southampton local safeguarding adults board care act workshop fiona bateman independent chair lsab...
TRANSCRIPT
Southampton Local Safeguarding Adults Board
Care Act Workshop
Fiona BatemanIndependent Chair [email protected]
LSAB: Role and ResponsibilitiesSafeguarding responsibilities arise where there is reasonable cause to suspect that an adult:
has needs for care and support (whether or not the LA is meeting any of those needs) is experiencing, or is at risk of, abuse or neglect and as a result of those needs is unable to protect him/herself against the abuse or neglect or the risk of it.
Section 43 of Care Act 2014 requires that a Local Authority establish a Safeguarding Adults Board in order to help and protect adults in its area by coordinating and ensuring the effectiveness of what each of its members does.
The Southampton LSAB is a multi-agency board made up of key statutory and voluntary sector partners with responsibilities to adults at risk in Southampton. The Board’s purpose is to ensure that local safeguarding arrangements and partnerships are effective in protecting adults at risk or experiencing neglect and/or abuse and to drive continual improvement.
The LSAB coordinates the strategic development of adult safeguarding across Southampton and ensures the effectiveness of safeguarding practices by:
•Monitoring the effectiveness of safeguarding practice within statutory partner agencies. The LSAB analyses data and quality-assurance reports from all agencies on a regular basis to identify good practice and highlight any shortcomings. It is also required to undertake Safeguarding Adults Review and monitoring implementation of any recommendations or actions arising from these.
•Setting priorities and coordinate the strategic development of adult safeguarding across all sectors in Southampton. The LSAB reports annually on what has been done by the Board and member agencies to achieve the strategic plan.
•Supports the work of frontline staff across all partner agencies by providing clear guidance on statutory safeguarding duties and powers and the application of these in operational processes.
Southampton City council’s Safeguarding adults team
The Local Authority’s Safeguarding Team role is to;
•receive and screen alerts relating to adults at risk of abuse or neglect received from the public, statutory partners, the private and voluntary sector
•Initiate or cause to be made any necessary safeguarding enquiries to enable it to decide what action is required and by whom [s42 Care Act 2014].
•Intervene where necessary and devise, with the adult at risk and their carer or representative, protection plans to address risks and achieve the outcomes identified by the adult. A key aim of the team is to enable the adult to build greater resilience against any future risk of abuse or neglect.
Agencies do not have any additional powers to investigate or intervene where there are adult safeguarding concerns, so any intervention must consider the legal and cultural framework of obligations owed to an individual who, notwithstanding their vulnerabilities, are entitled to live free from unwarranted or disproportionate interventions.
The Safeguarding Adults Team [‘SAT’] must therefore rely heavily on the cooperation of partner agencies, particularly those with care assessment or management responsibilities, the public, private and voluntary sectors to identify possible situations where a vulnerable adult might be experiencing or at risk of abuse and neglect, raise an alert and assist the SAT with enquiries or by undertaking actions required as part of the protection plans.
The LSAB can assist to request from anyone information that is relevant to the exercise of its functions [s45 Care Act]
SSAB Priorities 2014-15: Types of abuse
FINANCIAL ABUSE: 27.8% against national comparator of 18% in 2012-13•Need to be confident that this need across partner agencies is met and that those experiencing financial abuse have access to information and support to protect themselves in the future.
PHYSICAL ABUSE: 28.9% compared to 28.4% nationally for 2012-13
NEGLECT: 16.2% IN 2013-14 compared to national figures for 2012-13 of 27.4%. •Important for the SSAB to understand why abuse within residential care has decreased and share locally and nationally examples of good practice
in 2014-15 LSAB agreed to:•further develop links with key strategic forums within Southampton including LSCB, SCP and Southampton connects and SABs in neighbouring areas;•Re-establish the sub groups with committed membership, clear work streams and reporting frameworks so that the tasks identified within the Annual Report are completed and able to inform the work of the main board;•Prepare and consult on the strategic plan for the LSAB prior to implementation of the Care Act 2014 in April 2015.
