Safeguarding Adults Lead Network 28th July 2016

Workshop Outline Care Act 2014 – key messages Local multi-agency safeguarding adults arrangements Local developments Safeguarding Adult Lead Role Tools and guidance available HSAB Website Engaging Hampshire Communities resources Networking with other SALs

Programme 9.00 am Arrival and registration 9.15 am Care Act (2014) and safeguarding 10.10 am SAL role and responsibilities 10.40 am Break and networking 11.00 am Guidance and tools available 11.30 am Engaging Hampshire Communities 12.30 am Q & A 12.45 pm Finish

Key messages from the Care Act 2014

Terminology Introduces new definitions and terminology to describe adult safeguarding: Focus on a person’s well-being, safety and their right to live a life free from abuse or neglect. ‘Adult with needs of care and support’ replaces ‘vulnerable adult’ ‘Abuse and neglect’ placed in the context of harm caused and its impact on wellbeing, quality of life and safety Focus on actions needed to mitigate or manage risks to protect from further harm. Positive concepts replace negative attitudes e.g. human rights, autonomy, choice, control, empowerment instead of “susceptible, weak, dependent, defenceless, helpless, in danger, exposed, powerlessness, etc.”

Safeguarding in the Care Act Creates a new legal framework for how local authorities and other parts of the system need to work together to safeguard adults at risk of abuse or neglect. Chapter 14 of the Care Act statutory guidance replaces ‘No Secrets’ (2000). Establishes safeguarding as one of the core functions of care and support - helping people achieve the outcomes that matter to them in their life. The local authority must focus on the needs and goals of the person concerned and promote their wellbeing when exercising any of its care and support functions. Statutory guidance published in October 2014 – revised March 2016

Statutory Safeguarding Framework Have a multi-agency adult safeguarding system aimed at preventing abuse and neglect and stopping it quickly when it happens Set up a Safeguarding Adults Board and publish a safeguarding strategy and annual reports Carry out Safeguarding Adults Reviews when someone with needs dies as a result of neglect or abuse and there is a concern that local services could have done more to protect them Make enquiries, or request others to make them when an adult with care and support needs may be at risk of abuse or neglect to find out what action may be needed Share information arising from safeguarding enquiries and SARs Arrange for an independent advocate to represent and support a person who is the subject of a safeguarding enquiry, if required.

New definition for safeguarding When the local authority believes that an adult in its area: has needs for care and support (whether or not the authority is actually meeting any of those needs), is experiencing, or is at risk of, abuse or neglect, and as a result of those needs is unable to protect himself or herself against the abuse or neglect it must make (or cause to be made) whatever enquiries are necessary to enable it to decide whether any action should be taken in the case and, if so, what and by whom

Participation in work, education, training or recreation The definition of care and support needs is based on a person’s ability to achieve key outcomes in their daily life: Participation in work, education, training or recreation Social and economic wellbeing Personal dignity including respect Domestic, family and personal relationships Physical and mental health and emotional wellbeing Suitability of living accommodation. Protection from abuse and neglect National eligibility thresholds for adults with care and support needs consists of 3 criteria, all of which must be met for a person’s needs to be ‘eligible’ Control by the person over day-to-day life and care and support provided .

Safeguarding enquiries (s42) Purpose is to establish with the individual what (if any) action is needed re the situation and to establish who should take such action. Option to cause enquiries to be made – e.g. where the adult already has a relationship with another professional or the enquiry relates to a particular area of expertise. Local authority retains responsibility and accountability where it has ‘caused enquiries to be made’ - duty remains until all necessary action has been taken to resolve the risks. The local authority MUST arrange for an independent advocate to represent and support a person if the person would have ‘substantial difficulty’ to understand and take part

Wrap around themes

Prevention and wellbeing The care and support system must actively promote wellbeing and independence, and not just wait to respond when people reach a crisis point. The ‘system’ needs to intervene early to support the individual. Help to retain or regain skills and confidence in order to prevent or delay deterioration in needs wherever possible. This approach applies equally to adult safeguarding

Safeguarding is everyone’s responsibility All organisations have key roles and responsibilities in carrying out the work to safeguard adults at risk as part of ‘business as usual’. Support based on empowerment – reinforcing principles of choice, self-determination and autonomy. A balanced approach supporting a person’s right to make choices and be independent – information and advice to help people to consider and weigh up options. The most proportionate and least intrusive safeguarding responses based on wishes of the adult and level of presenting risk

Making Safeguarding Personal Response focuses on improving the person’s wellbeing, quality of life and safety. Approach enhances involvement, choice and control. Asking about and working towards, the outcomes the person wants – response defined by the wishes and views of the adult. Recognising people as experts in their own lives and working alongside them to enable them to resolve issues and support their recovery. Information and advice to enable the person to make informed decisions Providing access to independent advocacy Decisions relating to people assessed as lacking capacity are in their best interests.

Safeguarding process – underpinning principles OUTCOME FOCUSED rather than procedurally driven - service user’s wishes an outcomes sought discussed at the beginning, middle and end of the process INCLUSIVE approach with MSP and user participation built into each stage. PROPORTIONATE response with concerns dealt with at the lowest level possible by the most appropriate organisation appropriate to the level of risk and wishes of the service user STRUCTURED with meetings at the beginning, middle and end but re-designed to enable service users to take part. Flexible and can adapt to the service user’s needs and wishes.

Safeguarding process – underpinning principles TIMELY operating to defined timescales – important to prevent drift and to provide accountability. Variations may be needed to provide a more flexible approach for the adult but these must be recorded. FLEXIBILITY with ‘Pause and Review and Exit Points at key stages to enable the process to stop before ‘the end’ to ensure proportionality. EFFECTIVE risk management process which engages the adult and relevant partners in the response. FORMATIVE process in which the safeguarding support plan starts to be developed within 24 hours and is reviewed and revised at each stage.

