agenda · john bruynseels (bbc), vicky allen (bedfordshire and luton fire and rescue service), ian...

Agenda Title of Meeting: Bedford Older People’s Partnership Board

Date: 26th May 2011

Time: 10.00 – 12.00 noon

Venue: Committee Room 1 , Borough Hall, Cauldwell Street, Bedford

Contact: Claire Minney – 01234 228205 Ext 42204

No Item Please tick box below if there is an attachment

Time Lead Person

1. Apologies & Welcome

2. Minutes of Last Meeting JB

3. Matters Arising

15

All

4. Advocacy for Older People Presentation Questions from Presentation

30

Simon Daize All

5. Joint Strategic Needs Assessment Update 10 Dzifa Agbenu / Edmund Tiddeman

6. Dementia Strategy Update 10 Howard Shoebridge

7. Service User News and Views 10 All

8. Carer News and Views 10 All

9. Transport Forum Update 5 Ted Bowen

10. Reablement Monies Plan 10 JB

11. Housing Options for Older People 5 JB

12. Safeguarding Statement Of Government Policy On Adult

Safeguarding

10 All

13. AOB

5 All

14. Date of next meeting:- 7 July 2011 - 10.0 am – 12.00 noon Committee Room 1, Borough Hall

All to note

Bedford Borough Council, Borough Hall, Cauldwell Street, Bedford, Beds, MK42 9AP

Minutes

Title of Meeting: Older People’s Partnership Board

Date of Meeting: Thursday 14th April 2011

Attendees: John Bruynseels (BBC), Vicky Allen (Bedfordshire and Luton Fire and Rescue Service), Ian Petit (Bedfordshire Association of Senior Citizens),Jenny Poad (BBC), Jean Ceiriog-Jones, Vanessa Connolly (BCHA), Frances Darlow (BBC & CBC), Pat Horn (MCAG), Andrew Kyle (BBC), Claire Minney (BBC), Sonia Minney (Bedford Guild House), Kuldip Rupra (MENTER), Alison Shepherd (BBC), Gillian Turrell (Vice-Chair - NHS Bedfordshire), Teresa Boyle (Advocacy for Older People), Debbie Buck (SEPT) and Martin Westwood (SEPT) Apologies: Jodi Simpson (Chair - BBC), Gillian Abbott (BBC), Esther Bolton (NHS Bedfordshire), Chris Bradley-Rushe (SEPT), Yvonne Clarke (Carers in Bedfordshire), Max Coleman (Bedford Ménière’s Support Group), Jo Hawthorne (BBC), George Hunt (BBC), Karen Perry (Age Concern), Pauline Readman (Carers In Bedfordshire), Gail Shanahan (Advocacy for Older People), Ted Bowen (Federation for Occupational Pensioners (N.F.O.P)), Josie McLean (Bedford LiNK), Steve Tomlin (BBC Adrian Wareing (DSD Leisure) and Chris Bradley-Rushe (SEPT) No. Item Actions 1. Apologies and Welcome

John welcomed all members to the meeting and introductions followed.

2. Minutes of the last meeting The minutes were agreed as accurate pending the following amendment: Josie McLean to be added under item 1 as a new member welcomed to the Partnership Board.

3. (i)

Matters Arising Adult Learning Working With Day Centres Adult Learning and NHS Bedfordshire were going to link to explore the possibilities of working together on various initiatives e.g. chair based exercise programme in Day Centres and adult learning. No update on this today but a short report will be presented to the next partnership board. Frances to action.

FD

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(ii) (iii) (iv) (v) (vi) (vii)

