Housing and Safeguarding of Adults Conference: Implications of Care Act 2014

1. Presentation to Housing and Safeguarding Adults Conference re the implications of the Care Act 201418th September 2014 Pete Morgan Interim Independent Chair peter.morgan@hertfordshire.gov.uk

2. Safeguarding Adults under the Care Act • The statutory role of Safeguarding Adults Boards (SABs) • Who are the SAB? • What can and can’t SABs do? • Who are they accountable to? • What powers do they have? • How is HSAB responding to the Care Act?

3. The Safeguarding Vision • To promote and protect individual human rights, independence and well-being and • secure assurance that adults at risk stay safe, are effectively safeguarded against abuse, neglect, discrimination, embarrassment or poor treatment, • are treated with dignity and respect and enjoy a high quality of life” Birmingham SAB 2007

4. The Safeguarding Adults Vision -------------------------------- Citizenship Empowerment Protection m

5. What is ‘Safeguarding Adults?’ • I’m not sure, but ….. • whatever it is, it has to fulfil the Safeguarding Vision and assist or enable the individual to move along the continuum from Protection towards Citizenship and • I would suggest that the term itself may cause confusion as it can conflate quality assurance with protection from abuse and neglect.

6. What is ‘Safeguarding Adults’? Whatever it is and whatever we call it: • it must be timely • It must be proportionate • It must be outcome focused • Practice not procedure based • And remember LJ Munby – what is the point of making someone safe if you make them miserable?

7. The position pre-Care Act No Secrets (2000) • Issued under Local Authority Circular • Guidance only • Role of Local Authorities • Develop multi-agency Vulnerable Adult Protection P&P • Multi-agency Committees (VAPCs) • No Duty to Cooperate

8. VAPC evolved ….. Variable: • governance processes • membership & chairs • accountabilities • structures • infrastructures • policies and procedures • budgets • data bases

9. What does the Care Act say? Local authority must make or cause to be made whatever enquiries it thinks necessary where an adult in its area: • has need for care and support, • is experiencing, or is at risk of abuse or neglect • and as a result of those needs is unable to protect himself or herself against the abuse or neglect or risk of it to enable it to decide whether any action should be taken and, if so, what and by whom. (Section 41)

10. ‘Enquiry’ or ‘Investigation’? • What is the difference? • The Act doesn’t define what an ‘enquiry’ is and doesn’t refer to a ‘safeguarding investigation’

11. What is an ‘Enquiry’ within the Act? Presumably it is that which enables the local authority to decide: • ‘…whether any action should be taken in the adult’s case’ • ‘and, if so, what’ • ‘and by whom’

12. What is an ‘Enquiry’ within the Act? In other words: • It covers the entire process of the implementation of safeguarding adult procedures to the point where the safeguarding plan is in place

13. Types of possible ‘Enquiry’(I think they mean Investigation!) • Criminal • Regulatory • Health & Safety • Service Commissioners • Serious Incident • Social Care • Disciplinary • Court of Protection • etc

14. Function of the multi-agency safeguarding adults procedures • to provide the multi-agency forum to coordinate the above, to manage the response/s to an allegation or concern of adult abuse

15. Enquiry = total process from Alert to Assessment • Investigation = gathering information on a single agency basis • Assessment = analysing the findings of the different investigations to inform decision-making

16. In addition ….. Safeguarding must also include • Intervention = implementing and monitoring the decision/s • There is a final stage – the closure of the safeguarding procedure or process

17. What are the Duties of SABs under the Care Act? • The SAB’s Objective is to help and protect adults in its area in cases of the kind described in section 41 • The SAB must seek its objective by coordinating and ensuring the effectiveness of what each of its members does (Section 42)

18. What are the Duties of SABs under the Care Act? The SAB must commission a Safeguarding Adult Review if there is reasonable cause for concern about how the SAB, members or other persons with relevant functions worked together to safeguard an adult the SAB knows or suspects has died as a result of or experienced serious abuse or neglect (Section 43)

19. What are the Duties of SABs under the Care Act? The SAB must publish: • a Strategic Plan annually setting out its strategy for achieving its objectives and what each member is to do (Schedule 2; 3) • an Annual Report which details what it has done to achieve its objective and implement its strategy, any SARs commissioned during the year and the findings of any SARs concluded during the year (Schedule 2; 4)

20. Who are the SAB? • The LA that established it • Any CCG which covers part of the LA area • The chief officer/s of police for the LA area • Such persons as specified in regulations • Plus anybody the LA thinks appropriate* • The LA appoints a chair it considers* to have the required skills and experience * After consultation with the other statutory members (Schedule 2; 1)

21. What can and can’t SABs do? • An SAB may do anything which appears to it to be necessary or desirable for the purpose of achieving its objective (Section 42 (4)) • An SAB may regulate its own procedure (Schedule 2; 1 (7)) • Require persons to provide information to enable or assist the SAB to exercise its functions (Section 44)

