Contents
- SSASPB Message from the Chair and purpose of this strategic plan
- Strategic context
- Safeguarding adults – a description of what it is
- Vision for Safeguarding in Staffordshire and Stoke-on-Trent
- Safeguarding principles
- About the Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership Board
- Approach
- Our focus
- Our priorities
- Engagement
- Improve public awareness of adult safeguarding
- Making Safeguarding Personal
- Communication/engagement with those who work with adults
- Financial and Material Abuse
Appendices
- Categories of abuse and neglect
- Composition of the Safeguarding Adults Board
- Engagement with strategic partnerships and governance
This strategy sets out the vision, commitment and approach of the Staffordshire and Stoke-on-Trent Safeguarding Adults Board to do everything possible to minimise the risk of adults with care and support needs suffering abuse and neglect. The plan will support our fundamental aim to work with local people and with partners to ensure that adults who may be at risk are:
- Able to live independently by being supported to manage risk;
- Able to protect themselves from abuse and neglect;
- Treated with dignity and respect;
- Properly supported by agencies when they need protection in accordance with the Staffordshire and Stoke-on-Trent Adult Safeguarding Enquiry Procedures.
The strategy recognises that adults with care and support needs and their carers must be at the heart of what safeguarding partners do. It is important that safeguarding partners not only listen, but that we strengthen our commitment to engage with adults with care and support needs at both a strategic and operational level in all aspects of our safeguarding work. Through this plan the Board will continue to seek assurances that those working with adults with care and support needs know when and how to act when they are concerned about a possible risk.
The main purpose of this Plan is to set out the key outcomes and impact that the Board is aiming to achieve that will make a positive difference in the collective efforts to tackle the agreed strategic objectives of:
- Engagement with service users, their families, communities, safeguarding partners, and carers
- Financial and material abuse
These priorities have been developed with the engagement of members of the Board and sub-groups building on the progress made through previous plans. Arising from our learning since the introduction of the Care Act 2014 there is an increased emphasis on making the actions within the Plan as specific as possible to ensure that we are clear about the outputs, outcomes and impact that the Board intends to be achieved. This will further strengthen our ability to quality assure and monitor performance against planned and intended actions.
The Boardwill be publishing an Annual Report next year that will provide the details of how this strategy has been implemented and what has been achieved. I look forward to reporting on the good work that has been done to protect the adults at risk in our communities from harm.
John Wood
Independent Chair, Staffordshire and Stoke-on-Trent Safeguarding Adults Board
The Care Act 2014 provides the statutory requirements for adult safeguarding. It places a duty on each Local Authority to establish a Safeguarding Adults Board and specifies the responsibilities of the Local Authority, and connected partners with whom they work, to protect adults at risk of abuse or neglect.
The main objective of a Safeguarding Adults Board (Staffordshire and Stoke-on-Trent in this case) is outlined in Schedule 1 of the Care Act 2014 as being to help and protect adults in its local area by co-ordinating and ensuring the effectiveness of what each of its members does. The Board role is to assure itself that safeguarding partners act to help and protect adults who:
- have needs for care and support; and
- are experiencing, or at risk of, abuse or neglect; and
- as a result of those care and support needs are unable to protect themselves from either the risk of, or the experience of abuse or neglect
A Board may do anything which appears to it to be necessary or desirable for the purpose of achieving its objective.
A Safeguarding Adults Board has three primary functions:
- It must publish a strategic plan that sets out its objectives and how these will be achieved
- It must publish an annual report detailing what the SAB has done during the year to achieve its objectives and what each member has done to implement the strategy as well as detailing the findings of any Safeguarding Adults Reviews or any on-going reviews
- It must conduct any Safeguarding Adults Review where the threshold criteria has been met
The Statutory Guidance for the Care Act 2014 describes adult safeguarding as:
“Protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time, making sure that the adult’s wellbeing is promoted including where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances”.
Abuse and neglect can take many forms. The various categories as described in the Care Act are shown at Appendix 1 at page 15.
The Board has taken account of the Statutory Guidance and consulted all connected partners in determining the following vision.
