1. Safeguarding Adults New resources Care provider managers

2. Jim Thomas Programme Head Workforce Innovation

4. CQC State of Care Report Safety is one of five key lines of enquiry Services are rated on each of the five areas and also given an overall rating. Services were generally performing well in the other four areas The report cited safety as the greatest concern in the sector, with a third of adult care services also rated ‘requires improvement’ in this area. State of Care report launched today | Care Quality CommissionState of Care report launched today | Care Quality Commission First report since new inspection approach started

5. Safeguarding Adults The Care Act 2014 Jo Wilkins Team Manager, Safeguarding Adults Team Reading Borough Council

6.  A ‘Vulnerable Adult’ is now described as an ‘Adult at Risk’  Safeguarding investigations are now referred to as Safeguarding Enquiries.  Institutional investigations are now referred to as Organisational Investigations.  Serious Case Reviews (SCRs) are now called Safeguarding Adults Reviews (SARs) Changes in Language

7.  The Care Act requires all Local Authorities to have a SAB in place which must:  Include the local authority, the NHS and the police.  Meet regularly to discuss and act upon local safeguarding issues.  Develop shared plans by 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 organisations can make sure they are working together in the best way. Safeguarding Adults Board

8.  Section 42 of The Care Act requires Local Authorities to make appropriate enquiries into concerns around an adult with care and support needs, whether or not we are providing services.  There are no changes to how we make those enquiries, just that it is now in law rather than from Government guidance.  The SAB now has the power to request information from organisations (Sect. 45) and those organisations have a duty to share information with the SAB. Care Act Section 42 Enquiries

9.  The Care Act stipulates that self neglect is now a category of abuse.  A referral should now be made for anyone known or thought to be, neglecting themselves.  This could be self neglect over the short or long term.  How we respond will differ with each individual. Self Neglect

10.  Please ensure you consider whether the situation is also domestic abuse (relationship with the person) and report this appropriately.  Please ensure you understand how to complete a Domestic Abuse Stalking & Harassment (DASH) tool to assess the level of risk or that you ask for a trained person to support you with this.  If identified as domestic abuse, you may need specialist advise around what you take into consideration and how you act.  Please talk to your manager, Adult Social Care or Women’s Aid. Domestic Abuse

11.  Section 44 of The Act requires the SAB to arrange a SAR should circumstances suggest there were failings in systems or process or where there has been a serious failure on the part of an organisation to support/protect an Adult at Risk.  West of Berkshire SAB has a panel that meets once a month. That panel decides whether a SAR is required, what level of investigation is required and who will be the lead agency. Safeguarding Adults Reviews

12.  The local authority must now arrange for an independent advocate to represent and support a person who is the subject of an Enquiry or a SAR, if they need help to understand and take part in the enquiry or review and to express their views, wishes or feelings.  The person does not need to lack capacity to be entitled to an advocate.  The Local Authority should provide an advocate if there is no-one else who is appropriate. Independent Advocacy

13.  The Care Act incorporates into it the ethos of personalisation, choice and autonomy.  It echoes the Mental Capacity Act in its pursuit of the rights of the individual to be the lead person in any planning, support or other decisions that need to be made.  Please ensure that this is in the forefront of your mind when you are talking to people about a safeguarding matter and that your records reflect your efforts to promote the individual’s rights.  Making Safeguarding Personal will be a key area in Local Authority audits and CQC Inspections. Making Safeguarding Personal

14.  To talk about a safeguarding matter you need to call the Adult Social Care team in your local area.  They may take the details or they may ask you to contact their Safeguarding Adults Team direct.  Please ensure you have the telephone number available for staff, service users and family or friends.  Please discuss safeguarding adults with your teams as often as you can. And Finally…..