‘Safeguarding System’ Local Multi-Agency Safeguarding policy, s42 safeguarding enquiries and allegations management Care Act 2014 Chapter 14 (replaces ‘No Secrets’). Legal framework adult safeguarding. Responsibilities apply to LAs, Police and NHS. Six statutory safeguarding principles Support based on capacity, consent, self determination, person centred approach, MSP, advocacy Criminal justice (criminal investigation, prosecution, probation, MAPPA) Prevention and early intervention, information and advice, shared risk management ‘Safeguarding System’ Community safety (trading standards, ASB, hate crime, fire safety, domestic abuse, trafficking, HBV) and civil remedies Commissioning for better outcomes, contract and quality monitoring, improvement, regulatory action, enforcement

Adult abuse and neglect – the extent of the problem?

Prevalence of adult abuse Annual findings from the national safeguarding adults monitoring report published in Oct 2015. Source of risk was most commonly someone known to the adult at risk but not in a social care capacity (50%) In 2014/15 103,900 safeguarding referrals were opened and of these: Social Care support was the source of risk in 36% of referrals 60% were female In the remaining 14% of cases the source was someone unknown to the individual. 63% per cent were aged 65 or over. Location of risk was most frequently the home of the adult (43%) or in a care home (36%) 52% of the individuals required physical or mental health support. Most common type was neglect and acts of omission, (32%) followed by physical abuse (27%)

Serious Cases Under the Care Act 2014, the SAB is required to undertake a SCR (now SAR) when an adult has died or suffered serious harm. There were a total of 65 serious case reviews (SCRs) compared to 60 in 2013-14. These involved a total of 190 adults at risk, of which 30% suffered serious harm and died and 70% suffered serious harm but survived.

Hampshire picture 2015/16 Overall safeguarding enquiries were 3324 ( an increase of 101 on the previous year) – involving 2,847 individuals Older people accounted for 60% of the total referrals made. Clients aged 65 and under with a Physical Disability where the second most referred group accounting for 15%. No. of enquiries relating to people with a learning disability dropped for the second consecutive year from 570 to 463 representing 14% of safeguarding enquiries . Concerns about neglect and physical abuse were the most common reason for safeguarding referrals (41% and 23% respectively). Most common location for the abuse or neglect was the adult’s own home followed by residential care. Only one case met the criteria for a SAR – now been completed. A no. of other cases, fell short of criteria for a statutory review but these were subject to a multi agency review to gain learning

Any comments or questions?

HSAB guidance and tools Work undertaken by the Hampshire SAB with the other local SABs in Hampshire and IOW: Local multi agency safeguarding policy and guidance 2015 Safeguarding enquiry process Practice guidance on: - Information sharing - Prevention and early intervention Safeguarding in commissioned services Multi agency risk management Allegations management HSAB website SAL resources

For more information visit www.hampshiresab.org.uk

Safeguarding Adult Lead Role

Safeguarding Adult Lead Role Leads on safeguarding for their organisation. Ensures concerns are logged and stored securely First point of contact for staff for advice if they have concerns. Knows the contact details of relevant statutory agencies e.g. adult services, Police, CCG, CQC, etc. Assesses information relating to concerns about adults at risk. Ensures the organisation’s safeguarding policy and related policies are kept up to date. Decides if concerns should be notified to adult services  Completes the Organisational Safeguarding Self Audit Make safeguarding referrals. Liaises with the relevant DASM and LADO for their sector.

Creating the right culture Clear stated values and ethos within the organisation Internal safeguarding policy Raising awareness about personal rights   Personal centre approach Safe recruitment practice Open culture about whistleblowing and complaints Responsibility to prevent abuse and to report concerns in JDs Allegations management and DBS/fitness to practice referrals Code of conduct reflects zero tolerance stance

Prevention Staff, service user and family awareness of abuse and how to raise concerns. Focus on building or strengthening family or social networks Raising awareness about personal rights   Raising awareness of the signs of abuse or neglect ‘Keeping Safe’ information Information about sources of independent advice and advocacy. Recognising and responding to a person’s ‘vulnerability factors’ Effective risk management and early intervention Support to reduce loneliness or isolation

Internal adult safeguarding policy All organisations must have an up-to-date clear internal adult safeguarding policy consistent with the Multi-Agency Safeguarding Adults Policy Ensure all staff are aware of and can act upon concerns and allegations in accordance with this policy. Review of current internal policies to ensure fit with the new local multi agency safeguarding policy: Prevention of abuse and neglect New definition of abuse Addition of other forms of abuse Safeguarding enquiries Information sharing Making safeguarding personal

Safeguarding Enquiries Report concerns promptly to the local authority. Cooperate with safeguarding enquiries being undertaken. Undertake safeguarding enquiries – e.g. when the concern relates to the conduct or actions of staff and written report of the actions taken Share information and supporting documentation arising from the enquiry with the local authority (and advocate). Involve the service user in the enquiry (MSP) providing any additional support the adult may need. Provide information, advice and support is provided to the adult harmed

Tools to assist the SAL SAL Role Profile Safeguarding Adult Leads Network Care Act Implementation Checklist Safeguarding Self Audit Tool Safeguarding Learning and Development Strategy Guidance on producing an internal safeguarding policy Alerter Checklist Prevention and Early Intervention Practice Guide Publicity material on abuse and neglect HSAB Website Engaging Hampshire Communities resources

Useful Links www.hampshiresab.org.uk www.skillsforcare.org.uk http://www.scie.org.uk/adults/safeguarding https://khub.net

Any comments or questions?