Mick Wharton

Wakefield & District Safeguarding Adults Board

Business Manager

THE CARE ACT & THE CARE ACT & SAFEGUARDINGSAFEGUARDING

NEW STATUTORY DUTIESNEW STATUTORY DUTIES

• Sets out Local Authority responsibilities for adult safeguarding in primary legislation.

• Responsibility to ensure enquiries are made where safeguarding criteria is met.

• Safeguarding Adult Boards become statutory.

• Requirement to conduct Safeguarding Adult Reviews.

• Information sharing duties.

• Care providers Duty of Candour.

DUTY TO MAKE ENQUIRIESDUTY TO MAKE ENQUIRIES

• The Local Authority must make enquiries or ensure others do so, if it reasonably suspects an adult who has care and support needs is being abused or neglected and is unable to protect themselves against that abuse or neglect or the risk of it, because of those needs. (Section 42 eligibility criteria - Guidance 2014, Ch. 14).

• Any enquiry should establish whether any action needs to be taken to prevent or stop abuse and neglect and by whom.

• Risk Management action or formal Section 42 Enquiry.

DUTY TO MAKE ENQUIRIES DUTY TO MAKE ENQUIRIES

• The first responsibility to act must be with the employing organisation (unless conflicted) as provider of the service.

• The employer should investigate any concern, provide any additional support the adult may need, unless there is compelling reason why it is inappropriate or unsafe to do this.

• For example a serious conflict of interest (allegations against owners) or a matter that requires investigation by the Police.

TYPES OF ABUSETYPES OF ABUSE

• Physical

• Sexual

• Psychological

• Neglect

• Discrimination

• Organisational

• Financial

• Self-Neglect

OTHER TYPES OF ABUSEOTHER TYPES OF ABUSE

The Act acknowledges the wider aspects of adult safeguarding and makes links with:

•Domestic Abuse

•Modern Day Slavery (Human Trafficking)

•Forced Marriage

•Honour Based Violence

•Female Genital Mutilation

•(Section 42 must be met for these to become adult safeguarding issues)

GREAT EMPHASIS ON GREAT EMPHASIS ON OUTCOMESOUTCOMES

• Making Safeguarding Personal.

• No decision about me without me.

• Adult, families, and carers working together with agencies to help support people and make informed choices.

• A persons capacity to make decisions is determined by the Mental Capacity Act.

• In cases involving Service Provider staff, consent is overridden because of the potential risk to other service users.

ADVOCACYADVOCACY

•The Local Authority must arrange for an independent advocate to represent and support where the adult has substantial difficulty with the process and no other appropriate individual to assist.

•Family members or people with the consent of the person subject to any enquiry can act as advocates.

•If the LA arrange for an advocate because no one else is able to fulfil this role, the advocate must be qualified for the role.

STATUTORY BOARDS – STATUTORY BOARDS – 3 FUNCTIONS3 FUNCTIONS

Local Safeguarding Adult Board’s (LSAB) have three statutory members, LA, Police and CCG and are required to have a chair who can act with independence and must:

•Publish a Strategic Plan developed with the community and Health Watch.

•Publish an Annual Report.

•Conduct any Safeguarding Adult Reviews.

•Wakefield has a fully Independent Chair funded by the board statutory partners.

A NEW ROLEA NEW ROLE

• Designated Safeguarding Adults Manager (DASM).

• Required by three statutory Board members – the Local Authority, Police and Clinical Commissioning Group.

• In practice most Board partners are likely to already have someone undertake this role, as most have professional safeguarding leads in their organisations .

• Responsible for the management and oversight of complex cases.

DASMDASM

• Co-ordination role where concerns raised about a person, whether an employee, volunteer or student, paid or unpaid.

• Provides advice and guidance within own organisation and liaises with other agencies as necessary.

• Ensures cases are dealt with promptly under a consistent thorough but fair process with a clear audit trail in accordance with confidentiality requirements.(People’s employment at risk)

• Ensures service providers make necessary referrals to DBS and professional bodies when appropriate.

