shadow health and well being board · 2014. 12. 22. · notice of meeting shadow health and well...

NOTICE OF MEETING

Shadow Health and Well Being Board

TUESDAY, 26TH FEBRUARY, 2013 at 13:30 HRS - CIVIC CENTRE, HIGH ROAD, WOOD GREEN, LONDON N22 8LE. MEMBERS: Please see membership list set out below.

AGENDA 1. WELCOME AND INTRODUCTIONS - 1.30PM 2. APOLOGIES To receive any apologies for absence.

3. MINUTES (PAGES 1 - 6) To confirm the minutes of the meeting held on 4 December 2012.

4. HARINGEY ADULT SOCIAL CARE LOCAL ACCOUNT 2011/12 (PAGES 7 - 74) Lisa Redfern / Helen Constantine to present.

5. SAFEGUARDING (PAGES 75 - 146) i) Local Safeguarding Children Board Annual Report

Angela Bent to present ii) Winterbourne View Lisa Redfern / Beverley Tarka to present 5 minute introduction on each item, followed by 25 minutes small group discussion and 15 minutes plenary.

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6. HWB DEVELOPMENT (PAGES 147 - 154) i) Governance Update – Helena Pugh / Jeanelle de Gruchy

ii) Proposal on Joint Events – Jeanelle de Gruchy

iii) Performance – Jeanelle de Gruchy

7. HARINGEY CCG (PAGES 155 - 182) i) Commissioning Strategy Plan and Operating Plan – Sarah Price

ii) Equality Delivery System objectives - 2013/14 – Sarah Price

8. ANY OTHER BUSINESS To raise any items of AOB.

9. FUTURE AGENDA ITEMS AND DATES OF FUTURE MEETINGS Members of the Board are invited to suggest future agenda items.

The proposed dates of future meetings are as follows: Tuesday, 9 April 2013, 1.30pm

David McNulty Head of Local Democracy and Member Services 5th Floor River Park House 225 High Road Wood Green London N22 8HQ

Helen Chapman Principal Committee Coordinator Tel: 020 8489 2615 Email: [email protected]

MINUTES OF THE SHADOW HEALTH AND WELL BEING BOARD

TUESDAY, 4 DECEMBER 2012

Present: Cllr Bernice Vanier (Chair), Libby Blake, Dr Jeanelle de Gruchy, Cathy

Herman, Helena Kania, Dr Helen Pelendrides, Mun Thong Phung, Sarah Price, Dr Sherry Tang and Cllr Ann Waters

In

Attendance:

Helen Chapman, Archna Mathur and Helena Pugh

MINUTE

NO.

SUBJECT/DECISION

ACTION

BY

HSP11.

APOLOGIES

Apologies for absence were received from Cllr Kober and Libby Blake.

HSP12.

MINUTES

Matters arising Terms of Reference

• A paper reflecting the issues raised at the previous meeting, regarding the Board’s Terms of Reference, would be considered at the Board’s next meeting (February 2013).

• The Chair queried the term ‘workplan’ as set out on page 4 of the minutes; it was felt that ‘strategic oversight’ would be a more appropriate description of the Board’s business. With this change, it was suggested that Safeguarding should be added back onto the list of key developments for the Board to monitor, and that the annual safeguarding reports should form part of the Board’s agenda. There was a need to consider how this would link in with the wider structure and role of the sHWB in order that these were considered by the Board at the most appropriate time.

• The Board discussed the relationship between the Board and the Community Safety Partnership, particularly with regards to being aware of the statutory Community Safety Strategy; it was confirmed that Jeanelle de Gruchy, as a Member of the Community Safety Partnership would act as a link between the two bodies.

• In addition to the list of items for strategic oversight, it was felt that the Board should also have a forward plan in order to schedule its business throughout the year.

• Following on from the decision at the previous meeting that some of the Board’s meetings should be attended by a wider group in order to engage with stakeholders on certain issues, it was suggested that these sessions should be topic based and would enable the Board to fulfil its leadership role. It was suggested that the topic for the first of these sessions could be alcohol and that the following sessions should then be forward-planned, so as to

Agenda Item 3Page 1



deliver meaningful events.

• It was agreed, as discussed at the previous meeting, that there should be some reserve dates scheduled throughout the year, to be used only in the event that there was urgent business that could not wait until the next scheduled meeting. These would then be cancelled if not required. It was agreed that this point should be added to the minutes of the previous meeting.

RESOLVED

That, subject to the addition of the point regarding scheduling ‘reserve’ dates to the Board’s schedule of meetings, the minutes of the meeting held on 23 October 2012 be approved and signed by the Chair.

Clerk

HSP13.

MONITORING THE HEALTH AND WELLBEING STRATEGY

Jeanelle de Gruchy presented the monitoring report on the Health and Wellbeing Strategy, which set out a range of indicators reflecting the strategy’s priorities and provided benchmarking for Haringey’s performance compared with London as a whole, and the borough’s statistical neighbours. It was confirmed that further work was needed around the further targets, as it was not clear at present how these would be set and where responsibility for meeting them rested, and it was noted that from 2015 the Council would be required to demonstrate progress made. For several priorities, Haringey had set its own local targets, for example with regard to teenage pregnancy rates. The Board discussed the report and made the following points:

• Information on the measures needed in order to reach the targets was contained within the Health and Well Being Strategy and the delivery plan.

• It was noted that the figure for breastfeeding rates in Crouch End, as set out under Priority 1: Reduce Infant Mortality, should read 85.7% and not 5.7% as printed in the report.

• The Board felt that, in addition to information on where the borough ranked in comparison with its statistical neighbours, an indication of what quartile the borough was ranked would be helpful.

• Board members welcomed this report as a helpful way of monitoring progress; going forward, it was suggested that a summary front sheet could be produced, to highlight the most significant public health issues. For future reports, performance could be flagged as very good, quite good or below average, with issues being highlighted on an exception basis.

HSP14.

HAVCO: THE VISION FOR STRENGTHENING HARINGEY'S

VOLUNTARY AND COMMUNITY SECTOR

Fitzroy Andrew, CEO of Havco, addressed the meeting and covered the following in his presentation:

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• One of the challenges was to bridge the gap between the Havco Board, in its role as strategic manager, and service providers.

• A change in public behaviour was needed in order to address the gap in health need within the borough; there was a need to move towards self-reliance and an increase in volunteering was likely to be needed.

• The third sector was a vital resource, and had the potential to deliver prompt solutions at the same time as being fully inclusive of the whole community.

• Havco’s role was to support, challenge and inspire the sector, balanced against the need to support themselves as an organisation.

• It was important for Havco to develop its own knowledge base.

• With regard to volunteering, Havco had a role in encouraging growth in the number of volunteers, and increasing the recognition of the work undertaken by volunteers; it was noted that, within certain communities, there was already recognition of the importance of care provided within families, and this was a model that should be replicated.

