People In A Position Of Trust

Please note: 

This LSAB Practice Guidance is also available as a PDF document to enable printing.  

  • People in positions of trust guidance (PDF, 350KB)
  • Referral Form_ People in a position of trust (Word, 130KB)
  • Work is currently being undertaken to enable the Referral Form to meet accessibility standards. If the form is not accessible to you, please make your referral by contacting Leeds City Council: Adults and Health on 0113 222 4401.


    LSAB Practice Guidance

    Contents

    1. Introduction

    2. Scope of this guidance

    3. Referrals / Pathways: People in positions of trust

    4. Responsibilities of employers / volunteer organisations and student bodies

    5. Guidance for the local authority

    5.1  Concerns about a person in a position of trust

    5.2 Working within the multi-agency safeguarding adults procedures

    6. Information sharing

    6.1 Consent & Involvement of a person in a postion of trust

    7. Working with the Local Authority Designated Officer (LADO)

    8. Record keeping

    9. Appendix A: Illustrative examples

    10. Appendix B: Information Sharing Recording Template

    11. Appendix C: Advisory note

    11.1 Managing risk, duties and considerations

    11.1.1 Circumstances involving CCG or primary care services 

    11.1.2 Disclosure and Barring Service (DBS)

    11.1.3 Resignations and 'Compromise/Settlement Agreements'

    11.1.4 Suspension and changes to working arrangements

    11.1.5 Disciplinary hearing processes and responsibilities

    11.1.6 Professional bodies


    1. Introduction

    Safeguarding Adults Boards are required to establish and agree a framework and process for organisations to respond to allegations against anyone who works with adults with care and support needs.

    Where a person is experiencing or is at risk of abuse the multi-agency policy procedures should be followed. The purpose of the multi-agency policy and procedures is to provide guidance for organisations to work together, and with one or more specific people at risk of abuse, to support them to be safe.

    The Care Act 2014 also recognises however, that safeguarding concerns are not always in relation to the safety and wellbeing of an individual, but rather they relate to the possible risk posed more widely by a person in a position of trust to people with care and support needs.

    In both cases this practice guidance will be relevant in supporting the work of all agencies to prevent abuse and neglect.

    Its purpose is to:

    • Explain the circumstances in which a referral can and should be made to Leeds City Council: Adults and Health in relation to concerns about a Person in a position of trust.
    • Advise employers/volunteer organisations and student bodies of their responsibilities as set out in the Care Act 2014, to assess potential risks posed by a person in a position of trust to those who use their services, and, if necessary, to take action to prevent abuse or neglect.

    • Provide guidance by which concerns about a person in a position of trust can be appropriately shared with an employer/volunteer organisation or student body to prevent abuse or neglect.

    This guidance is designed to inform and support the decision-making of Board member organisations and wider partner agencies once they become aware of a concern within the scope of this guidance.

    2. Scope of this guidance

    For the purposes of this guidance:

    A person in a position of trust is an employee, volunteer or student who works with adults with care and support needs. This work may be paid or unpaid.

    The nature of the concerns about a person in a position of trust or the risk they may pose to adults with care and support needs, may be varied and far ranging.

    Examples of such concerns however could include allegations that 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 needs
      (Care & Support Statutory Guidance, Section 14.123)

      Such incidents may have occurred within the person's home / personal life, as well as within their employment, volunteering role or studies. Wherever it has occurred however, there is now a potential risk to adults with care and support needs.

     3. Referrals / Pathways: People in positions of trust

    Safeguarding Adults Concerns:

    If you have concerns that a specific person with care and support needs is at risk or is experiencing abuse or neglect:

    • Follow the Leeds Multi-agency Safeguarding Adults Policy and Procedures
    • Report your concerns:  Click here for the Leeds City Council: Adults & Health webpage which explains how to do that. 

     

    People in Position of Trust Concerns:

    If you have a more general concern however, that there is a person in a position of trust that may pose a risk to adults with care and support needs; then follow this LSAB People in positions of trust guidance

    A person in a position of trust is an employee, volunteer or student who works with adults with care and support needs. This work may be paid or unpaid.

