To report on the annual report of the Herefordshire Safeguarding Adults Board (HSAB), which addresses the work of multi-agency partners in Herefordshire in safeguarding and promoting the welfare of adults at risk within the county, including achievements and areas for improvement, and priorities identified for 2017/18.

The chair of the Herefordshire Safeguarding Adults Board (HSAB) presented his annual report for 2016 - 2017. In his opening comments he reminded members that the HSAB was focused on a defined cohort of the most vulnerable people in the county, with 3 strategic priorities of partnership working, prevention and protection, and communications and engagement. Within these priorities it was key to ensure that partners were contributing to the work of the board to ensure a whole system approach to safeguarding.

The HSAB chair highlighted a number of points regarding the work of HSAB:

There was a national network of independent chairs which had looked at a number of common issues including an emerging theme of closer working between child and adult safeguarding boards. In Herefordshire the two boards were innovative in the establishment of a joint business unit role, which supported closer working on shared issues and which boards in other areas were considering to replicate.  Consideration had also been given to cross-cutting issues that other agencies such as the community safety partnership were sighted on and there was assurance that the dynamics of such issues were understood and managed effectively within the Herefordshire system.

Other agencies contributed to safeguarding activity and the broader prevention strategy, examples of which included the fire and rescue authority extending their home safety check for those homes at more risk of fire to include assessments such as regarding risk of falls, and ‘flu jabs, on behalf of partners.

The promotion of ‘making safeguarding personal’ (MSP) was fundamental to resolving a safeguarding episode by enabling the system to understand the risks and mitigations around the choices people made.  Following an audit by the local authority, there was a mature understanding of the current position on MSP within the system.

A range of approaches had been attempted to increase engagement and this activity was to be referred to Healthwatch for additional support in seeking the views of people who have been through a safeguarding episode, in order for the system to learn from that experience.  The local authority had a role in actively engaging with providers to support them to make improvements in safeguarding where needed. 

Responding to the report, the chair asked for more explanation of the figures provided to understand the numbers behind the percentages.  

It was clarified that the figures were based on representative samples or a significant proportion of people across county and although there was potential to provide deeper analysis of specific cohorts, the resulting figures would be less reliable as meaningful statistics due to the smaller size of the samples.

A member commented on a reference to HSAB publicity in parish magazines, observing that this had not been apparent in the 5 parishes within her ward. Attention was drawn to the need for everyone to develop a better understanding of safeguarding issues and to be more aware within their communities.

A member made a number of comments regarding the data contained in the report and asked what the figures meant in reality. The member made particular reference to interventions in care homes, types of abuse reported, linked themes of domestic abuse, alcohol abuse and numbers of looked after children, and clarity on the report (at page 24 of the report) from the CCG’s director of nursing about reasons for low response rates to a Mental Capacity Act audit being understood. 

In response, the HSAB chair explained that with regard to nursing homes, the figures sought to highlight where quality needed to improve.   The director for adults and wellbeing clarified that of the CQC’s ratings of residential and nursing homes, Herefordshire had the best rating overall, so good average rating. There was close working with care homes and interventions were seen as positive, although there was further engagement with them to help them understand what they needed to do to improve. There were few homes that were of serious concern within the quality framework, and a small number where officers were actively working with homes and being clear about the need for rapid improvement. Members were reminded however, that there should not be assumed that there was an automatic link between quality and safeguarding concern. 

In responding further to the question, the HSAB chair explained that domestic abuse was defined as a category of abuse by the Care Act but there were differing levels of understanding of the act by organisations. Joint work with Shropshire on case audit had encouraged greater recording of instances of domestic abuse and involving support organisations and genuine learning had led to adoption of risk assessment models and changing practice. With regard to looked after children, the rate was higher in Herefordshire, which needed better understanding, and a domestic abuse strategy was developed through the community safety partnership. There was also a working group exploring where there is compromised parenting impacting on child safeguarding. Agencies were focused on domestic abuse and it was being embraced as an issue.

Referring to the point in the annual report provided by the CCG’s director of nursing regarding a Mental Capacity Act audit, it was identified that the audit had been perceived as being an inspection when the HSAB was instead seeking to identify partners’ learning and good practice.

A member expressed concern about action being taken regarding people outside a person’s family and home such as cold callers.  The HSAB chair explained that there was a role to promote learning and to hold the police to account about this. There were few successful prosecutions. House callers were the remit of trading standards who understood the profile of people vulnerable to abuse and followed up concerns with those people and provided preventive and supportive measures.

Financial scams could be referred straight to trading standards. The trading standards team was small and as well as casework, they attended development events about their initiatives and this was accepted as priority input over attending HSAB meetings. 

The vice-chairman noted the reference in the report to local councillors being a key group in the safeguarding system, and asked what additional action councillors should be taking.  A suggested activity was to improve an understanding of adult safeguarding and to promote it as the public was less aware of national scandals relating to adult safeguarding compared with child safeguarding.

The director for adults and wellbeing commented that the role of the HSAB was not an operational one and so it did not deal with individual cases, which should instead be a matter for individual organisations, and for them to know how to respond to concerns reported to them.  

The Healthwatch representative commented that Healthwatch was part of the quality subgroup, and had a remit to explore cases though this forum and raise the level of concern about the issue.

A member welcomed the inclusion of case studies in the report, noting their value in educating people and raising awareness of issues. 

RESOLVED

That

(a)  the matter of awareness raising and publicity be given further attention to ensure the public are more aware of how to express their safeguarding concerns; and

(b)  a briefing note be provided to members showing information about the numbers of safeguarding concerns dealt with in the year.