Agenda item

Sandi Keene, Independent Chair, and Jacqui Scantlebury, Safeguarding Adult Board Manager, presented the Rotherham Safeguarding Adult Board's annual report 2017/18.

 

Attention was drawn to:-

 

-          The Board operated under the legal framework of the Care Act 2014 and was now a statutory Board.  When the Care Act was published there were a number of different emphasises in relation to Adult Safeguarding e.g. making safeguarding personal which focussed on working with individuals to achieve the outcomes they wanted from the process rather than necessarily following a very rigid set procedure with defined outcomes

 

-          The Board was still in development.  Throughout other local authorities and Boards there were different interpretations of thresholds.  The threshold in Adult Services was what would constitute a concern and what would constitute an inquiry

 

-          When the Care Act was published, Rotherham was starting its Safeguarding Adults work from a very low base in relation to the organisation of the Board and prioritisation of the work.

 

-          There had been considerable investment in time and commitment from the Council and partner agencies.  The Board sub-structure was heavily dependent, and benefitted from, the individual commitments from members of the Board from other agencies.  There had been very little performance information, but as a result of commitment from the Council that was being vastly improved

 

-          There was not a great deal of benchmarking information nationally to ascertain where the Board was although work was being undertaken in Yorkshire and the Humber to look at some of the comparative information around thresholds.

 

-          Work had taken place on the constitution of the Board, developing within South Yorkshire revision and revitalising any procedures that had been using in the past and some individual procedures that the Rotherham Board had created in terms of what it had felt was important 

 

-          Next year there was to be a joint Adult and Children’s single audit of agencies around Safeguarding

 

-          Rapid progress within the confines of restricted resources

 

Headlines of Report

-          The data needed to be understood from the point of view that in Adult Safeguarding there would be a number of people who were referred as a concern/inquiry and deemed to have met a threshold for people who were in residential nursing care as well as people who were in their own homes

 

-          Also operating within the context of people having a variety of capacity in order to respond to and to be safeguarded and operated within the Mental Capacity Act

 

-          The latest quarter’s information showed that the Board was dealing with 46% within residential and nursing care, 36% people in their own homes and others from other settings e.g. hospital, community hospital community services and acute hospital

 

-          The level of concern reporting had decreased in the last year where as the level of inquiry investigation had increased.  This needed to be understood and investigated further, however, it was felt that the decrease of concern was because of effective signposting at the front door when enquiries came in

 

-          Nationally there was still some movement around what was deemed “quality” and what was deemed “safeguarding”.  The Board was confident that it was not an outlier in these matters.  In as much benchmarking data was available, the Board was fairly confidently that the reduction in concerns combined with the increase in the proportion of investigations meant that it was getting some of the decision making right

 

-          The areas of abuse that were deemed to be increasing at quite a significant rate included physical abuse, psychological abuse and domestic abuse.  Domestic abuse figures are where it was deemed that the person affected was a vulnerable adult within the Care Act

 

-          The Board now had a quality assurance process and had been quality assuring case files.  A variation in standards had been found with the biggest issue being consistency of decision making.  However, it was not just the Local Authority that carried out investigations and inquiries; other bodies such as RDaSH and the Hospital now did their own inquiry investigations so further work was required to continue to be satisfied with regard to consistency

 

National issues

-          The LeDer Programme (Learning Disability Mortality Review Programme).  The Board was now required, and as a community, to refer any death of a person with learning disabilities to the national programme where they were found to have passed away at an earlier stage of their life.  There was an investigation of the circumstances to ensure the person’s death could not have been prevented.

 

-          Rotherham had referred some cases to the LeDer Programme but had not had any feedback as yet due to a backlog with the actual investigations and reporting.  There had been 2 cases locally that had given rise to concern but they were historical cases; there were no current cases in terms of the Programme

 

-          In common with other authorities there were very significant backlogs in terms of the work of assessing people's capability and capacity in terms of Deprivation of Liberty Standards.   Not all Deprivation of Liberty were Safeguarding issues but some were.  The Board was keeping a watching brief and requested regular updates

 

-          There were a small but rising number of self-neglect cases of vulnerable people not caring for themselves adequately for whatever reason.  Case management was very complex due to a number of difference reasons but excellent support had been received from RDaSH in how to handle, manage and support such individuals

 

Our priorities for the future

-          Continued building of the foundations

-          Get the procedures right

-          Improving public engagement

-          Raise the voice of the individual

-          Need to understand far more about consistency of practice and areas for development

