1. Hampshire Safeguarding Adults Board Safeguarding Adult Lead Network

2. Programme 09.00 Arrival, Registration & Refreshments
Welcome and Introduction
09.20 Safeguarding Update
10:05 Table Top Discussion
Break
10.40 The work of Hampshire County Council Trading Standards, Safeguarding Team
11.25 MASH Update
11.55 Modern Day Slavery
12.50 Questions & Answers
13:00 Close of Event and Feedback Questionnaire

3. National and local developments in adult safeguarding

4. Care Act (2014) statutory guidance
An amended version of the statutory guidance published by the DH on 10th March 2016.
Main change is the removal of the DASM role - replaced with requirement for allegations management policy re people in a position of trust
Some forms of abuse such as financial and domestic abuse have been expanded to reflect new legislation introduced since April 2015.
Revision tracker

5. What are we talking about?
Adult Abuse and Neglect
Domestic
Abuse
What are we talking about?
Physical
Sexual
Neglect
Psychological/
Emotional
Discriminatory
Financial
Sexual violence and exploitation
Modern day slavery
Scamming
Female genital mutilation
Mate Crime
Organisational
Hate Crime
Self neglect
Exploitation by radicalisers
Forced Marriage
Honour Based
Violence

6. 4LSAB Safeguarding Policy
Refresh of the 4LSAB multi-agency safeguarding policy in response to the changes to the Care Act statutory guidance.
Policy now updated - new information added re modern day slavery, Prevent, self neglect, risk management, scamming, domestic abuse and the management of allegations against people in a position of trust.
Available on the HSAB website as a web based resource
Website reviewed to make navigation easier – new section on guidance or providers

7. HSAB Website

10. HSAB safeguarding plan – key priorities going forward
Wide awareness of adult abuse and neglect and its impact - engaging local communities
Making Safeguarding Personal embedded across all sectors
Clear, effective governance processes in place across all organisations
Prevention and early intervention – promoting wellbeing, safety and acting before harm occurs
Learning from experience - mechanisms in place to learn from serious cases and improve practice and services
Well equipped workforce across all sectors

11. Sounding Board Survey
A survey of over 175 community and voluntary organisations
Fear of repercussions and reprisals
Fear of not being believed of becoming isolated or the loss of relationships.
Responses highlighted further work needed around raising awareness about adult abuse and neglect
A lack of confidence, pride, shame and embarrassment
2/3 had not seen leaflets or other publicity on adult abuse and were unsure of the reporting process
Enablers to reporting:
Barriers to reporting:
A more personalised approach and access to a trusted person
Not understanding the behaviour is
abusive
Greater support for informal carers and also victims of abuse
Fears of being seen as interfering or nosy
Access to advocacy, counselling services, support networks
Assumptions someone else will respond
Invest in rebuilding community spirit and caring for others.

12. HSAB Training Programme
Training event
27th April
8th June
21st July
16th Aug
28th Sept
12th Sept
30th Nov
7th Dec
Title
Safeguarding Adult Lead (SAL) Network event
Topic day Multi-Agency Risk Management
Topic day Making Safeguarding Personal
SAMA Network
Conference
Duration
½ day course
Full Day
½ day courses
Purpose
Annual event providing an update on national and local developments and a spotlight on key topics of interest
Introduction to the 4LSAB Risk Management Framework
Introduction to Making Safeguarding Personal
Annual update on developments and sharing of good practice re allegations management
Annual update on national and local developments and a spotlight on key topics of interest
Joint conference with the HSCB:
‘Think Family’
and Domestic Abuse
Target Audience
Operational safeguarding leads (all sectors)
Responders, decision makers, safeguarding specialists, managers
All staff (all sectors)
Partner agency SAMA leads
Venue
Kings Community Church, Cedar Hall, Upper Northam Road Hedge End Southampton SO304B7
Kings Community Church, Olive Room, Upper Northam Road Hedge End Southampton SO304B7
Fort Southwick, James Callaghan Drive, Portsmouth, Fareham
PO17 6AR
TBC

13. Safeguarding Adult Lead Network
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 SAMA and LADO for their sector.
Annual update event

14. Resources to support SALs
Care Act Implementation Checklist
Safeguarding Self Audit Tool
Safeguarding Learning and Development Strategy
Guidance on producing an internal safeguarding policy
Engaging Hampshire Communities resources
Alerter Checklist
Publicity material on abuse and neglect
HSAB Website
SAL Network
Risk Management Framework
Responding to Self Neglect and Persistent Welfare Concerns
Allegations Management

