Sue Gunnion and Sarah Khalil CCG City Wide Commissioning, Quality and Safeguarding Team

1. Sue Gunnion and Sarah Khalil CCG City Wide Commissioning, Quality and Safeguarding Team cmccg.safeguardingpw@nhs.net0161 765 4710

2. What is adult safeguarding? ‘Adult Safeguarding’ is a range of activity aimed at upholding an adult’s fundamental right to be safe, at the same time as respecting people’s rights to make choices

3. Adult Safeguarding is shaped by 6 principles: Person led decisions and consent Empowerment Protection Prevention Support and representation for those in greatest need Prevention of harm and abuse is our primary objective National safeguarding Principles Proportionality Accountability Proportionality and least intrusive response appropriate to the risk or risks presented Accountability and transparency in delivering safeguarding Partnerships Local solutions through services working with communities

4. Who does the adult safeguarding process apply to? Inability to be Resilient, including: Emotional Physical Psychological Clinical LACK OF/NO RESILLIENCE Risks, including: To others From others From the environment From the care delivered From the support delivered RISKS Circumstances, including: Mental ill health Learning Disability/Difficulty Physical Disability/ill health Physical Frailty Old Age Mental Capacity CIRCUMSTANCES

5. Department of Health Strategic leadership and direction CQC regulator of providers e.g. dentists, GPs, NHS Trusts. Look at the essential standard of safeguarding National Quality Board Health Education England Public Health England NHS England (was NHS Commissioning Board) Monitor Assesses for Foundation Status. Checks if health care is effective, efficient and economical Local Education & Training Boards Look at education for designated and Specialist Professionals L.As Public Health Teams National of NHS England Responsible for policy Quality Surveillance Groups Memberships include all commissioners NHS Trust Development Authority Regional of NHS England Responsible for policy C.S.Us Research procurement, contract management LSABs & LSCBs Agree how organisations will work together and analysis of how well this works through annual report Local- Area Team of NHS England Responsible for leadership , assurance, day to day support, annual review, GP Safeguarding training Health & Well Being Boards JSNA, H&W strategies Complements the safeguarding Boards CMFT UHSM Community Health Services NMGH MMHSCT CHC and FNC (patients in care homes) Dentists Designated and Named Nurses are the source of advice to the CCGs, Providers and Others

6. The role of the CCG Adult Safeguarding Nurses • To provide expert advice to commissioners and providers regarding safeguarding incidents. • To support a prevention commissioning model with a particular focus on Care Homes. • To support the development and work plan of MSAB and its subgroups

8. Common Themes in Manchester Care Homes • Risk when home manager is also the owner • Recognition of and response to deteriorating patients • Staffing levels and dependency scores • Health professionals not looking at the holistic needs of the patient • NMC record keeping standards

9. Themes continued • Lack of escalation when care is substandard • Knowing how to refer safeguarding concerns • Training needs • Actions taken with regards to weight loss • An acceptance of poor standards of care and response to health needs

10. Themes continued Not using Capacity Assessments or the Best Interests process appropriately End of life care documentation DNARs documentation DOLS applications

11. Your role in safeguarding – 5 mins to discuss: • What challenges and/or issues face your practice team when you are involved with an adult safeguarding issue? • What do you feel works well when you are involved with an adult safeguarding issue? • How do feel your role could positively influence standards in the Care Homes?

12. Any questions?

13. Sarah Khalil and Sue Gunnion Contact details cmccg.safeguardingpw@nhs.net 0161 765 4710