Safeguarding Adults Board

Minutes of Meeting held on Wednesday 15 July 2015

in the Filby Room, Police Headquarters, Jubilee House, Falconers Chase

Wymondham, Norwich NR18 0WW

PRESENT:

Joan Maughan, Independent Chair

Elizabeth Morgan, County Councillor, Norfolk County Council

Harold Bodmer, Executive Director of Adult Social Services

Lorna Bright, Assistant Director – Social Work

Helen Thacker, Head of Service, Safeguarding

Nigel Andrews, Tenancy Support Manager, Norwich City Council

Nick Davison, Chief Superintendent, Norfolk Constabulary

Stuart Horth, Head of Community Safety, Norfolk Fire & Rescue Service (part)

James Kearns, Chief Executive Officer, BUILD, Norwich

Kate Rudkin, Head of Development & Operations, Age UK, Norfolk

Dawn Collins on behalf of Jane Sayer, Director of Nursing, Quality & Patient Safety, Norfolk & Suffolk NHS Foundation Trust

Ian Sturgess, Domestic Abuse Co-ordinator, Police & Crime Commissioner’s Office on behalf of Jenny McGibben

William Styles, Governor, HMP Norwich

Sue Doolan, Governor HMP

Mark Talbot, Vice Chair, ARMC

Walter Lloyd-Smith, Safeguarding Adults Lead, East Coast Community Health & Care

Jackie Schneider, Norfolk CCGs

Howard Stanley, Senior Nurse, Safeguarding Adult Lead, Norfolk CCGs

Julie Wvendth, Detective Superintendent, Norfolk Constabulary

Ray Harding, Chief Officers, District Councils Representative

Julie Shorten, Business Support Co-ordinator, Adult Social Services(Minutes)