Reablement Monies John informed all that a plan for how to spend Reablement monies has been agreed and for the plans to be brought to the next partnership board. Older People’s Festival - 18th May 2011-03-03 At the last partnership board it was noted that Ian had made contact with Richard Fuller, Alistair Burt and Nadine Dorris to make them aware of the event. Ian queried whether it would be an idea to ask them to speak at the festival. John agreed to follow this query up. Ian also mentioned that he had written to the Mayor about having a Community Stand on market day to help promote the festival and was still awaiting a response from the Mayor. Flyers were distributed at the meeting and for extra copies to make contact with Gillian Abbott. International Day of Older People -1 October 2011 John welcomed board member suggestions as to how the day could be marked. Please email John with any ideas. Implementing the National Dementia Strategy - 9 March 2011 Ian McCreath attended this conference and will feedback to the next partnership board. Claire to take forward. Ian attended the March partnership board and it was noted by some members of the board that the charge for the home support service of £19.50 seemed quite expensive and requested a breakdown of the cost. Claire to liaise with Ian for an update. Partnership Board Forward Plan The forward plan is being updated and maintained on a regular basis. It was agreed to add Dignity In Care and End of Life to the plan. Claire to action. Care and Compassion – Ombudsman Report John explained that he has been in discussions with the Hospital to try to find a representative to attend the partnership board to discuss the report in more detail. It is hoped they will attend the next partnership board.

JB JB All to note CM CM CM

4.

Presentation by Debbie Buck and Martin Westwood – Mental Health Presentation slides attached. Debbie Buck (Clinical Group Manager, SEPT) and Martin Westwood (Interim Team Manager of OP CMHT) introduced themselves to the Board.


The aim of the presentation is to give a broad overview of what is currently happening and what the future holds, challenges SEPT are facing and look at future developments to overcome the challenges. Today there are 1.7 million more people over the age of 65 than there was 25 years ago. By 2053 it is projected to rise another 1.7 million people in Mental Health. This places a huge challenge on the services, resources and society generally. SEPT’s aim is to promote recovery, changing the mindset of service users and society by training service users and staff. To ensure equality SEPT are planning to merge the single point of contact (ASPA) with the Older People’s Community Mental Health Team. Multi agency memory assessments take up to 4 weeks to complete. The idea of the memory clinic is for early detection of diagnosis, information and advice and sign posting. SEPT will also be engaging with the A&E department at the Hospital to look at how crisis intervention is handled especially in relation to dementia. Questions raised were: - What is Lewy Bodies? - Martin explained that it is a type of dementia

but suggested for individuals to make contact with the person who gave the diagnosis for a more detailed explanation.

- Will the Complex Care Team continue their service? – Vanessa

mentioned that the team had been very helpful in reducing the numbers of service users in reducing their medication and using techniques to help people with violent dementia symptoms. Martin explained that 1 SEPT staff member (nurse) has been assigned specifically to residential homes to look at a dementia mapping programme. Vanessa welcomed this approach.

- Is there a specific budget aligned against cultural and language

challenges facing SEPT services? Martin explained that SEPT’s Commissioning Team aware of the challenges and in some areas there are individuals to help clients through the pathways. Interpreters and information leaflets in other languages are also available. Kuldip felt that staff need to be trained to manage conflicting service user, family and carer views.

- Pat complimented the good work SEPT have managed in a short

space of time and felt that to make good progress on services in the future, it is important for Managers to recognise the pit falls of the past.

5. Charging Policy Update

Simon White (Assistant Director – Business Support and Operational Housing Services) was welcomed to the meeting. He briefly explained about the history of charging which said that local authorities had a legal


duty to charge people for receiving residential care. Several years later the local authority then started to charge for non residential care. At the moment, charging for non residential care is not a legal requirement but is the choice of the local authority if they wish to charge. Bedford Borough Council have both policies and have been in use for the past 2 years. Simon informed members of a fundamental change in the legislation which will be more evident in Autumn. The Law Commission will be reviewing the legislation in relation to social care and also the Government has created a committee/body to look at how social care is funded in the future. All financial assessments are undertaken on an individual basis and is means tested. If an individual has money, savings or capital above the threshold, they may have to pay the full price for services. Ian expressed concern that the cost of the services may be precluding people from accessing care. Simon explained that when receiving a financial assessment, clients will automatically be given the option to receive benefits advice, unless the client refuses. Bedford Borough Council has claimed over £1million for and on behalf of clients in benefits over the last 2 years. Turn2us is a charity who express the same concern as some members of the board, that not everyone is accessing the benefits they are entitled to and all throughout April is raising awareness. Information to be distributed with the minutes. www.turn2us.org.uk Pat mentioned that: - St. Andrews Church - offer benefits advice using trained volunteers.

