Safeguarding post Winterbourne

Chairs: Penny Furness-Smith, retiring ADASS national policy lead

Mike Briggs, incoming ADASS national policy lead

Key Speakers:• Claire Crawley, Safeguarding Policy Lead at the DH• Louise Lawton, Safeguarding Lead at CQC• Cathie Williams, Adult Safeguarding Lead in the LGA

The workshop is aimed at highlighting the wider generic lessons and learning around safeguarding and provides an opportunity to hear from our key partners in CQC and the DH.

 

Background• National events: Winterbourne view, Southern Cross,

Dignity in Care and individual scandals• Think Local Act Personal • Sector-led improvement and ADASS/LGA work on

Safeguarding Standards and Performance• Emerging national performance framework from CQC• NHS reforms• Economic austerity and public sector squeeze• Increased awareness of abuse and increased alerts

Challenges

How to balance two opposing forces when:

the aim for people using services is to maximise their personal freedom

the aim for service providers is to minimise theirliability

SAFEGUARDING FORCES

Professionals’ values

Users’ wishes

Families wishes

Organisations’ liability

Public interest

Statutory duties

Regulatory requirements

The Safeguarding challenges

What needs to change within our organisations and in our approaches to promoting and managing safeguarding in the communities we serve?

What are the main issues for the commissioners, the providers, the regulators and the service user?

Where does the local leadership come from? (Safeguarding Adults Boards, Health & Wellbeing Boards, local authorities, Community Safety Partnerships?)

What will be the impacts of personalisation and more integrated services?

Where does the buck stop?

Safeguarding Standards and Performance: Summary of Work in 2011/12

Cathie Williams: LGA Adult Safeguarding Lead

Adi Cooper: ADASS Co-National Policy Lead

The context:• Sector led improvement processes have identified

that whilst all councils that we have had contact with have some areas of excellence, all have areas they struggle with and there are some universal areas for development

• The LGA and ADASS work on standards and performance in safeguarding has been supported by the standards and performance policy leads and TEASC and has strong links with SCIE, RiPfA and NHSConfed

WHAT WE HAVE:

We aren’t starting from scratch. We have been building for the last couple of years…

We aren’t starting from scratch. We have been building for the last couple of years…

Vision and purpose

Our vision is that Safeguarding Adults Boards or Partnerships lead work in our communities to ensure that for adults who are at risk or in vulnerable situations, the agencies who support them and the wider community together can:•Develop a culture that does not tolerate abuse;•Raise awareness about abuse;•Prevent abuse from happening wherever possible;•Where abuse does happen, support and safeguard the rights of people who are harmed to:

1 stop abuse continuing

2 access services they need, including advocacy and post‐abuse support

3 have improved access to justice

We have worked with Local Government Improvement and Development to pilot, and have endorsed, the set of standards for safeguarding practice that describe what ideal looks like.ADASS: adapted from the WIHSC review of In Safe Hands. Wales’ vision also includes work with perpetrators

Standards for Safeguarding

Domains

• Outcomes for and the experiences of people who use services

• Leadership, strategy and commissioning

• Service delivery, effective practice and performance and resource management

• Working together

Ownership

• Developed by IDeA…LGA• Endorsed by ADASS,

NHSConfed, SCIE• Tested in 4 peer reviews,

evaluated• Used in 4 further peer

reviews, adapted and used for Boards’ self assessment, being used in other contexts

Guidance

For councils• ADASS Advice Note April 2011• From DH on personalisation and

safeguarding• LGA “Making Safeguarding

Personal”• Advice Note on the safeguarding

dimensions of Local Accounts, Nov 2011, ADASS/ LGA

• SCIE: the Governance of Safeguarding Boards, a Guide to the Law, Involving People, Self Neglect

• ADASS Advice Note April 2011• From DH on personalisation and

safeguarding• LGA “Making Safeguarding

Personal”• Advice Note on the safeguarding

dimensions of Local Accounts, Nov 2011, ADASS/ LGA

• SCIE: the Governance of Safeguarding Boards, a Guide to the Law, Involving People, Self Neglect

For partners• For the NHS in the form of a suite of

best practice guides

• From ACPO (in draft) for the police

• From the Ministry of Justice for the police in working with vulnerable witnesses

• From DH on commissioning services for women and children who experience violence or abuse