• Developing networks and sharing best practice within the sector was essential. It was suggested that, in order to familiarise the sector with the changing shape of the health economy, a session should be set up to allow the local authority, CCG and shadow Board to discuss the changes with representatives from Havco member authorities, and it would be most useful for this to be arranged before the start of the next financial year.

• Things that Havco needed to be good at included accessing resources, maintaining relationships and building its reputation as a trusted partner; this should underpin all of its activities.

• Mr Andrew advised that there was a funding opportunity for a trial project on engaging with young people, using technology to communicate health messages around the consumption of fast food.

In discussion with the Board, the following points were raised:

• Having watched the videos from Havco’s AGM, the Board asked about the possibility of moving to paid membership, and the impact this might have on membership numbers. Mr Andrew advised that, before looking at the issue of paid membership, there was a need to consider the relationship with the wider sector and how the organisation was going to deliver what it wanted to deliver. Being able to demonstrate how the organisation could add value would increase the number of members. Mr Andrew advised that, were they to move to paid membership, Havco’s services would still be available to non-members.

• Mr Andrew emphasised the importance of engaging with younger people in terms of succession planning for the sector.

• The Board expressed an interest in the project for engaging with

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young people; it was reported that the Council had already started looking at a similar piece of work, and it was agreed that Jeanelle de Gruchy, Libby Blake, Fitzroy Andrew and Caroline Rowe should connect around the possibility of linking these pieces of work together, outside the meeting. It was also reported that there was a Young Commissioners group looking at issues including obesity, and it would be good to link in with their work.

• It was noted that organisations within the voluntary sector in Haringey varied significantly in size and capacity, as a result of which there was a lot of capacity-building work necessary to support the full range of voluntary organisations.

• It was noted that there was a map of voluntary organisations in Haringey on the Havco website, but that this was in the process of being updated. It was noted that there were around 1600 voluntary organisations in the borough, most of which were micro-organisations, with the majority of organisations based in the east of the borough.

• With regard to involving young people in volunteering, young people needed to be asked what it was they would want to gain from volunteering; this could link with developing enterprise in the borough, and with young people developing skills which would help them in applying for paid jobs. It was recognised that there was a need to sell the idea of volunteering to young people, in terms of what it could help them to achieve.

• Although the current climate was identified as a potential challenge in terms of encouraging young people to volunteer, the experience of people helping out after the riots last year and this year’s Olympics demonstrated that goodwill was there, but needed the right catalyst to make use of it. It was noted that in both of these instances, there was an identifiable cause for people to rally around, and the challenge was to generate interest in the absence of such an obvious cause.

• The Board agreed that meeting with Havco member representatives to discuss changes in the structure of healthcare service would be useful and that such a meeting would be facilitated in the near future.

JdG, LB, FA & CR

HSP15.

CCG COMMISSIONING STRATEGIC PLAN AND PRIMARY CARE

STRATEGY

Sarah Price gave a presentation on the CCG commissioning strategic plan 2013/14 to 2015/16, which set out:

• The purpose and current status of the commissioning strategic plan and operating plan

• Ambitions for the future

• Overview of the strategy

• Priority areas

• QIPP 2012-13 to 2014/15

• 2013/14 and 2014/15 financial position The Board was asked to consider how the link between this strategy and

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the Joint Strategic Needs Assessment and Health and Well Being Strategy should be maintained, and how success would be measured. The Board discussed the issue in groups, and the following points were raised:

• It was reported that the budget assumption for 2014/15 was based on national planning assumptions; this was in advance of the decision in December, which would be the first budget allocation to the CCGs. It was not anticipated that there would be a significant change, although it was noted that, as the amount would be smaller in comparison with the local authority and PCT budgets, even a small change could be destabilising. It was further noted that changes in acute provision could also have a knock-on effect on the overall budget.

• In response to a question regarding the Mental Health Trust budget, it was reported that this was largely block-funded on the basis of care packages, for which contract negotiations were held. Haringey worked with Barnet and Enfield CCGs to discuss issues such as the QIPP and what was needed going forward with regards to the BEH MHT budget.

• Libby Blake confirmed that the strategic aims and outcomes outlined were the same as those the Children and Young People’s directorate were working to.

• Sarah Price reported that there was a need for ongoing challenge to ensure that the CCG commissioning strategic plan related to the Health and Well Being strategy and to identify the overall ‘story’. It was felt that structures, and the way in which services were provided, would change in order to meet the changing needs within the borough; it was intended that more services would be provided in the community, with an increased focus on prevention and early intervention, and encouraging self-management.

• Indicators of success might include a reduction in spending on acute services, an increase in people registered with GPs and increased life expectancy. In terms of reducing health inequalities, things such as the number of healthchecks could be an indicator, and further work was needed with regards to how success could be measured.

• It was agreed that any measure of success should include feedback from service users.

• There would be some further work to clarify respective areas of responsibility, in order to avoid duplication, and a draft document, looking at the issue of alignment with the Health and Well Being Strategy would then be circulated.

HSP16.

LBH BUDGET PLANNING

It was reported that Public Health now came within the Council; while the budget was ring-fenced, there was still a need to look at efficiency savings. It was important to maintain partnership working, in accordance with the existing memorandum of understanding and core offer, while

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working within the constraints of the current economic climate.

HSP17.

FUTURE AGENDA ITEMS AND DATES OF FUTURE MEETINGS

The Board discussed the topics for the proposed seminars for 2013/14 and the following were suggested:

• Alcohol

• Mental health

• Encouraging cultural change on health issues, especially among young people

It was agreed that Jeanelle de Gruchy would bring some outline proposals for the seminars to the next Board meeting for discussion. It was agreed that an alternative date should be sought for the next meeting of the Board in February 2013, and circulated to members outside the meeting.

HSP18.

ANY OTHER BUSINESS

There were no new items of business. The meeting closed at 15:35hrs.

Councillor Bernice Vanier Chair

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Report for:

Shadow Health & Wellbeing Board 26 February 2013

Item number

Title:

Haringey Adult Social Care Local Account 2011/12

Report authorised by:

Mun Thong Phung, Director of Adult & Housing Services

Lead Officer:

Lisa Redfern, Deputy Director of Adult and Community Services

Ward(s) affected: All

Report for Non Key Decision: Non key decision

1. Describe the issue under consideration

It is suggested by the Department of Health (DH), that all councils with social care responsibilities consider producing a short, accessible local account annually, to describe successes, challenges and priorities in our performance in adult social care to local people. The format of the Local Account is down to local discretion.

2. Cabinet Member Introduction I am very proud of Haringey’s Second The Local Account as it provides an important opportunity to demonstrate to Haringey residents what we do and what we have achieved across adult social care in 2011/2012. It describes our approach to deliver positive social care outcomes for vulnerable people who use adult social care and their carers through high quality prevention and personalised care services. Enabling vulnerable people and their carers to have the right care, when they need it so they can live in their own home as independently as possible is central to what we do.

