Agenda item

13.1     The independent Chair of the Safeguarding Adults Board(SAB) presented the annual report, production of which is now a statutory requirement as part of the changes to adult safeguarding introduced by the Care Act. He noted that the increase in safeguarding alerts over the past year primarily relates to the new categories of domestic violence, self-neglect and modern slavery. There has also been an increase in alerts received from the police and homecare providers following awareness raising activities with these sectors. The following three areas of work were particularly highlighted:

·         Safeguarding Adult Reviews (SAR) – these reviews are now a statutory requirement for relevant cases, of which there were none in 2015/16 and one so far in the current year. In 2015/16 one multi-agency review was undertaken for a case which was outside the criteria for a full SAR. The review identified the need for a specific strategy around domestic violence for older people and the need for better data collection and staff training on this issue.

·         Clients and carers safeguarding advisory network: this group, chaired by Healthwatch, has been very active in challenging the board from a carer and client perspective.

·         Training sub-group: this group has extended its original remit to include delivery of training on modern slavery, self-neglect, and coercion and control.

13.2     The following points were made by the SAB Chair in response to the Committee’s questions:

·         The Board’s effectiveness is monitored through annual review of the business plan (which includes performance measures and evidence) and accountability is through reports to Lead Member, Health and Wellbeing Board and the Scrutiny Committee. In addition, there is a desire to increase the involvement of clients and carers in order to better see impact in terms of improved outcomes.

·         The increase in domestic violence alerts appears to be due to a combination of increased reporting and increased incidence. The key outcomes are increased safety/protection and education.

·         The Board is aware of an increase in homelessness and street sleeping and will keep this issue on the agenda. The Director of Adult Social Care and Health assured the Committee that the SAB works in conjunction with other agencies e.g. community safety, to ensure there are no gaps, but equally no duplication, and to ensure that responsibilities are clear.

·         The effectiveness of safeguarding plans is monitored by a sub-group which reviews and oversees any single agency audit, identifying gaps and good practice. A plan for multi-agency audits is also being developed, building on the focus to date on Care Act compliance. The first year’s data suggests reduction in risk has improved, outcomes were met in 99% of cases and advocacy take-up is good. The Director added that the Adult Social Care outcomes framework includes statistical reporting but for an overview of quality this needs to be looked at alongside analysis of specific cases, such as through multi-agency reviews.

·         The work of the Board is funded from contributions from local authorities, police, NHS Clinical Commissioning Groups and East Sussex Healthcare NHS Trust. The SAB Chair’s view was that this has been sufficient to deliver work to date but that resources will be stretched by the current SAR and any additional reviews would be very challenging to resource. Work is underway across East Sussex and Brighton and Hove with a view to securing additional resources from other health bodies and district/borough councils, particularly now that SAB work is on a statutory footing and there is an increase in referrals.

·         The threshold between quality of care concerns and safeguarding is challenging at national level and links to the role of the Care Quality Commission, since a quality concern can trigger the three key safeguarding tests for those individuals who are affected by it. The Board is continuing to work on developing a pathway which allows the quality management work to go on whilst also flagging safeguarding concerns. The Director explained that there may be a level of duplication as it is preferable to record safeguarding concerns if there is any doubt so as not to miss cases, but this risks both undue use of resources and potential communication issues. This issue will have greater impact as social care integrates further with healthcare and NHS quality systems are factored in.

13.3     The committee RESOLVED to:

1)    request a further report in September 2017

2)    support the ongoing efforts to engage with other partners in relation to the resourcing of the Board’s work, particularly given the increase in referrals.