An appointment can be made by contacting 01234 216881. - Salvation Army - Commercial Road – offer benefits advice using

trained volunteers. To book an appointment contact 01234 357174. Teresa informed members that the Department of Working Pensions has a number of helplines available for those making benefit checks or enquiries.

CM PH

6. Eligibility Policy Update John said that throughout February and March everyone had had the opportunity to contribute to the consultation. As a result it was agreed to maintain the current position whereby the eligibility criteria is available to those with a low need for a short term period. For all to note that with future budget and resources going forward, the Eligibility policy is likely to be reviewed again.

7. Dementia Strategy Update Howard was unable to attend this meeting and is therefore to be rescheduled to attend the next partnership board. Claire to update the

CM


http://www.turn2us.org.uk/

forward plan.

8. Housing Strategy Update Andrew was welcomed to the meeting. Andrew explained that his job role has changed slightly as a result of housing now being apart of Adult Services and that he no longer has overall responsibility for the Housing Strategy. However he does still have responsibility for the Older People’s Accommodation Strategy and the Supporting People Accommodation Strategy. It is hoped draft strategies will be available in time for the Older People’s Festival. These strategies will then influence the overall Housing Strategy Vanessa requested that the strategies within the Health and Wellbeing Thematic report be distinguished clearly between each other. John to action. Andrew gave a brief update on ongoing housing projects: - Cardington Court (BPHA) – Demolition is complete and builders are

due to commence work. Completion date = May 2012. - Bromham Road (mixture of housing association, private sell and

shared ownership) – appointed contractors. Completion date = 2013. - River Valley Park Retirement Village (private) – Aspirational

development. Jean informed members of the Board that she finds that older people want to downsize in property but Bedfordshire does not have many options for this to happen and feels that this should be taken into account. Andrew agreed with Jean and stated that this point has been included in the Older People Accommodation Strategy. Andrew agreed to attend members groups to discuss and answer questions on the strategies.

JB

9.

Service User News Pat reported some concern about transport complaints in particular where the drivers are not assisting elderly or disabled people with getting on and off the busses with their luggage and wished for this concern to be flagged up at the next Transport Forum. It was agreed for Ted to take forward at the next meeting and report back to the next partnership board. Cost of care – Ian stated that he had had a meeting with Richard Fuller regarding the cost of care for older people, but has not had a response from Richard Fuller and feels that politicians are ignoring this issue. Vanessa and John explained that when a service user enters a care home, they should be aware of the cost of the bed and are required to sign a contract.

TB

10. Carer News No update at today’s meeting.


11. Transport Forum Update Ted sent his apologies for today’s meeting but was able to give an update over the phone to Claire which noted the following: - working groups on transport, first of all bus shelters can contain

details of timetables of all operators that use the same bus stop - the need timetables to be in larger print or Braille - the need for audio systems at bus station to inform passengers

change of bay numbers - the need for leaflets at bus stations notifying people of bay numbers

and destinations so public can pick it up - the need for a contact official at bus station for customers requiring

advice and information

12.

Safeguarding No update at today’s meeting.

13. Health and Wellbeing Board Report John produced and presented the attached report to the Health and Wellbeing Thematic Partnership Board. The report contains the Older People Strategy Action Plan for 2010 – 2013. John explained that this is a working document and if members, organisations would like anything to be included, comments can be emailed to John for inclusion in the plan. Page 15 – Vanessa stated that the care providers are working towards the Gold Standard Framework in principle but not in practice as it is heavily paper driven. John noted Vanessa’s comment. John to action comments regarding strategies above.

All to note JB

14. (i) (ii)

AOB Newnham Ward – Gas checks Ian informed members that Newnham Ward have been subjected to having gas appliances and pipes checked which has resulted in individuals receiving work to repair gas leaks etc but to note that many older people have mentioned they can not afford the maintenance charges. John said that on the Council’s website there is a Trusted Trader Schemes of companies which assures companies carry out good work. Draft Report of Chief Fire Inspector Vicky Allen agreed to pass information on how to access this report for reading.

VA



15. Date and Time of Next Meeting 26th May 2011 - 10.00 am – 12.00 noon Committee Room 1, Borough Hall 7th July 2011 (10 – 12noon) 18th August 2011 (10 – 12noon) 6th October 2011 (10 – 12noon) 10th November 2011 (10 – 12noon) 15th December 2011 (10 – 12noon)

1

What is Advocacy for Older People (AOP)?