Adults with care and support needs are supported to make choices in how they will live their lives in a place where they feel safe, secure and free from abuse and neglect.
Our vision recognises that safeguarding adults is about the development of a culture that promotes good practice and continuous improvement within services, raises public awareness that safeguarding is everyone’s responsibility, responds effectively and swiftly when abuse or neglect has been alleged or occurs, seeks to learn when things have gone wrong, is sensitive to the issues of cultural diversity and puts the person at the centre of planning to meet support needs to ensure they are safe in their homes and communities.
The Department of Health set out the Government’s statement of principles for developing and assessing the effectiveness of their local adult safeguarding arrangements and in broad terms, the desired outcomes for adult safeguarding, for both individuals and agencies. These principles will be used by the Staffordshire and Stoke-on-Trent Safeguarding Adult Board and partner agencies with safeguarding responsibilities to benchmark their adult safeguarding arrangements:
Empowerment
People are supported and encouraged to make their own decisions and informed consent.
Outcome “I am asked what I want as the outcomes from the safeguarding process and this directly inform what happens.”
Prevention
It is better to take action before harm occurs.
Outcome “I receive clear and simple information about what abuse is, how to recognise the signs, and I know what I can do to seek help.”
Proportionality
The least intrusive response appropriate to the risk presented.
Outcome “I am sure that the professionals will work in my best interests, as I see them and will only get involved as much as needed.”
Protection
Support and representation for those in greatest need.
Outcome “I get help and support to report abuse and neglect. I get help to take part in the safeguarding process to the extent to which I want and to which I am able.”
Partnership
Local solutions through services working closely with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
Outcome “I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”
Accountability
Accountability and transparency in delivering safeguarding.
Outcome “I understand the role of everyone involved in my life.”
The Board has a broad membership of key partners in Staffordshire and Stoke-on-Trent and is chaired by an Independent Chair appointed by Staffordshire County Council and Stoke-on-Trent City Council in conjunction with Board members. The Board membership is shown at Appendix 2, at page 16.
The strategic partnerships with which the Board is required to agree responsibilities and reporting relationships to ensure collaborative action are shown in the Governance Structure at Appendix 3, at page 17.
The Board is dependent on the performance of agencies with a safeguarding remit for meeting the following objectives, to:
- identify the role, responsibility, authority and accountability with regard to the action each agency and professional group should take to ensure the protection of adults
- establish ways of analysing and interrogating data on safeguarding notifications that increase the SAB’s understanding of prevalence of abuse and neglect locally that builds up a picture over time
- establish how it will hold partners to account and gain assurance of the effectiveness of its arrangements
- determine its arrangements for peer review and self-audit
- establish mechanisms for developing policies and strategies for protecting adults which should be formulated, not only in collaboration and consultation with all relevant agencies but also take account of the views of adults who have needs for care and support, their families, advocates and carer representatives
- develop preventative strategies that aim to reduce instances of abuse and neglect in its area
- identify types of circumstances giving grounds for concern and when they should be considered as a referral to the local authority as an enquiry
- formulate guidance about the arrangements for managing adult safeguarding, and dealing with complaints, grievances and professional and administrative malpractice in relation to safeguarding adults
- develop strategies to deal with the impact of issues of race, ethnicity, religion, gender and gender orientation, sexual orientation, age, disadvantage and disability on abuse and neglect
- balance the requirements of confidentiality with the consideration that, to protect adults, it may be necessary to share information on a ‘need-to-know basis’
- identify mechanisms for monitoring and reviewing the implementation and impact of policy and training
- carry out safeguarding adult reviews and determine any publication arrangements;
- produce a strategic plan and an annual report
- evidence how SAB members have challenged one another and held other boards to account
- promote multi-agency training and consider any specialist training that may be required. Consider any scope to jointly commission some training with other partnerships, such as the Community Safety Partnership
The Board has established the following sub-groups to facilitate the delivery of its objectives.
