1. Safeguarding Effectiveness Workshop - Supporting Care Providers
WELCOME

2. Aim
By the end of the workshop participants have identified the ways in which the Safeguarding Adults Board can empower providers to be robust and proactive when safeguarding concerns are identified and be assured of safeguarding effectiveness

3. Leicestershire and Rutland SAB
The Care Act requires local authorities to set up a Safeguarding Adults Board (SAB) in their area, giving these boards a clear basis in law. The SAB must:
include the local authority, the NHS and the police, who should meet regularly to discuss and act upon local safeguarding issues;
develop shared plans for safeguarding, working with local people to decide how best to protect adults in vulnerable situations;
publish this safeguarding plan and report to the public annually on its progress, so that different organisations can make sure they are working together in the best way.
Boards Website

5. Role of the Board
To ensure the effectiveness of Safeguarding in Leicestershire and Rutland
To promote and ensure effectiveness of Multi Agency collaboration
Securing Learning and Development from Reviews and Performance Data

6. Safeguarding Adult Board Priority 2016-2017
To be assured of continuous improvement in safeguarding effectiveness within care settings

7. Why is this a Board Priority?
National findings in relation to safeguarding in provider settings
Improve safeguarding by sharing best practice
Understanding current challenges for providers

8. What is Safeguarding Effectiveness
Preventing and Managing risk
Responding appropriately to Safeguarding Concerns
Involving people who receive care
Multi Agency Working
Building competency within your workforce

9. Competency The Competency Framework determines the minimum standards
It should be used to support individuals and organisations to undertake their safeguarding roles and responsibilities in a confident and competent manner.
It can be used as a ‘measure’ for SAB and single agency Quality Assurance activity.

10. A competency based approach;
supports and strengthens practice.
provides information about improved outcomes.
is more flexible (different learning and evidence recognised.)
allows a more individualistic approach.
focus’ on how learning is used and applied

13. Areas to Highlight Thresholds - To refer or not
Feedback – Escalation (CSC swamped with incidents)
Alerting ( Referral Form)
Recording
Evidence that you have taken action and the reason why

14. Laura Sanderson, Leicestershire County Council
Provider Role in Safeguarding Adults Enquiries and Making Safeguarding Personal
Welcome
Introductions
Parking sheet- questions
Housekeeping
Laura Sanderson, Leicestershire County Council

15. Aims and Objectives:
To explore what the Care Act says about provider roles in safeguarding enquiries
To provide information to support you to embed the principles of Making Safeguarding Personal (MSP) within your organisations and about some of the tools available to help with this process
The information from this workshop should be used in conjunction with the Multi-Agency Safeguarding Adults Policy and Procedures (MAPP) which remains the primary guidance to be used within any Safeguarding Adults enquiry

16. What the Care Act guidance says about provider roles in safeguarding enquiries
14.52 In any organisation, there should be adult safeguarding policies and procedures. These should:
reflect the statutory guidance
support the reduction or removal of safeguarding risks, as well as to secure any support to protect the adult
to help the adult recover and develop resilience.
Assist those working with adults how to develop swift and personalised safeguarding responses and how to involve adults in this decision making.
This, in turn, should encourage proportionate responses and improve outcomes for the people concerned.

17. Duties of employers and the local authority
14.69 When an employer is aware of abuse or neglect in their organisation, then they are under a duty to correct this and protect the adult from harm as soon as possible and inform the local authority, CQC and CCG where the latter is the commissioner.
Where a local authority has reasonable cause to suspect that an adult may be experiencing or at risk of abuse or neglect, then it is still under a duty to make (or cause to be made) whatever enquiries it thinks necessary to decide what if any action needs to be taken and by whom.

18. Making an alert to the local authority
14.78 The purpose of the enquiry is to decide whether or not the local authority or another organisation, or person, should do something to help and protect the adult. If the local authority decides that another organisation should make the enquiry, for example a care provider, they should be clear about
timescales
the need to know the outcomes of the enquiry and what action will follow if this is not done.

19. Provider investigation
14.70 The employer should investigate any concern (and provide any additional support that the adult may need) unless there is compelling reason why it is inappropriate or unsafe to do this. For example, this could be a serious conflict of interest on the part of the employer, concerns having been raised about non-effective past enquiries or serious, multiple concerns, or a matter that requires investigation by the police.
The adult should always be involved from the beginning of the enquiry unless there are exceptional circumstances that would increase the risk of abuse.