Local independent charity.

Providing free and confidential advocacy support.

Serving Bedfordshire, Luton and surrounding areas.

Operating for 12 years.

2

Mission Statement

To enable older people to retain their independence, rights and dignity.

Have their wishes heard. Make their own choices. Control their lives. Available and responsive to any older person who

needs our help. Access services, information and advice, provide

support and advocate for them. Ensure that their wishes are paramount. We promote opportunities for older people to be

socially included and involved in local communities to maintain a good quality of life.

Older people often feel:

People are making decisions for them.

They are not in control of their lives.

They are losing their independence.

People are not listening to them.

They don’t know what choices are available to them.

3

Issues

Abuse.

Access to support services.

Care provision.

Complaints.

Consumer problems.

Family.

Financial.

Health care.

Home care.

Housing/home moves.

Legal issues.

Social care.

Support in specialist units.

When clients come to us they are often:

In crisis.

Distressed.

Anxious.

Overwhelmed.

In fear.

Lonely.

Very elderly.

Alone.

Health issues.

Physical constraints.

Mental health issues.

Bereaved.

4

An Advocate’s help is personal & practical:

Advocates will listen.

Advocates are there solely for their client.

Advocates have time.

Advocates will give independent support to their client.

Practical help:

Ensure client has access to information, advice and services.

Identify their options. Accompany to

meetings. Represent clients. Support client to

voice their wishes.

5

Who are the Advocates?

Trained and supported volunteers.

Time to listen. Completely

independent. Confidentiality. Tactful and discreet. Work is rights and

choice based, client-centred.

Dedicated to improving the quality of life of older people.

Where we help:

In client’s own homes.

In residential care homes/nursing homes.

Specialist units.

Hospitals.

6

Referrals:

Self referral. Family referral. OP Social work team. Community mental health team. Community health nurse. Residential care home managers. Alzheimer’s Society. Specialist units. Voluntary services.

Specialist mental health & dementia team:

Mental health & dementia worker.

Commissioned work in specialist units.

Orchid Lawns & PottonHouse in Central Beds, Relatives Group, and unit issues.

Lime Trees & Poplars (L&D Hospital) advocacy presence.

Chaucer & Milton Wards (Bedford Hospital) advocacy presence.

Implementing the National Dementia Strategy, at a local local.

7

Mental health & dementia Advocates provide:

Ongoing, individualised, non-clinical support.

Ensuring clients voices, questions & wishes are heard.

Enabling them to be part of all processes and decisions affecting them.

Continuing personal support.

Safeguarding Vulnerable Adults

SOVA Team Leader appointed January 2011

Delivering in-house SOVA training

Provide training to nursing homes

Provide training to residential care homes

Offer support and guidance on SOVA to staff, volunteers and professionals

8

Routine AOP SOVA Work

15-20 Ongoing SOVA cases

Regular visits to clients

3-4 New SOVA referrals per month

Monthly visits to specific care homes

Attendance at strategic SOVA meetings

Maintain relationships and contact with other key professionals

Recent SOVA Cases include:-

Financial abuse

Physical abuse

Emotional / Psychological abuse

Sexual abuse

Theft / Burglary

9

Recent SOVA Case Study

Mrs X is 79 years old and currently resides in a care home

Previously repeatedly assaulted by her grandson and hospitalised

Grandson lives in Mrs X’s house with his family rent-free

Suspicions that Mrs X is also being financially abused by her niece

AOP role in this case

Listen to Mrs X

Ensure Mrs X is safe

Liaise with police and social services and present Mrs X’s views

Provide Mrs X impartial support in her decision-making

Facilitate legal advice from solicitors

10

Mrs X’s key priorities

“Maintain a relationship with my grandson and niece”

“Receive visits from my grandson and niece”

“Remain in my current nursing home until I die”

“Cause as little distress to my family as possible”

Mrs X Disinterested in:-

Any financial investigation

Or

Supporting any criminal prosecution

11

Thank You for Listening

We welcome any questions ……….

apart from difficult ones!!!

