Agenda item

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 due to their particular needs.

·           It was queried whether the higher levels of reporting of mental health problems from women was due to higher prevalence or due to a greater willingness to present to services. In response it was stated that the reasons were complex, but women were more likely to seek help, and men in deprived areas are particularly unlikely to seek help which may account for higher rates of suicide.

·           The references to improvements in transitions between children’s and adult services were welcomed, particularly for very vulnerable young people.

·           Clarification was sought on the reasons for the increase in the number of psychiatric cases. In response it was stated that there were a complex series of reasons, including better reporting, recording, changing perception around mental health and a greater willingness to come forward. Classification of conditions had also evolved over time leading to changing numbers recorded.

·           It was commented that those from deprived areas were three times more likely to suffer from mental health problems than those from affluent areas, suggesting that a harder life lead to poorer mental health.

·           Efforts to bring together the work of the Adult and Children Safeguarding Boards were welcomed. In response it was stated that there were over a 100 practioners at a recent joint event.

RESOLVED – (1) That the report be noted and Gill Frame and Nuala O’Rourke be thanked for their attendance and presentation.

(2) That the Director of Public Health be requested to submit a report to the next meeting on efforts to prevent falls.