16. Multi-Agency Risk Management Framework

17. Overview
Multi-agency process for managing high risk, complex cases sitting outside statutory s42 enquiry process.
In complex cases, professionals are often dealing with long term and entrenched behaviours requiring a commitment to a longer term, solution-based approach with a focus on building trust and rapport .
Provides a collaborative, coordinated and multi-agency response to these ‘critical few’ cases ensuring:
Timely information sharing around risk;
Identification and holistic assessment of risk;
Development of shared risk management plans;
Shared decision making and responsibility;
Adult’s involvement and engagement in the process
Improved outcomes for the adult at risk.

18. Process
Any agency can initiate the process – it takes the lead coordinating role with responsibility for convening and chairing the initial meeting.
Collaborative risk assessment may highlight circumstances or risks which would be more appropriately dealt with under another process and a referral should be made
Ensures timely information sharing between agencies – provides a holistic (multi-agency) overview of current risks and to develop a shared management plan.
Process continues until the identified risks are either resolved or managed to an acceptable level.
Any on-going support needed to maintain well-being and safety should be agreed before the case is referred back into the ‘business as usual’ process for any on-going work.
Adult should, as far as possible, be included and involved in the assessment process and in developing the risk management plan

19. Used when circumstances present an unmanageable level of risk to the organisation (not related to abuse or neglect by a 3rd party) e.g.:
On-going needs/behaviour leading to lifestyle choices placing them and/or others at risk;
Complex needs and behaviours leading the adult to cause harm to others;
Vulnerability factors place the adult at a higher risk of abuse or neglect including mate crime, network abuse, etc.;
‘Toxic Trio’ of domestic violence, mental health and substance misuse
Self neglect including hoarding and fire safety;
Risks previously addressed via a section 42 enquiry but for which the need for on-going risk management and monitoring has been identified.
Refusal or disengagement from care and support services;
Complex or diverse needs which either fall between, or span a number of agencies’ statutory responsibilities or eligibility criteria;

20. When is someone at risk?
An adult is considered to be ‘at risk’ when s/he is unable or unwilling to provide adequate care for him/herself and:
Is unable to obtain necessary care to meet their needs; and/or
Is unable to make reasonable or informed decisions because of their state of mental health or because they have a learning disability or an acquired brain injury; and/or
Is unable to protect themselves adequately against potential exploitation or abuse; and/or
Has refused essential services without which their health and safety needs cannot be met but do not have the insight to recognise this.

21. Capacity, consent and control
Adult’s right to make apparently unwise lifestyle choices and to refuse support should be respected.
Adult’s decisional and executive capacity to make a decision must be taken into account as well as their ability to understand and to manage in practice any risks and safety implications of the choice or decision being made.
Information and advice about how to minimise risks to be given to the person who (with capacity) has refused to accept support
Information also about how they can access reassessment in the future should they change their minds.
Decisions (either by the adult or the agency) should be kept under constant review

22. Allegations Management

23. Statutory Guidance March 2016
Removes DASM role - replaced by a new requirements on managing allegations against ‘people in positions of trust’.
Local agencies providing universal care and support services must have clear policies for dealing with allegations against people in positions of trust.
Reflect LSAB guidance
Clearly distinguish between an allegation, a concern about quality of care or practice and complaint.
Enable assessment of potential risks and actions needed to safeguard adults with care and support needs.
Includes clear recording and information-sharing guidance and timescales for action
Relates to current or historical allegation or concerns.

24. 4LSAB Allegations Management Guidance
An overarching framework setting standards around the management of allegations against people in a position of trust.
Supported by clear reporting requirements and arrangements across the whole system - this includes clear information-sharing arrangements and explicit timescales for action.
Individual member organisations are expected to develop its own business process detailing how it will implement this framework internally.
Ratified by all 4 SABs and replaces the joint DASM framework published in May 2015.