22. Who are they accountable to? • The Act doesn’t say, but the LA is charged with establishing the SAB, not the DASS • The Strategic Plan has to be ‘published’(?) (Schedule 2; 3) • A copy of the Annual Report must be sent to the chief executive and leader of the LA; any police body in the LA’s area; the local Healthwatch and the chair of the Health & Wellbeing Board for the area • Note – no mention of CCGs (Schedule 2; 4)

23. What powers do they have? • A local authority must co-operate with each of its relevant partners, and each relevant partner must co-operate with the authority in the exercise of their respective functions relating to adults with needs for care and support (Section 6 (1) a) • They must comply unless it considers that doing so would be incompatible with its own duties or have an adverse effect on the exercise of its functions (Section 7 (1))

24. What resources do SABs have? A statutory member of an SAB may: • make payments directly or by contributing to a fund towards the expenditure incurred by or for purposes connected with the SAB and • provide staff, goods, services, accommodation or other resources for purposes connected with the SAB (Schedule 2; 2) There is no formula to calculate the above

25. An opportunity missed? Membership: • Service users • Carers • Providers – health and social care • Voluntary sector • Minority Groups (including BME)

26. An opportunity missed? Independent Chairs: • Not required nor recommended • How can a member agency hold itself to account for the effectiveness of its actions? • (Think Police; think MPs; think the Press; think Bankers.)

27. An opportunity missed? Resource base: • Requires distinction between work of the SAB and the safeguarding activity of individual agencies • No base level • Section 7 provides a ‘get-out-of-jail’ card

28. An opportunity missed? Links to other partnerships: • Remember the continuum • Safeguarding adults overlaps with safeguarding children • It overlaps with Community Safety • It overlaps with Health & Wellbeing

29. Will Regulations help? • They could but …… • Specifically not with regard to membership • The DoH has continually stressed its wish to retain what currently works well locally • The emphasis is therefore on Practice Guidance which is focused on ‘wicked issues’

30. Role of the Safeguarding Board • Policy & Procedure ratification • Communication Strategy • Staff Development Strategy • Commissioning Strategy • Service Development Strategy • Quality Assurance Strategy • Dissemination of Best Practice • ‘Horizon-watching’ • Informing the National Agenda

31. Conclusions • SABs will need: • to establish their own structures • to clarify the difference between ‘members’ and ‘partners’ – strategic v operational? • to know what sanctions they can impose/seek to have imposed • Independent Chairs and Independent Chairs need a peer support system • to develop protocols with other LCPs • to recognise issues of non co-terminosity

32. Safeguarding is about ‘empowerment’ • How do you achieve ‘empowerment’? By empowering practitioners to empower service users ………. by enabling them to exercise their professional judgement

33. But remember ….. • Where does most abuse occur? • Who are the most frequent abusers? • What do most ‘victims’ want?

34. How is HSAB responding • to the Care Act?

35. Underlying Principles • Be Care Act 2014 compatible • Separate the Strategic from the Operational • Refocus HSAB on its ‘core business’ • Make members accountable • Reduce duplication of effort • Coordinate internal and external activity • Facilitate transparency • Responsibility = Power

36. Proposed Structure • Strategic Board – HSSAB • Operational Board – HSAB • Sub-Groups • Task-and-Finish Groups

37. HSSAB • Meets quarterly • Membership as required by the Care Act – LA, CCGs x 2 & Police + Independent Chair • Sets and allocates HSSAB budget • Agrees Strategic Objectives • Agrees Business Plan • Establishes Sub-Groups • Reports back as required by the Care Act and to members’ internal governance structures

38. HSAB • Meets quarterly • Membership – as required by Care Act + representatives of Health and Social Care Providers, Service Users, Carers • Implements Business Plan • Populates & Chairs Sub-Groups • Establishes Task-and-Finish groups as necessary • Reports back to HSSAB

39. Proposed Sub-Groups • Safeguarding Adults Review • Learning & Development • Public Engagement • ?Audit • ?Policy & Procedures • ?

40. Proposed Budget • 3 year-rolling budget • Contributions from HCS, CCGs x 2 + Police • 2 posts – p/t admin + 1fte ‘Business Manager’ • Managed by HSSAB • Allocations to activity areas for HSAB to access • Quarterly reports to HSAB

41. Business Process • Maintenance activity • Informs agenda setting for HSSAB & HSAB • Governance processes for both Boards • Drawn from current Business plan

42. Business Plan • Set by HSSAB • Rolling 3-year plan • Developmental in nature • Informed by consultation process required by the Care Act • Informed by SARs and other review/audit processes • Informed by the national agenda • Implemented by HSAB

43. Risk Register • Risk Register for HSSAB • NOT a collation of member agencies’ Risk Registers • Informed by a combination of the Business Plan and Process • Managed by HSSAB • Reported quarterly to HSAB