    Examples of such concerns could include allegations that 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 needs

    What you should do:

    If you are an organisation i.e. employer, volunteer manager, student body, of the person in a position of trust:  
    You must assess and manage risk as set out in this LSAB People in positions of trust guidance. If the person also works within another organisation, you will need to consider the need share information to protect people within that service.


    If you are not the person's employer, volunteer manager, student body; or

    If the concerns are in relation to a personal assistant, employed by a person with care and support needs, or

    If you need additional advice and support in relation to people in positions of trust concerns:

    Then report your concerns to Leeds City Council: Adults & Health.

    Complete the LSAB People in Positions of Trust Referral form (to be found at the top of this page) and email it to: leedsadults@leeds.gov.uk


    4. Responsibilities of employers / volunteer organisations and student bodies

    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[1], and those providing universal care and support services[2], 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

    5. Guidance for the local authority

    5.1  Concerns about a person in a position of trust

    If the local authority is given information about concerns that do not relate to the safety of identified adults with care and support needs but rather the potential risk posed by a person in position of trust, use of the multi-agency procedures will not usually be the appropriate way to respond to the concerns. 

     In these situations, this People in Positions of Trust guidance will need to be followed:

    Where the concern is raised by an employer, volunteer manager, student body:
    • The local authority may need to signpost agencies to this guidance, for them to take precautionary actions as appropriate in relation to identified risks
    • Employers, volunteer managers and student bodies would need to be responsible for taking actions within this guidance as set out in Section 4.
    • Employers, volunteer managers and student bodies that are raising concerns, will often be best placed to share information with another employer, volunteer manager or student body, if it is justified and necessary to do so as set out in Section 6. There may however be circumstances where the local authority is best placed, and so this decision will need to be made on a case-by-case basis.

    Where the concern is not raised by an employer, volunteer manager, student body:
    • The local authority will need to determine whether it is justified and necessary to share the concerns with an employer, volunteer manager or student body as set out in Section 6.

    • The local authority may need to signpost agencies to this guidance, for them to take precautionary actions as appropriate in relation to identified risks.

    • Employers, volunteer managers and student bodies would need to be responsible for taking actions within this guidance as set out in Section 4.

    Where the person in a position of trust is a personal assistant, employed by a person with care and support needs, the local authority may need to provide the employing individual additional support to understand and manage the risks effectively and to access appropriate support.

    5.2 Working within the multi-agency safeguarding adults procedures

    The multi-agency safeguarding adults policy and procedures will be the primary source of guidance for when it should be used. However, where a concern involving a person in a position of trust relates to the safety of an identified person or people with care and support needs, use of the multi-agency policy and procedures will usually be appropriate.

    In these situations:

    • This People in Positions of Trust practice guidance should be followed alongside the Multi-Agency Safeguarding Adults Policy and Procedures.
    • Employers, volunteer organisations and student bodies retain responsibility for actions as set out in Section 4 to prevent abuse or neglect within their setting.

    • If during the course of working within the multi-agency policy and procedures it is identified that the person in a position of trust may pose a risk in another setting, there will need to be consideration as to which agency is best placed to share information as may be required with other employers, volunteer managers or student bodies to prevent abuse or neglect (Section 6). This will need to be made on a case-by-case basis, taking into account the need to assess the risk and engage with the person in a position trust as set out in this guidance.

    6. Information sharing

    Where an organisation has information relating to the risk posed by a person in a position of trust, they have a responsibility to consider whether this information needs to be passed on to ensure risks are appropriately considered and managed.

    Each organisation is individually responsible for ensuring that concerns relating to a person in position of trust is shared, where necessary and appropriate, with other organisations to prevent abuse and neglect.

    The potential need to share information with an employer/volunteer organisation or student body will be indicated when there is reasonable cause to suspect that a person in a position of trust may pose a risk to adults with care and support needs within another service.

    This may include situations such as where:

    • a member of staff has been suspended pending a disciplinary or safeguarding enquiry, and who is known to be carrying out a similar role working within another organisation where they are assessed as potentially posing an immediate risk to others.
    • a member of staff has been dismissed due to their behaviour towards adults with care and support needs, and is also known to be undertaking professional training, for example, as a social worker or as a health professional.
    • an employee's role and responsibilities have been changed in response to dangerous practice, but they continue to have a similar role within another organisation, where they may pose a risk to people who use that service.