15. LGA, ADASS DH Guide Aug 2015 Publications | Local Government Association Publications | Local Government Association

16. Highlights Supporting Staff Staff are clear about their responsibilities, know where to go locally for help/advice and must have access to practical and legal guidance There should be effective and well publicised ways of escalating concerns where immediate line managers do not take action in a response to a concern being raised. Agencies should support development of positive learning environment Regular face to face supervision from skilled managers is essential to enable staff to work confidently and competently in difficult and sensitive situations Employers must ensure staff keep accurate records Staff should be made aware of their rights under employment law and any disciplinary procedures

17. Highlights Policies and Procedures In any organisation there should be adult safeguarding policies and procedures which should reflect the statutory guidance. Such policies should assist those working with adults to develop swift and personalised safeguarding responses and how to involve adults in the decision making. Therefore be aware of the need for adult safeguarding policies and procedures and the areas to cover; benchmark against existing policies and procedures and draw up new ones where required.

18. Highlights Culture- taking the ‘adversarial’ out of safeguarding Break down cultures that seek to scapegoat or blame practitioners Commissioners of care or other professionals should only use safeguarding procedures in a way that reflects the 6 safeguarding principles not as a means of intimidating providers or families Transparency, open- mindedness and timeliness are important features of fair and effective safeguarding enquiries Commissioners should encourage an open culture working in partnership with providers to ensure the best outcomes for the adult

19. Highlights Quality versus Safeguarding? Need to clarify how responses to safeguarding concerns deriving from poor quality and inadequacy of service provision including patient safety should be responded to. Repeated instances of poor care may be an indication of more serious problems and of what we now describe as organisational abuse. Important that information is recorded and shared and emerging patterns identified. Agencies should implement robust risk management processes in order to prevent concerns escalating to a crisis point and requiring intervention under safeguarding procedures CQC and commissioners have alternative means of raising standards including support for staff training, contract compliance and enforcement powers.

20. Highlights Information Sharing Early information sharing is the key to providing effective responses where there are emerging concerns All orgs must have arrangements in place which set out clearly the processes and principles for info sharing If a professional has concerns then they should share the information with the LA and or the police if they suspect a crime has been committed. When an employer is aware of abuse or neglect in their org they are under a duty to correct this and protect the adult from harm ASAP and inform the LA, CQC and CCG where the latter is the commissioner. If someone knows that abuse or neglect is happening they must act upon this knowledge not wait to be asked for information.

21. Highlights Making Enquiries The employers should investigate any concern unless there is compelling reason why it is inappropriate or unsafe to do this e.g. conflict of interest, performance of the provider in undertaking past investigations or serious multiple concerns or a matter requiring a police investigation. If the LA decides that another org should make the enquiry then the LA should be clear about timescales, the need to know the outcomes and what action will follow if this is not done. The LA should assure itself that the enquiry satisfies its duty under s42..In this role if the LA has caused an enquiry to be made it is able to challenge the agency if it considers the process or outcome unsatisfactory. Where a crime is suspected....then the police must lead the criminal investigation.

22. Highlights HR Processes Employers should ensure that their disciplinary procedures are compatible with the responsibility to protect adults at risk of abuse or neglect. When criminal procedures are concluded without action being taken this does not automatically mean that regulatory or disciplinary procedures should cease or not be considered.

23. Highlights Criminal Investigations The Police and Crown Prosecution Service (CPS) should agree procedures with the LA, care providers, housing providers, and the NHS/CCG to cover the following situations: action pending the outcome of the police and the employer’s investigations; action following a decision to prosecute an individual; action following a decision not to prosecute; action pending trial; and responses to both acquittal and conviction.

24. Highlights Cooperating Sections 6 and 7 Section 6 creates a general duty to cooperate and section 7 a specific duty on individual cases when requested by a LA. Section 6- LA’s must cooperate with each of their relevant partners and those partners must cooperate with the LA e.g. NHSE, CCG’s, NHS Trusts, DWP, Police, Probation and Prisons Section 7-LA’s must also cooperate with such other agencies as it considers appropriate e.g. GP’s, dentists, pharmacists, housing, health and care providers The request must be complied with unless it is “incompatible with its own duties” or “would otherwise have an adverse effect on the exercise of its functions”. Written reasons must be given for a decision not to comply with a request.