Advocacy for Older People

3 Union St.

Bedford.

MK40 2SF

Tel: 01234 218880

Email:[email protected]

www.basop.info

Objective Outcome Key Actions Timescale Lead Officer RAG Monitoring

1. Raise awareness of dementia and encourage people to seek help

Specific Bedfordshire Dementia Services Leaflet

1) Jan Sexton Carers leaflet to be adapted 2) Comms Plan will need to be developed to ensure effective engagement especially with BME groups

December 2010

George Hunt – Bedford Borough Council

Bedford Borough to report progress at next BB Dementia Meeting

2. Good quality

early diagnosis, support and treatment for people with dementia and their carers, explained in a sensitive way.

Uniform Memory Clinic Model throughout Bedfordshire

1) SEPT(provider) currently reviewing Memory Clinic Model, initially feedback is to potentially extend the service to other Locality’s within Bedfordshire 2) Present the new Memory Clinic Model for Bedfordshire

October 2010 December 2010

Dr Schoeman Dr Schoeman

Dr Schoeman to present new model at next BB Dementia Meeting

3. Good-quality information for people with

Provision of information on coping strategies & maintaining skills.

1) Directory of Services currently being developed by Bedford Borough Council

Completed Bedford Borough Council Commissioning

Howard Shoebridge to liaise with respective IT departments to ensure a link from PCT to Council

NHS Bedfordshire & Bedford Borough Council Dementia Action Plans 2011/12

dementia and their carers

Provision of Directory of Services

2) Provision of information on coping strategies & maintaining skills can link in with Objective 1.

Team NHS Health Promotion

directory of services exists

4. Easy access to care, support and advice after diagnosis

People with dementia will be supported from the memory assessment clinics through whole dementia journey by dementia support workers.

1) Ensure dementia support workers have access to the memory assessment clinic 2) Recruit to current vacancies

Jan 2011 Jan 2011

Howard Shoebridge, SEPT, Alzheimer’s Society Alzheimer’s Society

Recruitment complete

5. Develop structured peer support and learning networks

Varied Provision of Carers Breaks & support groups for people with Dementia.

1) PCT & BB Council to provide information on current commissioned services for carers. 2) It is identified that there is a gap of provision for younger people with dementia

Oct 2011 Howard Shoebridge & Marek Zamborsky.

Tendering for carers services started

3) This shared data to be used to explore rationalising carers provision to jointly commission services to provide better outcomes

6. Improve community personal support services for people living at home

Access to crisis services for suffers of dementia Develop specialist organic disorder CMHT

1) Crisis Team to be available out of hours e.g. after 5pm on weekdays and weekends. 2) NHS Bedfordshire currently in discussion with SEPT around providing this or a similar service as part of the QIPP initiatives 3) BB Council currently revising accreditation for homecare services

April 2011

Howard Shoebridge

HS to feedback to the group on developments of Crisis team/CMHT for organic disorders MZ to feedback on Council commissioned homecare services.

7. Implement the New Deal for Carers

Holistic Carers Assessment & Information pack

1) BB Council Revising Carers Policy will need PCT involvement

October 2011

BB Council Commissioning Team & SEPT

Tendering process started for carers services

8. Improve the Dementia Liaison Dementia Liaison Nurse to April 2011 Howard HS to feedback to group

quality of care for people with dementia in general hospitals

Post based in hospitals Transfer of Care Policy

2) provide increased awareness of dementia and help support better quality of care for dementia patients whilst in acute setting with coordinated discharge protocols. 3) Engage with Bedford Hospital to have representative on Bedford Borough Dementia group 4) NHS Bedfordshire to discuss with SEPT on potential to resource acute liaison post 5) Health & Social care to work with acute hospitals in drafting a transfer of care policy.