Agenda Item 4Page 7

of 4

Some of our services are provided in conjunction with the community and voluntary sector and we are committed to working with our partners to develop services that reflect local demand. We are proud of our joint working approach through our shadow Health and Wellbeing Board (sHWB) and we aim to strengthen and develop this even further in 2012/2013 and beyond.

3. Recommendation

That the Shadow Health and Wellbeing Board note the content of Haringey’s Adult Social Care Local Account attached in Appendix 1.

4. Background information

This approach to reporting on adult social care outcomes, aims to be responsive to local circumstances, therefore, the format, structure and content of the Local Account are down to local discretion. As we are currently aiming to produce the Local Account annually, this current document is aimed to reflect 2011/2012. In line with Association of Directors of Adult Social Services (ADASS) recommendations, our Local Account includes the following information:

• Outcomes achieved for citizens and consumers (taking into account the national outcomes frameworks);

• The Safeguarding Adults Board has produced an annual report of adult safeguarding activity in Haringey, which is available on the Council’s website

http://www.haringey.gov.uk/index/social_care_and_health/safeguardingadults.htm and attached as Appendix 2;

• Equalities and diversity considerations;

• Productivity issues;

• Feedback from relevant scrutiny reviews; and

• Improvement priorities Our 2011/2012 Local Account (see Appendix 1) is structured around the Adult Social Care Outcomes Framework (ASCOF). This allows our performance to be clearly linked to these outcomes. To ensure the account is reader-friendly we have kept the document to 20 pages in length and used text boxes and pictures to highlight important information and to create an interesting layout. We have also published an easy-read version alongside the full document to increase accessibility.

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http://www.haringey.gov.uk/index/social_care_and_health/social_care_policy_and_practice/adult_social_care_local_account.htm The 2011/2012 Local Account is published on the Council’s website so that it is accessible to local residents. If a paper copy is required, these requests will be dealt with individually and a copy printed from the website. We received minimal feedback on our 2010/2011 Local Account, however we have reviewed some of the Local Accounts produced for other Councils, to establish best practice and what we think would work well in our borough. Accordingly we have decided to make some minor changes to the Local Account for 2011/2012; for example:

(a) We now highlight questions that were raised and the action we took as a result; (b) We have sought to include more pictures; and (c) We have included further case studies.

To ensure that the Local Account is useful for local residents, we have again included our contact details to receive feedback for next year’s account. This approach has been adopted by some other councils.

5. Comments of the Chief Financial Officer and Financial Implications There are no specific financial implications included in this report. It is expected that any costs associated with printing the report from the Council’s website will be contained within existing budgets. The financial aspects of the work undertaken by Adult and Housing Services are monitored by the regular financial and performance management framework of the Council.

6. Head of Legal Services and Legal Implications

There are no legal implications to this report.

7. Equalities and Community Cohesion Comments

Haringey’s Adult and Community Services provides a range of information, advice and care services to support residents over the age of 18, in particular, older people, people with mental health needs, people with physical and learning disabilities, people with substance misuse issues, people living with HIV/AIDS and carers.

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The Local Account details our positive approach to equalities and community unity embedded within our service delivery. The report also celebrates specific services and initiatives that have embraced diversity and helped service users to access social care services. Adult and Community Services continues to gather equalities information of residents assessed for or receiving services.

8. Head of Procurement Comments

Not applicable.

9. Policy Implications

The 2011/2012 Local Account sets out the main policy implications for adult social care. In line with the Government’s Vision for Adult Social Care, the Localism Bill and the Think Local, Act Personal agenda, we are working closely with community and voluntary organisations to find ways of developing more personalised and preventative services which meet people’s changing care needs. Joint working with health services is one of our key priorities. Our sHWB, established in April 2011, is made up of elected Councillors, Council officers, health services, the Clinical Commissioning Group and the voluntary and community sector. This Board is taking forward the promotion of early intervention, prevention and wellbeing for everyone in Haringey. Haringey's Health and Wellbeing Strategy 2012-2015 has been developed by our sHWB. Key emerging issues for 2012/13 will include The Care and Support Bill 2012-13 and the Health and Social Care Act 2012.

10. Use of Appendices

Appendix 1: London Borough of Haringey Adult Social Care Local Account 2011/2012: A Review of Progress and Emerging Priorities Appendix 2: Haringey’s Safeguarding Adults Annual Report 2011/12

11. Local Government (Access to Information) Act 1985

Not applicable.

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Front cover

8

1 Cllr Dogus was the Cabinet member for Health and Social Care up to May 2012.

18

–

Haringey Safeguarding Adults Board

Annual Report 2011/12

Haringey

Safeguarding Adults

Board

Annual Report 2011/12

Page 31

[HARINGEY SAB ANNUAL REPORT 2011-12]

P r o t e c t i n g A d u l t s a t r i s k f r o m a b u s e i n H a r i n g e y Page 2

CCoonntteennttss

Foreword 33 1. Introduction 44 2. Safeguarding Adults Board & local work 66 3. Safeguarding Adults Board Sub-Groups 1133

MASH 1144 Members Panel 1155 Case examples - substantiated referrals 1166

4. Safeguarding adults data 1188 5. SAB Business Plan objectives for 2012-2013 2255

AAppppeennddiicceess

Appendix 1 Partner Statements 2266 Appendix 2 National Developments 4411

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FFoorreewwoorrdd

MMuunn TThhoonngg PPhhuunngg Director of Adult & Housing Services Chair of Haringey Safeguarding Adults Board Welcome to the 2011-2012 Haringey Safeguarding Adults Board (SAB) Annual Report. 2011-2012 was a year of consolidation for the SAB. I took up my role as chair of the early in the year reflecting the changes to the health service. A major development in safeguarding was the launch of the local Multi-Agency Safeguarding Hub (MASH). partner agencies and we hope to see the service extended to safeguarding adults in the future. The Safeguarding Adults Members Panel provides an additional tier of scrutiny of adult safeguarding and has produced its first annual report. There are challenges ahead for us. We need to update and review our essential protocols and procedures and prepare for the proposed changes to adult safeguarding as set out in the draft Social Care Bill (July 2012). We need to develop our engagement with service users and within the community. We have very good safeguarding data but we need to use that data more effectively in planning preventative work. We have prepared the ground for more active sub-groups which will include local campaigns and targeted work. One particular success of 2011-2012 was the work of the Carers task and finish sub-group. The launch of the online safeguarding adults training has been a key development which opens up good quality training for internal council staff as well as SAB partner agencies and local providers. report. That is testament to the thriving safeguarding work being completed locally. We are very fortunate to have such commitment, and I look forward to working with you all in 2012-2013.

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11.. IInnttrroodduuccttiioonn 11..11 The Haringey SAB is a board made up of senior managers of key partner

agencies in Haringey as well as representatives of community groups. The SAB provides an oversight of all adult safeguarding matters with the board meeting quarterly. The annual business plan covers local arrangements, service provision and quality assurance.

