THE CARE ACT & THE SAFEGUARDING PROCESS

THE CARE ACT & THE SAFEGUARDING PROCESS Mick Wharton Wakefield & District Safeguarding Adults Board Business Manager

CARE ACT ETHOS – Quality and Abuse • Distinguishes between Quality of Service and Abuse. • Places Quality as a CQC and Commissioner led issue. • Abuse is a statutory duty for the Local Authority to enquire into or cause others to enquire into. • Continued poor quality can become abuse so has to been seen as a continuum • Alerts are now called Concerns. • Referrals are now called S42 Enquiries / Formal S42 Enquiries. • Enquiries need to be proportionate to the concern.

CARE ACT ETHOS – Making Safeguarding Personal • Places the adult at the centre of the process. • Builds on the premise of person centred care. • The voice of the adult needs to be heard where possible. • Places into statute the concept of Making Safeguarding Personal. • It is the outcomes the adult desires / best interests which is important – not how they are achieved. • Allows flexibility for a proportionate safeguarding response.

CARE ACT ETHOS – Advocacy • The Local Authority must arrange for an independent advocate to represent and support where the adult has substantial difficulty with the process and no other appropriate individual to assist. • Family members or people with the consent of the person subject to any enquiry can act as advocates. • If the LA arrange for an advocate because no one else is able to fulfil this role, the advocate must be qualified for the role.

CARE ACT ETHOS – Statutory Adult Boards Local Safeguarding Adult Board’s (LSAB) have three statutory members, LA, Police and CCG and are required to have a chair who can act with independence and they must: • Publish a Strategic Plan developed with the community and Health Watch. • Publish an Annual Report. • Conduct any Safeguarding Adult Reviews. • Wakefield has a fully Independent Chair funded by the Board statutory partners.

CHANGES PROCEDURES & PROCESS • Quality monitoring to prevent abuse. • Wakefield has a multi-agency quality group which has grown and expanded in recent years. It has always been seen as an important part of preventing quality issues becoming abuse. • Used to be called Reportable Concerns Group – Now called the Quality Intelligence Group (QIG). • System to report quality issues (NoC – now QIN). • Changes required due to Care Act reference to Concerns. • Key part of the Wakefield response to Care Act demarcation on quality & abuse issues.

DUTY TO MAKE ENQUIRIES • Abuse. • The Local Authority must make enquiries or ensure others do so, if it reasonably suspects an adult who has care and support needs is being abused or neglected and is unable to protect themselves against that abuse or neglect or the risk of it, because of those needs. (Section 42 eligibility criteria - Guidance 2014, Ch. 14). • Any enquiry should establish whether any action needs to be taken to prevent or stop abuse and neglect and by whom.

CHANGES PROCEDURES & PROCESS • New policy and procedures introduced in April 2015. • Introduced the Risk Management approach and retained the traditional strategy / enquiry / case conference which might still be needed for certain cases. • Risk Management is just an all encompassing name for any safeguarding action which is deemed appropriate and proportionate to the circumstances and can vary dependent on the concern being dealt with. • The policy and procedures have been effective but remain under review.

Duty to Make Enquiries (Procedure Extract – The Three Step Test)

TYPES OF ABUSE • Physical • Sexual • Psychological • Neglect • Discrimination • Organisational • Financial • Self-Neglect • Any type of abuse

OTHER TYPES OF ABUSE The Act acknowledges the wider aspects of adult safeguarding and makes links with: • Domestic Abuse • Modern Day Slavery (Human Trafficking) • Forced Marriage • Honour Based Violence • Female Genital Mutilation • (Section 42 must be met for these to become adult safeguarding issues)

FREEDOM TO ACHIEVE OUTCOMES • Achieving the desired outcome is more important than how it is achieved. • Builds on the traditional social work ethos of person centred care through none formal and formal S42 pathways. All none formal S42 enquiries are dealt with under a risk management process. • Such enquiries can range from a telephone call to formal meetings with service providers and commissioners. • This pathway is suitable for the vast majority of concerns and aims to seek a speedy and proportionate resolution. • No requirement to make a determination on abuse.

OUTCOMES CONTINUED • Formal S42 enquiries follow the traditional strategy meeting / enquiry report / case conference pathway. • Generally more suited to allegations against professionals. Requires a fair process with advanced disclosure and a need to decide if abuse has occurred – civil standard test. • Has links to DBS and professional registration. • Able to move from one pathway to another as circumstances dictate. Most likely change is a strategy meeting moving to a risk management approach.

RISK MANAGEMENT & MSP • All safeguarding concerns must be reported to Social Care Direct (SCD). • LA now receives around 2500 such concerns per year. • Third of these are dealt with by SCD staff as they can be quickly dealt with by telephone enquiries or signposted as not meeting S42 criteria. • Remainder allocated to the operational teams. Vast majority now being dealt with under a risk management approach. • Small number now follow the formal S42 pathway.

CARE ACT CHANGES - NUMBERS • 12 month rolling total figures: StrategyCase Conference • 31/12/2013 568 167 • 31/12/2014 357 177 • 31/12/2015 194 83 • The 2015 data still includes 3 months of pre Care Act information so full 12 months in the region of 60 case conferences, which may still be too many.

CARE ACT CHANGES – MSP • MSP survey for service users with capacity or a survey for their family member or advocate. • Written information about the safeguarding procedures for the adult and their representative. • Easy read version of the procedures. • Guide to case conferences for adults and their representatives. • New safeguarding leaflet and easy read version.

RISK MANAGEMENT & MSP • National reporting requirements on all Safeguarding Concerns. • Previously we only had to report on cases which were fully investigated to a case conference. • New recording process from April for safeguarding concerns following the risk management pathway. • New recording process for MSP to capture desired outcomes at start of process. • Same recording process for all formal S42 enquiries but aligned with new MSP outcome recording process.

MSP • Cases dealt with by SCD. Concluded quickly no MSP requirements. • Risk Management. More complex or protracted enquiry which if it involves an identifiable adult will follow the MSP process. • All formal S42 Enquiries will follow the MSP process explaining why we will be taking action regarding allegations against paid workers, but involving the adult where possible throughout the process. • Both require face to face discussion with adult or advocate to decide on outcomes.

MSP • All completed MSP surveys to be sent to: msp@wakefield.gov.ukand attached to Care Director. • MSP will give us outcome information. What did the safeguarding procedures mean to the individual / family supporter. • Means a lot more than just the numbers. • Allows free text responses. • Some responses from the current survey to ensure our procedures are person centred.

ADULT’s SURVEY COMMENTS “I am happy that I was believed and someone took me seriously” “I felt listened to and believed” “I felt at ease throughout the process. I was able to speak of how I felt without any intimidation from others” “Things have changed 100%” “We couldn’t have felt any more included – we were kept fully informed. In such a stressful situation like this we felt that we couldn’t have been better supported”

THE CARE ACT & THE SAFEGUARDING PROCESS