Agenda item

Purpose of report: To provide the Committee with an update on adult safeguarding in the county.

Witnesses:

Mark Nuti, Cabinet Member for Adults and Health

Sinead Mooney, Cabinet Member for Adults Social Care

Sarah Kershaw, Strategic Director of Adults, Health and Wellbeing

Paul Richards, Area Director East & Mid Surrey, Adult Social Care (ASC)

Jonathan Lillistone, Assistant Director of Integrated Commissioning

Key points raised during the discussion:

1.    The Strategic Director for Adults, Health and Wellbeing provided a brief overview of the Adults Safeguarding Update. The paper set out a rise in both concerns and enquiries and covered the decision making, legal duties, and how the Directorate was working to strengthen the learning received.

2.    A Member referred to the Adult, Wellbeing and Health Partnerships (AW&HP) current process of reviewing safeguarding arrangements to ensure there would be the right capacity, and asked what the timeline was for this. The Area Director for East & Mid Surrey (ASC) explained that the newly appointed Interim Executive Director had started the process of reviewing the arrangements. The Service had received additional capacity with the recent appointment of a Principle Social Worker, who would work across the AW&HP teams to identify good practice and where improvement was needed, and an Assistant Director for Safeguarding and Quality, who would review Safeguarding teams and their processes, and the continued review of performance plans and finalisation of the wider Safeguarding Adults Improvement Plan. The Service would expect this to ensure the right capacity to work effectively with partners and care providers. A new team manager with previous experience as a social worker and an approved mental health practitioner is expected to join the Adult Safeguarding Hub in January 2024. The Service would expect this team, from January onwards to be effective and to see good improvements within the next six months.

3.    A Member asked if the Safeguarding Adults page on the Council’s website would be accessible to those who were digitally excluded and how the Directorate were advertising it. The Area Director for East & Mid Surrey (ASC) explained that the Directorate recognised some people experience issues with online access, but they were fairly confident people were able to access this information, based on the volume and types of referrals and concerns the Service received. The Area Director stressed that the Directorate would always want arrangements in place to enable digitally excluded people to voice their concerns and highlighted the reference in the report to providing information in a physical form, which work with partners in communications would be done to distribute this to parts of the county with digitally excluded people.

4.    A Member queried if there was an intention to support people who experience language barriers. The Director of Integrated Commissioning stated that it would be a key area where the Directorate would need to work with partners, providers and care staff who have these skills, and an area where the Directorate would need to make sure staff were having conversations with Surrey residents.

5.    A Member asked if online training had been offered to libraries to support safeguarding issues. The Strategic Director for Adults Health and Wellbeing stated that the Service works closely with the Customers and Communities Directorate and underlined that libraries would be an essential tool for getting into the community. The Directorate would be looking at how they could maximise the benefit of this as part of their work, and had communicated with the Executive Director of Adults, wellbeing, and Health Partnerships (AW&HP) about how they could do this quickly, with training being considered through the academy to support it.

6.    The Chairman asked for more information on the Improvement Plan, the key areas that required most improvement and how it would be addressed. The Area Director highlighted that the number of outstanding section 42 safeguarding enquiries there were in Surrey was significant, with 5,007 outstanding on 10 August 2023, which impacted on other work including statutory duties. There were three areas of immediate focus in the Improvement Plan; to legitimately close cases where no further action was needed by the Council; triage more cases from the Adults Safeguarding Hub where possible; and to change and streamline the process of Liquid Logic Adults System (LAS), to enable more proportionate recording of cases and make it less time consuming, which went live in August 2023. By 23 November 2023 the number of open cases had reduced to 3,621. The Area Director highlighted that delays in acting on these enquiries were not just within the Service, it also resulted within partnerships, which was being addressed. Further improvements had been identified and would be taken forward by the Interim Assistant Director for Safeguarding and Quality Assurance.

7.    A Member asked if lessons learnt were taken from the Covid-19 period, and how the Service was learning from this process in the Improvement Plan. The Area Director for East & Mid Surrey confirmed an increase in safeguarding incidents with Covid-19. Within Surrey, the Adult Safeguarding Hub changed some of the processes to help identify cases quickly and to work differently with partner agencies. Training had been updated to include the learning from the Domestic Homicide Reviews (DHRs) and the Safeguarding Adult Reviews (SARs). The Area Director also highlighted his appointment to the role of Domestic Abuse Lead for the Senior Leadership team within AW&HP and would attend the Domestic Abuse Executive Group. This work would form a major part of the Improvement Plan and the improvements of safeguarding responses and service were actively being looked at.

