Report to:                  East Sussex Health and Wellbeing Board

Date:                           26 September 2024

By:                              Seona Douglas Independent Chair East Sussex Safeguarding

                                    Adults Board

Title:                           East Sussex Safeguarding Adults Board Annual Report 2023-24

Purpose of Report:  To present the annual report detailing how effective the work of the Safeguarding Adults Board (SAB) has been as required by The Care Act 2014.

Recommendations:

East Sussex Health and Wellbeing Board is recommended to:

1. Consider and comment on the report.

1. Background

1.1. The Care Act 2014 requires each Safeguarding Adults Board (SAB) to:

• Develop and publish a strategic plan setting out how they will meet their objectives and how their member and partner agencies will contribute.
• Publish an annual report detailing how effective their work has been.
• Commission safeguarding adult’s reviews (SARs) for any cases which meet the criteria for these.

2. Supporting information

2.1. The format of the report is structured against the SAB priorities as set out in the Strategic Plan 2021–24. The data section (Appendix 1) includes contributions from a number of partner agencies in addition to the core data from the local authority (see Appendix 2 – SAB Annual Report 2023-24). A copy of the Safeguarding Adults Board Annual Report 2023-24 is contained in Appendix 2 and a copy of the SAB membership is in Appendix 3.

2.2. The Strategic Plan for 2024-27 has been recently published and next year’s annual report  2024-25 will be structured against these new SAB priorities.

2.3. Seona Douglas was appointed as the SAB Independent Chair in November 2023 following a six-month period of acting as interim Independent Chair. A number of staff changes have also taken place within the SAB business support area including the permanent appointment of a Board Support Coordinator, funded jointly by Adult Social Care (ASC) and a newly appointed SAB administrator.

2.4. Safeguarding Adult Review (SAR) referral activity during 2023/24 decreased by64%.

• Five SARs were published in 2023/24 relating to six adults: SARs Charlie, Donna, Finley, Hannah and Gwen and Ian.
• A total of 35 recommendations and associated actions in relation to SARs: Charlie, Donna, Finley, Hannah, the Thematic Review and SAR Gwen and Ian were incorporated into the SAR Action Plan in 2023/24 and the recommendations developed in partnership with SAB partner agencies.
•  It should be noted that SAR’s commissioned in one year may not be completed until subsequent years. 

2.5. Highlights in the report under the SAB five strategic themes are as follows:

           Strategic Theme 1:

           Accountability and leadership

• A recommendation from  the Thematic Safeguarding Adult Review (SAR) and SAR Charlie (published in 2022 and 2023 respectively) related to transitional safeguarding processes.
• A transitions task and finish group was established in January 2023 by the East Sussex Safeguarding Adults Board (ESSAB) and East Sussex Children’s Safeguarding Partnership (ESSCP)  and chaired by the Head of Safeguarding for the Sussex NHS Integrated Care Board.   The work of the task and finish group was concluded in January 2024 with the production of the East Sussex Multi-Agency Transition to Adulthood Protocol.

The protocol sets out a commitment, from the partner agencies of the ESSAB and the ESSCP, that a young person’s transition experience is a positive, coordinated, and supportive one jointly owned by all partner organisations.

• A review of the Multi-Agency Risk Management Protocol (MARM) took place in 2023/24. The review also considered a recommendation from SAR  Donna to review multi-agency risk assessment processes. The review was led by the Head of Safeguarding & Quality for ASCH, with involvement from multi-agency SAB partners.

The review resulted in a number of recommendations which were agreed by the SAB and have been implemented as follows:

Ø Refreshed and targeted communications have been circulated to referring agencies outlining the purpose of the MARM and what it aims to achieve, the importance of completing other available processes before a referral is made and benefits of a trauma informed approach.

Ø MARM referral data will be fed into the SAB dashboard on a quarterly basis: to aid future monitoring and evaluation. This will include discussions on where under-represented groups may be identified in the referral data.

Ø The MARM review group have developed a standardised multi-agency risk assessment which has been incorporated within the MARM referral form to improve consistency in referrals.

• In preparation for a CQC assessment a Local Government Association (LGA) Peer review of Adult Social Care and Health (ASCH) was undertaken in February 2024, including arrangements with the SAB. LGA peer reviews are assessments conducted by local government professionals to evaluate the performance of other councils. These reviews aim to provide constructive feedback and support improvements that will benefit local staff, residents, and businesses.

The CQC assessment will look at how local authorities meet their duties under Part 1 of the Care Act (2014) and how the local authority ensures safety within the system which includes safeguarding.