20. Background to MSP
The MSP programme was established in 2012 by the Local Government Association.
It was recognised that safeguarding adults practice had become process driven, and overly focussed on outputs rather than outcomes for individuals.
The focus for the project was to develop an approach for safeguarding practice which was person-led and outcome focused, to enhance choice and control and to improve quality of life and well-being as well as safety.
As part of an action plan to help achieve this locally Leicester City and Leicestershire and Rutland Safeguarding Adults Boards have established a Multi-Agency MSP Task and Finish Group.
The focus of the group is to support partner agencies to embed the principles of MSP within their organisations, and a training toolkit is being developed to assist with this. .
As a result it has been agreed by LCC and the Leicestershire and Rutland Safeguarding Adults Board that embedding the MSP approach into safeguarding practice was a priority, and that this should be achieved by April This has resulted in an action plan which includes developing guidance and training to support front line staff in using the MSP approach within safeguarding adults practice.
For more details on the national MSP programme please use the link below:
For guidance for using the MSP fields within IAS please refer to Ontuitive.

21. Some Key Principles of MSP
Outcome Focussed
Asset based approach
Positive risk taking
No decision without the person
Always feedback
Training toolkit in development

22. Considerations if a disclosure is made to you, or you suspect abuse
Immediate risk to Service User and others
Mental Capacity
What does the person want to happen?
Confidentiality
Being honest and clear about the action you are going to take and why
Consider whistleblowing procedures
A referral to the local authority is required if abuse is known or suspected
You must inform the police if a crime has been committed

23. What you should expect from the Local Authority
Initial discussion to see if the person agrees to the enquiry and what outcomes they want
Clarity about what is being requested from you re: the enquiry and timescales for this
Opportunity to discuss your enquiry if you have queries about this
Considerations such as the time of the visit, should there be somebody else there who they trust, is advocacy required?
Consideration that some people will need to have information available in different formats
Examples of possible outcomes should be available if required

24. How Should we Approach ‘Risk’?
What good is it making someone safer if it merely makes them miserable? We must tolerate acceptable risks as the price appropriately to be paid in order to achieve some other good – in particular to achieve the vital good of the elderly or vulnerable person’s happiness
Lord Justice Munby, re MM

25. Defensible Decision Making
Take all reasonable steps;
Collect and thoroughly evaluate information;
Use reliable risk assessment tools;
Record and account for decisions;
Follow agency policies and procedures;
Ensure decisions are grounded in evidence;
Match risk management to risk factors;
Respond to escalating risk, deteriorating behaviour and non-compliance.
Defensible Decision Making - Parallel Social Work, Risk Assessment and Recording
Defensible decision making means providing a clear rationale based on legislation, policy, models of practice or recognised tools utilised to come to an informed decision. This decision is based on the information known at that particular time. It is important to accurately and concisely record your decision making processes, in order that you can explain how and why you came to the decision at that time. Often additional information comes to light at a later date which may discredit your decision and on reflection a person can be asked to account for their actions. Accurate, timely, concise, specific, appropriate recording will support your decision making and provide justification for actions taken.
Within care services we do not wish to be risk averse but consider all issues relevant to the decision being made. Learning to Live with Risk outlines the criminal and civil law context in which social workers and their employers work with risk. Essentially ... if an organisation or individual can demonstrate that their decision and the processes involved in reaching it were, as a matter of fact, consistent with contemporary professional practices, then they have not been negligent. It is also essential to remember that, regardless of deployment arrangements, Approved Mental Health Practitioners (AMHPs) retain accountability to the Director of Adult Services. The Department of Health (2010) also outline the elements of a defensible decision, which they define as, if an objective group of professionals would consider:-
 All reasonable steps have been taken
 Reliable assessment methods have been used
 Information has been collated and thoroughly evaluated
 Decisions are recorded, communicated and thoroughly evaluated
 Policies and procedures have been followed
 Practitioners and their managers adopt an investigative approach and are proactive.
Adult Protection is an aspect of service that requires true defensible decision making,
paying particular regard to positive risk taking Learning to Live with Risk contains a
specific section on working with the Mental Capacity Act and outlines the five
underlying principles contained within it. Essential to working within the Act is ‘... a
person who has the mental capacity to make a decision, and choses voluntarily to live
with risk is entitled to do so.’ This document also presents a risk decision model
which can assist in the process and recording of defensible decisions in this context. It
looks at the balance of the impact and the likelihood of negative and positive outcomes. Core to this model is that: Risks need to be shared – no one person should
take full responsibility

26. Making Safeguarding Personal
At the end of the ENQUIRY the person should be able to say….
The people I wanted were involved
I had good quality care
I was helped to manage the risks
I felt safe and in control
People understood me and recognised what I could do
I had the information I needed in the way I needed it
People worked together reducing risk to my safety and well-being

27. Case Studies
Please read the case studies and discuss the questions below within your groups
What would be your initial actions?
If the local authority asked you to undertake the enquiry how would you plan this?

28. Has anyone got any questions?

29. What are the ways in which the Safeguarding Adults Board can empower providers to be robust and proactive when safeguarding concerns are identified and be assured of safeguarding effectiveness

30. Group Discussion
What’s working well already ?
and
What else can we do ?