Social & Housing Services

Attachment 1

BATH & NORTH EAST SOMERSET

LOCAL SAFEGUARDING ADULTS BOARD

NOTES OF MEETING HELD ON

Tuesday 26th March 2013

2 p.m. – 5 p.m.

in the Board Room

Trust HQ, St Martin’s Hospital, Bath.

Those Present

Robin Cowen – Independent Chair B&NES LSAB

Lesley Hutchinson – Assistant Director Safeguarding and Personalisation, B&NES Council

Jane Shayler – Programme Director for Non-Acute Health, Social Care & Housing, B&NES

Dr Louise Leach – B&NES Clinical Commissioning Group Representative

Dawn Clarke – Director of Nursing & Quality, NHS Bath & North East Somerset CCG

Val Janson – Associate Director ofQuality &Patient Safety(Commissioning), B&NES CCG

Janet Rowse – Chief Executive Officer, Sirona Care & Health

Geoff Wessell – Det Superintendent, Avon & Somerset Constabulary PPU

Damaris Howard –Director, Regulated Services, Freeways (Health & Wellbeing Network Rep)

Julie Evans – Director of Neighbourhoods, Curo Group

Mark Dean – Assistant Director & Head of Safeguarding, AWP

Sonia Hutchison – Chief Executive Officer, Carers Centre, B&NES (Carers rep)

Janet Goodfellow – Regional Manager, Four Seasons Health Care

Alan Mogg – B&NES S.A. Team (attended for Agenda Item 9)

Clare Tozer – Administrator/Note-take for LSAB

Apologies

Mary Lewis – Acting Director of Nursing (Medicine), RUH NHS Trust
Rayna McDonald – Director of Operations & Clinical Practice, RNHRD

Mick Dixon - Head of Risk Reduction and Operational Training, Avon Fire & Rescue

Marc Anderson – Unitary Manager, Avon Fire & Rescue Service

Cllr Simon Allen – B&NES Cabinet Member for Wellbeing

Kevin Day – Senior Probation Officer, Avon & Somerset Wiltshire Probation Service

Janet Dabbs – CEO Age UK (B&NES) representing Supporting People Forum in B&NES

Sophie Kent-Leger – Asst Head Teacher, Threeways Special School (B&NES)

Kirstie Mann – Manager, Your Say Advocacy Service

Jenny Theed – Director of Operations, Sirona Care & Health

David Trethewey – Divisional Director, Policy & Partnerships, B&NES Council

Karen Taylor – Compliance Manager, CQC South West Region

Sue Smith – Clinical Standards Manager, SWAS NHS Trust

Cllr Simon Allen – Cabinet Member for Wellbeing, B&NES Council

SUBJECT

/

DISCUSSION

1. /

Apologies & Introductions

/ Robin Cowen welcomed everyone to the meeting and asked each person to introduce who they were and the organisation they were representing.
Mark Dean announced this would be his last attendance at the B&NES LSAB due to AWP reorganisation. Robin Cowen thanked Mark for his expertise and commitment to the LSAB and over recent years.
2. / Notes & Actions from last meeting & Matters Arising (11th Dec 2012) / Notes of 11th Dec 2012 – agreed.
Actions Arising from last meeting
A217a Safeguarding Activity Report – Indicator 5. Info still awaited.
A216b Indicator 5 - Awaiting training from non-commissioned agencies. Need a better system to obtain this info which is needed on a quarterly basis – info to go in the Annual Report. Follow up outside of this meeting. Action 216b: LH
3. /