- Executive
- Safeguarding Adult Reviews – remit also includes overseeing implementation of lessons learned at organisational level
- Audit and Assurance – this sub-group oversees the assurance element of the Training Strategy
- Prevention and Engagement – supports the delivery of the Engagement Strategic Priority
- Practitioner Forum - where tactical/operational and procedural matters are discussed.
- Policies and Procedures - operates through virtual engagement. Task to finish groups may be formed when the need arises
- Mental Capacity Act – operates through virtual engagement to share and consult upon new guidance or matters of interest. Task to finish groups may be formed when the need arises
Progress reports and updates from the sub-groups will be routinely provided to the Executive sub-group.
The main focus of the Board is to ensure that safeguarding is consistently understood by anyone engaging with adults with care and support needs who may be at risk of or experiencing abuse or neglect. Whilst there is a common commitment by safeguarding partners to keeping adults at risk of abuse safe, in practice, this means understanding how to support and empower adults at risk of harm and anti-social behaviour to resolve the circumstances which put them at risk.
Safeguarding partners want to encourage and develop practice which puts the person with care and support needs in control and generates a more person-centred set of responses and outcomes. This means the Safeguarding Adults Board seeking assurances and being confident that effective advocacy services are in place for anyone who may need them at any point during a safeguarding episode.
When things go seriously wrong, the SSASPB has a responsibility to look into this thoroughly with a Safeguarding Adults Review and report the findings and learning so that practice will improve. Equally important, is the Board role in promoting good practice and generating confidence within our communities that concerns about abuse and neglect can be expressed openly and are encouraged and will be responded to effectively by safeguarding partners when raised.
All working in adult safeguarding have the difficult task of understanding risk, assessing the level of this for the individual concerned and constructing a plan to manage it which works for the person and is understood by those around them. This requires practitioners to have a sound grasp of the legal basis for their work and to demonstrate effective listening and communication. This often presents a challenge in a society where there can be a tendency to avoid rather than to manage risk.
It is a key task for the Board is to seek assurances as to effectiveness of risk management and oversight in safeguarding in Staffordshire and Stoke-on-Trent and seek assurances that the right balance is being struck. To that end the SSASPB initiated and hosted a conference in November 2019 on the theme of ‘Let’s Talk About Risk’ Thisevent washeld on 4th November 2019. It was attended by almost 200 people, most of whom were frontline practitioners from connected partners.
The purpose of the conference was to encourage front line practitioners to work with risk and remain within the various legal frameworks pertaining to adult safeguarding. The conference programme covered:
- Practical illustrations of positive risk taking and Making Safeguarding Personal
- Legal literacy: working positively with risk
- Duties and responsibilities in safeguarding
- Positive risk management case studies on Financial Abuse; Hoarding and Self-neglect; Mental Health and Midwifery
Looking forward the above themes are highly relevant to practitioners and the Board will build on these through its programme of learning events.
Why it is important
Considerable progress has been made over recent years raising awareness of adult safeguarding. The Board and its connected partners have produced and distributed a wide range of information using a variety of methods that feedback suggests has been well received. These activities appear to have had the desired effect of contributing to an increase in safeguarding referrals and alerts. There is more to be done on raising awareness and it is important that there continues to be an emphasis on producing good quality and up to date information and publicity materials targeted to meet the needs of the diverse range of recipients.
What we will do
Continue to develop and enhance the Board communication plan to raise public awareness of:
- what constitutes abuse and neglect
- when and how to report it
- what happens after a report is made
- concerns that are not abuse or neglect and how these should be reported
- practical things that can be done to prevent or reduce the risk of abuse or neglect occurring
The messages conveyed through the communication plan will be informed and updated by periodic feedback from service users, carers, the public and practitioners about what is working well, what needs to improve and what the plan should focus on.
How we will know that we have made a positive difference?
- raised public awareness of what constitutes abuse and neglect
- raised public awareness about how to prevent abuse and neglect
- raisedpublic awareness of how to report concerns about abuse and neglect
- expected initial increase in reports of abuse and neglect
- increased proportion of concerns that go on to require a section 42 enquiry (appropriate referrals)
- increased public awareness of how to report concerns that do not amount to abuse and neglect
- raised public awareness of what happens after a report is made
- positive feedback on the effectiveness of the communication methods for target audiences
Why it is important
Making Safeguarding Personal is a significant shift in approach, that requires engagement with a person at an early stage to establish desired outcomes that are then supported by a person centred approach to make this happen. There is an emphasis in those conversations about what would improve an individual’s quality of life as well as their safety. Unless people's lives are improved, all the safeguarding work, systems, procedures and partnerships have limited value.