11..22 The SAB aims to improve safeguarding arrangements for adults at risk by: Providing an oversight of safeguarding arrangements Steering/coordinating and driving the agenda Co-ordinating safeguarding work between local agencies Agreeing safeguarding adults policy Co-ordinating joint training Monitoring progress against agreed safeguarding objectives Facilitating learning from safeguarding matters

11..33 The SAB links to other bodies such as the Community Safety Partnership

Board and the Local Safeguarding C

11..44 This annual report provides a review of the year, details and analysis of the safeguarding referrals raised, and details of the work of partner agencies. Some of the key achievements highlighted in this report include:

Development of the Anti-Hate Crime Strategy and Action Plan Launch of the Complex Care Transfer Protocol for people with learning

disabilities and mental health issues with Islington Creation of a new monitoring post to work across safeguarding and

commissioning Extra scrutiny provided by the Safeguarding Adults Members Panel Robust work with providers, such as:

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o Free safeguarding training for local providers o A new accreditation scheme for domiciliary care providers o A monthly forum for providers of care services o Deprivation of Liberty Safeguards (DoLS) information sessions

for care home providers.

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22.. SSaaffeegguuaarrddiinngg AAdduullttss BBooaarrdd aanndd LLooccaall WWoorrkk The SAB Annual Report 2010-2011 set out eight priorities for work during 2011-2012. These are revisited below with a brief summary of the actions taken.

22..11 SSAABB PPrriioorriittiieess ffoorr 22001111--22001122 22..11..11 PPrroodduuccee aa SSAABB aannnnuuaall rreeppoorrtt

This was completed and the SAB Annual Report is available on the Haringey website at: http://www.haringey.gov.uk/index/social_care_and_health/safeguardingadults.htm

22..11..22 CCoonnttiinnuuee ttoo pprroommoottee aawwaarreenneessss ooff aadduulltt ssaaffeegguuaarrddiinngg aanndd rriisskk aasssseessssmmeenntt Training sessions were provided for staff in the mental health teams, the Joint Learning Disability Community Team, and for elected Council Members. Information leaflets (http://harinet.haringey.gov.uk/safeguarding_adults_leaflet.pdf) were reprinted for staff and information was provided to a carers group.

22..11..33 CCoonncclluuddee wwoorrkk ttoo iimmpplleemmeenntt tthhee PPaann--LLoonnddoonn ssaaffeegguuaarrddiinngg pprroocceedduurreess Information was provided to internal staff. The Social Care Institute of Excellence (SCIE) at a Glance Pan-London procedures document was distributed to staff. Haringey appendix to the Pan-London procedures produced. This is at: http://harinet.haringey.gov.uk/haringey_sab_plp_appendix_v3.doc We also took a lead role in the four-borough work to introduce the Pan-London risk assessment. The Social Care Institute of Excellence (SCIE) http://www.scie.org.uk/publications/ataglance/ataglance44.asp

22..11..44 RReevviieeww tthhee aadduulltt ssaaffeegguuaarrddiinngg ttrraaiinniinngg pprrooggrraammmmee ffoorr 22001111--22001122 oonnwwaarrddss,, ggiivviinngg mmoorree eemmpphhaassiiss ttoo ssppeecciiffiicc ttrraaiinniinngg ssuucchh aass ddeeaalliinngg wwiitthh ffiinnaanncciiaall aabbuussee,, eennssuurriinngg tthhaatt hhiigghheerr nnuummbbeerrss ooff iinnddeeppeennddeenntt sseeccttoorr ssttaaffff rreecceeiivvee ttrraaiinniinngg..

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New financial abuse courses were provided for staff, in partnership with Enfield. Free training was offered to local providers of care services. New online training courses for staff and partner agencies were launched, and can be accessed via the Learning Pool website, http://www.learningpool.com/. The safeguarding training programme has been reviewed with a new programme in place for 2012-2013. In addition, the SAB Training sub-group was relaunched, completing an assessment of local provision and examining potential for developing services in line with the Bournemouth University Safeguarding Adults competencies. 22..11..55 CCoonnttiinnuuee ttoo ccoonnssoolliiddaattee ssaaffeegguuaarrddiinngg ppaarrttnneerrsshhiippss wwiitthh NNHHSS ccoolllleeaagguueess aanndd GGPPss

All local health partners are represented on the SABNHS Haringey has good links with Haringey Council and is part of the local management team meetings. Haringey safeguarding team continued to work in Viability nurses. The SAB agreed to adopt the Whittington Health pressure ulcer protocol. Links are maintained with the London Ambulance Service which continues to be a major referrer of safeguarding adults referrals.

22..11..66 MMoonniittoorr tthhee ddeevveellooppmmeenntt aanndd iimmpplleemmeennttaattiioonn ooff hheeaalltthh ccaarree pprroovviiddeerrss ssaaffeegguuaarrddiinngg bbooaarrddss Whittington Health, the North Middlesex Hospital and Barnet, Enfield and Haringey Mental Health NHS Trust have their own safeguarding adults at risk committee. There is good communication between these boards and the SAB, assisted by each health agency having a safeguarding adults lead.

22..11..77 IImmpplleemmeenntt nneeww ppoolliiccyy rreeppoorrtt ttoo rreeffoorrmm aadduulltt ssoocciiaall ccaarree It has not been possible to implement new policy directives as, although the Law Commission reported and made recommendations about safeguarding adults, these have not yet become either law or a directive for local authorities. The Coalition government set out an advice note in 2011 and released a White Paper in July 2012. The consultation period ended in the autumn of 2012.

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22..11..88 CCoonnttiinnuuee ttoo ddeevveelloopp --AAggeennccyy SSaaffeegguuaarrddiinngg HHuubb ((MMAASSHH)) aanndd iiddeennttiiffyy iittss iimmppaacctt oonn ddoommeessttiicc aanndd ggeennddeerr bbaasseedd vviioolleennccee Haringey MASH was launched in February 2012. Further information can be found in the section on the MASH below.

22..22 AAddddiittiioonnaall SSAABB aanndd llooccaall ssaaffeegguuaarrddiinngg wwoorrkk 22..22..11 DDoommeessttiicc VViioolleennccee aanndd MMuullttii AAggeennccyy RRiisskk AAsssseessssmmeenntt CCoonnffeerreennccee ((MMAARRAACC)) There are key links between domestic violence and safeguarding adults at risk. The domestic and gender based violence partnership informs local work, and the council employs a domestic violence co-ordinator. SAB members are part of this local partnership as well as being members of the MARAC.

22..22..22 SSeerriioouuss CCaassee RReevviieeww ((SSCCRR)) Following the death of an adult at risk who was a resident of a local supporting living service, the SAB Serious Case Review (SCR) sub-group made the decision to hold a SCR. An independent chair was appointed and a meeting arranged for March 2012. However, the SCR had to be postponed as police were still investigating the death. The SCR will be completed in 2012-2013. One aspect of its work will be a process diary kept by the chair which will be used to update the local SCR policy and procedure.

