Agenda item

The Committee will receive a report outlining the Safeguarding issues in Havering.

The Committee received a report providing information about the position of Safeguarding Adults in London Borough of Havering and highlighting some of the main challenges and achievements of 2012.

The London Borough of Havering Safeguarding Adults Board (SAB) was a partnership. It was tasked with the co-ordination of a borough-wide partnership to ensure that adults at risk are protected from abuse and associated harm.  The partnership was made up of a broad range of organisations including the Council, Police, Probation Service, National Health Service bodies and the voluntary sector.  There was also an input from the Care Quality Commission (CQC).  The Board had three sub-groups focussing on performance, training and audit and serious case reviews.  The sub-groups met six to eight times a year.

The Safeguarding Adults Team in Havering was a small team consisting of two Senior Practitioners, two Business Support Officers and the Service Manager.  The team carried out the following functions:

·         Provided a central route for all safeguarding adult alerts in the Borough.

·         Screened all referrals and determined whether a Safeguarding intervention was required.

·         Led on the Safeguarding Adult investigations within care homes where the adult at risk is not allocated to a community team or had been placed by another Local Authority.

·         Led on the coordination of very complex cases.

·         Provided operational advice and guidance in relation to safeguarding issues for internal staff, external partners and service providers.

·         Developed policy and procedures for the borough

·         Co-ordinated Deprivation of Liberty Safeguards authorisations in accordance with the Mental Capacity Act 2005.

The Statement of Government Policy on Adult Safeguarding identified six guiding principles that underpinned local safeguarding arrangements.  They were empowerment, protection, prevention, proportionality, partnership and accountability.

The Committee noted that the Safeguarding Adults Self-Assessment Assurance Framework (SAAF) was introduced in 2011 to enable NHS commissioners and providers to review and benchmark their safeguarding adults’ systems.  The SAAF had several standards that related to measures that supported good safeguarding practices including strategy, systems, workforce and partnerships.  A validation event was held in November 2012 where representatives from the four outer London authorities, the CCGs, LINks, the four Outer London SAB chairs and the Directors of Adult Services attended the meeting and formed a panel acting in the role of “critical friend”.

The Committee was informed that the Quality and Suspension meeting took place on a 3-weekly basis and had a broad membership which included safeguarding adults, commissioning, complaints and Adult Social Care operational managers. The meeting focussed on emerging quality issues in relation to all external providers operating in Havering.  This included residential and nursing homes, domiciliary care providers, day opportunity providers and providers of supported living schemes.

Officers outlined the Deprivation of Liberty Safeguards legislation which was enacted on 1 April 2009. The legislation was for the safety of others who could not take care of themselves.

The Committee was shown a number of safeguarding alerts and noted that the highest alerts related to clients with a physical disability (39.9%) or those aged 75-84 (33.7%).  Officers stated that physical disability service users account for 10.6% of all service users. 

The Committee noted 55% of alerts had proceeded to investigation in 2011-12, vs. 33.7% in 2010-11.  This was partly attributed to an improved awareness of thresholds amongst staff and colleagues.

A member asked how “Whistle-blowers” were responded to.  Officers stated that this issue was dealt with on a regular basis. At the 3-weekly Quality and Suspension meeting the cases were more likely to be whistleblowing cases.  e.g. an Occupational Therapist observing different practices in a nursing home and therefore reporting this back.  Within 24 hours the Safeguarding Team would have visited the premises and a report would be written within 48 hours.

A member asked how vulnerable people who lived in their own home, with a care plan, but who were essentially independent were monitored as regards problems with other family members.  Officers stated that if the person was not a Social Care client then it would be very difficult, however if they had a care plan, this would be reviewed regularly by care workers or social workers who would pick up on any issues.

A member asked if there was any Police involvement and how quickly they responded.  Officers stated that they work very closely with the Police.  The Police have a dedicated Police Safeguarding Officer who would respond quickly if needed.

A member asked about the partnership working between the Council and BHRUT.  If a patient could not make a decision about their care themselves, how was that dealt with?  Officers stated that the Safeguarding Team would take the lead on this, especially if it involved a head injury. The hospital would contact the social worker team, who were based at the hospital, who would carry out a mental capacity assessment.

A member raised concern about the level of perpetrators coming from the Social Care staff category, and asked if this was Council staff. Officers explained that this was all social care staff, including council employees, nursing care staff and domiciliary care staff. 

The Committee raised concerns about an elderly or vulnerable couple living together, who due to their age could be categorised as neglecting each other.  Members asked how this was detected and dealt with.  Officers explained that if the couple were known to Social Care then they could deal with the situation.  All staff were trained to recognised and deal with these types of situations.  If however they were not receiving care then it was very difficult to detect and it would come down to a neighbour or family member to report it.  All staff had been trained in mediation and family conflict.

Officers explained that all nursing homes are regulated by the CQC and if there are any concerns raised then unannounced visits are taken of the homes, and visits to A&E or GPs are taken into consideration.