Large Scale Investigations

Care home G was an independent care home in North Lanarkshire registered to care for up to eighty adult residents with mental health problems, associated disabilities and health issues. An LSI commenced for care home G following an escalation of multi-agency concerns.

The guidance aims to provide a framework that can be used across Scotland, with a view to improving the quality and efficacy of Large Scale Investigations (LSIs). The guidance also aims to achieve greater consistency across Scotland in how LSIs are commenced, conducted, concluded and reported on. The guidance supports using LSIs as a planned and structured intervention wherever possible, while recognising that LSIs will also need to be flexible and respond to changing circumstances.

This review was commissioned by the Highland Adult Protection Committee (APC) in August 2021. It relates to the care and protection arrangements for three brothers, Hugh, David and Roderick McCulloch.

Themes and learning points in this review include:

* the existence of a Power of Attorney in an ASP investigation

* financial harm

* participation of family members in an ASP investigation

* use of Large Scale Investigation to investigate a perpetrator in the community.

This paper surveys the data, research, and sector knowledge on Large Scale Investigations. It includes reflections on complex issues such as thresholds, information sharing, and the difference between 'poor care' and 'harm'.

This paper and its findings helped contribute to the establishment of the Adult Support and Protection national Large Scale Investigation framework.

Duty of candour is a professional responsibility to be honest with people. It means being open and transparent in health and social care support. It also means that services must say sorry when things go wrong. The Duty of Candour Procedure (Scotland) Regulations 2018 came into force on 1 April 2018. These regulations apply when there is an event which causes unintended, or unexpected, harm to an individual receiving a health or care service.

The national Large Scale Investigation (LSI) framework offers a set of processes and principles helpful to those conducting and/or participating in LSIs. To help think through how these processes and principles can be realised, the framework also contains hallmarks of good practice. It complements the Adult Support and Protection (Scotland) Act 2007 Code of Practice, building on good practice happening around Scotland.

This pack is for staff and volunteers working within care home settings. It contributes to a unified approach to addressing Adult Support and Protection concerns. At its heart is improving the lives of residents in care home settings, and responding to residents' changing needs. Issues covered include the legislative context; Large Scale Investigations; spotting harm, abuse or neglect; and raising concerns.