What we will do
- For the Safeguarding Adults Board to comply fully with its statutory functions it must continuously seek to develop effective ways of engaging with people and communities, including in the production of this strategic plan
- The Board will be actively advocating for the Making Safeguarding Personal approach to become a ‘golden thread’ that will run through strategic and operational adult safeguarding work in Staffordshire and Stoke-on-Trent and reflected prominently in connected agency work programmes
- Partners are asked to complete the Tier 2 individual organisation audit, section 5 of the audit relates to Making Safeguarding Personal
How we will know that we have made a positive difference
As part of implementing ‘Making Safeguarding Personal’ the Board will want to see evidence of the following:
- Evaluation of the experiences of people using safeguarding services and how those experiences have been used to improve services. The extent to which service users have a sense of being in control and feeling that they sufficiently influence and determine outcomes
- Effective support provided for carers
- Effective application of the Mental Capacity Act and appropriate use of advocacy.
- That commissioners are developing procurement and contracting arrangements that ensure the provision of personalised services
- An understanding of emerging trends in relation to safeguarding people with care and support needs and how this awareness informs practice development across connected agencies
- Positive content in the Annual Report relating to Making Safeguarding Personal
Why it is important: The SSASPB is a broad partnership made up of organisations who have a varying degree of contact with adults with care and support needs. Some organisations and teams work with adults daily, others much less frequently. It is important that all professionals and volunteers have the confidence to recognise adult abuse and neglect and know what to do if they have a concern.
What we will do:
- Ensure that adult safeguarding policies and procedures clearly demonstrate how agencies will work together from the point that safeguarding concerns are raised, during all safeguarding enquiries and actions, and for any follow up action or review
- Ensure that Information Sharing Agreements are up to date and that agencies are sharing information appropriately without undue delay
- Provide multi-agency focussed practical guidance to support practitioners when gaps in knowledge are repeatedly evident
- Produce ‘learning lessons’ briefing notes which will be available on the SSASPB website
- Publish guidance on what a ‘quality of care’ concern is, how it differs from adult safeguarding and how to report it
How we will know that we have made a positive difference:
- The conversion rate of concerns to safeguarding activity, including S42 enquiries, will increase
- Improved awareness of what constitutes abuse and neglect of an adult with care and support needs will:
- Decrease the number of safeguarding concerns and
- Increase the number of care quality concerns
- Professionals and volunteers can learn from reviews and act to prevent reoccurrence of areas for improvement
What it is:
It includes theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
Why it is important:
During 2018/19 financial or material abuse was identified in 20% of Staffordshire and 22% of Stoke-on-Trent completed Section 42 safeguarding enquiries. The national average was 14.6% in 2017/18.
It is strongly suspected that the number of victims of financial or material abuse who have care and support needs is likely to be massively under reported. Nationally it is estimated that between 10 – 20% of incidents are ever reported but this is not widely recognised. Coupled with this, perpetrators exploit the vulnerabilities of the victims and perceive that the risk of detection is low which contributes to this offending being a significant problem.
Financial abuse can also be identified in other forms of abuse, financial control is often found in domestic abuse and modern slavery. It is important that when completing enquiries into such situations financial safeguards are considered.
The consequences of being a victim are far more costly than just the financial loss and in terms of deteriorating health, loss of independence and loss of self-confidence than with pure financial loss. The consequences extend to additional resource demands on the health and social care sector to provide support - which could be prevented through earlier intervention and protection.