SAFEGUARDING ADULT SAFEGUARDING ADULT REVIEWSREVIEWS

• Sets out the grounds for a review.

• Previously known as Serious Case Reviews.

• Gives Boards flexibility to choose a proportionate methodology.

• Purpose of a Safeguarding Adult Review (SAR) must be to learn lessons, improve practice and interagency work.

• Boards have the power to require information from relevant agencies relevant to the SAR’s function.

DUTY OF CANDOURDUTY OF CANDOUR

• Section 81 of the Care Act sets out the statutory duty of candour on providers of health care and adult social care services registered with the CQC.

• Intention being to ensure that honesty and transparency are the norm in every organisation overseen by the CQC,

• The Duty of Candour is one of the new Fundamental Standards (Mums test) on which the Care Quality Commission (CQC) assess Service Providers.

• Alleged breaches of the duty to be reported to Commissioners and the CQC.

New Safeguarding Adults New Safeguarding Adults ProceduresProcedures

• Any person may raise a concern with the Local Authority where they are concerned that an adult with care and support needs is experiencing, or at risk of abuse and neglect.

• The Local Authority will undertake Initial Enquiries to determine if the concern meets the Section 42 safeguarding eligibility criteria and if so, how to respond.

• A response will include working to understand the adult’s desired outcomes and agreeing with the adult how their concerns will be acted upon. (Capacity to make decisions and reasons to override consent may be factors)

• The Local Authority will need to decide what the most proportionate response to the concerns are.

Safeguarding Procedures

• This response may include either:

• Risk Management Response, the term given to a range of actions that may be required to safeguard the adult from the risk of abuse and neglect.

• A Formal Enquiry to establish the facts, and gather evidence to support a safeguarding plan. This will involve a Strategy meeting, an investigation either by employer, Police, Social Care or combination of these and a Case Conference meeting to determine an outcome on the civil standard of balance of probabilities.

• Risk assessment, safeguarding planning, and the provision of support to enable the adult at risk to be in control of decisions about their own life, are core elements throughout.

Duty to Make Enquiries (Duty to Make Enquiries (Procedure Procedure Extract)Extract)

Initial Enquiry (Procedure Extract)Diagram A: Initial Enquiry: Summary of actions and considerations

Adaptation:

Care and Support, Statutory Guidance, Diagram 1a

Consider risk of coercion or undue influence

Evaluate risk

Consider public interest issues

Consider need for advocacy representation

Discussion with the adult at risk, or their representative;

Confirms causes for concern Establishes desired outcomes Agrees actions to be taken

Consider need for immediate safeguarding

arrangements

Consider mental capacity

Gather Information

Consider need for police involvement

Consider risk to any other adults or child

Act with proportionality

Adult at Risk

Procedures Flowchart

Safeguarding Performance Information

416

617

918

1087

1404

1272

1523

2125

2523

0

500

1000

1500

2000

2500

3000

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15

Num

ber

of a

lert

s du

ring

year

Safeguarding alerts received - by year

Safeguarding Performance Information

2014 / 15

Alerts 2523

Strategy Meeting 305 (12.1%)

Case Conference 140 (5.6%)

Case Conference

Abuse Substantiated 90 (64.3%)

Safeguarding Performance Information Outcomes Survey

Nearly half of everyone subject to the adult safeguarding procedures are unable to complete a survey due to:

•Lack of capacity

•Person dies

•Person chooses not to take part

Therefore relatives are asked to complete surveys on behalf of their loved ones and this can affect the survey returns if they complete the survey from their own point of view. (This will be addressed in 2015/16 under the new Making Safeguarding Personal process).

Safeguarding Outcomes

• 23 completed surveys

• 91.3% satisfied / very satisfied

• 68.2% felt safe whilst procedures ongoing

• 87% said their views were fully recognised

• 82.6% felt fully included

• 60% felt safer after procedures (skewed by relative responses)

• 89.5% felt it had made a difference to their lives