Introduction
The Care Act 2014 was given Royal Assent on 14th May 2014 and the majority of the Act comes into force on 1st April 2015Norman Lamb MP, Care & Support Minister described the Act as being the most significant reform of care and support in more than 60 years.
Purpose of this session- headlines Brief summary of the safeguarding headlines of the
Act and what it will mean for professionals. other important changes not be covered here are: Assessment & eligibility LA establishing and maintaining information and
advice Market shaping and commissioning of services Charging and financial assessment Personal budgets and direct payments Moving between areas-ordinary residence
For additional information
Safeguarding sections 42-46 CA 2014 and mainly in Chapter 14 statutory guidance
In addition to the CA2014 itself you can access the Statutory guidance, fact sheets and regulations at:https://www.gov.uk/government/publications/care-act-2014-statutory-guidance-for-implementation
https://www.gov.uk/government/publications/care-act-2014-part-1-factsheets
https://www.gov.uk/government/consultations/updating-our-care-and-support-system-draft-regulations-and-guidance
Aim of the Act• The aim of the Act was to address the whole of the
community care law in a single document and to impose a structure and a rationale for the provision of care and support
• The Act will affect the work of social workers, their colleagues in others departments and many other organisations.
Much of the community care law in reality remains the same but there are some new key new principles and statutory duties which the Local Authority are bound to comply with.
Some other relevant legislation remains e.g. Mental Capacity Act 2005 and deprivation of liberty safeguards
What is changing
At present many of the LA’s obligations can be summarised as: “ Meet the assessed need”
After 1st April 2015 it will be:
“Prevent the need arising, set goals to achieve wellbeing; meet the assessed need; and involve others as appropriate to achieve the above”
General Principles under the Act
Promoting well being, including preventing abuse and neglect (safeguarding)
Preventing, reducing or delaying needs To establish and maintain information and
advice services Market shaping and commissioning of adult
care and support services Managing provider failure and other services
Chapters of the Statutory Guidance relevant to safeguarding
Area Chapter
Well-being 1
Prevention 2
Information and Advice 3
Market shaping and market failure 4
Assessment and eligibility 6
Advocacy 7
Care and support planning 10
Review 13
Safeguarding 14
Section 1 Promoting individual well-beingThe Act has a number of core values which shape the specific duties and powers
The first key principle is the general duty of a local authority “in exercising a function” under Part 1 of the Act “is to promote that individual’s well- being”.
Function includes individual service provision decisions in addition to policy decisions and also includes service provision and contact with individuals whose needs are not eligible and also applies to children, carers and young carers when subject to transition assessments.
Well-being principleWell- being broad concept but includes:
Personal dignity (including treatment with respect)Physical and mental health and emotional well-beingProtection from abuse and neglect, including safeguardingControl of the individual over day-to-day life( including over care and support)Participation in work, education training or recreationSocial and economic well-beingDomestic, family and personal relationshipsSuitability of living accommodationThe individuals contribution to society
Promoting well-being Involves actively seeking improvements in well-being
when carrying out any care and support function in relation to an individual
At any stage from the provision of information and advice to reviewing a care and support plan
Covers a broad range of aspects of a persons life and will be a wide variety of specific considerations depending on the individual
Shift from existing concept of “meeting needs” to establishing a clear and consistent set of duties and powers for all people
When discharging any obligation under the Act LA MUST “have regard to”:•The principle that the individual is best placed to judge their well-being, outcomes and goals•The individual’s views, wishes, feelings and beliefs,•The need to prevent/delay the development of needs for care and support and reducing existing needs•The need to make decisions that are not based on stereotyping of individuals,
Additional key principles and standards• Individual being able to participate as fully as
possible• Achieving a balance between the individual’s well-
being and that of any friends or relatives who are involved in the care
• The need to protect people from abuse and neglect
• The need to ensure any restrictions on individuals rights/freedoms to be kept to an absolute minimum
“Having regard” is the same as “due regard” under the Equality Act 2010. proper and appropriate regard in all the circumstances requires a conscious directing of the mind to the obligations- with rigour and an open mind.
