Policy Aim
The policy aims to ensure a consistent and responsible approach to information sharing. It should be read alongside the Lancashire County Council Adult Safeguarding Policy.
3. Principles
3.1 Information sharing principles
When sharing information with other practitioners and organisations, applying the following principles will help to ensure that all information which is shared is:
Necessary and proportionate: When taking decisions about what information to share, you should consider how much information you need to release. Data protection legislation (including the Data Protection Act and UK General Data Protection Regulations / UK GDPR) requires you to consider the impact of disclosing information on the information subject and any third parties. Any information shared must be proportionate to the need and level of risk.
Relevant: Only information that is relevant to the purposes should be shared with those who need it. This allows others to do their job effectively and make sound decisions.
Adequate: Information should be adequate for its purpose. Information should be of the right quality to ensure that it can be understood and relied upon.
Accurate: Information should be accurate and up to date and should clearly distinguish between fact and opinion. If the information is historical then this should be explained.
Timely: Information should be shared in a timely fashion to reduce the risk of harm. Timeliness is key in emergency situations and it may not be appropriate to seek consent for information sharing if it could cause delays and therefore harm to an adult or child. Practitioners should ensure that sufficient information is shared, as well as consider the urgency with which to share it.
Secure: Information should be shared in an appropriate, secure way. Practitioners must always follow their own organisation’s policy on security for handling personal information.
Record: Information sharing decisions should be recorded whether or not the decision is taken to share. If the decision is to share, reasons should be cited including what information has been shared and with whom, in line with organisational procedures. If the decision is not to share, it is good practice to record the reasons for this decision and discuss them with the requester.
3.2 Principles of Confidentiality
- Information will only be shared on a ‘need to know’ basis when it is in the interests of the adult.
- Confidentiality must not be confused with secrecy.
- Informed consent should be obtained but, if this is not possible and other adults are at risk of abuse or neglect, it may be necessary to override the requirement.
- It is inappropriate for agencies to give assurances of absolute confidentiality in cases where there are concerns about abuse, particularly in those situations when other adults may be at risk.
4. The Legal Framework
4.1 Record keeping
Good record keeping is a vital component of professional safeguarding practice. Whenever a complaint or allegation of abuse is made, Lancashire County Council should keep clear and accurate records. After receiving a complaint or allegation of abuse, staff must follow defined procedures for incorporating all relevant records into a file in order to document all action taken. In many situations, abuse and neglect arise from a range of incidents over time so good record keeping will help managers to look for past incidents, concerns, risks and patterns whenever instances of alleged abuse or neglect are raised.
In the case of providers registered with the Care Quality Commission (CQC), records of alleged abuse or neglect should be available so Lancashire County Council can take appropriate action.
Good record keeping is also essential in helping Lancashire County Council to assemble records for local, regional and national data collection and reports, including statutory data collection programmes administered by central government departments and regulatory agencies.
Similarly, good record keeping – consistent with principles such as fairness and confidentiality and the laws on data protection – enables information to be made available to adults affected by, and subject to, a safeguarding enquiry. If the alleged abuser is using care and support services themselves, information about their involvement in an adult safeguarding enquiry, including the outcome of the enquiry, should be included in their case record. If it is assessed that the individual continues to pose a threat to other people, then this should be included in any information that is passed on to service providers or other people who need to know.
4.2 Sharing information with Lancashire Safeguarding Adults Board
In order to carry out its functions, the Lancashire Safeguarding Adults Board (LSAB) needs access to information that a number of different organisations may hold. Some will be LSAB members, like the NHS and the police, while others will not be members, such as private health, care, education, housing or other support providers.
In the past, there have been instances where the withholding of information has prevented organisations being fully able to understand what went wrong and so has hindered them identifying, to the best of their ability, the lessons that could help prevent or reduce the risks of such cases occurring in the future. If Lancashire County Council employees have concerns that an adult or child is being abused or neglected, they must take appropriate action.
The LSAB may request a person to supply information to it or to another person. The Care Act 2014 specifies that the person who receives the request must provide the information to the LASB if:
- The request is made in order to enable or assist the LSAB to do its job.
- The request is made of a person who is likely to have relevant information and then either:
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- the information requested relates to the person to whom the request is made and their functions or activities.
- the information requested has already been supplied to another person subject to an LSAB request for information.
4.3 Confidentiality
Confidential information includes all data collected for the provision of health and social care services where individuals can be identified and would expect that it will be kept private. This may include for instance details about symptoms, diagnosis, treatment, names and addresses.