Feedback indicated the SAB is excellent in terms of its plan and engagement from multi-agency partners.

• Bi-Annual SAB Self-Assessment 2023 - the purpose of the bi-annual Safeguarding Adults Self-Assessment process is to provide the SAB with assurance in relation to safeguarding activity taking place across the partnership. A pan-Sussex approach was taken with a self-assessment tool jointly developed by all three Sussex SABs to reduce unnecessary duplication for pan-Sussex organisations and to enable consistency in identifying areas of focus.

There were 12 questions in total covering four safeguarding areas as follows:

1. Recognising, monitoring & responding to safeguarding concerns

2. Embedding learning and assurance

3. Making Safeguarding Personal

4. Leadership, governance, and accountability

Each agency provided a rating based on their own assessment on the evidence and examples they provide on whether they had achieved the following ratings:

Fully achieved with robust evidence for this and continual development.

Partially achieved with some actions in progress but with more to do/areas to improve.

           Strategic Theme 2:

           Safeguarding Policies and Procedures

• To raise awareness of safeguarding policies and procedures relating to specific local themes the SAB developed a number of learning briefings and resources and reviewed a number of guidance documents this year. These included :

Ø Learning Briefings for 5 published SARs

Ø The Brighton & Hove and East Sussex Safeguarding Adults Boards worked with a range of partner agencies to develop an updated and expanded Multi-Agency Responding to Hoarding Behaviour Frameworkthat replaces the previous multi-agency Hoarding Framework.

• A number of documents were reviewed in 2023/24 to ensure they reflected new legislation, national guidance, and local learning from SARs – these are detailed in  Appendix 2 (Annual Report pages 14 and 15).

• The Sussex Safeguarding Policy and Procedures Review Group has responsibility for the Sussex Safeguarding Adult Policy and Procedures (which are held by the three local authorities as the statutory leads for adult safeguarding) and the development and implementation of changes to these.

In 2023 the three SABs and local authorities agreed the development of a new Sussex Safeguarding Adults Policy and Procedures website. The new website which was launched this year is easy to navigate and digest, is accessible, has cost saving benefits and promotes a unified approach to safeguarding adults across Sussex.

A number of the sections in the Policy and Procedures have been refreshed and updated including the development of new sections on multi-agency working, trauma informed practice, care and approaches in adult safeguarding and multiple compound needs.

         Strategic Theme 3:

         Performance, Quality and Audit, and Organisational Learning

• One of the objectives of the Performance, Quality and Audit (PQA) subgroup is to establish systems for monitoring, reporting, and evaluating performance across organisations with regards to adult safeguarding, linking annual reporting to improvement planning and a measurable work programme.

A new SAB Multi-Agency Data Dashboard has been developed to routinely collect safeguarding data across agencies and display this data in an effective and accessible dashboard to help steer the work of the group and support safeguarding assurance to the SAB. 

The dashboard will evidence the progress being made against specific safeguarding indicators, identifies emerging trends, and extracts actionable insights to assess the performance of our safeguarding approaches. Indicators will continue to be developed further with partners in 2024/25.

• Two audits were undertaken in 2023/24 in relation to two recommendations in SAR Charlie as follows:

1. The East Sussex Safeguarding Children’s Partnership (ESSCP) should consider how best to undertake a multi-agency audit of selected young people aged between 16 and 18 subject to child protection plans in the last two years to assure themselves that effective safeguarding arrangements were in place.

In February 2024, a ‘deep dive’ was undertaken , involving front line professionals working with the child and family, of two recent cases where a 16–18-year-old had a child protection plan. In both cases, the ESSCP felt that the child protection plan was appropriate, robust, and supported the family to reduce risk.

The audit identified strong social work, and multi-agency, practice in both of these cases.

The audit also explored the challenges to safeguarding vulnerable young adults and identified areas for multi-agency learning as transition is a joint ESSCP and SAB responsibility as highlighted in the Annual Report

2. ESSAB and Brighton and Hove SAB (BHSAB) should assure themselves through shared multi-agency audit that adults moving between borders in Sussex and local authorities are supported and safeguarded with clarity of case responsibility and accountability.

The multi-agency audit group consisted of 8 agencies all of whom had identified an adult in receipt of support to meet their assessed need who had experienced or had been at risk of abuse or neglect and moved from Brighton & Hove or East Sussex to another Local Authority (LA) area.