Agenda Item 3

/ LSAB Sub-Group Reports [Attachment 2 refers]
/ Safeguarding Adults Training and Development sub-group
Chair: Jenny Theed
Lesley Hutchinson reported on behalf of Jenny Theed.
The Staff Development Framework and Training Audit Questionnaire has been circulated to LSAB Members, LSAB sub-group members, Domiciliary Care Providers and Carers Agencies to complete and return to us by Frid 30th April.
The training sub-group is still poorly attended and therefore it is difficult to put principles in place.
Level 3 Training Workshop: Discussions have taken place with the Police about carrying out joint investigative training however the Police may have difficulty in finding the capacity to do this at the moment. Geoff Wessell commented that he had heard that South Glos and B&NES Adult Safeguarding Boards had commissioned joint training; however neither Robin Cowen nor Lesley Hutchinson were aware of this. Lesley Hutchinson said that she believed that Sirona and Keynsham PPU had had a discussion about training, but not aware of South Glos as well.
Essentially a good idea, but Geoff Wessell to check resources and capacity. Action 220: GW
Trigger Protocol: Discussion around ‘triggers’ and when something tips into safeguarding. Jenny Theed and Lesley Hutchinson working on this to open up to a wider range of people/groups. To link with Janet Goodfellow on this. Action 221: JT/LH/JG
LSCB/LSAB Joint Working: Suggestion that LSAB merge with the LSCB training group still in abeyance – need to follow through to see if this is a viable proposition. Jenny Theed has put a hold on training at the moment until decision is made, but it needs to happen quickly. Robin Cowen asked that JT work out a proposal for joint training arrangements to start things off. Geoff Wessell suggested that key people should also meet to discuss joint training. Action 222: JT
S.A. Awareness, Involvement & Engagement sub-group
Chair: Mary Lewis [RUH]
Sonia Hutchison reported. Meeting held on 29th January which included a ‘workshop’ with 3rd sector organisations, to look at how we can best manage the outreach of safeguarding information, including setting up a calendar of events. The workshop was well attended and some good ideas to take forward.
Carer and Service User rep at LSAB: Robin Cowen sent round an email to LSAB on 8th Feb 2013 regarding service user engagement at the LSAB. No real answers to this at the moment – on going discussion needed to resolve desired outcome of involving service users in the work of the LSAB. “Your Say” Advocacy Service are commissioned to support service users voice on the LSAB however this is specifically for people with learning disabilities, but we also need to include representation of people with physical disability as well. Further consideration for this is needed. Action 223: RC/SH
Whistleblowing: Still need a good practice example of whistleblowing – the Bristol guidance didn’t include a good practice example and there was some concern about this. Ideas on good examples to be sent through to Lesley and Sonia for consideration. Action: 224: All
S.A. Policy & Procedures sub-group
Chair: Damaris Howard [Freeways]
Damaris Howard reported.
Multi-Agency Policy: Alan Mogg still working on this and should be ready for LSAB in June; once approved will go on the B&NES Council website.
Trigger Protocol: Multi-agency workshop held at end of January to progress this work and develop a meaningful protocol. Did look at the Cornwall trigger protocol but it is not a compatible area for B&NES to adopt. Need to come back to LSAB with an update on Trigger Protocol for B&NES. Action 225: DH/LH
LSAB Induction Pack: The sub-group are looking into this and expect to bring a draft induction pack to the LSAB in Sept for consideration and approval.
Information-Sharing Protocol: Lesley Hutchinson informed the meeting that Sue Dicks (B&NES Community Safety Team) mentioned the Council had an over-arching protocol. Lesley will check this out. The current LSAB document needs reviewing. Action 226: LH/DH
Lessons learned from Winterbourne View: Geoff Wessell asked if we would have sight of/obtain the Plan being put together by North Somerset and Wiltshire with a view to B&NES giving a perspective as well. Damaris Howard said this would be happening.
