Agenda item

The Worcestershire Safeguarding Adults Board (WSAB) Independent Chair, Kathy McAteer and the Board's Manager, Bridget Brickley had been invited to provide an overview of the WSAB's role and the Annual Report 2016/17.

 

The Council's Assistant Director of Adult Services was also present.

 

The Independent Chair highlighted the key messages from the presentation which had been included in the agenda papers, and focused on the WSAB's work this year and what it revealed about safeguarding.

 

Although WSAB had existed for many years, this was only the Board's second year as a statutory body and many changes had been needed in terms of its functionality. The statutory requirements for safeguarding boards were set out in the Care Act 2014, section 42.

 

The Board's role was to protect adults in its area who:

·         had needs for care and support (whether or not the local authority is meeting any of those needs) and;

·         were experiencing, or at risk of, abuse or neglect; and

·         as a result of those care and support needs were unable to protect themselves from either the risk of, or the experience of abuse or neglect

 

Other organisations may also look at issues affecting adults more broadly, for example Trading Standards could look at doorstep scams affecting older people.

 

The key priorities for 2016/17 had been to:

·         improve communications with public and partners – development of an website and app had been the main focus of work which was due to be completed by the end of the year. It was best practice to have an independent website, rather than the current arrangement of a webpage linked to the Council's website. The first shared learning event had also taken place

·         check Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) were understood and properly used – progress had been made although this area continued to be a significant risk

·         improve how WSAB listened to adults with care and support needs – it was hoped to establish a reference group by the end of the year

·         build on work with other boards (Worcestershire Safeguarding Children's Board, Health and Wellbeing Board, Community safety Partnerships). The new website would combine adults and children's safeguarding

·         work with partners to identify risks for adults – this had been a huge area of work to introduce a regular flow and analysis of safeguarding data for the WSAB, which was proving very useful 

·         continue to improve community awareness and approve a Prevention Strategy

·         complete work from year 1

 

A lot of work had been put into the ambitious priorities, to get the foundations in place. Overall good progress had been made, with some slippage, for example as a result of changes in partner representatives which affected momentum, and also the WSAB team's administrative resources were very small.

 

Five Safeguarding Adults Reviews were started during 2016/17, of which one was published and four carried over. Mental capacity continued to be the main theme, with some evidence of inconsistent practice in its assessment, which had fed into the WSAB's 2017/18 priorities. The number of reviews and the lessons learnt were in line with other Boards. All reviews had action plans with target dates for completion, which were monitored by the WSAB's Performance and Quality Assurance Group.

 

Safeguarding data was collected every quarter, where possible using organisations' existing reports.

 

Looking at activity trends, anyone could raise a concern. Slightly fewer concerns had been raised than in the previous year (2342 compared to 2653), with 15% meeting the threshold for a full investigation, a slight improvement on the previous year. The national benchmark was 25%.

 

Awareness about inappropriate referrals was being addressed; sometimes a referral was more about quality of care which may be better dealt with through other means.

 

Types of abuse were in line with the national picture. Concerns about women outnumbered men in all age groups, though less so in the 65-74 age group, with older women most at risk, which reflected Worcestershire's demography. Reporting patterns continued to indicate under-reporting in black and ethnic minority (BME) groups and engagement work was ongoing.

 

The new approach was to ask people what outcomes they wanted from a Section 42 case and the second year of this approach showed an improvement, which was reassuring.

 

Looking forward to 2017/18, the number of priorities had been reduced to four, to enable a focus on definitions of Section 42 and enabling other concerns to be directed in the appropriate direction.

 

Main discussion points

 

·         Interpretation of the threshold for Section 42 had been debated nationally and Worcestershire's interpretation was not out of line with other areas.

·         The sub-group structure was clarified; each was set up around three strategic objectives and had a Board member as sponsor. Each sub-group set action plans and produced quarterly reports, had a Chair, Vice-Chair and sub-group members. Sub-groups were involved in planning and prioritising the Board's business plan for the year.

·         The Panel requested details of current Board and sub-group membership (names and organisations) and the sub-groups' terms of reference – these were not published on the website because of capacity issues in keeping the information updated. Newsletters were available on the website.

·         Board minutes were not published because of the amount of confidential information, however a newsletter had been introduced and this could be circulated to Panel members if they wished.

·         Board membership had been reviewed over recent years and the Care Act set out a list of appropriate members. Capacity was a factor – housing was now represented by Nina Warrington of the Worcestershire Housing Strategic Group, but this had taken time to secure.

·         The Board manager met quarterly with district councils to discuss safeguarding issues.

·         Panel members suggested that district councils' recent reports on homelessness would be of interest to the Board.

·         This year Board members' attendance at meetings had started to be recorded and would be published.

·         Board membership did not include anyone from BME communities, however the Board was very mindful of the county's diversity. One problem was a lack of multi-faith forums and the fact that community representatives were often male meant that a more informal way of engagement was needed. For cultural reasons, BME communities tended to looked after their own family members and did not know how to access services.

·         Panel members pointed out that councillors could help build links with community groups, for example with women's groups at mosques.

·         The prison sector was not represented on the Board, as Hewell Grange prison felt an established link was more appropriate – this was in line with other areas.

·         Monitoring of Deprivation of liberty safeguards (DoLS) in care homes was raised and the Assistant Director of Adult Services advised that monitoring took place by the Council, Care Quality Commission and the Clinical Commissioning Groups.

·         Public awareness about Power of Attorney was raised, and the Panel was advised that social workers asked about this as part of initial assessments, although it needed to be the decision of the individuals involved. The Council's website included information.

·         Professional curiosity was important, since serious case reviews often revealed that not enough questions had been asked.

·         Resources were an issue, and the Board had adopted a project management approach in order to target work where it was most needed. Other actions included using virtual networks to cascade information to partners, clarifying governance and roles, and also working with other agencies and the voluntary sector to identify additional capacity.

·         Support for the Board had been boosted by the addition of a part-time Board Manager and an administrative role.

·         Any concerns were shared across the Board's sub-groups and individuals; it was not just a matter of collecting data.  

 

Comments were invited from the representatives present from other organisations present.

 

John Taylor from Healthwatch Worcestershire queried the fact that 519 concerns were recorded from an unclassified source and the Board Manager would check this operational query with the County Council, which may be a data error.

 

Regarding concerns about the potential for people to "fall through the gaps", the Board Manager found that the Board's links to service user and carer representatives worked very well.

 

Sandra Hill from Speakeasy N.O.W agreed that an informal, conversation approach was often the most informative. She would welcome inclusion of her organisation on the Board and be happy to attend meetings – it was confirmed that links were being developed with Speakeasy NOW and also Onside (which provided independent advocacy).

 

It was agreed that the discussion had been mutually helpful. The Panel requested some further information and would then consider whether any further work was needed.

 

The following actions  were agreed:

·         details to be forwarded on current Board and sub-group membership (names and organisations) and the sub-groups' terms of reference

·         business objectives for the year to be forwarded and sign-up link to newsletters

·         the Panel would be interested in receiving more information about learning briefs and events

·         consider a session on care home monitoring for the Panel's work plan

 

The Panel agreed the following comments be forwarded to the Cabinet Member for Adult Services:

·         More public information on power of attorney would be helpful; there was some information on the Council's website but several members felt there was a lack of general awareness.

·         It was concerning that the work of the Safeguarding Adults Board was affected by lack of capacity.

·         A nominal budget for training should be provided for the Safeguarding Adults Board.