1. Provider Forum
January 2018

2. Safer recruitment This is a part of the prevention agenda
Several recent cases and monitoring inspections where there are no staff files, incomplete, chaotic systems, no DBS checks, no/ poor referencing, references from inappropriate sources, old references, significant offences without any risk assessment of the job role subsequently
Leaves providers open to criticism
Times article

3. Safer Recruitment
retention/Secrets-of-success/Recruitment-and-retention-secrets-of- success-report.pdf Skill for care recruitment and retention advice document.
Start with a statement in all relevant documentation:
“This authority/school/charity etc. is committed to safeguarding and promoting the welfare of adults, engages with adults and staff in policy and practice developments, and proactively encourages feedback”
“This organisation is committed to safeguarding and promoting the welfare of adults and expects all staff and volunteers to share this commitment.”

4. Safer Recruitment 2
Put it in advert, JD, candidate information pack and application form
Consider when taking references, shortlisting and interviewing (how do you bring this in)
The importance of a single record (place) for all associated information (“staff folder”), versus a DBS folder, reference folder, application folder etc.
How does this cross reference to complaints procedure and records (especially in domiciliary) as well as whistleblowing procedures (do the records talk to each other and form a picture for management oversight to pick up any trends.

5. Cambridgeshire CB List (adapted)
Their motivation and reasons for working with Adults
Their perceptions about the boundaries of acceptable behaviour towards adults
Their ability to form and maintain professional relationships
Their understanding of safeguarding adults
In Addition: Checking gaps in work history, role play/ scenarios

6. Risk Assessing If a DBS comes back with offenses:
When did they take place
How relevant are the to working with adults with vulnerabilities
If more than one offense what was the nature of the offence
If employed does the person require additional supervision, oversight and scrutiny

7. Quality Assurance
Recent cases have highlighted the need for management quality assurance
Often management struggle to carry this out as they are busy with operational duties
This could be done by a head office function
There is value in on site management carrying this out
Desk based QA as well as observational QA

8. Quality Assurance
Desk based: Daily notes, risk assessments, incident forms* (frequency, staff involved, clients involved), care plans, ABC forms, MARS Observational: Watching the interaction, a specific task that requires technical requirements- hoisting/ manual handling, trained intervention like de-escalation and redirection System: Where are we recording this, is there a separate record, link to training and supervision plans and input, begin to trend map over time, data becomes more meaningful

9. Provider Concerns and Quality Discussion
8 Providers in PC
ADASS London Region and placing authorities informed, often reviews
Can suspend new business or withdraw existing business
6 step process as laid out by Pan London
Usually results in improvements
Quality Discussions: Stitch in time saves nine philosophy.
Series of Evidence based discussion

10. Learning form serious cases
Suzy Braye and Michael Preston –Shoot did research for the London Safeguarding Adults Board on SARS since the Care Act.
17 Boards submitted for analysis (27 reviews)
More men than women, emphasis on older adults
Organisational abuse was the most significant form of abuse
Second was self neglect
All SARS were concerns about inter professional practice, service coordination and communication, no overall risk picture, lacking leadership/ coordination, absence of escalation between agencies
Concerns over legal (including safeguarding) literacy

11. SAR report 2
Commissioner – provider split, hurried discharges, lack of integration between health care and social care, size of care packages, delayed assessments, workloads for social workers and district nurses, reliance on inexperienced staff in care home
Ongoing concerns about sharing data
Ongoing concerns about the mental capacity act use and interpretation (assume someone has capacity, hold a BI Meeting if not, who is invited, what is the decision/ time specific question, what is the least restrictive)
Absence of Advocacy, multi agency meetings and BI decision making

12. SAR report 3
Record keeping is important, not just what was done but the rationale for the decision
Calls for manager to exercise proactive scrutiny of records and provide oversight
SARs-Report-Final-Version.pdf

13. SAR Committee in Croydon
Please read the Mr A1 executive summary
Make referrals where required

14. Policy Updates Reminder of the Pressure Ulcer Protocol
Been in place since December 2015
Operates the NHS scoring system (15 and above) based on significant wound definition
Croydon localised the policy via the posters (see s following)
Several cases where this has not been followed
This becomes a policy/ procedure matter in legal cases
The protocol is there to help us all joint work and be proportionate