-          Look at the prevention and early support offer across the Borough

-          Look to refresh the Board’s plan for development over the next 3 years (the Rotherham Safeguarding Adults Board Strategic Plan for 2019/21)

 

Questions

·           It was not felt that the increase in self-neglect was as a result of the  Mental Capacity Legislation but agencies were required to ask whether somebody had the capacity to make their own decisions and, even though some of the decisions may  not be wise decisions there may not be a legal base for intervention  That did not mean to say that authorities did not have a duty of care and one of the issues was the threshold.  The Board was working with RDaSH who were a national exemplar

 

·           With regard to the Learning Disability Mortality Review the person’s area of residence was the significant not their area of GP practice.  Many of the incidents were as a result of recognising medical problems and providing or ensuring there was sufficient medical assistance for people.  There was now a growing body of evidence of what to watch for but in the main ensuring people with a learning disability received the most appropriate medical support at the earliest possible opportunity

 

·           The Board had not been informed of the proposed changes to the Learning Disability Services.  However, within the Board’s priorities was to assure itself that people with Learning Disabilities were receiving an appropriate safeguarding response if and when required

 

·           There was no guidance on “oversights” and when they became a safeguarding issue.  An oversight would be deemed by any provider to be an initial quality issue.   Currently it was a matter of professional judgement within the overall boundaries and guidance that existed with regard to level of concern.  Currently the Board did not record repeat referrals and it may be something for the future in terms of monitoring.  If there was a referral 3 times as result of an oversight it would be referred elsewhere.  It would be something that the hospital would take up with the individual practitioners in terms of their response to an individual

 

·           The lead for human trafficking and modern day slavery was the Safer Rotherham Partnership with whom the Board were working very closely with.  The Board had received on the topic and, on behalf of the SRP, had conducted mystery shopping exercises into the first point of referral to test out people’s reactions.  At the end of last year the Board had increased its awareness of vulnerable adults coming under this umbrella from one to 3 so there was recognition that some of the individuals described had such a vulnerability and eligibility for services from the operational staff

 

·           In comparison to other local authorities, Rotherham had given a high degree of commitment to developing services for vulnerable adults who might not traditionally fit a box of somebody with learning disability/ mental health problems.  The Vulnerable Adults Team within the Local Authority, which had commitments from Adult Social Services, Housing Services and other services in the Borough, was well placed to be able pick up and support people who were identified in those situations with a degree of vulnerability

 

·           Due to it being operational, an answer could not be given with regard to catching up on of new assessments/reviews.  However, there was a dedicated team that carried out Safeguarding investigations and enquiries, as well as the Area Teams, who dealt with the highest profile and most urgent matters.  There was not an awareness from a Safeguarding perspective that there was a backlog in following through safeguarding enquiries

 

·           An assurance could not be given that the voice of the victim, particularly vulnerable adults, was being captured and being heard.  There had been less focus on victims of domestic abuse who had vulnerabilities than possibly Children’s.  The Board had not had a dedicated report other than a general report that they had been involved in the action planning and fully participated in.  There had no deep dive into interrogating the specific incidences for individuals as part of the Board’s performance monitoring as yet and would form the next level of its development.   So far the case file audits had been in relation to a cross-sectional perspective on individuals

 

·           Under the Care Act people who were undergoing inquiries as a result of safeguarding concerns, had a right to have an advocate.  The Board had undertaken some initial work to attempt to establish if individual had been offered an advocate although it was difficult to interrogate the data.  At present that data had been difficult to establish and achieve.  The Council was retendering the Advocacy Service and the Board assumed that the tendering process would monitor quality and the appropriate measures in terms of delivery of service.  It would be the interest of the Adult Safeguarding Board that the volume of activity was available to enable not just those who came under DoLS and the Mental Capacity Act, but anyone who was going through a safeguarding enquiry that they had somebody to support them to do so.  It was a live and current piece of work for the Board to establish that baseline; once established the Board would assure itself with regard to the quality of the offer

 

·           Due to its operational nature, an answer could not be provided with regard to the Vulnerable Care Leavers Risk Management Pathway

 

Sandie and Jackie were thanked for their presentation.

 

Resolved:-  (1)  That the Rotherham Safeguarding Adult Board Annual Report 2017/18 be noted.

 

(2)  That the Board give priority to ensure that people with learning disabilities were adequately safeguarded under the new arrangements.

 

(3)  That when the 2018-19 Annual Report was submitted that it also include the Rotherham Safeguarding Adults Board Strategic Plan for 2019/21.