S.A. Quality Assurance, Audit & Performance Management sub-group (QAA&PM) Chair: Val Janson
Val Janson reported. The group met on 6th March and following points highlighted:-
o  Agreed to pilot a different methodology for auditing cases
o  Whistleblowing – no good practice examples received as yet; CQC are reviewing their own WB Policy
o  Business Plan – on target
o  Status Report – all agencies discussed the referral figures and clarifying these are accurate – the RUH noted a disparity in these
o  Risk Register – on agenda
o  Ofsted Report – on agenda
o  Report on Safeguarding Referral Audit – Sirona Care and Health undertook a snap shot of responses to all safeguarding referrals received in October 2012, positive feedback was given demonstrating referrers felt they were getting better feedback
o  LSAB Feedback Questionnaire – on agenda for update
MCA/DOLS Quality & Practice Group
Chair: Lesley Hutchinson
Lesley Hutchinson reported – group met on 14th March.
o  DOLS: x59 applications to date and an increase in number of hospital applications. LSAB to note that the increase in applications is impacting on services capacity and therefore the Council are commission BIA’s from external sources to meet some of the statutory assessment requirements.
o  IMCA Service: Have a new provider (Swan Advocacy Network) and a rep will be attending the MCA/DOLS sub-group. B&NES are indicated in an IMCA report as an ‘outlier’ with a ‘low’ number of safeguarding and IMCA referrals, we are looking into the reasons why.
Geoff Wessell asked in respect of advocacy services and a new service provider – one of the issues arising from the Winterbourne review was that staff didn’t understand the role of the advocacy service. As this is a new agency can we say what we need them to do?
Damaris Howard commented that the IMCA service is generally for people with lack of capacity. Lesley Hutchinson to check with Swan the extent of their commission and offer. Action 227: LH
o  MCA and DOLS Training: Training being reviewed and services asked to consider any areas of specific focus they would like.
o  MCA and DOLS Indicators: Draft indicators were considered however these require further development- work in progress.
o  MCA and understanding within Children’s Services: Need to raise awareness of MCA within the children’s teams – work in progress
o  Quality Assurance: Sub-group agencies are proactively engaging in this and several agencies have undertaken audit reports on providing assurance regarding staff application of the MCA.
5. / Agenda
Item 3a / LSAB Risk Register [Attachments 3 refers]
/ Val Janson asking if the LSAB agree with the risks and scores listed.
Robin Cowen suggested each agency/organisation represented on the Board should take the register back to their respective organisations and check the Risk Register and email Val Janson direct with their comments. To come back to LSAB in June for wider discussion.
Action 228a: All
Dawn Clarke referred to No. 4 on the risk register – sharing information and ‘softer intelligence’. There is useful information available from the Dept of Health around ‘softer intelligence’ which Dawn will forward to Lesley Hutchinson. Action 228b: DC
Janet Rowse asked what the level of risk was that we were prepared to tolerate. The changes to the benefits system and economics generally pose risks now, which wouldn’t have been prior to the reforms.
Julie Evans said the welfare benefits reforms will have huge impact and the LSAB needs to take up as a separate discussion item to see how agencies are preparing themselves to manage the impact.
Louise Leach said also need to link from a Public Health perspective (Suicide Group).
Action: Julie Evans and Louise Leach to liaise outside of this meeting.
Action 228c: JE/LL
Jane Shayler said that the Council had also done some preliminary work around the impact of the new welfare reforms and would ask someone to attend the meeting with Julie and Louise. Action 228d: JS
Lesley Hutchinson said we also need to identify those who were carers and how the new welfare reforms might impact on their lives and the people they are caring for.
Robin Cowen asked for the new welfare reforms to be an agenda item for the LSAB in June. Action 228e: LH/Clare
6. /