25. Underpinning principles
A proportionate, fair and transparent process building on current good practice and existing processes.
Each organisation responsible for taking action using their allegations management procedure
Clear reporting arrangements across the whole system built into contracts, commissioning arrangements, grant allocations, etc.
Timely, thorough action when concerns are raised with justifiable and proportionate information sharing
Well understood and managed interfaces with other processes(e.g. LADO, DBS, fitness to practice) and prompt referrals to relevant bodies
Clear recording of decisions and recommendations

26. Partner organisations responsibilities
Align (or develop) current allegations management processes in line with the standards set out in this framework.
Commissioners to use existing frameworks and processes to ensure allegations management and safe working procedures are in place within the organisations from whom they commission services.
Providers to adhere to reporting requirements and promptly share information about relevant incidents with their commissioners.
Statutory organisations to nominate a Safeguarding Allegations Management Advisor (SAMA)
Non statutory organisations to nominate a Safeguarding Adult Lead (SAL)
Each LSAB is responsible for leading development work in its area to support this

27. Effective governance
SPOC for allegations or concerns raised by other agencies
Gaining assurance that appropriate systems are in place to demonstrate:
Ensuring managers appropriately identify and manage risks
- Effective risk assessment
- Safeguarding actions carried out
Management oversight of individual complex cases.
- Support/update the employee
- Recording provides an audit trail
- Prompt DBS/FTP referrals
‘Managing Concerns Meetings’ to assess and determine actions required.
- DPA/Confidentiality compliance
Maintaining records of the no. and nature of allegations and using this data to inform service improvement
Information sharing with statutory agency SAMAs and LADOs.

28. Interface with s42 enquiries
Any concerns relating to a person in a position of trust who is alleged to have abused an adult with care and support needs must be reported and responded under the Hampshire Multi-Agency Safeguarding Adults Policy and Guidance.
These concerns could arise from the person’s home / personal life, as well as within their work.
Includes anyone working with adults with care and support needs such as paid or unpaid employees, volunteers, students and personal assistants

29. Circumstances relevant to s42 enquiries
A ‘person in a position of trust’ has or is alleged to have abused an adult with care and support needs
A ‘person in a position of trust’ has behaved (or is alleged to have behaved) towards another adult in a way that indicates that they may pose a risk of harm to an adult with care and support needs
Includes situations involving an investigation into a criminal offence, even if the victim of that offence was not a person with care and support needs
A ‘person in a position of trust’ has behaved (or is alleged to have behaved) towards children in a way which means they could pose a risk of harm to adults with care and support needs.

30. Useful Links www.hampshiresab.org.uk www.skillsforcare.org.uk

31. Any comments or questions?

32. Table Top Discussion
Personal reflection and experience in these area of new and emerging policy.

34. Financial Abuse

35. Multi-Agency Safeguarding Hub (MASH)
Mandy Grahamsley

36. What is the MASH?
The MASH acts as a single front door for all children and adult safeguarding in Hampshire County Council area to receive, triage and support or case manage all safeguarding concerns for children and adults at risk.
The Hub supports children and adults at risk to prevent and stay safe from harm, neglect and abuse
It is made up of professionals across the public sector to deliver a true multi-agency approach when dealing with children's and adults’ safeguarding
Adults Health and Care (AHC) MASH screens and gathers information on all safeguarding concerns received by adult services in order to make defensible decisions on next steps
AHC MASH will consult with multi-agency strategic partners to review the risk and take immediate decisions and actions where required.
Where AHC MASH identifies that further information is required or that the concern meets the criteria for enquiries under Section 42 then these are forwarded to community teams to coordinate.
Adults Health and Care (AHC) MASH undertakes strategic developmental work with partner agencies around safeguarding, and delivers training both formally and informally both in-house and externally

37. Hampshire Trading Standards
Mash partners Who are our partners sitting in the MASH AHC MASH is comprised of social workers, case workers, senior practitioners, a team manager, administrative assistants, project lead and a service manager. In addition AHC MASH is supported by professionals from across the statutory sector, helping to support adults at risk through effective and efficient partnerships and information sharing.
Health
Representatives from the health sector help to support with referrals related to health by liaising with other health professionals from the community and hospitals (2 nurses based in the team)
Hampshire Police
Representatives from Hampshire Constabulary help to deal with referrals related to criminal activity
HFRS
Representatives from Hampshire Fire and Rescue services support with referrals where there is a concern around fire and safety risks (sit within the team)
Hampshire Trading Standards
Representatives from trading standards support with referrals where there are concerns around scams or goods and services supplied to adults at risk (sit within the team)
Children’s Services
AHC MASH is co-located with children’s services to support where there is a concern that a child/children may be at risk as a result or in conjunction with concerns around an adult at risk