    Public bodies or organisations commissioned by them should be considered to be undertaking a public task as a lawful basis for sharing information. Other agencies not fulfilling public tasks should consider relying on legitimate interests as a lawful basis for sharing information. These terms are explained within the LSAB Information Sharing Policy.

    In both cases however, the judgement to be made is the same. In deciding whether sharing the information is justified and necessary, a professional judgement will be required based upon balancing the safety and needs of those potentially at risk, and the rights of the employee/volunteer or student as described below:

    • A fair balance must be struck between the rights of the person in a position of trust to privacy and the interests of those at risk of abuse and neglect.  This requires a careful assessment of the severity and consequences of the interference in the life of a person in a position of trust and the risk posed to others.

    • The risks to adults with care and support needs must be sufficient to justify interfering with the person in a position of trusts' right to privacy.  The consideration is therefore one of proportionality - there should be a need for the disclosure in order to protect adults with care and support needs.

    Ask yourself: Is the sharing of this information fair, i.e. is sharing this information something people would reasonably expect you to do in these circumstances?

    • If it is reasonably believed that the sharing of information will achieve the aim of preventing abuse or neglect, there should be no more interference in the person's right to privacy than is necessary to achieve this aim.

      Ask yourself: Am I only sharing information that is necessary to share? You should always ensure you share no more information than is necessary to achieve your purpose.

    It will be important to record your judgement, your reasons for sharing or not sharing the information, the factors you have considered, and why you have given weight to some factors more than others. The recording template in Appendix C, can be used where it is helpful, to support decision making and record decisions.

    6.1 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 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.

    Whilst it is important to work with the person in a position of trust and seek their agreement to share information wherever possible, consent however will not always be considered a lawful basis to share information in such situations.  Consent must be freely given, specific and informed and the imbalance of power in such situations may mean that it cannot always be relied upon. In such cases, decisions will need to be proportional to the concern as set out in Section 6 above. This does not preclude however in any way, the responsibility to consult with the person in the position of trust unless it is wholly impracticable to do so or may place someone at risk.

    7. Working with the Local Authority Designated Officer (LADO)

    If there is concern that a person in a position of trust may, in the course of their work pose a risk to a child or young person under the age of 18 years of age, then the local authority designated officer should be notified and actions taken within the LADO process.

    Sometimes however, the risk may relate to both children/young people and adults. In such cases there will be a need for organisations and safeguarding leads to consider their responsibilities under both this guidance and the LADO process.

    For more information about the LADO and referral information:  

    LADO One Minute Guide

    LSCP website: Managing-allegations against child care professionals


    8. Record keeping

    Recording of discussions, decisions and disclosures are essential and each organisation must ensure that it has a process for recording this information in accordance with their own policies and any legal requirements.

    9: Appendix A: Illustrative examples

    Applying the guidance as part of an organisation's management process

    Example 1:

    John and Mary have been married for many years and both work for the same supported living service in Leeds. Mary approaches the manager disclosing that she is experiencing domestic abuse at home and asks for the manager's help.

    Mary identifies that working together with her husband makes her situation worse and asks to be moved to a vacancy in the organisations other service. The manager talks to Mary about her situation and makes sure she is fully aware of support services for both of them in Leeds; and agrees to her request to move across to the other service from the end of the month.

    Now aware of the allegations of John's violent behaviour at home, the manager considers if there are any potential risks to tenants at work. John is a longstanding member of staff and the manager is aware that there have never been any concerns about his practice. Quite the opposite, he is considered by tenants to be supportive and helpful.

    Having explored Mary's concerns and allegations, the manager assesses that the alleged incidents at home relate to their particular personal circumstances and current difficulties. As such the manager assesses that there is a low risk of any such occurrence to tenants and decides that they do not need to make changes to the John's working arrangements.

    John also works part-time for another company in a very similar role. In that the manager has not assessed a risk within their work environment; she decides that it would not be justified and necessary to share this information with another employer.

     

    Example 2:

    Tina is the manager of a private leisure centre in Leeds.