22..22..33 CCoommmmiissssiioonniinngg IInniittiiaattiivveess Haringey Adults Commissioning Team has launched two new developments which address safeguarding matters:

a new accreditation scheme for domiciliary care providers. Each provider wishing to provide services for the local authority must first either be registered with the Care Quality Commission (CQC) or be successfully accredited with Haringey Council. Since the launch of the accreditation process, we have reviewed five accredited suppliers. The reviews involved unannounced spot checks, a review of policies and the review of client and care worker records. We also observed how care is delivered to individual clients and interviewed residents using care, to find out whether the services they received improved the quality of their lives.

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the consolidation of the local Providers Forum. This has grown into a well attended monthly forum for providers of care services within Haringey. A special joint CQC and safeguarding session took place in May 2012. Notes including examples of good practice were distributed to members of the providers forum. 22..22..44 QQuuaalliittyy AAssssuurraannccee

The council Adult Social Care Services Quality Board meets quarterly to review quality initiatives. Quality outcomes for safeguarding adults work include the completion of safeguarding questionnaires with staff. Three of these were completed in 2011-2012 and will be followed up in 2012-2013 to assess progress. The case file audit tool has been implemented. The safeguarding team completes two case file audits per month. The performance team analyses the completed audit and produces a report highlighting areas for improvement. This report is presented quarterly to the Quality Board for further action and improvement. The case file audit has been designed in line with the pan-London tool.

22..22..55 SSaaffeegguuaarrddiinngg ddaattaa The Haringey Council performance team compile monthly statistical returns of the safeguarding data. These form the basis of the statutory return Abuse of Vulnerable Adults (AVA) return which each local authority must present to the Department of Health. The data is also presented at each SAB meeting. Extracts from the data are presented below in table 1. TTAABBLLEE 11 PPeerriioodd AApprriill 22001100 MMaarrcchh 22001111 PPeerriioodd AApprriill 22001111 MMaarrcchh 22001122 Local Authority 16 25 PCT 8 9 Independent Hospital 0 0 TToottaall 2244 3344

22..22..66 HHaattee CCrriimmee Preliminary work to develop a local Anti-Hate Crime Strategy for adults at risk began in 2011-2012 and will continue in 2012-2013. There is an ongoing successful local Mencap-led Learning Disabilities Hate Crime

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project; this empowers people with learning disabilities to take action to protect themselves. Links have been made with the Community Safety Team and their work in responding to local hate crime. Anti-Social Behaviour Partnership meetings include key local agencies including the police and adult social care staff. 22..22..77 DDeepprriivvaattiioonn ooff LLiibbeerrttyy SSaaffeegguuaarrddss ((DDooLLSS))

Haringey Council is the DoLS supervisory body and is therefore well placed to provide data. The DoLS co-ordinator provided regular briefings for the SAB throughout the year. In addition, agencies came together in the early part of 2011-2012 to share information about DoLS and agree a delivery plan. This included the provision of information sessions for care home providers by the DoLS co-ordinator. A more detailed briefing session for local providers is planned for 2012-2013. DoLS applications have been lower than expected, in line with the rest of England. There has been an increase since 2010-2011 (in line with the slight trend upwards in the rest of England); however numbers are still relatively low. Extracts from the data are presented below in table 2. TTAABBLLEE 22 PPeerriioodd AApprriill 22001100 MMaarrcchh 22001111 PPeerriioodd AApprriill 22001111 MMaarrcchh 22001122 AAuutthhoorriisseedd DDOOLLSS 1100 2222 22..22..88 IInnddeeppeennddeenntt MMeennttaall CCaappaacciittyy AAddvvooccaattee (IIMMCCAA)) SSeerrvviiccee VoiceAbility (http://www.voiceability.org), a local advocacy scheme, has a joint contract with Haringey, Enfield and Barnet Councils to provide an IMCA service. This is a very useful service and VoiceAbility IMCAs have been working with DoLS applications as well as with safeguarding

22..22..99 AAccccoouunntt Safeguarding adults information links with other parts of the council and their reporting mechanisms. Examples include the Public Health-led Joint Strategic Needs Assessment (JSNA) and the Adult Social Care Local Account. Safeguarding information and data is provided for both. The JSNA is available at http://www.haringey.gov.uk/jsna The Local Account can be viewed at:

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http://www.haringey.gov.uk/index/social_care_and_health/social_care_policy_and_practice/local_account_2010_11.htm 22..22..1100 CChhaannnneell

Channel is a police-led supportive multi-agency process, designed to safeguard individuals who may be vulnerable to being drawn into any form of terrorism. It is a key part of Prevent rable ble to being drawn into any ble

to stop people becoming terrorists or supporting terrorism. Channel works by identifying individuals who may be at risk, assessing the nature and extent of the risk, and, where necessary, providing an appropriate support package tailored to their needs. A multi-agency panel, chaired by the local authority, decides on the most appropriate action to support an individual after considering their circumstances. In 2011-2012 an internal Haringey meeting was held with the Channel team to agree the way in which Haringey will respond to Channel referrals. The local Channel panel sits on an y wias and whend to basis and involves local partners. The Safeguarding Adults Team has taken the lead for the adult Channel Panel to date. The new Prevent co-ordinator in Haringey Council will be involved in the work as we go into 2012-2013. Channel is a key element of the Prevent strategy. The Home Office has published guidance which provides advice for local partnerships on how to deliver Channel projects and provides advice on the support that can be provided to safeguard those at risk. http://www.homeoffice.gov.uk/publications/counter-terrorism/prevent/channel-guidance?view=Standard&pubID=1077165

22..22..1111 TTrraannssffeerr pprroottooccooll bbeettwweeeenn tthhee LLoonnddoonn BBoorroouugghh ooff HHaarriinnggeeyy aanndd tthhee LLoonnddoonn BBoorroouugghh ooff IIsslliinnggttoonn ffoorr iinnddiivviidduuaallss wwiitthh aa ccoommpplleexx lleeaarrnniinngg ddiissaabbiilliittyy oorr mmeennttaall hheeaalltthh iissssuuee,, oorr bbootthh In January 2012, the Deputy Director of Adult & Community Services initiated a transfer protocol for the safe transition of adults with a complex learning disability or mental health issue from Islington to Haringey, as most people are transferred in that direction and not from Haringey to Islington. The Deputy Director met with her counterpart in Islington; a protocol was subsequently completed in March 2012 and formally launched by the two boroughs.

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The Protocol helps to further safeguard a vulnerable pethey are placed in a home in Haringey from the London Borough of Islington. When a vulnerable person from Islington, with a complex learning disability, mental health need, or both, is placed in a Haringey home, this protocol provides a chhas all the details they need about them and that they are registered with a GP who has all the necessary information about them.