8.    A Member requested more detail on the learning used from the SARs to inform improvements, particularly with the elderly and vulnerable populations.The Area Director for East & Mid Surrey (ASC) explained that senior managers, area directors and assistant directors across AW&HP attended and contributed to the SAR panels and took away learning. Learning events were held online for all partner agencies and frontline staff, which would still be accessible on the Surrey Safeguarding Adults Board website. Each SAR would result in recommendations and actions which would be shared back to organisations. All lunchtime learning space sessions would be open to the Service’s workforce for learning from SARs. Both the Principal Social Worker and the Interim Assistant Director for Safeguarding and Quality Assurance would look at how best to disseminate the learning from the SARs. Safeguarding training had been updated to include learning from the SARs and DHRs, and the directorate would signpost people to publish SARs in their E-brief, which would be circulated to all their staff. Standard operating procedures were being reviewed to reflect those changes, with changes to processing already been made to ensure that concerns and decisions to proceeding with section 42 enquiries, would always be reviewed by a second person, with assistant team manager oversight.

9.    A Member asked for clarification on how to go about reporting a safeguarding concern. The Cabinet Member for Health, Wellbeing and Public Health emphasised that the aim would be that people could report a safeguarding concern to anyone, and to reach this aim the Directorate would need to raise awareness, communication, and education around what safeguarding is and on the different types of abuse. The Strategic Director for Adults, Health and Wellbeing highlighted that the Directorate would be commissioning training with the academy for Members around safeguarding. The Area Director for East & Mid Surrey explained that addressing safeguarding concerns for people at risk of abuse and neglect under the Care Act 2014 is the duty of local authorities and highlighted the streamlined process of making a referral from the Council’s website or a telephone number that people could call. 

10.A Member asked how the newly appointed community link officers and local area coordinators were improving local community wellbeing, and whether safeguarding was included in their training. The Cabinet Member for Adult Social Care clarified that community link officers and local area coordinators did undertake safeguarding training and engaged directly with social care teams, which helped them to understand what process to follow if they were to come across safeguarding concerns. There were also reflective practice sessions on safeguarding that were held locally within the AW&HP team, and Community Link Officers’ and local Area Coordinators’ connections with relevant teams had been developed but could be built on further.

11.A Member questioned what ‘Making Safeguarding Personal’ looked like and what actions were being taken to embed it into behaviours and practices.The Area Director for East & Mid Surrey (ASC) explained it would involve including people from the outset and looking at what people would want to achieve from the Safeguarding process. Improved triaging of safeguarding concerns would be an important part of this approach and an approach the Directorate sought to adopt by making the Adult Safeguarding Hub responsible for triaging and only transferring cases to teams when the matter would require further work or was particularly complex. Assuming people would have the capacity to make their own decisions was one way the Directorate would make the process more personal, and any action or decision made on their behalf would be made in the person’s best interest. The Area Director highlighted to the Committee that a risk enabled framework was being developed, to move away from the past paternalistic approach and improve the way mental capacity assessments are undertaken to ensure people would have the opportunity to participate as much as possible. The need to embed this approach was recognised.

Actions/requests for further information:

1. It was suggested that the Member Seminar Programme should include a session on Adult Safeguarding.

2. The Area Director, East & Mid Surrey Adult Safeguarding to identify whether messaging to report safeguarding issues within libraries could be more robust in effectively reaching all communities across Surrey.

3. The Cabinet Member for Adult Social Care agreed to ensure that concerns raised by Healthwatch Surrey related to reports received concerning poor communication and delayed response times are reflected within the Improvement Plan.

4. The Cabinet Member for Adults Social Care agreed to communicate with the adult social care service to reassure the committee that training undertaken by local area community officers on safeguarding is meeting the standards expected.

Resolved:

The Adults and Health Select Committee recommended for Adults Wellbeing and Health Partnerships:

1.    To manage processes in line with capacity versus demand needs and monitor improvements in how operations will be more efficient. Analysing the demand and capacity will enable improvements to be made that smooths the flow of service users through the system and helps to create a better patient and staff experience of the healthcare process.

2.    Implement the necessary processes which are needed to cope with demand to reflect the transformation work and help to improve the service.

3.    To review the Healthwatch reports and incorporate any learning into the Improvement Programme.

4.    Make it clear that Surrey County Council supports the protections given in employment law for whistleblowers and provide a simple easy to access reporting route for them.

5.    To organise a Members Briefing session on safeguarding and provide future training for Members around safeguarding.