Issue - meetings

To consider a report of the Stockport Safeguarding Adult Board.

The report summarises the work of the Safeguarding Adults Board in Stockport during 2017/18, highlighting key issues in the borough.

The Board is invited to consider and comment on the report.

Officer contact: Nuala O’Rourke, Head of Safeguarding and Learning, 0161 474 5659

Gill Frame, Independent Chair of the Stockport Safeguarding Adult Board, accompanied by Lee Woolfe, Safeguarding Adults Board Business Manager, attended the meeting to present the Board’s Annual Report for 2017/18 (copies of which had been circulated) and to answer questions from the Health & Wellbeing Board.

The following comments were made/ issues raised:-

·           Further information was sought on the changes that were likely to take place in respect of the Deprivation of Liberty Safeguards regime. In response it was stated of most significance in the draft legislation currently before Parliament was that the burden of the new regime would be more on care homes to carry out ‘best interest’ assessments, and to ‘mainstream’ activity for frontline social workers. Many agencies had concerns about the emphasis on care homes and lobbying was taking place to seek changes to this. The Chair reminded members of the work that the then Health Scrutiny Committee had undertaken an investigation into the impact of the DOLS regime in Stockport, and had written to the Chief Coroner and the Local Government Association expressing concern about the unintended consequences of DOLS.

·           Clarification was sought on the contribution of the North West Ambulance Service to the Board given their contact with vulnerable residents. In response it was stated that the Trust were active participants in the Board and their input was valued.

·           The report indicated a reduction in the cases of neglect and comment was sought on whether this correlated with increased levels of training or whether this should lead to increased levels of identification. In response it was acknowledged that it was counterintuitive to see a reduction after efforts to raise awareness but that it may be reflective of improvements in the categorisation of cases. Assurance was also given that the situation was being monitored.

·           Comment was sought on whether no cases of modern slavery and child sexual exploitation was a concern. In response it was stated that there was a complex safeguarding team working across the children’s and adults boards addressing such cases should they arise.

·           The positive impact of the Equip Team, a partnership between the Council and CCG, on the quality of local care homes was highlighted and welcomed.

·           Assurance was sought about commitment from partners to the priorities for the children’s and adults safeguarding boards given the changes in the statutory responsibilities. In response it was stated that partners had reaffirmed their commitment and the joint working arrangements would be maintained. Given the pressure on resources it was important for partners to try to mainstream safeguarding activity and to work closely on whole age vulnerability.

·         It was commented that from the perspective of GPs increasing training and simplifying process was to be welcomed it often seemed that the children’s and adults safeguarding system operated in different ways. Support was offered from the CCG /GPs in providing detailed feedback into developing new systems.

RESOLVED – (1) That the report be noted.

(2) That Gill Frame and Lee Woolfe be thanked for their attendance and presentation.

To consider a report of the Stockport Safeguarding Adult Board.

The report summarises the work of the Safeguarding Adults Board in Stockport during 2017/18, highlighting key issues in the borough.

The Scrutiny Committee is invited to consider and comment on the report.

Officer contact: Nuala O’Rourke, Head of Safeguarding and Learning, 0161 474 5659

Gill Frame, Independent Chair of the Stockport Safeguarding Adult Board, accompanied by Nuala O’Rourke, Head of Safeguarding and Learning, attended the meeting to present the Board’s Annual Report for 2017/18 (copies of which had been circulated) and to answer questions from the Scrutiny Committee.

Mark Fitton, Director of Adult Social Care and Dr Donna Sager, Director of Public Health, were also in attendance at the meeting and responded to questions.

The following comments were made/ issues raised:-

·           Clarifaction was sought on why the Oldham Safeguarding Board had been chosen as park of a peer programme. In response it was stated this had been at the suggestion of the Association of Directors of Adults Services (ADAS) and that this work had now been completed and had highlighted some areas for learning and improvement.

·           The recommendation made by the Board in relation to mandatory reporting on harm levels was welcomed and clarification was sought on whether there were any proposal to introduce this requirement to existing contracts. In response it was stated that the Council could not require a Section 40 investigation as part of existing contractual arrangements but it was an area the Council was seeking to strengthen. The value of learning from ‘near misses’ in indentifying areas for improvement and training was stressed.

·           Clarification was sought on whether the figures in the report relating to prevalance of a mental health condition in Stockport were high or low. In response it was stated that these were broadly in line with national averages, but lower than Greater Manchester average. Stockport had good primary care services for mental health.

·           A number of questions were asked in relation to falls prevention both in the community and in hospital. In response it was proposed to submit a report to the next meeting.

·           Clarification was sought on whether reviews of medication included efficacy as well as correct administration to assess the benefit to the patient in receiving them. In response it was confirmed that the Quality Care Inspection Team who visited care homes assessed the safety and efficacy of medication and would alert GPs if there was a concern.

·           Further information was requested in relation to circumstances where medication specified in a care plan was not administered. In response it was stated that there were instances when the administering of medication could be more distressing for the patients than the harm they would suffer from not taking it. In such circumstances a risk assessment would be undertaken.

·           Confirmation was sought on the number of care homes requiring improvement. In response it was stated that there were no inadequate care homes in Stockport, and performance was on an upward trajectory.

·           Assurance was sought on the implications of the decline in the number of Deprivation of Liberty Safeguards (DoLS) assessors. In response it was stated that social workers were undertaking best interest assessments but that many were doing this in their own time. Agreement had now been given to recruit two more assessors for one year before moving toward new safeguarding system.

·           Further information was sought on suggestions that care home managers would be undertaking DoLS assessments in the future. In response it was stated that the legislation before Parliament would allow for more assessment in such settings, although the Council and other had concerns that the best interest test no longer needed to be met and the onus was placed on care homes. It was also likely to have cost implications for residents.

·           Concern was expressed at the increase in the number of mental health referrals and whether there was too great a focus on older people to the detriment of younger adults who were more at risk of suicide. In response assurance was given that the Board was engaged in multi-disciplinary work to address issues relating to adults at risk of harm. It was also commented that there were young adults in care home  ...  view the full minutes text for item 4