December 2011 December 2011 Ongoing

Shoebridge & BB Council Commissioning & Acute Hospital

progress and implementation of a dementia Liaison nurse(s) & function Acute hospital is attending Bedford Borough Dementia implementation group. NHS Bedfordshire to attend Acute hospital steering group AS to feedback to group on the status of the transfer of care policy

9. Improve intermediate care for

To ensure intermediate care is inclusive to

1) Expansion of Service e.g. of the Archer Unit to accept Dementia Patients

TBC Howard Shoebridge & BB Council

HS to feedback to the group on intermediate care

people with dementia

Dementia patients Establish a renablement team

2) Renablement is part of the BBCouncil Transformation Plans

Commissioning Team,

AS to feedback to the group on progress around renablement

10. Consider how housing support, housing-related services, technology and telecare can help support people with dementia and their carers

Ensure there is an increased awareness of Telecare and available assisted technology is

1) Telecare is a key part of BB Council transformation agenda 2) Up skill Frontline Social Workers on telecare 3) Retender of Aragon housing contract, Dementia to be mentioned specifically

TBC BB Council Commissioning team

MZ & AS to feedback to the group progress of retendering of Aragon housing contract & telecare

11. Improve the quality of care for people with dementia in care homes

Implementation of National Guidance on Model of care within Care Homes

1) Await National Guidance 2) Training is a big issue within Care Homes which the model of care will pick up

BB Council Commissioning Team & Lead for Local Residential Nursing Homes

MZ, AS or Chris Ryan to feedback to the group update on national guidance. Training commissioned from

3) Home from Home Publication to be circulated

Ian McCreath

Training consultant to complement BB training packages Ian McCreath to circulate document prior to next BB Dementia Meeting

12. Improve end of life care for people with dementia

Ensure effective links to NHS Bedfordshire End of Life Strategy

1) Invite Nicky Bannister (End of Life Commissioner) to Bedford borough Dementia Meetings 2) Agreed Advanced Directives protocol

Completed Tim O’Donovan Action Plan

13. An informed and effective workforce for people with dementia

Co-ordinated multi agency Dementia training across Bedfordshire

1) To establish an education group made of cross agency staff, drawing on expertise across the county 2) To establish accreditation for the Dementia training

Local Authority & NHS Bedfordshire Workforce Leads

package 3) Liaise with Claire Ryan Central Bedfordshire to explore countywide training opportunities 4) To confirm amount and remit of SWIFT funding and discuss opportunities 5) Identify funding source for education group as should be self-sustaining and a business plan needs to be set up

January 2011 December 2010

Howard Shoebridge Howard Shoebridge

14. A joint commissioning strategy for dementia

To ensure national dementia strategy is reflected within Bedford Borough

1) Joint Strategy between Bedford Borough and NHS Bedfordshire including commissioning intentions

January 2011

George Hunt Draft currently being circulated for comment

15. Improve assessment and regulation of health and care services and of how systems are working

To ensure robust contracting & monitoring processes for NHS Bedfordshire & Local Authority commissioned placements

1) Develop with Local care homes agreed competencies in line with QCF qualification Support residential and care homes with access to training and education 2) To include where appropriate Dementia clauses to contracts with commissioned placements

April 2011 April 2011

Local Authority & NHS Bedfordshire Contract Leads

Monitor through Contract meetings

16. Provide a clear picture of research about the causes and possible future treatments of dementia

To ensure National and Local research informs commissioning decision making

1) Use of the Dementia Executive Software 2) Presentation of Dementia Executive Tool 3) Ensure clear

February 2011

Howard Shoebridge

Action Plan

communication with the 4) Alzheimer’s Research department to ensure latest developments are made aware. 5) Nice guidance implemented in line with best practice

17. Effective national and regional support for local services to help them develop and carry out the Strategy

Clear leadership driving Dementia services within Bedford Borough

1) Establish a countywide cross agency Dementia Steering group 2) Engage with regional Dementia Lead regularly on progress 3) Analysing existing areas of excellence and not re-inventing the wheel e.g. carer support provided by Alzheimer’s society and carers in Bedfordshire

Completed Completed

NHS Bedfordshire & Local Authorities

Links to regional dementia commissioners group.