Item / Minute / Action
1 / Apologies
1.1 / Michelle de Oude, Norfolk Community Relations & Equality Board
Christine MacDonald, Healthwatch
Julia Sharp, Norfolk Probation Service
Mark Taylor, , Chief Officer, Norfolk CCG
Jane Sayer, NSFT
Jenny McGibben, Police & Crime Commissioner’s Office
2 / Welcome and Introductions
2.1 / The Chair welcomed everyone to the meeting and thanked all for attending. Particular thanks was passed on to Adult Social Services Business Support, Norfolk County Council, for arranging business support cover for this meeting.
2.2 / The Chair welcomed Michelle de Oude from Norfolk Community Relations and Equality Boardto the Group, in absentia. Unfortunately Michelle was unavailable for today’s meeting as she will be taking maternity leave shortly. Michelle hopes to attend the next meeting and she plans to send a deputy during her maternity leave period. The Chair also welcomed Ray Harding, who represents the Chief Officers of District Councils.
3 / Confirmation of any part of the minutes that is exempt under the Freedom of Information Act
3.1 / State if Whole report of the Section number(s) involved: None
3.2 / Exemption(s): None
4 / Approval of Minutes
The group agreed that the minutes of the 16 April 2015 represented an accurate record of that meeting and they were to be finalised.
Signed as a definitive record of the meeting
Joan Maughan, (Chair of the Meeting)
5 / Matters Arising from the Previous Meeting
5.1 / Item 13 - Cllr Morgan asked for an update on the NSAB manager vacancy. The Chair explained this was one the items on the Newsdesk, however, she was pleased to confirm that Walter Lloyd-Smith had been appointed. Walter’s start date is 7 September 2015, however, he had been invited to today’s meeting for awareness purposes.
5.2 / Item 5 – Walter advised that the first Self-Neglect Task & Finish Group has been set up in August.
Action: Nigel to arrange for a Housing representative from Norwich City Council to attend this meeting. / NA
6 / Newsdesk
6.1 / Development Day - Joan asked the Board to note Wednesday 16 September in their diaries for the NSAB Development Day, which is being held at Mattishall South Green Park. The Board were asked to advise of any other people that should be invited to this event.
6.2 / Safeguarding Week – Safeguarding Week commences Monday 7 September. Joan asked the Board to review the publicity material (item 10) in the pack and choose their preferred design, adding comments if they wished. The posters will be collected at the end of the meeting. It is hoped that the posters will go to print shortly so they can be available by mid-August. / ALL
6.3 / Suzie Lockwood from Norfolk County Council’s Comms team will be working with the EDP.
6.4 / The Library service have been supportive. The Millennium Library in Norwich will publicise the event on their website.
6.5 / Claire Crawley Seminar – This seminar is being held in partnership with Suffolk County Council at the UEA on Tuesday 8 September2015. The Chair asked the Board whether they had any groups of people whom they thought should be invited. Cllr Morgan suggested the Safeguarding Forum, Adult Social Services.
6.6 / Will Styles advised that HMP held similar campaigns where merchandise was used to publicise contact details. Will agreed to source merchandise quotes and will forward to Joan and Julie. / WS
6.7 / Mental Capacity & DoLs–Alison Simpkin has highlighted the challenges around the lack of psychiatric beds for adults of working age and older people. The Board needs to give this some serious thought over the next few months. / ALL
6.8 / HT to invite Alison Simpkin to the next Board meeting / HT
7 / Risk & Performance Subgroup
7.1 / Kate Rudkin presented the Dashboard and asked the Board to review the document and provide feedback.
7.2 / Julie to forward the Risk Register as the papers were not included in the pack. / JS
7.3 / The meeting discussed how the data should be presented, for example by quarter. It was noted that the timing of meetings and the availability of data should be taken into consideration, as there could be a time lag which will need to be managed going forward. Kate also asked how many quarters of historical data were required.
7.4 / The Board agreed to review the papers and provide feedback regarding layout, metrics etc. It was agreed that the Dashboard should be kept simple. Feedback on the layout was very positive. / ALL
7.5 / Joan acknowledged the hard work that the Risk and Performance Group had been put into the risk register.
7.6 / Julie Wvendth to catch up with Harold and Lorna regarding the impact of increased DoLs on the Coroner service and need for Police attendance. / JW
7.7 / The intensive GP training could have caused some increase in addition to the Cheshire West ruling. The Chair will ask Alison Simpkin for an update on DoLS at the next Board meeting. / JM
7.7 / The existing Risk Register has been revised to align with the Strategic and Business Plan. The Risk Register should be interpreted in conjunction with the Business Plan as numbering from the Plan has been added, where relevant.
The visual display of the information has been altered by adding colour boxes to the column headed Target Score.
7.8 / Jackie Schneider questioned how the Board audits the effectiveness of our own processes. Helen explained that as a result of the Peer Review, one action was to introduce an audit of safeguarding cases at Norfolk County Council. Jackie thought it should be wider across organisations so that all organisations take responsibility. Joan agreed that the Board required something it owned for consistency of measurement.
Action: Joan to follow this up with Jackie and Julie W. / JM
7.9 / Joan and Walter will look at arranging a smaller group to agree what appropriate actions were required. / JM/WLS
7.10 / Risk 20 – Joan confirmed that virtual Governance Sub-Committee had been established.
Risk 17 – It was noted that there was an increasing reliance of the voluntary sector. There is concern around the governance and the contract the organisation might hold. Joan and Howard to take back to the Business Group meeting. Harold stated that there is a risk as strategic organisations shrink whilst financial pressures increase, so that we will be moving out of our territory. We are trying to manage this as safely as we can. The new model of Community Social work goes beyond what is in the contract. / JM/HS
Risk 5 – Resource allocation across organisations – whether there is a dilution of resources and how this impacts on the Board. Staff levels have improved, however it is unlikely they will increase further, although referrals will increase.
Risk 6 – Mental Capacity Act – Good progress has been made with understanding awareness. Joan to request the Mental Health Sub Group to provide an update in time for the next meeting. / JM
Risk 16 – GP Practices – There is concern about the impact of a closed list in Dereham. The Board agreed we should seek assurance from NHS England to ensure they are managing the situation. Joan to write a letter expressing the Board’s concern. / JM
Risk 14 – Deprivation of Liberty – The Board requested further information from the Mental Health Sub Group on progress, which will be reviewed at the next meeting. / JM
8 / Business Group Report
8.1 / Joan to liaise with Julie Wvendth on how we can pick out relevant issues for the NSAB. / JM/JW
9 / Peer Review Sign Off
9.1 / Norfolk County Council volunteered through the Eastern Region of Authorities to sign up for a Peer Review, as Norfolk had appeared on the recent CQC Safeguarding Inspection list.
9.2 / Norfolk County Council felt the exercise was challenging and helpful, with many of the actions now complete.
9.3 / Lorna has work on the way to develop a new model of social work for Adults and Children’s Services.
9.4 / The Peer Review outcomes have been sent to Catherine Underwood for sharing with the Making it Real group.
9.5 / There is ongoing work for a stronger community approach, with information being circulated to various community groups.
9.6 / Harold is seeking the Board’s approval to sign off the work that has been completed. Norfolk County Council will continue to concentrate on the areas to complete.
9.7 / Joan will take responsibility for the Board for item 3.5. Steve Holland to be invited to present at the next Board meeting about progress on this action. / JM
9.8 / It was noted that a number of actions have been rolled into business as usual.
9.9 / Cllr Morgan will liaise with Walter on how we can take this forward. / EM
10 / Safeguarding Adults Board Publicity Materials
10.1 / The Chair asked for the Board to review the posters in their Board papers and highlight their preference, including any comments they wish to make. Feedback has already been sought from residents and consumers. Please return the posters to Julie Shorten for collation. It is hoped that the posters will go to print as soon as possible so they can be available by the end of July/early August. / ALL
10.2 / The Board asked whether the posters were to be printed in other languages, for example, Polish or Lithuanian. The Chair confirmed the current posters are a starting point and other languages will be considered at a later date. It was noted that the INTRAN logo will be included on the leaflets.
11 / SAR Group Update
11.1 / Julie Wvendth is now chairing Safeguarding Adults Review Group meetings. The SAR policy and procedure has recently been published on the Website. The Board were asked to ensure they and other agencies were aware of the referral forms and policy. The criteria and process is listed. SARs will be reviewed by the SAR Group, where as much agency information is included as possible to aid the decision making process.
11.2 / Cases will be logged on receipt, which will allow us to consider reviews taking place by other bodies and cases being picked up by other authorities.
11.3 / Case AA is an agenda item. The SAR is in progress.
11.4 / Case JD is a single agency review. A presentation will be given at the SAR Group in September.
11.5 / Case JC awaits additional agency information.
11.6 / Case LY is a new referral agreed as a Health/NSFT. A TOR is in progress and will be circulated for agreement.
11.7 / Self-referral of young anorexic female. Howard will pick up the liaison work to consider whether this meets the criteria. The case involves three agencies. / HS
11.8 / Case OS involves a death at Norwich Prison. Reviewed through internal Police network. Independent management report required whilst in custody. A review is ongoing to establish the facts and to assess whether the individual’s needs were met.
Sue requested for a central telephone number to be identified, so the Prisons can inform of a death in custody. Julie W and Sue to discuss this further. / SD/JW
11.8 / Case JM – External Police investigation. Closed on register.
12 / SAR AA Update
12.1 / AA is a complex case that has required an independent report writer. The case is nearing its final stage and has involved Norfolk and Suffolk County Councils involvement. This case is strictly confidential and a number of lessons can be learnt. A final report has been produced. It was not possible to bring this case to today’s meeting as our Suffolk colleagues are attending two SARs later this afternoon, so they were unavailable. The Chair mentioned that the Board will be requested to attend an urgent Extraordinary Board meeting alongside the Suffolk Board to consider the SAR report. The meeting is likely to be scheduled early September and the Board were asked to ensure their attendance.
12.2 / It was noted that costs involved in this case will be shared 50/50 with Suffolk. The three main partners from each county (Health, Police, Council) will then split the costs between them. Total costs are estimated at £16-17K.
12.3 / The meeting acknowledged that it was impossible to predict how many SARs would be required, however, it was important to make an allowance in the budget for these costs. The Chair agreed to take this forward through the Governance Group. / JM
12.2 / Helen summarised the specific points of the case to the meeting. The meeting heard that AA received CPA early 2000 following issues of self-neglect. He managed to live independently. In 2011 his outreach worker was made redundant following an reorganisation and his level of support reduced. AA was discharged from CPA in 2013, which was the beginning of the events that eventually led to his death in 2014. The report highlights concern with the delayed assessment, the significant amount of restraint that was used and issues surrounding the transfer to Ipswich Hospital and the level of medication. The reports makes recommendations for partners to work together to:
  • Effectively support people who self-neglect;
  • Involve the person and their family as appropriate in planning care;
  • Consider the impact of organisational change on adults at risk;
  • Improve the quality of multi-agency risk assessment and joint decision making when managing complex case;
  • Improve information sharing;
  • Ensure the appropriate use of all types control and restraint methods