Agenda

Item 3b

/ LSAB Feedback Questionnaire [Attachment 4 refers]
/ Val Janson reported.
The LSAB Feedback Questionnaire was circulated to the LSAB and LSAB sub-groups. 60% response rate. Attachment 4 gives breakdown of responses to the questions asked.
Comments from LSAB
o  Robin Cowen would like feedback from LSAB and the LSAB sub-groups separated out.
o  General areas to take further: communication; training; proactive/reactive comments; engagement with frontline staff; involvement of service users.
o  Dawn Clark found feedback helpful. With reference to Q4 and Q5 - would those who submitted their comments be willing to be contacted?
Comment made that the questionnaire was sent out with the proviso it was confidential feedback.
o  Geoff Wessell with reference to Q6 – LSCB/LSAB sharing experience and learning. Need to ensure we do learn lessons and share information.
o  Robin Cowen with regard to “engagement” – LSAB partner agencies need to promote the safeguarding agenda in their own organisations. The LSCB Stakeholder Event is a good forum for broader outreach and includes operational staff – could the LSAB do the same?
o  Awareness & Comms sub-group to look at doing an event around promoting safeguarding messages; or look at other forums already in existence where safeguarding messages can be incorporated. Action 229a: SH
o  Val Janson – some comments/actions given in the feedback can be added to the LSAB Business Plan.
o  Geoff Wessell asked if a summary-type overview document covering the themes could be pulled together to present to the Police & Crime Commissioner. Val Janson to do this. Action 229b: VJ
Robin Cowen – agreed that a response be sent back to all those who completed the feedback questionnaire thanking them for their input and attaching an “Executive Summary”. Action 229c: VJ/Clare
7. / Agenda Item 9 refers / Home Office Peer Audit Team visit to Bath & North East Somerset
Re: Multi-Agency Working and Safeguarding Project
3.15pm Robin Cowen welcomed Home Office Peer Audit Team representatives to the LSAB. The Team was made up of 3 auditors and a note taker, Sue Dicks attended to present a report.
Sue Dicks from B&NES Community Safety Team talked through a picture presentation (hard copies circulated at the meeting) case study regarding a serious hazardous incident which escalated into a fire risk and had safeguarding implications. She described someone who had slipped into a very chaotic lifestyle as a result of relationship breakdown, loss of job and as a consequence sought solace in substance misuse. The picture presentation showed the extremely poor conditions the service user was living in; the service user had taken to rough sleeping because of the conditions. From the outside of the property the flat looked perfectly normal and not out of keeping with the neighbourhood – it was only when one entered the flat that the extent of the problem became apparent. The Fire & Rescue service became involved because of the fire risk and also raised the safeguarding alert. The eventual outcome of this situation was positive, and the living conditions for the service user improved with professionals worked together collaboratively and the surrounding residents were no longer at risk of fire – it also sparked other stakeholders to become proactive with safeguarding.
Robin Cowen thanked Sue Dicks for her presentation and the issues it raised.
Points/issues to be taken forward from this presentation:-
o  Discussions with the Community Safety Team around safeguarding and the community are on-going, this needs to continue.
o  Fine line between ‘rights’ of the individual versus ‘rights’ of the community they live in and are impacting on – agencies to be mindful of this and the wider public interest and need to take action.
The Audit team and Sue Dicks left the meeting.
8. /

Agenda

Item 4

/ Local Safeguarding Children’s Board (verbal update)
/ Jenny Theed not able to attend LSAB, so no update given on this occasion. Action 230: Request written note from JT
9. /

Agenda

Item 4a and 4b

/ LSCB/LSAB Joint Working Group [verbal update LH]
/ Lesley Hutchinson updated the meeting.
o  Training sub-group: On-going discussion about joint training – direction of travel from LSCB is not clear and waiting confirmed position on this.
o  Joint LSCB/LSAB Chair: Feedback to Ashley Ayre (Strategic Director for People & Communities Dept, B&NES Council) regarding joint Independent Chair for LSCB/LSAB. Jane Shayler gave feedback to Ashley as agreed at the previous LSAB meeting but explained that she did not realise that the LSAB had also wanted Jane to agree with Ashley a formal response back to the LSAB. In her conversation with Ashley, he accepted that the LSAB and LSCB have slightly different views on this about and acknowledged that this may, in part, be as a consequence of the different positions and circumstances of the two current Chairs. There is, in particular, a timing issue in respect of the Independent Chair for the LSCB, which may present a difficulty in taking a “market testing” approach. Ashley will need to give further thought to this.
o  Children’s Ofsted Inspection: Some of the actions from the Ofsted Inspection are pertinent for Adult Safeguarding (approx 10) – these will be looked at by the interface group. The item of the Children’s Ofsted inspection was not taken separately on the agenda and was handed for the interface group to work through.
Geoff Wessell said that Ofsted were also doing an inspection within the Police and it may be they will want to visit partner agencies.
Janet Rowse and Lesley Hutchinson left the meeting.
10. /

Agenda

Item 5

/ Chairs Report
/ Not dealt with at the meeting – deferred until next time.
11. /

Agenda Item 6

/ Service user involvement and feedback
/ Robin Cowen reported that the Communications Sub Group was carrying out further work on this. In discussion it was agreed to consider Healthwatch as a possible conduit for this work. Action 231: RC and SH
12. /

Agenda

Item 7