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33.. SSaaffeegguuaarrddiinngg AAdduullttss BBooaarrdd SSuubb--GGrroouuppss 33..11 --ggrroouuppss 2011-2012 saw a review of the work of -groups. In April 2011, as part of the consolidation of the membership, the SAB asked for each sub-, the SAB made the decision that sub-group work would proceed on the basis of having specific sub-groups, such as training, as well as additional task and finish sub-groups to look at specific items. Examples of task and finish sub-groups are the Rogue Traders sub- -group. The SAB also made the decision to set up a Prevention sub-group, the groundwork for which was completed at the end of the year. The SAB has a Serious Case Review (SCR) sub-group which meets as and when required. 33..11..11 TTrraaiinniinngg aanndd WWoorrkkffoorrccee DDeevveellooppmmeenntt SSuubb--ggrroouupp

The Training and Workforce Development sub-group re-formed in 2011-2012 with new terms of reference. Over three meetings, its focus was on bringing together partner agencies, particularly in health and social care. This allowed sharing of information about provision of safeguarding training. The agreement reached was that each agency would provide basic training with additional training provided by the local authority to cover safeguarding investigations. Further meetings took place with neighbouring local authorities to assess how each of them worked and to explore possibilities for joint training work. An example of this was the provision of financial abuse training in a joint Haringey and Enfield partnership. Work to explore the introduction of the Bournemouth University began. This scheme categorises staff into a number of distinct groupings for training purposes and sets out which of the competencies each grouping should complete. Haringey Council has a successful and easily accessible online training scheme in partnership with Learning Pool for the provision of safeguarding, DoLS, Mental Capacity ACT (MCA and other training. It can be accessed by council staff as well as external staff and partner agencies through the Learning Pool website.

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33..11..22 RRoogguuee TTrraaddeerrss TTaasskk aanndd FFiinniisshh SSuubb--ggrroouupp Haringey Council Trading Standards Officers have been active SAB members for the past few years. They have been able to offer advice and practical help for adults at risk affected by doorstep crime and other abuse coming into the category of rogue traders. During 2011-2012 the trading standards lead officer worked with the police to produce information about local rogue traders and set up a system for trading standards to respond to incidents.

33..11..33 CCaarreerrss TTaasskk aanndd FFiinniisshh SSuubb--ggrroouupp In July 2011, the Association of Directors of Adult Social Services ( Carers and Safeguarding Adults http://www.adass.org.uk/images/stories/Policy%20Networks/Carers/Carers%20and%20safeguarding%20document%20June%202011.pdf. This sets out the difficulties for carers in raising safeguarding referrals and at the same time being at risk of abuse themselves. The ADASS report asked for local SABs to take action to address these issues. SAB agreed that a task and finish Carers sub-group should be established to carry out a piece of work engaging with Carers groups and providing them with accessible information. An interim progress report was presented at the SAB and a meeting with Carers held in March 2012. Action points for future work with carers were agreed and an information session was held during Carers week in June 2012.

33..11..44 MMuullttii--AAggeennccyy SSaaffeegguuaarrddiinngg HHuubb ((MMAASSHH) The Haringey Multi-Agency Safeguarding Hub (MASH) was designed, planned and brought into operation during 2011-2012. A project team was set up in the summer of 2011 and the MASH became fully operational in February 2012. Staff from the Safeguarding Adults Team are involved in the MASH as are other SAB partner agencies.

, MASH brings together representatives of key local agencies. The aims are to provide a confidential and secure setting where agencies can share information about children so that an informed decision about intervention can be made. This can substantially speed up decision making by having relevant information shared at the initial stage. In addition, it allows the police to share information quickly and securely.

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The MASH is staffed with professionals from a range of agencies including: adult social care police health and probation

Where additional information is required to ensure that a child is safe, MASH staff will share information. Based on the information gathered, MASH staff decide on what appropriate action needs to take place - whether it be a social work assessment, referral to early help services, or no further action. http://www.haringey.gov.uk/index/children-families/childrensocialcare/childprotection/mash.htm

33..11..55 SSaaffeegguuaarrddiinngg AAdduullttss MMeemmbbeerrss PPaanneell The Haringey Safeguarding A Members Panel was set up in October 2010. It consists of three elected Haringey Council Members who act as the monitoring arm of safeguarding adults work. The panel was set up to provide scrutiny of the functioning of Adult Safeguarding issues in Adult Services and its partner agencies as they function in Haringey, and to give some reassurance to Members who are collectively responsible for the safeguarding of adults at risk in Haringey. The panel meets bi-monthly and is chaired by one of the councillors. The panel has an annual programme of work focusing on aspects of safeguarding and panel members have the opportunity to look at safeguarding performance reports as well as the Business Plan. During 2011-2012 the panel considered personalisation, commissioning and DoLS work.

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33..22 CCaassee eexxaammpplleess -- ssuubbssttaannttiiaatteedd oouuttccoommeess ffrroomm rreeffeerrrraallss The following case examples are from substantiated or partially substantiated safeguarding referrals in 2011-2012. All names have been anonymised. 33..22..11 Financial abuse was a common type of abuse and featured in a number of substantiated referrals. For example, Mr A was an elderly man living alone and receiving home care from a private agency. Over a number of months his care worker was stealing from him by helping himself to money whilst carrying out the weekly shopping. The matter came to light when a council employee visited to carry out a financial assessment and was shown a bank statement. Mr A had not noticed that his money was dwindling. A safeguarding referral was made, the money was safeguarded at the bank, a police investigation was launched and the care worker was suspended. Fortunately, Mr A was patient and assisted the police with their work which involved two trips to the police station. prosecution was brought, the care worker was convicted and imprisoned and a claim for compensation was made for Mr A with his bank. Not all of the stolen money had been returned to Mr A. 33..22..22 Another financial abuse referral illustrates the importance of the wide network of people in the lives of an adult at risk. Each person in the network can act as a means of monitoring and checking that the adult at risk is well. In the case of Mrs B, a family member had been stealing money from her. This came to light when a local newsagent became suspicious about a newspaper bill which had not been paid by the family member. The newsagent asked other family members some questions and this led to an investigation again involving the police. 33..22..33 Mrs C is another example demonstrating what happens when agencies work well together. She was a resident in a sheltered housing scheme who was being financially abused by her son. He was living with Mrs C and at the same time exhibiting anti-social behaviour and upsetting other tenants in the scheme. A multi-agency safeguarding meeting led to an injunction being served on the son, a new assessment for Mrs C and the involvement of the police Safer Neighbourhood Team to monitor the situation. 33..22..44 Mrs D also lived in a sheltered housing scheme. The warden raised a safeguarding referral after n

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full amount of time on a number of occasions. This lead to the home care agency investigating and finding that the care worker was not staying for the required time at a number of service users homes. Mrs care worker was changed and the care worker was disciplined and re-trained. 33..22..55 Abuse in care homes featured in an increased number of safeguarding referrals. A number demonstrate vigilance by the care home in identifying and reporting incidents of abuse. In the case of Mr E, the care home took rapid action after it was discovered that money had been stolen from him by a member of staff. That resulted in police action and the dismissal of the care worker. Other referrals were made after discoveries of abuse during visits from council staff or friends and relations. In one referral a resident (Mr F) had money that was not being properly accounted for by the care home. This led to a review and a mental capacity assessment for Mr F, followed by involvement of the IMCA service. Mr F then received help with managing his money and a regularisation of how his money was looked after.