12.3 / The final report will be circulated to the SAR panel.
12.4 / The Chair discussed the David Bennett case, who died as a result of restraint. There needs to be more explicit information as to what is/not acceptable restraint. Joan has met with the family, who are aware of this case and she will meet with them again following the Extraordinary Board meeting.
12.5 / Due to the confidential and sensitive nature of AA’s report, the Board agreed to hand back the paperwork at the end of the meeting.
13 / Human Trafficking
13.1 / Amanda Murr gave a presentation on Human Trafficking and Modern Slavery. The report will be circulated at a later date.
13.2 / The meeting heard that Human Trafficking numbers within Norfolk are relatively low. The presentation explained the different types of trafficking and the signs to look out for. Exploitation can include sexual, domestic, forced labour, criminal, organ removal, forced begging/benefit fraud/marriage etc.
13.3 / Modern slavery can take many forms, including the trafficking of people, forced labour, servitude and slavery.
13.3 / Action: JM to forward AM contact details for her to link in with to raise public awareness. / JM
13.4 / The Board discussed the need for training to raise awareness. Julie W will put Community Champions to do work with LSAPs. There will be a significant connection with District Councils, with localities linking with Districts. / JW
13.5 / Joan to contact James to start engagement with the voluntary sector. / JM
14 / Dementia/Alzheimer’s in Care Homes
14.1 / In Jenny McGibben’s absence, the Chair asked the Board how reassured they were about the quality of care and services for Dementia/Alzheimer sufferers in the community or residential care. The Chair pointed out that Norfolk had one of the highest number of elderly residents in the country, many of which live alone in old age.
14.2 / The Chair shared that Jenny had some resource that could carry out a data gathering exercise from CQC reports and health reports. Joan agreed to follow this up with Jenny. Ian is happy to support as this is something that is already on his radar. / JM
14.3 / Lorna commented that there has been an increase in referrals which indicates an awareness. Care homes are struggling with this increase. Joan agreed to contact Willie Cruickshank to discuss this further and work with Jenny on a proposal for the Board on how to take this forward. / JM