38. What value does AHC MASH add to the customer?
A timely and proportionate response to safeguarding concerns which are consistent and coordinated, identifying S42 duties and providing a risk assessment and recommendations for further actions.
Immediate multi agency assessment of risk with immediate agreement on protection planning
Through prompt multi agency strategy discussion and the interrogation of alternative electronic records AHC MASH is able to identify potential risks which enables multi agency preventative action to be taken without delay
Through immediate access to colleagues in emergency services, potential risks to service users, members of the public, the council and members of staff, are able to be quickly identified and necessary action taken to minimise these. This includes ‘blue light’ responses
Closer partnership working leads to greater accountability and better decision-making, leading to a reduction in the number of inappropriate referrals and re-referrals. This in turn reduces duplication and time wastage
Improved efficiency and reduction in the duplication of work across agencies through immediate and concise communication
Clear focus on a customer-led journey commensurate with Making Safeguarding Personal principles to allow for an effective early intervention from all agencies

39. AHC MASH main focus and approach to safeguarding adults at risk
Person Centred Approach
Working towards the outcomes that the person wants to help them manage the risk of abuse and/or neglect
Greater emphasis on ensuring that the person is fully involved with all decisions.
Greater autonomy for practitioners to determine the best approach
More ‘tools’ to help provide the relevant response
Proportionate
Greater emphasis on using professional judgement to determine if abuse occurred or not
Enquiries will only be needed when certain criteria are met
Fewer Enquiries

40. AHC MASH - Business Process
Currently AHC MASH manage all referrals to Adult Services where there is a safeguarding concern relating to an adult.
Referrals are received from a number of sources with the largest numbers being received from Police and Ambulance referrals.
In the first half of 2017 AHC received 10,015 contacts compared to 8,527 during the same period of 2016.
AHC MASH is seeing on average a 20% increase in referrals month on month compared to similar periods in 2016 and it is predicted these rates will continue to rise.
Currently AHC are resolving and closing 70% of all referrals with no further action required by adult services.
Of the remaining 30% of referrals, the current business process is to forward these referrals to community teams with recommendations.
Of these referrals a high proportion of concerns relate to service users not previously known to adult services.

41. AHC MASH - Current Activity
Month
Contacts
% increase
2016
2017
Jan
1617
1670
3.28%
Feb
1584
1435
-9.41%
March
1259
1723
36.85%
April
1266
1540
21.64%
May
1318
1812
37.48%
Jun
1483
1981
33.58%
Jul
1469
1700
15.72%
Aug
1508
1668
10.61%
Sept
1625
Oct
1413
Nov
1465
Dec
1713

42. Referrals by Source

43. Safeguarding duties apply to an adult who:
Has needs for care and support (whether or not the local authority is meeting any of those needs) and;
Is experiencing, or at risk of, abuse or neglect; and
As a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse and neglect.
10:00 – 10:05

44. REPORTING AN ALERT Ensure immediate safety of the individual
Preserve any evidence and support the person making a disclosure
Avoid asking leading questions. Record what is said.
Log the nature of alleged abuse, any information given or witnessed, actions taken, who was present at the time, dates and times of incident
Report to appropriate line manager or supervisor. Record decisions and rationale.
If a criminal offence is suspected, contact the Police
Refer to Adult Services

45. Information Gathering
Details of the alleged victim - name, contact details, DOB, gender, ethnicity
Principal language, any disability, any communication issues.
Name and contact details of GP.
Reasons for the concerns, the context of these, and how they came to light.
An impression of the seriousness of the situation.
Any concerns or doubts about the person’s mental capacity.
Action already taken to protect the person.
Whether the service user is aware of, and has consented to, the referral.
What the service users views and wishes are.
Whether the alleged perpetrator is a known vulnerable adult.

46. Useful numbers/websites
Hantsdirect - Adults Health and Care
Safeguarding Telephone Enquiry Advice Line
Hampshire Safeguarding Adults Board
Hantsweb Protecting People from Abuse
afeguarding
[PRESENTATION]
Safeguarding Telephone Enquiry Advice Line has been set up to respond to day to day SG queries. Available during office hours to all partners.
Tel Not to be used for referrals. E
Hampshire Constabulary - The Central Referral Unit - for adult protection and domestic violence referrals (7.30am – 8pm Mon-Fri, 8am – 4pm Sat & Sun)
Emergency Number still 999
Non emergency no. 101

47. Modern Day Slavery

48. Questions and Answers

49. Feedback Questionnaires

50. Thank You For Attending