Need for an audit trail of all significant decisions
Well-being includes a focus on delaying and preventing care and support needs and supporting people to live as independently as possible.
At the heart of the reformed system will be the assessment and planning process. The guidance describes this as a genuine conversation about peoples needs and how meeting these can help them achieve the outcomes.
Prevention of abuse and neglect and safeguardingSafeguarding was contained in “No secrets” guidance. The CA statutory guidance replaces this and gives this a new statutory basis.Where a person is at risk of harm or abuse LA must act swiftly and put in place an effective response
When carrying out an assessment LA must consider if person is at risk of abuse/neglect and if believe so they must carry out a safeguarding enquiry and decide with the adult what if any actions are appropriate
Safeguarding framework of support
Adult at risk
Community Safety (Safer
Neighbourhoods, ASB, Hate Crime, Domestic
Abuse)
Support based on capacity, consent, self determination, person
centred
Six statutory Safeguarding Principles
National Multi Agency Safeguarding Roles and
Responsibilities Concordat
Prevention and early intervention activities backed up by robust risk management
Care Act 2014 Chapter 14 (replaces ‘No Secrets’).
Provides a new legal framework adult safeguarding. Responsibilities apply to LAs,
Police and NHS
Local Multi-Agency Safeguarding policy
and Procedures
Six key safeguarding principles
• Empowerment-being supported and encouraged to make own decisions
• Prevention-Take action before harm occurs• Proportionality-Least intrusive response appropriate to the
risk • Protection-support and representation to those in greatest
need • Partnership-local solutions and working with commutes• Accountability- Transparency
Safeguarding S42 enquires
Where LA has reasonable cause to suspect that an adult in its areaa)has needs for care and supportb)is experiencing, or is at risk of, abuse and neglect, and,c)as a result of those needs is unable to protect themselves against the abuse or neglect.
LA must make whatever enquiries it thinks necessary to enable it to decide what action should be taken
Section 42 EnquiriesA duty on local authorities to make enquiries, or to ask others to make enquiries
Purpose of the enquiry is to establish with the individual and/or their representatives, what (if any) action is needed in relation to the situation and to establish who should take such action
The section 42 duty will apply when a person with care and support needs whether or not: -ordinarily resident in the local authority area and -the local authority is meeting any of those needs
AbuseStatutory guidance give some illustrations:Physical abuseSexual abusePsychological abuseFinancial or material abuseMoen slaveryDiscriminatory abuseOrganisational abuseNeglect and acts of omissionSelf-neglect
Abuse contd
Incidents can be one-off, multiple and effect more than one personPatterns of abuse may vary and include:Serial abusing-perpetrator seeks out and grooms individuals,Long/short term abuse within long term family relationship or within residential settingsOpportunistic abuse
Spotting signs of abuse and neglect Statutory guidance confirms workers across a wide
range of organisations need to be vigilant about adult safeguarding
Noticing changes that may indicate abuse or neglect and act on their concerns and seek information to prevent harm
Changes could include care fees suddenly stopping being paid, lack of heating & food, change in daily routine, unclean clothes etc
Safeguarding procedures Everyone must understand their role and responsibility and
have access to practical and legal guidance advice and support,
All organisations should have safeguarding polices and procedures in place which may include:
(a)A statute of purpose(b)Statement of roles and responsibilities(c)Procedures for dealing with allegations of abuse, including
dealing wit emergencies,(d)Full list of points of referral(e)How to record allegations or abuse and neglect, any enquiry
and subsequent action,
Safeguarding procedures contd(f) List of sources of expert advice,
(g) Description of channels of inter-agency communication and procedures for information sharing,
(h) List of services that might offer access to support or redress, and,
(i) How professional disagreements are resolved
Carers
Carers could be involved in safeguarding situations:The carer may witness or complain about suspected abuse or neglectThe carer may experience intentional or unintentional harm from the adult or other professionals or organisations in touch with the adult,The carer may intentionally or unintentionally harm or neglect the adultAny assessment must include consideration of the carers and adults well being
CarersSupport carers by offering a needs or carer’s assessment and use this as an opportunity to explore the individuals’ circumstances
Considering whether it would be possible to provide information, or support that prevents abuse or neglect from occurring, for example, by providing training to the carer about the condition that the adult they care for has or to support them to care more safely.