16 May 2011 Gateway reference: 16072 STATEMENT OF GOVERNMENT POLICY ON ADULT SAFEGUARDING Introduction The purpose of this document is to set out the Government’s policy on safeguarding vulnerable adults. It includes a statement of principles for use by Local Authority Social Services and housing, health, the police and other agencies for both developing and assessing the effectiveness of their local safeguarding arrangements. It also describes, in broad terms, the outcomes for adult safeguarding, for both individuals and agencies and outlines the next steps. Government Policy The Government’s policy objective is to prevent and reduce the risk of significant harm to vulnerable adults from abuse or other types of exploitation, whilst supporting individuals in maintaining control over their lives and in making informed choices without coercion. The Government believes that safeguarding is everybody’s business with communities playing a part in preventing, detecting and reporting neglect and abuse. Measures need to be in place locally to protect those least able to protect themselves. Safeguards against poor practice, harm and abuse need to be an integral part of care and support. We should achieve this through partnerships between local organisations, communities and individuals. The State’s role in safeguarding is to provide the vision and direction and ensure that the legal framework, including powers and duties, is clear, and proportionate whilst maximising local flexibility. This framework should be sufficient to enable professionals and others to take appropriate and timely safeguarding action locally while not prescribing how local agencies and partnerships undertake their safeguarding duties. We know that when local people get involved, communities can do things differently. We need local authorities and local multi-agency partnerships to provide leadership in moving to less risk-averse ways of working, and to concentrate on outcomes instead of focusing on compliance. Local multi-agency partnerships should support and encourage communities to find local solutions. These solutions will be different in different places, reflecting, for

example, local demographics and environmental characteristics. However, they should all reflect the key Principles that we set out below. Principles Agencies can use the following principles to benchmark existing adult safeguarding arrangements to see how far they support this aim and to measure future improvements:

Empowerment - Presumption of person led decisions and informed consent. Protection - Support and representation for those in greatest need. Prevention - It is better to take action before harm occurs. Proportionality – Proportionate and least intrusive response appropriate to the risk presented. Partnership - Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. Accountability - Accountability and transparency in delivering safeguarding. Outcomes Below we make some suggestions for translating these principles into outcomes. Local partnerships might find these a useful starting point in developing locally agreed visible outcomes that local communities, users and carers, understand and agree. We look at these from an individual and a organisational perspective. Individuals A summary of how people might experience these outcomes: A People worked together to reduce risk to my safety and well being • I had the information I needed; in the way I needed it

• I was helped to plan ahead and manage the risks that were important to me • People and services understood me - recognised and respected what I could do and what I needed help with • The people I wanted were involved • I had good quality care - I felt safe and in control • When things started to go wrong, people around me noticed and acted early People worked together and helped when I was harmed • People noticed and acted • People asked what I wanted to happen and worked together with me to get it • The people I wanted were involved • I understood the reasons when decisions were made that I didn’t agree with • I got the help I needed by those in the best placed to give it • The help I received made my situation better • People will learn from my experience and use it to help others B Empowerment –I am consulted about the outcomes I want from the safeguarding process and these directly inform what happens. Protection - I am provided with help and support to report abuse. I am supported to take part in the safeguarding process to the extent to which I want and to which I am able. Prevention - I am provided with easily understood information about what abuse is, how to recognise the signs and what I can do to seek help. Proportionality - I am confident that the responses to risk will take into account my preferred outcomes or best interests. Partnership - I am confident that information will be appropriately shared in a way that takes into account its personal and sensitive nature. I am confident that agencies will work together to find the most effective responses for my own situation. Accountability - I am clear about the roles and responsibilities of all those involved in the solution to the problem Local Agencies Empowerment We give individuals relevant information about recognising abuse and the choices available to them to ensure their safety. We give them clear information about how to report abuse and crime and any necessary support

in doing so. We consult them before we take any action. Where someone lacks capacity to make a decision, we always act in his or her best interests. Protection Our local complaints, reporting arrangements for abuse and suspected criminal offences and risk assessments work effectively. Our governance arrangements are open and transparent and communicated to our citizens. Prevention We can effectively identify and appropriately respond to signs of abuse and suspected criminal offences. We make staff aware, through provision of appropriate training and guidance, of how to recognise signs and take any appropriate action to prevent abuse occurring. In all our work, we consider how to make communities safer. Proportionality We discuss with the individual and where appropriate with partner agencies the proportionality of possible responses to the risk of significant harm before we take a decision. Our arrangements support the use of professional judgement and the management of risk. Partnership We have effective local information-sharing and multi-agency partnership arrangements in place and staff understand these. We foster a “one” team approach that places the welfare of individuals above organisational boundaries. Accountability The roles of all agencies are clear, together with the lines of accountability. Staff understand what is expected of them and others. Agencies recognise their responsibilities to each other, act upon them and accept collective responsibility for safeguarding arrangements. These Principles are not separate but integral to wider Government policy. Links to other statements on adult social care No Secrets This document builds on “No Secrets”, which will remain as statutory guidance until at least 2013. In the principles described above, we have taken account of the responses to the public consultation on “No Secrets” in 2008/09, the implementation of the Mental Capacity Act 2005 and the drive towards increasing personalisation of services. The Government intends to seek to legislate for Safeguarding Adults Boards (SABs) Making existing Boards statutory, while maintaining their freedom to operate in locally flexible ways, will secure a transparent and locally