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44.. SSaaffeegguuaarrddiinngg AAdduullttss DDaattaa 44..11 In April 2011 there was a change in the way we respond to safeguarding alerts. Previously, all safeguarding alerts went directly to the Safeguarding Adults Team after initial reception in the Integrated Access Team. This had led to a large amount of work for a small team especially as a large number of safeguarding alerts did not proceed to an investigation.

From April 2011 it has been the responsibility of the Integrated Access Team (IAT) to look at all safeguarding alerts in the first instance. They do not pass on those where they can establish there is no safeguarding content. In many instances, they will seek advice from the safeguarding team and will refer on if there is any doubt. This has meant that, in 2011-2012, 960 safeguarding alerts were raised, only 470 of which were passed to the Safeguarding Adults Team for further screening and investigation. The data presented below is based on the 470 alerts that were passed to the Safeguarding Adults Team for further screening and investigation. TThhee nnuummbbeerr ooff aalleerrttss iinn 22001111--22001122 The total numbers of safeguarding alerts received were as follows:

Female 555 Male 405 TToottaall 996600 Of those sent to the Safeguarding Adults Team:

Female 270 Male 200 TToottaall 447700 The table below reflects the number of Safeguarding referrals which were investigated by the Adult Protection Team during the 2011/12 financial year. The number of safeguarding referrals closed in 2011-12, relates to the number of safeguarding cases which were closed during the aforementioned year, regardless of when the referral was raised. This accounts for the greater number of cases closed (510) than referrals raised (470) in 2011/12. Of the represented within the graphs 4.2 below.

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AAVVAA TTaabbllee 11 -- NNuummbbeerr ooff aalleerrttss,, rreeffeerrrraallss,, rreeppeeaatt rreeffeerrrraallss aanndd ccoommpplleetteedd rreeffeerrrraallss bbyy aaggee,, pprriimmaarryy cclliieenntt ggrroouupp aanndd ggeennddeerr ooff aalllleeggeedd vviiccttiimm.. SSoouurrccee:: NNAASSCCIISS bbeenncchhmmaarrkkiinngg ttooooll ((hhttttppss::////wwwwww..iiccwweebb..nnhhss..uukk))

CCoommppaarraattoorr BBoorroouugghhss RReeffeerrrraallss rreecceeiivveedd 22001111//1122

RReeffeerrrraall ccoommpplleetteedd 22001111//1122**

PPeerrcceennttaaggee ccoommpplleetteedd aaggaaiinnsstt tthhee nnuummbbeerr ooff rreeffeerrrraallss rreecceeiivveedd HHaarriinnggeeyy 447700 551100 108.5% Hounslow 405 400 98.8% Waltham Forest 555 505 91.0% Brent 345 305 88.4% Lewisham 450 345 76.7% Lambeth 915 700 76.5% Hackney 510 385 75.5% Southwark 500 305 61.0% Newham 520 215 41.3% Ealing 590 195 33.1%

*Please note that the 2011/12 outturns are subject to validation and figures may change as a result.

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44..22 PPeeooppllee aaffffeecctteedd

The group with the highest number of safeguarding referrals is for those with Mental Health issues aged between 18 to 64. There were 86 referrals during 2011/12. The highest number of safeguarding referrals for people aged over 65 were for people with Physical Disabilities. There were 157 referrals during 2011/12.

Categories are set by the Department of Health (DH)

Number of SOVA Referrals Received Between 1st April 2011 and 31st March 2012 By

Service User Group source:AVA return 2011-12

464

25

65

57

86

4

74

9

22

9

42

50

10

0

10

20

30

40

50

60

70

80

90

18 - 64 65 - 74 75 - 84 85+ 18 - 64 65 - 74 75 - 84 85+ 18 - 64 65 - 74 75 - 84 85+ 18 - 64 65 - 74 75 - 84 85+ 18 - 64 65 - 74 75 - 84 85+

Learning disability M ental health Physical disability f railty and sensory

impairment

Substance M isuse Vulnerable people

Service User Group & Age Range

Co

un

t o

f A

lert

s R

eceiv

ed

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EEtthhnniicciittyy The group with the highest number of safeguarding referrals were for White British. referring 181 of the 467 raised; which represents 38.76% of the total referrals. However, the numbers are lower than the Haringey overall White British percentage -2012 has seen a rise in the percentage of the Other White Background group. This has risen to 14.35% from 10.22 The Black Caribbean group remains over represented in safeguarding adults referral figures. That is despite a fall in percentage terms in 2011-2012 from 17.62% to 13.92%. The overall Haringey percentage for Black Caribbean is 6.6%. Other BME groups are more likely to be under represented in terms of safeguarding adults referrals. For example, even though referrals for the Black African group has risen in 2011-2012 from 4.90% to 6.64% the numbers are still below that of the overall Haringey Black African percentage of 8.1%. Similarly, the figures for the Indian group show a slight rise but they are still beneath that of the overall Indian Haringey figure of 4%. The story is the same for the Chinese group. Other Asian groups have very small numbers of referrals and do not feature in the table above. However, there is work to be done with local BME groups to make sure that referrals are made when required and to address the overrepresentation in the Black Caribbean group.


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44..33 TTyyppee ooff aabbuussee In 2011-2012 the majority of safeguarding referrals raised reported Emotional & Psychological abuse, with 177 cases reported. There were also 171 cases of Physical abuse reported within the same financial year. There was a distinct change from 2010/11, where the most common form of abuse recorded was for neglect. This has fallen from the highest form of abuse recorded in 2010/12, to the fourth highest form of abuse recorded in 2011/12.


44..44 PPllaaccee ooff aabbuussee Again, as in previous years, the most common place where abuse has occurred is in the vulnerable adult own home. There was an increase in the number of referrals which identified the location of abuse as a residential care home, from 56 cases recorded in 2010/11 to 68 cases recorded in 2011/12. This reflects a greater emphasis on reporting abuse from care homes and a higher focus on monitoring of care homes following the Winterbourne View Hospital BBC Panorama programme in May 2011.

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44..55 SSaaffeegguuaarrddiinngg oouuttccoommeess The table below provides details of the 502 referrals that have been closed.

Substantiated 34 6.8% Partially substantiated 43 8.6% Not substantiated 328 65.3% Inconclusive 97 19.3% 44..66 AAccttiioonnss ttaakkeenn ttoo hheellpp tthhee aadduulltt aatt rriisskk

The graph below details the outcomes of the alleged victims for cases closed during 2011/12, as a result of the safeguarding investigation/intervention. The with the 328 referrals which were not substantiated.