Recognising that abuse or neglect may be unintentional and may arise because a carer is struggling to care for another person. This makes the need to take action no less important, but in such circumstances, an appropriate response could be a carer assessment and support package for the carer and monitor.
LA role in carrying out S42 enquires LA must make enquiries, or cause others to do so, if they
reasonably suspect an adult meets the criteria or is at risk of, The enquiry could range from a conversation with the adult
right thorugh to a multi-agency formal plan or course of action, depending on the individual circumstances,
The professional must record the concern, the adults views and wishes, any immediate action taken and reasons for the action,
The purpose of the enquiry is to decide whether someone/organisation should do something to help and protect the adult
LA role in carrying out S42 enquires
If LA decides another organisations should carry out the enquiry it must set out timescales and need to know outcomes and what action to take if this is not done,
The adult should always be involved unless there are exceptional circumstances that would increase the risk of abuse & what happens should reflect the adults wishes if possible,
All enquires should be handled in a sensitive and skilled way to ensure distress to the adult is minimised.
Independent advocacyThe local authority MUST arrange for an independent advocate to represent and support a person who is the subject of a safeguarding enquiry or a safeguarding adult review if:
They need help to understand and take part in the enquiry or review and to express their views, wishes, or feelings.
Independent advocacy
This provision relates to people with capacity. People lacking capacity will access advocacy support (e.g. an IMCA) via existing provisions under the Mental Capacity Act 2005.
3 routes to advocacy:1)Independent advocate (Care Act duty)2)IMCA (MCA duty)3)IMHA (MHA Act duty)
Integration and Co-operation
Duty to co-operate not new. There are many examples of how LA and others have to co-operate e.g. homelessness enquiries, MAPPA, Children Act enquiriesCA introduces 2 new provisions dealing with co-operationSection 6-general duty to co-operateSection 7 specific duty unless consider it would be incompatible with own duties or have an adverse effect on the exercise of its functions
Safeguarding is not a substitute for:
Providers’ responsibilities to provide safe and high quality care and support;
Commissioners regularly assuring themselves of the safety and effectiveness of commissioned services;
Clinical and care governance to respond to pressure points
CQC ensuring that regulated providers comply with the fundamental standards of care or by taking enforcement action; and
Core duties of the police to prevent and detect crime and protect life and property
S 42 enquiry processAlert received Pre S 42 enquiry Information gatheringViews of adult (or their relative, advocate) and outcomes sought?Can the matter be resolved through information and advice?Can the matter be resolved through referral to another agency to deal with?Should a S 42 enquiry should be undertaken?Non statutory enquiry?Decision to undertake a S42 enquiryInformation to the adult about the process and what to expect Strategy discussion/meetingFocus of the enquiry – who will lead?Need for advocacy? Adult’s participation in meetingsTimescales Arrangements for keeping the person up to dateSafeguarding activity undertakenSafeguarding planReview RecordingClosure
How do you think the Care Act will impact on your work?
Adults at risk and what you need to know..
023 8083 3003
Adult social care,Southampton City Council,Civic Centre,Southampton,SO14 7LY
What do you think are your own additional training needs?
Q&A Session