The audit explored local guidance and identified a step-by-step guide would be beneficial for practitioners which sets out the differing aspects of need and circumstances when someone is transferring or moving from one area to another. There was an improved understanding that Local Authorities have very limited, available social housing stock and this stock is even more limited when agencies are looking to provide accommodation for adults with additional needs.

            Strategic Theme 4:

            Prevention, Engagement and Making Safeguarding Personal

• The SAB continue to develop approaches to safeguarding which recognise the value of prevention and early intervention. The SAB is a supporter and contributor to the NHS Sussex Fortnight which consists of a fortnight of multi-agency learning events held in November each year. Sessions cover a wide range of topics including learning from statutory reviews, exploitation, domestic abuse, and trauma informed care.

A Working with self-neglect - focus on responding to Hoarding Behaviour session was delivered jointly, by the East Sussex and Brighton and Hove Safeguarding Adults Boards and supported by Sussex Partnership Foundation Trust and East Sussex Fire and Rescue Service. This was the best attended session of the fortnight.

Of those who attended and provided feedback 100% reported that the session was relevant and useful to their work.

• Through the SAB Safeguarding Community Network, focussed discussions take place regularly on particular safeguarding themes which community groups have requested in order to be more aware of and which would improve their confidence in recognising and responding to concerns. Topics covered this year are detailed in Appendix 2 (Annual Report on pages 19 and 20).

• An Easy Read Safeguarding Leaflet was developed and published in collaboration with the ASC Adult Learning Disabilities Team and the Involvement Matters Team (IMT) easy read guide.

           Strategic Theme 5:

            Integration, and Training and workforce development

• The SAB Training and Workforce Development (TWD) subgroup supports the strategic objective of ensuring the workforce is equipped to support adults effectively where abuse and neglect takes place. The current East Sussex SAB training programme includes the following courses:

Ø Self-neglect

Ø Modern Slavery and Human Trafficking

Ø Mental Capacity Act 2005: A Multi-agency Approach to Complex Cases

Ø Adopting a Whole Family Approach to Domestic Abuse

Ø Coercion and Control

• In partnership with the Safer Communities Substance Misuse Team, the SAB hosted two virtual workshops facilitated by Alcohol Change: Safeguarding Vulnerable Dependent Drinkers.

These workshops were commissioned as a result of recommendations from two Safeguarding Adult Reviews (Hannah and Donna) published in 2023.

Both reviews identified the need to promote an understanding amongst practitioners of the relationship and interplay between alcohol misuse and self-neglect and when and how safeguarding referrals and enquiries related to alcohol use and self-neglect should be instigated and that staff who work with chronic, highly vulnerable, dependent drinkers have relevant training on the use of legal frameworks.

Practitioners who attended the sessions reported a 100% satisfaction rate with the workshops.

3.  Conclusion and recommendations

3.1  The key priority areas identified for the SAB in 2023 – 24: embedding the Mental Capacity Act into practice, safeguarding transitions for young people at risk and supporting adults who face multiple disadvantage, continue to be areas of support and operational practice development by SAB partners and continue to be embedded within safeguarding practice.

3.2 Priority areas for the SAB over the next 3 years (2024-27) include:

• Self-Neglect - Improve and develop effective multi-agency working and practice with adults who self-neglect and develop a shared understanding, and early recognition of the issues involved in working with adults who self-neglect with a focus on substance misuse, mental capacity, exploitation, and multiple compound needs.

• Prevention and Early Intervention - Ensure unpaid carers who take on adult caring responsibilities have an understanding and awareness of adult safeguarding and what support they can access for the person they are caring for as well as for themselves. Promote and raise awareness of the important role unpaid carers have in preventing neglect, abuse, or harm and ensuring carers know how to raise and report safeguarding concerns.

• Safeguarding and Homelessness- Promote positive practice with professionals working at the interface of homelessness and adult safeguarding and ensure professionals use trauma informed approaches and consider local multi-agency risk management pathways and legal frameworks to identify what action is needed to reduce or remove potential risk.

3.3 The SAB will progress work in relation to any newly commissioned SARs in 2024/25 and seek assurance to ensure that the learning and recommendations from previous SARs continue to be embedded in practice.

Seona Douglas

Independent Chair East Sussex Safeguarding Adults Board

Contact Officer: Lucy Spencer, Safeguarding Adults Board Development Manager 

Tel. No: 07753 416684

Email:Lucy.spencer@eastsussex.gov.uk

Appendix 1 – SAB Partnership Safeguarding Information & Data

Appendix 2 – SAB Annual Report 2023-24

Appendix 3 – SAB Membership