    David joined the team three months ago, and support and supervises activities in the centre. There have already been several complaints from younger women who use the centre about sexually inappropriate comments, overly tactile and lewd behaviour that has made customers so uncomfortable they have complained.

    Despite being challenged about these, these behaviours have persisted. Tina is concerned about the lack of boundaries and awareness of the impact of his actions. Tina addresses these issues within their organisations disciplinary processes, and through this decides to end David's employment with them.

    Tina however is aware that David in recent weeks has taken on a second job working with younger women with a learning disability, which involves taking them out on activities on a one-to-one basis. Tina raises her concerns with David as to how he might relate to them. David declines any discussion and declines to speak to his other employer about these issues.

    Tina weighs up the potential risk to those women with learning disabilities, people who may not be able to speak up for themselves; and considers the potential impact on David of breaching his privacy.

    The private leisure centre is not a public body nor is it commissioned by one. However, the manager considers that it is in the legitimate interests of those residents to consider sharing the information.

    Upon weighing up the decision, Tina is so concerned that she decides it is justified and necessary to inform the manager of that service of their concerns so that they can assess any potential risk and take actions if needed.

    Tina contacts the manager of the learning disability service, who already has feedback from colleagues about suggestive comments towards female staff. They decides to seek advice from their HR manager about how to assess and manage potential risk in their service.


    Applying the guidance alongside the multi-agency safeguarding adults policy and procedures

    Example

    Emma is an older person with physical disabilities residing in a care home. Her daughter raises a safeguarding concern in relation to neglect. Adults Social Care ask the Care Home to look into the concerns raised.

    During the enquiry, the care home identifies evidence that a particular member of staff, Karen was turning off Emma's call alarm and not attending to her needs. This placed her at significant risk due to her epilepsy. A safeguarding plan is put in place to safeguard Emma; and the care home decide within their policies to hold a disciplinary hearing for Karen.

    During this process it is identified that this member of staff also works weekends for another care home that support people with similar needs. As part of their employee management process, the care home talk to Karen about the need to share the information with the other care provider.

    The care home can be considered to be carrying out a public task, as it is commissioned by a public body.  Having spoken to Karen and weighed up the potential risks to other residents and Karen's right to privacy, the care home manager assesses that on balance that it is justified and necessary to inform the other care home manager, so that they can assess the risk and take appropriate actions.

    Karen understands that this will happen but has asked to tell her employer herself. The care home manager explains that she will need to follow up with a call to confirm they have been informed.

    10. Appendix B: Information Sharing Recording Template

    Decisions to share information with a third party organisation will require a professional judgement. These considerations can however be used to support decision making. Consider and record:

    1. Name of person concerned:       

    2. Job title / outline of their role:

    3. Identified risks and concerns:

    4. What is the evidence for these concerns?  Is there reasonable cause to suspect there is a risk to others?

    5. What are the person in position of trusts views about the concerns?

    6. Changes to working arrangements required within your work context:

    7. May the person pose a risk to children in carrying out their role for you or another organisation? If so, liaise with the Local Authority Designated Officer?  What was their advice?

    8. Is there a risk to adults with care and support needs in other settings?                 

    a. Where else does the person work?

    b. What is the nature of the role? 

    c. What might the risks be for adults with care and support needs if the information is not shared?

    d. What might the impact be for the person in a position of trust of sharing the information?

    e. What are the views of the person in a position of trust?

    f. In your judgement, is it justified and necessary to share the information to protect adults with care and support needs?  Explain your reasons, and factors you have considered. 

    h. Did you decide to share the information? Record your reasons.  

    i. If the information was shared. When and how was this done?


    Your name:  

    Role/Title:         

    Organisation:                  

    Date:     


    11. Appendix C:  Advisory note

    11.1 Managing risk duties and considerations

    Each organisation will have in place policies and procedures in relation to employees, volunteers and students as appropriate and these will be the primary source of guidance. This advisory note should not be read as or used as a substitute for the organisation's own policies and procedures.

    Where organisations have specific Human Resource (HR) departments, they may need to be consulted to ensure practice is in accordance with organisational policies and procedures. However, to support managers in this area the following guidance has been produced to assist good decision making.