• For the NHS in the form of a suite of best practice guides

• From ACPO (in draft) for the police

• From the Ministry of Justice for the police in working with vulnerable witnesses

• From DH on commissioning services for women and children who experience violence or abuse

All of these are available on the Adult Safeguarding Community of Practice on the Knowledge Hub: http://knowledgehub.local.gov.uk/

Priorities for sector based improvementFor safeguarding

• Support for currently “adequate” councils

• Peer challenge and review accessed by any council

• Undertaking national improvement and development where issues have already been identified

• Developing “warning” mechanisms for when councils (start to) fail

For the LGA programme (with ADASS and partners)

• Sector based improvement and peer support, review and challenge

• Making Safeguarding Personal – developing a range of responses to safeguarding circumstances (to contribute to 3rd point on left)

• Disseminating learning and effective practice

Learning from Peer Reviews and other activity

Key messages for leaders of safeguarding

10 years on from “No Secrets”........• Everyone has examples of excellent practice and all have

some areas they are struggling with• There has been huge effort put in to establishing and

clarifying structure and process: the next stages have to be about focusing on people and the outcomes they want

• Collaborative leadership – supporting, integrating and holding partners to account

• Health and Wellbeing Boards, Community Safety Partnerships, Children’s Safeguarding and membership of Trust Boards and Police Authorities

Challenges:

• Practice that gets the best possible balance of people’s right to life and a life free of inhuman and degrading treatment with their right to privacy, autonomy and a family life

• Proportionality and balance in the safeguarding system…..

The Council, with NHS Boards and

the Police Authority lead this

The safeguarding board manages delivery across agencies

There is support and empowerment for people experiencing abuseThere is support and empowerment for people experiencing abuse

Safeguarding is everybody’s business

Development Areas

Outcomes rather than process or output

Access to justice: criminal, civil, social and restorative

A portfolio of responses: alternatives to increased services or monitoring – counselling, peer support, family group/network conferences, mediation, building self esteem, peer support etc

Skills base – confidence to tailor the process

Work with people causing harm or abuse

Making Safeguarding Personal Test-Beds

Personalisation and safeguarding are two sides of the same coin

Focus on outcomes….a golden thread that links practice at the interface with people needing social care and at risk of harm with the effectiveness of boards….

What is it you would wish for from safeguarding? What outcomes do you want? Three wishes…. I do want to feel and

be safe but….

….guilt, fear of consequences, shame, I’m trapped, I have no-one else, I’ve lived like this for so long I can’t see any alternative ….

….guilt, fear of consequences, shame, I’m trapped, I have no-one else, I’ve lived like this for so long I can’t see any alternative ….

Let’s weigh up the risks and benefits of a number of options…..

MEASURING AND MANAGING OUR PERFORMANCE:

We have engaged with the Zero Based Review but we know and will know a lot about how much we do but not much about what difference we make or how effective practice and Boards are…

We have engaged with the Zero Based Review but we know and will know a lot about how much we do but not much about what difference we make or how effective practice and Boards are…

Examples of outcomes measures for the future?

• People feel safe and in control• “Vulnerable” people are safeguarded in the community and in

establishments such as care homes and hospitals• Fewer people are harmed or abused in our communities and institutions• There is greater reporting/referral of harm or abuse: people recognise harm

and abuse in the community and in institutions and know what to do about it• People define the outcomes they want and how they should be achieved • People are supported to identify and weigh up the risks and benefits of their

options• People don’t have to choose between an abusive relationship or no human

relationships• People have access to justice: social, civil, criminal or restorative…..

• Number and % of people referred for services who define the outcomes they want (or outcomes that are defined through Best Interest Assessments or with advocates if people lack capacity)

• Number and % of expressed outcomes met

• Number and % of people referred for services who define the outcomes they want (or outcomes that are defined through Best Interest Assessments or with advocates if people lack capacity)

• Number and % of expressed outcomes met

Next Steps:

• Supporting peer review and challenge and work on “tipping points”

• Developing a wider range of responses to safeguarding: Making Safeguarding Personal, the test beds and further research and development in order to secure an evidence base of what works in adult safeguarding and with whom. This will also involve supporting skills development.

• Eliciting and sharing learning through a variety of means• Engaging with broader sector led improvement in adult social

care, and • Continuing to integrate safeguarding and personalisation• Implementing new legislation