1. Multi Agency Safeguarding Hub MASH
National Adult Support & Protection Conference
2nd October 2019 – Dovecot Studios, Edinburgh
Caroline Ronaldson – Team Manager – Social Work
Elaine Wylie – ASP Adviser – NHS Dumfries & Galloway

2. Demographics Region wide remit over four localities
At 30 June 2017, the population of Dumfries & Galloway was 149,200 - the 13th highest population in 2017 out of all 32 council areas in Scotland
Population by age:
15.7% of the population aged between 0 and 15
59.2% aged between 16 and 64
25% aged 65 and over
Largest town is Dumfries with a population around 40,000 in Nithsdale area. The next largest town is Stranraer at >10,000.
Length across D&G by road approx 100 miles.
Although 13th highest in population, it is the 3rd largest geographical area behind Highlands and Argyle and Bute.

3. Refer onwards/ signposting
Life Before MASH
Locality Team Screen
Referral
Manage under ASP
Refer onwards/ signposting

4. Dumfries & Galloway Statistics and Trends 2011 - 2015
2011/12
2012/13
2013/14
2014/15
Average 2011/15
Number of Adult Referrals
6474
6808
7809
7637
7182
How many went to Inquiry
1380
1676
1666
1279
1500
How many went to investigation 49 63 43 57 53
How many went to AP Conference 16 17 12

5. Why was MASH created?
To improve our overall multi-agency approach to protecting and safeguarding adults at risk of harm by bringing together all essential partners i.e. Police, Health and Social Work.
Considering key messages and recommendations from:
Report of a joint inspection of adult health and social care services, Services for older people in Dumfries and Galloway (Care Inspectorate, 2016);
Report of a joint inspection, Services for children and young people in Dumfries and Galloway (Care Inspectorate, 2014);
National and Local Significant Case Reviews in relation to vulnerable adults and children.

6. Remit / Core Functions
Protect and safeguard individuals who may be at risk of harm
Provide a single point of entry for screening referrals
Identify and assess risk
Facilitate Initial Referral Discussions (IRDs)
Assess and share information timeously and securely
Implement interim safety plans
Provide joint performance reporting to evidence outcomes and support Quality Assurance

7. Consultation / Challenges
Practitioner / Strategic consultation – pre and post inspections
Chief Officers Group
Adult and Child Protection Committees
Resource, finance, location (vetting within Police HQ)
Agreement of remit / functions and hours
Escalation processes

8. Implementation September 2016: Soft launch of Adult MASH
Co-located within Crichton Hall (NHS property)
Remit for only the East of the region
February 2017:
Full implementation of both Adult and Child MASH
Co-located within Police Headquarters, Cornwall Mount

9. Structure / Key Partners
Social Work:
Adult – Senior Social Worker x 2; Care-Coordinator; Council Officer, Admin.
Police Scotland:
Detective Inspector; Detective Sergeants x 2; Detective and Police Constables; Admin.
NHS:
Health Advisor
Nurse Consultant for Clinical Risk – 2-3 mornings per week.
Direct links to other partner professionals within Social Work, Police and NHS.

10. Referral Process / Triage
Triaged by Access Team
Referral received by Contact Centre
MASH
Locality SW Team

11. Adult Initial Referral Discussion
An Adult Initial Referral Discussion (aIRD) is a formal face to face tripartite meeting between Social Work, Health and Police to:
Consider the concerns raised
Source and share single agency information (including information from relevant partner agencies)
Analyse information to support identification of risk factors and protective factors (using the Risk Matrix Tool)
Inform decision making as to whether or not action needs to be taken to protect an adult from harm
Agree actions

12. IRD Outcomes Potential outcomes from an IRD:
Adult Support & Protection Investigation
Planning Meeting (exceptional)
Self Directed Support planning
Signposting / referring on to other agencies
No further action

13. Governance
The Adult MASH has, since implementation, been subject to regular multi-agency scrutiny – performance and governance is monitored to improve / acknowledge good practice. Also, ensuring policies and procedures are adhered to:
Quarterly and annual reporting – data collated within MASH
MASH Steering Group / IRD Review Group
Public Protection Committee

14. What works well? Shared understanding of risk
Faster and more effective joint decision making
Information sharing
Earlier and more effective co-ordinated intervention
Collaborative commitment to continuous improvement
More effective use of public resources
Links with MARAC / MATAC / DSDAS
A shared understanding of thresholds
Simple structure: 1 x NHS Board and 1 x Local Authority

15. Challenges Information sharing IT Systems Thresholds
Multi-agency management decision making
Workload within MASH

16. What are we continuing to explore?
Enhanced knowledge and skills
Additional input from partner agencies / professionals
Multi-Agency training both within MASH and from MASH to partner agencies / professionals
Feedback to referrers for all ASP concerns
Chronologies
Ideas for change

17. Questions?