What we will do
- Seek assurances as to the effectiveness of safeguarding partner arrangements to widely communicate to communities the risk of financial abuse and scams, with a particular emphasis on people most vulnerable to risk
- Seek assurances as to the effectiveness of the current arrangements for reporting concerns, by safeguarding partners and the wider public, that an adult with care and support needs is suspected of being subject to financial or material abuse
- Seek assurances as to the effectiveness of the current arrangements of safeguarding partners to respond to concerns that an adult with care and support needs is suspected of being subject to financial or material abuse
- Conduct an analysis of the reported cases of financial or material abuse involving adults with care and support needs to identify trends in abuse and opportunities for prevention actions. (This action is linked to the work of the Audit and Assurance sub-group)
- Respond to the findings of the review of reporting arrangements with actions that may be necessary to raise awareness. A consideration should be that the more complicated and time consuming the referral process is, the less likely it is that an individual will make a referral
- Encourage and co-ordinate actions around workforce development, including signs to look for and how to respond. (This action is linked to the work of the Learning and Development sub-group)
- Update financial abuse guidance through the policy and procedure sub-group and make this available through the SSASPB website
How we will know that we have made a positive difference
- Practitioners in partner organisations will have an awareness of what to look for and how to report concerns about financial or material abuse
- Increase in reports of financial or material abuse relating to adults with care and support needs
- Increase in reports of enforcement action
- Feedback from victims
Appendices
Section 14.17 of The Care Act Statutory Guidance describes the various categories of abuse and neglect:
- Physical abuse – including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.
- Domestic violence – including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence.
- Sexual abuse – including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.
- Psychological abuse – including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
- Financial or material abuse - including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
- Modern slavery - encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
- Discriminatory abuse - including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion.
- Organisational abuse – including neglect and poor care practice within an institution or specific care setting such as a hospital or care home for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.
- Neglect and acts of omission – including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating
- Self-neglect – this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding.
Through the requirements of the Care Act 2014 Staffordshire County Council, Stoke-on-Trent City Council, Staffordshire Police and the six Clinical Commissioning Groups in Stoke-on-Trent and Staffordshire are statutory partners of the SSASPB.
As part of its inclusive approach that recognises that safeguarding is everyone’s responsibility the statutory partners have agreed to invite the following organisations or departments to become members of the SSASPB.
- Community Rehabilitation Company; Staffordshire and Stoke-on-Trent (CRCs)
- District Safeguarding Sub-Group
- Domestic Abuse Fora
- Hate Crime Forums
- Healthwatch; Staffordshire and Stoke-on-Trent
- Her Majesty’s Prison Service; West Midlands (HMPS)
- Housing; Stoke on Trent
- Local Authority Lead members
- Midlands Partnership Foundation Trust (MPFT)
- National Probation Service; Staffordshire and Stoke-on-Trent (NPS)
- Staffordshire and Stoke-on-Trent Clinical Commissioning Groups (CCGs)
- North Staffordshire Combined Healthcare NHS Trust (NSCHT)
- Representatives from the voluntary sector
- Staffordshire Association of Registered Care Providers (SARCP)
- Staffordshire Fire & Rescue Service (SFARS)
- Support Staffordshire
- Trading Standards; Staffordshire and Stoke-on-Trent
- University Hospitals of North Midlands including County Hospital in Stafford (UHNM)
- University Hospitals of Derby and Burton (UHDB)
- West Midlands Ambulance Service (WMAS)
Governance
The Board has a statutory responsibility to produce an Annual Report which is presented annually to the relevant Stoke-on-Trent and Staffordshire overview and scrutiny committees. It is also presented at Staffordshire and Stoke-on-Trent Health and Well-Being Boards and sent to both Healthwatch Stoke-and-Trent and Staffordshire and the Police and Crime Commissioner for information in accordance with the Care Act 2014 guidance.
Structure
The SSASPB delivers the Strategic Plan and Care Act responsibilities through its 5 sub-groups:
- Executive
- Safeguarding Adult Review
- Audit and Assurance
- Prevention and Engagement
- Policies and Procedures (virtual)
There is also a Practitioners Forum which reports into the Prevention and Engagement sub-group and a Mental Capacity Act group which will act as a reference group for all matters connected to Mental Capacity and the Deprivation of Liberty Safeguards.