    11.1.1 Circumstances involving CCG or primary care services

    Safeguarding Children, Young People and Adults at Risk in the NHS: Safeguarding Accountability and Assurance Framework 2019

    This NHS assurance framework sets out specific expectations in circumstances involving members of staff in a CCG or primary care service:

    "Where there is an allegation that a member of staff in a CCG or primary care services has abused or neglected an adult in their personal life, the designated professional for safeguarding adults in the CCG should be informed" (Section 3.5.7)

    Such NHS services will need to ensure they have arrangements in place to work in accordance with the NHS Assurance Framework.

    11.1.2 Disclosure and Barring Service (DBS)

    On the 1st December 2012 the Criminal Records Bureau (CRB) and the Independent Safeguarding Authority (ISA) merged into the Disclosure and Barring Service (DBS). This means that these same services are now provided by a single organisation rather than two.

    The Disclosure and Barring Service 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 'regulated 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:

    1. Been cautioned or convicted for a relevant offence; or
    2. 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
    3. Satisfied the Harm Test in relation to children and/or vulnerable adults [e.g. 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.

    This is just an overview, the full official up to date guidance and definitions must be referred to when deciding whether to make a Disclosure and Barring Service referral, as guidance may change over time and it can be an offence to make a referral without good reason.

    For further information contact the Disclosure and Barring Service (DBS):

     11.1.3 Resignations and 'Compromise/Settlement Agreements'

    The fact that a person tenders his or her resignation, or ceases to provide their services, must not prevent an allegation of abuse being reported or addressed within the safeguarding adult procedures, disciplinary procedures or this guidance.

    It is important that every effort is made to reach a conclusion wherever there are allegations concerning the welfare of an adult at risk, including any in which the person concerned refuses to co-operate with the process.

    By the same token, so-called 'compromise/settlement agreements' – by which a person agrees to resign, the employer agrees not to pursue action, and both parties agree a form of words to be used in any future reference – must not be used in such cases. In any event it cannot override an employer's statutory duty to make a referral to the Disclosure and Barring Service where circumstances so require.

    11.1.4 Suspension and changes to working arrangements

    The possible risk of harm posed by an employee or volunteer to adults with care and support needs will need to be assessed and managed effectively, taking into account the nature and seriousness of any allegation, the particular circumstances and the risk of repeated incidents. In assessing the risk of harm it is important to recognise also the emotional or psychological distress of the patient/service user.

    In some cases the employer will need to consider suspending an employee. Suspension should not be viewed as a form of sanction. It is a neutral act and does not imply guilt. People must not be suspended automatically or without careful thought. Employers must consider carefully whether the circumstances of a case warrant a person being suspended until the concerns are resolved. If the person is suspended the employer should also make arrangements to keep the individual informed about developments in the workplace.

    Suspension may not be required where there are appropriate alternatives. This may sometimes include changes to working arrangements, such as not working with a particular patient/service user or working in a non-patient/service user contact role whilst the concerns are being investigated. The potential for alternative working arrangements will be determined by the nature of the organisation's structure and services.

     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 decision reached.

    11.1.5 Disciplinary hearing processes and responsibilities

    The need for and timing of a disciplinary hearing is a decision for the relevant employer and will depend on the specific circumstances of the situation.

    Disciplinary hearings will be focused on the conduct of the individual as an employee. Decisions reached should, however, also give due consideration to the organisation's responsibility to safeguard adults at risk.

    For these reasons, the disciplinary hearing process should:

    • reassure itself that it is acting proportionately to the risk of abuse occurring or reoccurring
    • understand the potential impact of disciplinary decisions on the adult at risk and other service users
    • assure itself that the person in a position of trust is safe to work with adults with care and support needs and where needed detail the measures required to provide this reassurance
    • consider the need to seek advice from their organisation's safeguarding adult lead in relation to the impact of their decisions on an adult at risk
    • understand and act upon responsibilities to refer individuals to professional regulatory bodies and make referrals to the Disclosure and Barring Scheme, where appropriate.

     11.1.6 Professional Bodies

    If the member of staff is registered with a professional body and there are concerns about their fitness to practice, the employer/volunteer/student body 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.

    The principal organisations within health and social care are:

    Each of these:

    • 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

    [1]  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.

    [2] 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.