Consultation on guidance on the involvement of GPs in multi-agency adult protection arrangements

Annex A: Adult Support and Protection (Scotland) Act 2007: Overview

GPs are well placed to identify adults at risk and are a vital component in the multi-agency arrangements that exist to provide support and protection where it is necessary. GPs must make themselves aware of the 2007 Act and its implications for them. The Act places a duty on councils to make inquiries where they know or believe that an individual may be an adult at risk. Other public bodies and office holders have a duty to inform councils of situations where an individual may be an adult at risk.

The 2007 Act has a rights-based approach and has an overarching principle which demands that any intervention provides a benefit to the adult that would not be possible otherwise and is the option least restrictive to the adult's freedom. Any action to support and protect is always balanced with the rights of individuals to live their lives as they wish.

Definition of Adult at Risk

The 2007 Act defines adults at risk as individuals, aged 16 years or over, who:

• are unable to safeguard their own well-being, property, rights or other interests;
• are at risk of harm; and
• because they are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected

All three elements of this definition must be met for an adult to be regarded as an adult at risk of harm. This is commonly referred to as the 'three point test'. So, for example, an adult is not necessarily an adult at risk of harm simply because they have a disability.

It is the responsibility of the council to decide whether or not an adult meets the definition of an adult at risk. Where someone is suspected of being an adult at risk, a referral should be made to the council.

Definition of harm

The 2007 Act defines harm broadly as 'all harmful conduct'. The Act specifically highlights the following types of harm:

• physical
• psychological/emotional
• sexual
• neglect
• financial or material

However, all kinds of harm fall within the scope of the 2007 Act.

Council responsibilities

The 2007 Act places a duty on councils to make the necessary inquiries and investigations where they know, or believe, that an adult is, or may be, at risk of harm and may need to intervene to safeguard the adult's well-being, property or financial affairs. It is the council who is responsible for deciding whether an individual is an adult at risk of harm and what further action, if any, is necessary. However, this decision should be arrived at on a multi-agency basis wherever possible. In order to make inquiries, council officers have powers to:

• carry out visits
• conduct interviews
• require health, financial or other records to be produced in respect of an adult at risk (see paragraph 64 of the guidance).
• nominate a health professional (e.g. a doctor or nurse) to carry out a medical examination (see paragraph 51)

In addition, the 2007 Act creates a suite of protection orders which can be used to:

• remove adults from certain places for defined periods of time, both to assess whether they are adults at risk, as defined by the 2007 Act, and to remove them from exposure to harm
• ban those who cause harm from being in certain places

Protection orders are the most formal and far-reaching options possible through the 2007 Act. In line with the least restrictive principle which underpins the Act, they should be considered only where they are absolutely necessary. Depending on the circumstances, less restrictive, support-based interventions may provide an effective and proportionate response, for example the use of care packages.