accountable mechanism for local communities to ensure the protection of vulnerable adults. Research commissioned by the Department of Health has shown that specific legislation for statutory Safeguarding Adults Boards would help to hold agencies accountable in ways which guidance, differentially binding on the partners, has not so far been able to do. Such a move is widely supported by stakeholders. . The Law Commission has now published the final report of its review of adult social care law and has recommended making SABs statutory. Vision for social care We published A vision for adult social care: Capable communities and active citizens in November 2010. In the vision we set out a new direction for adult social care, putting personalised services and outcomes centre stage. We emphasized the crucial role of local government and front-line workers and carers in the delivery of personalisation, giving them the freedom and responsibility to improve care services. The section on protection made it clear that we should protect people when they are unable to protect themselves, and that this should not be at the cost of people’s right to make decisions about how they live their lives. Social care outcomes framework With the sector, we have developed a new strategy for transparency, quality and outcomes framework in adult social care, which aims to empower councils, local people and the wider social care sector to undertake new leadership roles. It provides support to the critical link between adult social care and other local partners. Wider context Community Empowerment and Localism The Government wishes to empower individuals to take responsibility for their own lives. This includes enabling them to protect themselves from harm and abuse, with and without assistance from others. The Government also wishes to empower communities to make decisions and their own arrangements to suit local needs and priorities. This includes ensuring that we protect adults at risk of significant harm from abuse. Policing reforms The Police Reform and Social Responsibility Bill is currently being considered by Parliament. Through this new legislation, in particular the introduction of Police and Crime Commissioners (PCCs), the Government is seeking to

ensure the public are able to set the direction of their policing and hold the police to account, through their PCC, for the provision of policing in their area. We will replace bureaucratic accountability to central Government with democratic accountability to the public. Key milestones Publication of Law Commission report on the law on Adult Social Care 11 May 2011 Report of the Independent Commission on the Funding of Care and Support July 2011 White Paper on social care reform December 2011 Supporting Materials

Below are links to some supportive good practice materials that underpin our approach to safeguarding. These include work we have both commissioned and co-produced with partners, such as SCIE, LGID (formerly IDeA) and CQC. • A Vision for Adult Social Care: Capable Communities and Active Citizens • Practical approaches to safeguarding and personalisation http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121508 • The 2011/12 Adult Social Care Outcomes Framework and the formal

Government response to the consultation Transparency in outcomes: a framework for quality in adult social care can be found at:

http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_125464

• Local Government Improvement and Development Standards and Probes for Adult Safeguarding Peer Review (LGID) http://www.idea.gov.uk/idk/core/page.do?pageId=22653865 • Health guidance for managers, commissioners and nurses. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_124882 • A guide to achieving good outcomes in safeguarding adults in health services, with a voluntary self-assessment framework

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121508

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121508

http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_125464

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_125152.xls • Protecting adults at risk: London multi-agency policy and procedures to safeguard adults from abuse http://www.scie.org.uk/publications/reports/report39.pdf Awaiting publication: • Research on Safeguarding Adults Boards-SCIE • Guide to safeguarding law-SCIE • National Police Guidance on Safeguarding and Investigating the Abuse of

Vulnerable Adults-NPIA / ACPO • Financial Crime against Vulnerable Adults Report -City of London

Police/ACPO.

http://www.scie.org.uk/publications/reports/report39.pdf

agenda · john bruynseels (bbc), vicky allen (bedfordshire and luton fire and rescue service), ian...

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