Agencies should draw up a common agreement relating to confidentiality and setting out the principles governing the sharing of information, based on the welfare of the adult or of other potentially affected adults.
Any agreement should be consistent with the Caldicott Principles ensuring that:
- information will only be shared on a ‘need to know’ basis when it is in the interests of the adult.
- confidentiality must not be confused with secrecy.
- informed consent should be obtained but, if this is not possible and other adults are at risk of abuse or neglect, it may be necessary to override the requirement. and
- it is inappropriate for agencies to give assurances of absolute confidentiality in cases where there are concerns about abuse, particularly in those situations when other adults may be at risk.
Where an adult has not given consent to information being disclosed for these purposes, then practitioners must consider whether there is an overriding public interest that would justify information sharing (for example because there is a risk that others are at risk of serious harm). In many cases, the public interest arguments will be clear, and practitioners should feel confident to share. Sometimes, however, the decision can be more difficult, and staff should seek advice from their manager, the Information Governance Team, or the Caldicott Guardian.
Decisions about who needs to know and what needs to be known should be taken on a case by case basis, within Lancashire County Council policies and the constraints of the legal framework.
The duty to share information for individual care is as important as the duty to protect patient confidentiality. Health and social care professionals should feel able to share confidential information in the best interests of patients / adults, within the framework set out in the Caldicott Principles.
Principles of confidentiality designed to safeguard and promote the interests of an adult should not be confused with those designed to protect the management interests of an organisation. These have a legitimate role, but must never be allowed to conflict with the welfare of an adult. If it appears to an employee or person in a similar role that such confidentiality rules may be operating against the interests of the adult, then a duty arises to make full disclosure in the public interest.
Where it is necessary to exchange or disclose personal information, this will need to be in accordance with the law on confidentiality and the Data Protection Act 2018.
5. Seven Golden Rules for Sharing Information
- Remember that data protection legislation is not a barrier to justified information sharing but provides a framework to ensure that personal information about living individuals is shared appropriately.
- Lancashire County Council will be open and honest with the individual (and/or their family where appropriate) from the outset about why, what, how and with whom information will, or could be shared, and seek their agreement, unless it is unsafe or inappropriate to do so.
- Staff should seek advice from other practitioners or line managers if they are in any doubt about sharing the information concerned; they should do this without disclosing the identity of the individual where possible.
- Where possible Lancashire County Council will share information with consent, and respect the wishes of those who do not consent to having their information shared. Under the UK GDPR and Data Protection Act 2018, information can be shared without consent if, in the judgement of staff, there is a lawful basis to do so, such as where safety may be at risk. The judgement will need to be based on the facts of the case. When sharing or requesting personal information Lancashire County Council will be clear of the basis upon which it is doing so.
- Lancashire County Council will consider safety and wellbeing, and base information sharing decisions on considerations of the safety and well-being of the individual and others who may be affected by their actions.
- Lancashire County Council will ensure that information which is shared is necessary for the purpose for which it is shared, that it is shared only with those individuals who need to have it, that it is accurate and up-to-date, is shared in a timely fashion, and is shared securely.
- Lancashire County Council will keep a record of all decisions and the reasons for then – whether it is to share information or not. If information is shared, the record will state what has been shared, with whom and for what purpose.
When asked to share information, Lancashire County Council will consider the following questions to help make a decision about if and when to share. If the decision is taken to share, staff should consider how best to effectively and securely share the information.
6.1 When
Q1. Is there a clear and legitimate purpose for sharing information? This includes taking action in relation to safeguarding children and adults.
- Yes – see Q.2
- No – do not share
Q.2 Does the information enable an individual to be identified?
- Yes – see Q.3
- No – you can share but should consider how
Q.3 Is the information confidential?
- Yes – see Q.4
- No – you can share but should consider how
Q.4 Do you have consent?
- Yes – you can share but should consider how
- No – see Q.5
Q.5 Is there another reason to share information such as to fulfil a public function or to protect the vital interests of the information subject?
- Yes – you can share but should consider how
- No – do not share.
6.2 How
- Identify how much information to share
- Distinguish fact from opinion
- Ensure that you are giving the right information to the right individual
- Ensure that you are sharing the information securely.
Lancashire County Council will inform the individual that the information has been shared if they were not aware of this, as long as this would not create or increase risk of harm.
All information sharing decisions and reasons must be recorded in line with Lancashire County Council procedures.
7. Further Reading
7.1 Relevant chapters
7.2 Relevant information
Care and Support Statutory Guidance
Professional Standards (Social Work England)