25. Highlights Mental Capacity Act 2005/Making Safeguarding Personal Professionals and staff need to understand and always work in line with the MCA 2005. They will need considerable guidance and support from their employers if they are to help adults manage risk in ways that put them in control of decision making

26. Making Safeguarding Personal Making Safeguarding Personal is a shift in culture and practice. It is about having conversations with people about how we might respond in safeguarding situations in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety. It is about seeing people as experts in their own lives and working alongside them.

27. Table discussion Alun Bayliss – NHS Simon McGurk Sue Brain- West Berkshire Abigail Simmons – Bracknell Forest Nicolette Barry - Slough Julie Willis – RB Windsor and Maidenhead Sarah.O'Connor – Wokingham Introducing - Safeguarding Leads

28. Table discussion Eve McIlmoyle – Reading Sophie Trezise – Surrey Gemma Lacey – Optalise Neil Dewdney – West Berkshire Introducing Learning and Development leads

29. Table discussion What are the provider manager’s challenges in meeting Safeguarding expectations? Write on Post it notes How can you work with commissioners and safeguarding leads to meet expectations? Group Post -it notes on flip chart paper Record suggested ways to work together on flip chart paper Meeting Care Act expectations

30. Care Quality Commission - Is the service Safe?

32. CQC State of Care Report Safety is one of five key lines of enquiry Services are rated on each of the five areas and also given an overall rating. Services were generally performing well in the other four areas The report cited safety as the greatest concern in the sector, with a third of adult care services also rated ‘requires improvement’ in this area. State of Care report launched today | Care Quality CommissionState of Care report launched today | Care Quality Commission First report since new inspection approach started

33. CQC – Is the service Safe? The new approach

34. CQC seminar – Is the service Safe? Provider Handbook & Appendices

35. CQC seminar 5 Key Questions:

36. CQC – Is the service Safe? BY SAFE WE MEAN THAT PEOPLE ARE PROTECTED FROM ABUSE AND AVOIDABLE HARM How are people protected from bullying, harassment, avoidable harm and abuse that may breach their human rights? How are risks to individuals and the service managed so that people are protected and their freedom is supported and respected? How does the service make sure that there are sufficient numbers of suitable staff to keep people safe and meet their needs? How are people’s medicines managed so that they receive them safely? How well are people protected by the prevention and control of infection? (not mandatory)

37. Table exercise Identifying evidence opportunities for PIR completion and inspections Have a go at filling it in! Meeting CQC “Safe” standard

38. CQC – Is the service Safe? Care Improvement works http://www.careimprovementworks.org.uk

39. CQC – Is the service Safe? Rachel Reid rachel.reid@skillsforcare.org.uk 07770507812 Website : www.skillsforcare.org.ukwww.skillsforcare.org.uk

40. New Resources A guide to adult safeguarding for social care service providers Safeguarding Route Planner Jim Thomas

41. Table discussion Feedback on how you can use the information and resources we have talked about today Write on Post-its and put on flip chart How will you use what you have heard about today?

42. Registered Managers If you are interested in joining a network or would like to start one! Contact your Skills for Care Locality Manager Registered Managers networks

43. Locality Managers Bucks, Berks, Oxon and Milton Keynes - Rachel.Reid@Skillsforcare.org.ukRachel.Reid@Skillsforcare.org.uk Surrey – Marianne.Davis@skillsforcare.org.ukMarianne.Davis@skillsforcare.org.uk Sussex – Karen.Stevens@skillsforcare.org.ukKaren.Stevens@skillsforcare.org.uk Kent – Margaret.Sharpe@skillsforcare.org.ukMargaret.Sharpe@skillsforcare.org.uk Hampshire – Caroline.Munro@skillsforcare.org.ukCaroline.Munro@skillsforcare.org.uk London

44. Thank you