Agenda item

To consider the annual report of the Haringey Safeguarding Adults Board for 2018/19.

Dr Adi Cooper, Independent Chair of the Haringey Safeguarding Adults Board, introduced the Board’s annual report for 2018/19. The Board is required to produce this report as a statutory duty. The report provides details of how the Board is delivering on its annual Strategic Plan and how it is improving safeguarding for adults in Haringey. It also includes information from partners who have varying roles and responsibilities.

Dr Cooper explained that the Board meets four times a year but that much of the work is carried out through a series of sub-groups. The Safeguarding Adults Reviews sub-group covers one of the largest areas of work and looks at referrals of cases that meet the statutory criteria and to oversee all Safeguarding Adults Reviews (SARs). This year there had been a referral from the Police which didn’t meet the threshold for a SAR did require the sub-group to look at issues of homelessness and rough sleeping which became a work programme for the Board. There was also a referral which led to a new priority being identified for 2019/20 to review the transitional safeguarding in conjunction with Children’s Services. 

In terms of SARs, workshops had been held and progress monitored on the Robert SAR which took place a couple of years ago. The report on the Ms Taylor SAR was published in February 2019 which is the second SAR published in Haringey since the Care Act 2014 was implemented. That report is summarised in the annual report. A successful workshop had recently been held on disseminating and understanding the learning from this SAR.

The Quality Assurance sub-group provides a monitoring function for the Board looking at performance information, care services and policies and procedures. It also provides a function to hold partners to account. The sub-group also looks at the data on safeguarding adults and can escalate any issues that the Board needs to consider.

The Prevention and Learning sub-group’s role is to promote awareness across the Borough through actions such as events, information stalls and leaflets on issues such as modern slavery, self-neglect, fire risks and domestic abuse. There is ongoing work on training and development with a focus last year on the charity and voluntary sector to build community awareness of safeguarding.

The report also includes a summary of the Safeguarding Improvement Plan, an NCL Challenge Event bringing partners across the area together to share learning, activity data, the priorities for 2019/20 and the Strategic Plan for 2018-21.

Overall the Board is pushing to move forward each year and improve in different areas and there is a really high level of commitment from partners. There are challenges with the churn of front line staff, changes in organisational structure and pressures of demand and lack of resources on services. 

In response to questions from the Panel, Dr Cooper, Beverley Tarka, Director of Adults & Health and Charlotte Pomery, AD for Commissioning said:

• That the transition issue with young people was an area that the Board looked at for a number of reasons. This included a SAR in Enfield which involved a women who was an former looked-after person from Haringey, but there are also a number of SAR cases across the country concerning young people. A recent publication called Mind the Gap from the organisation Research in Practice has highlighted the gap between safeguarding for younger children and adults but less well for adolescents in between the two systems. There is therefore a challenge for local Safeguarding Chairs to consider what should be done locally. The starting point for this is improved joint working for Adult Services and Children’s Services.
• On safeguarding in care homes there is a link between poor quality care and abuse so promoting good quality care should be emphasised as a means of prevention. The Board has pushed for regular reports from commissioning colleagues on who in placed in care provision, what the quality of care is and how any problems can be managed so that care quality is monitored. Placements about the borough is a concern for the Board and the same scrutiny and monitoring needs to be in place. A wider proactive audit of out of borough placements had been carried out following the Panorama programme on Whorlton Hall. The Council does not make placements with uninspected care providers. Local inspections are carried out in between CQC inspections in response to a range of triggers.
• Progress against the priorities set out in Appendix 2 is monitored by the Board every couple of months. Mostly they are progressing but there are a couple of pieces of work that the Board was trying to do across the whole NCL area that haven’t been progressed due to difficulties in getting all partners to work together. The Chair’s approach to priorities has to be ambitious and stretch what the Board is trying to do which is positive but sometimes means that not every objective is achieved.
• The two multi-agency workshops previously mentioned had been about the Robert SAR. The first was on the learning from that review and the follow-up workshop was on inter-agency working. The workshop on the Ms Taylor SAR had focussed on the lessons including the recommendations of the SAR and developments since then. The full range of agencies represented on the Board had been present. There hasn’t been a workshop on transitions yet but CAMHS would need to be there as their role is critical. The work on transitions has been delayed because the children’s partnership arrangements have been undergoing significant change and the Haringey Children’s Partnership had only just been launched in the last couple of weeks.
• The membership of the Quality Assurance sub-group is multi-agency but doesn’t directly involve care workers or care providers. The data guides what the group focuses on. The increase of 12 cases of ‘Care Home – Residential’ as a location of abuse corresponded with a decrease of 11 cases of ‘Care Home – Nursing’ so this could just be a result of a coding issue. The increase in the ‘Other’ category is a concern as it there are issues in determining whether this is due to data or reality. There has been some work going on nationally to develop a more consistent approach on how incidents are categorised. A significant decrease in Police referrals had resulted from work with the Police that improved triaging of safeguarding concerns.
• With regards to the fire safety measures set out at page 34 of the report, these issues are covered by CQC inspections.
• On why the Making Safeguarding Personal section on page 49 of the report stated that outcomes were recorded for only 68%, this was partly because people who are cognitively impaired and cannot articulate an outcomes are not being recorded so this is an area that requires further work to enable the wishes of individuals to be recorded.
• Newer areas of safeguarding such as modern slavery and self-neglect are areas that we are still learning to recognise, do not yet always have a clear picture of and still have relatively few referrals so we do not necessarily know the full extent.

Lauritz Hansen-Bay of the Older People’s reference group suggested that neighbourhood watch groups should be provided with a safeguarding guide of what to look for as they are well placed as the largest community group in Haringey to widen the scope of safeguarding.