The Committee to consider the Annual Safeguarding Report (to follow, marked:  6), assess performance and assure itself that all necessary action is being taken to keep people safe.  This item will also cover an update on the implications of the Mental Capacity Act and Deprivation of Liberty Safeguards Legislation.

Contact:  Stephen Chandler, Director of Adult Services (01743) 253704

The Director of Adult Social Care introduced the Annual Safeguarding Report (a copy is attached to the signed minutes).  He drew attention to the increasing number of referrals but explained that this was felt by the Board to be acceptable and linked to greater public awareness around adult safeguarding.

Current priorities focused on improving the experience of all within the safeguarding process and speed of investigations, on addressing a change in interpretation of the law around Deprivation of Liberties Legislation, and meeting the legislative duties in relation to implementation of the Care Act in time for April 2015.

The Care Act would put the Adult Safeguarding Board on the same legal framework as the Children’s Safeguarding Board and involve a change in its composition.  Consideration was being given as to whether these requirements would allow a Board across Shropshire and Telford and Wrekin to function effectively or whether there would be a need for separate ones.

Members questioned the Director of Adult Services on a number of areas, including whether there was a mechanism for feeding back to a person who had reported a safeguarding issue, in order that they could be satisfied that action had been taken on the concern they had raised.

Questions also covered the figures around staff training, and how much training was provided to those actually working with vulnerable people whether in a care setting or in their own home.

In response, the Director of Adult Services stated that when an adult safeguarding concern was raised, the details would be recorded and at that point, the person making the report should be informed what the likely feedback route for them would be, and reassurance provided that the report would be acted upon.

Members felt it was important that a person making a report should be informed once an investigation had been completed.  They did not believe that any other information should be fed back but this would provide reassurance that the issue had been looked into.  The Committee suggested that this mechanism should be reported on in next year’s annual report.   The Director of Adult Services said that staff should be aware that a person making a referral could be informed that an investigation had been concluded.

In addressing the questions asked about training, including how many domicillary workers were trained in safeguarding, the Director of Adult Services said that the Council needed to ensure that its contractors provided the same training as the Council would.  All contractors were registered with the Care Quality Commission which took training provision into account and safeguarding was a mandatory element.   The Committee asked how confident the Council was that this reflected 100% of the workforce who had contact with service users and the Director said he would report back on the actual figure. 

Members also asked why the majority of incidents (43%) happened within care homes and some felt this was worrying considering these should be the places where vulnerable people would be most safe.    The Director of Adult Care explained that a large scale investigation, for example into a residential care home, was deemed to impact on all residents in the setting, and these would all then be listed separately as a potential victim of abuse.  Such incidences would now be addressed as large scale institutional investigations.   Also, there were more people within an institutional setting who were better equipped to raise concerns and increase the chances of a safeguarding issue being spotted. 

Members also asked what happened when cases were ‘not substantiated’ and whether this determination would lead to any increased monitoring.  The Committee noted that where an investigation concluded with ‘not-substantiated’ a final meeting would be held and next steps identified if necessary, for example, increased monitoring by a social worker. 

The Committee asked whether people receiving care in their own homes were advised on how to report abuse, particularly those who may have dementia or serious learning difficulties.   A social worker and reviewing officer would check understanding of this during reviews which happened at least annually.  The main Adult Social Care telephone number was the contact and ‘First Point of Contact’ cards were made available.  The Director Adult Services said that in cases of severe learning disability or dementia there was likely to be a large number of people involved in providing care but there would be a lead person with responsibility for that person and this would be set out in contracts. 

The Director of Adult Services reassured Members that he would know at any period in time if an organisation might be failing and what safeguarding action was in place.  Intelligence would be shared in such cases between HealthWatch, the Care Quality Commission and Clinical Commissioning Group and checks were made where necessary.  If there was a failure to reach an appropriate standard within a set period of time additional action would be taken.

Attention was drawn to some errors in the report which the Director of Adult Services said would be corrected (pie chart page 10, and in paragraph 7.1 figure should read 48, not 448.)

Deprivation of Liberty Safeguards (DoLS)

The Director of Adult Services reported on the implications in a recent change of interpretation in law around the Deprivation of Liberty Safeguards.  These were first introduced in 2009 as a way to keep someone in hospital or in a care home when the person needed to receive care and treatment but were unable to make this decision themselves.    The Supreme Court had issued a decision earlier in the year on a number of cases which gave rise to significant implications in terms of the increase in numbers of people who would require assessments, even if they were compliant and happy.  This also widened the setting in which deprivation of liberty became applicable and this now included supported living, foster care, shared lives schemes and domicillary care. 

The Committee heard that last year Shropshire had conducted 165 assessments in total but had received over 500 requests so far for this year.  The process to grant an authorisation was complex, time consuming and costly, and the number of people qualified to carry out assessments was limited.  Following an initial assessment review was also required within a maximum of a 12 month period, often much shorter periods of time. 

When asked what action was being taken to address this, the Director of Adult Service reported that a formal approach for funding this new cost burden had been made to central government by the Local Government Association and the Association of Directors of Adult Social Services.  The situation in Shropshire was being monitored on a monthly basis and some underspend was being used to fund this to date.  A business case was being built around future requirements.  There would also be a cost attached to any decisions which were challenged through the complaints procedure. 

In response to a question from the Healthwatch representative, it was confirmed that every Deprivation of Liberty referral was considered by the DoLS Manager who would consider the urgency of the application and prioritise as necessary. 

RESOLVED:

That the Director of Adult Services be asked to provide information through the Annual Safeguarding Report confirmation that people making referrals were informed that an investigation had been conducted and completed

That the Committee be provided with further information in the new year on the costs and challenges associated with the change in interpretation of Deprivation of Liberty legislation and the effect on the Social Care Budget