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44..77 AAccttiioonn ffoorr tthhee ppeerrppeettrraattoorr Similar to the outcomes chosen for the alleged victims for cases closed during 2011/12, referrals which were not substantiated. Police action and continued monitoring were the most common forms of action taken against the alleged perpetrator/organisation/ service during 2011/12

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55.. SSAABB BBuussiinneessss PPllaann OObbjjeeccttiivveess ffoorr 22001122//22001133 There is a SAB overarching safeguarding adults strategy SAB involves effective multi-agency working with partner agencies working collaboratively Provide well connected safeguarding services that make links between adults Provide well connected safeguarding s Further enhanced work with service users and carers in safeguarding work through provision of information and strategies to assist people protecting themselves The local DOLS system provides assurance that DOLS works effectively and sensitively locally The SAB and local scrutiny of a safeguarding panel made up of local elected representatives. Produce an annual report of adult safeguarding activity and make available on the cduce an annual repo Each SAB sub-group provides a regular report to the SAB as well as an annual report SAB information links to other council documents including the local authority Local Account and the JSNA. Provide an effective local safeguarding service. Have agreed ways of working together to respond to domestic violence that affects adults at risk. There is an agreed strategy for responding to Hate Crime as it affects adults at risk. The MASH is an integral part of local safeguarding arrangements The SAB monitors quality outcomes and performance data to continuously improve practice. Have a local safeguarding prevention strategy including a prevention sub-group. Safeguarding data is analysed to identify prevention trends and to inform the SAB prevention work. There is an effective workforce development programme in place with partner agencies working jointly on workforce development Training and workforce development events are provided locally periodically throughout the year. Information about safeguarding adults is provided to local individuals and groups in a variety of formats The Haringey Council website provides up-to-date and relevant information to staff and the public about safeguarding adults matters. There is capacity for local campaigns on safeguarding adults matters aiming at providing information and helping people to protect themselves.

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PPaarrttnneerr SSttaatteemmeennttss AAppppeennddiixx 11 11.. LLoonnddoonn FFiirree BBrriiggaaddee ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss aanndd ootthheerr arrrranngemmennts suchh as mmonniitorriinng annd rreporrtiinng arrrranngemmennts.

As part of our statutory duties our staff come into regular contact with a wide range of people including adults who may be at risk. The policy details reporting procedures both internally and with the Police or other agencies. All safeguarding concerns must be reported to the Officer of the Day (OOD) within 4 hours if there is an immediate risk, and within 24 hours for all other concerns. Responsibility for referral to the local Social Services Department lies with the Duty Deputy Assistant Commissioner. In addition, in order to comply with the Vetting and Barring scheme, our staff who work in roles which involve working with children or adults at risk in a regulated activity are subject to a CRB check at enhanced level. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TToo iinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn.. Through Community Fire Safety work our crews in Haringey have made two referrals to Social Services. In addition following a fire in Gorlesden Rd, N15 we made contact with safeguarding adult practitioners for a gentleman whose home showed evidence of hoarding. Hoarding is an increasing area for concern for our organisation in terms of fire safety and escape from premises. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 As the new Borough Commander for Haringey I will be ensuring that this area of our work receives the necessary investment of time and resources in order to significantly reduce the risk to vulnerable adults in Haringey. Internally, I will be ensuring that all personnel undertake the required training and understand their role and responsibilities. Externally, I will be working closely with our partners raising awareness of fire safety and its impact for vulnerable adults, particularly the risks associated with hoarding behaviour and inappropriate sleeping accommodation.

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DDeettaaiillss ooff iinntteerrnnaall aarrrraannggeemmeennttss ffoorr pprroovviiddiinngg ssttaaffff ((aanndd ootthheerrss)) wwiitthh ssaaffeegguuaarrddiinngg aadduullttss ttrraaiinniinngg.. All staff have undertaken training and instruction in the requirements stipulated now planned for all personnel due to be completed by the end of October 2012. SPENCER ALDEN-SMITH BBOORROOUUGGHH CCOOMMMMAANNDDEERR

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22.. NNHHSS NNoorrtthh CCeennttrraall LLoonnddoonn ((HHaarriinnggeeyy)) ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss aanndd ootthheerr aarrrraannggeemmeennttss ssuucchh aass mmoonniittoorriinngg aanndd rreeppoorrttiinngg aarrrraannggeemmeennttss . The Haringey safeguarding adults lead currently sits within the role of the Head of Adult Commissioning with dual reporting lines to NHS North Central London (Haringey) Borough Director and NHS North Central London Executive Lead for Safeguarding Adults. Reports on safeguarding adult matters are provided to the NHS North Central London Quality and Safety Committee quarterly with more frequent papers being presented as required. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TToo iinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn.. NNuurrssiinngg HHoommeess wwoorrkkiinngg ggrroouupp Following on from the initial meeting held on 29 June 2012 with key stakeholders a further meeting was arranged for October 2012. The aim is to agree key priorities and to draw up a realistic plan during this period of transition, and to propose a longer term plan that can be adopted by the Clinical Commissioning Groups (CCGsi) One of the family carers who attended a Patient Story session at the last Quality and Safety Committee meeting in July has agreed to be the patient representative on this working group. LLeeaarrnniinngg DDiissaabbiilliittiieess SSeellff AAsssseessssmmeenntt AAssssuurraannccee FFrraammeewwoorrkk This was completed for NHS London in 2011. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 SSaaffeegguuaarrddiinngg AAdduullttss PPoosstt A full time safeguarding adults post has been agreed by Haringey Clinical Commissioning Group. Recruitment will commence in the autumn of 2012. This within NHS North Central London (Haringey) until 31 March 2013 and will move to Haringey Clinical Commissioning Group when this becomes a legal entity on 1 April 2013. SSaaffeegguuaarrddiinngg AAdduullttss SSeellff AAsssseessssmmeenntt aanndd AAssssuurraannccee FFrraammeewwoorrkk NHS London is requiring all health providers across London to complete a self-assessment and assurance framework which has now been completed. NHS

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providers and commissioners are expected to work closely with their local SAB and for the SAB to validate the assessment. MMeennttaall HHeeaalltthh CCoommpplleexx CCaarree PPaatthhwwaayy PPllaann NHS Barnet, Enfield and Haringey Mental Health commissioners have been developing care pathways which ensure clients with complex mental health needs receive quality services which are local, cost effective, personalised and which help early recovery. Support for individuals in regaining and maintaining good mental health and well-being should be offered in the least restrictive settings possible. NNuurrssiinngg HHoommeess wwoorrkkiinngg ggrroouupp To continue to develop a proactive approach to quality assuring care within care homes and an early warning system if concerns arise. DDeettaaiillss ooff iinntteerrnnaall aarrrraannggeemmeennttss ffoorr pprroovviiddiinngg ssttaaffff ((aanndd ootthheerrss)) wwiitthh ssaaffeegguuaarrddiinngg aadduullttss ttrraaiinniinngg.. Safeguarding adults training is a mandatory requirement for all employees of NHS North Central London. The content of the training is dependent on job/role. A rolling programme of delivering training to all General Practitioners (GPs) is underway with a number of sessions delivered so far. This commitment regarding training will continue with Haringey Clinical Commissioning Group from April 2013. KKaarreenn BBaaggggaalleeyy AAccttiinngg SSaaffeegguuaarrddiinngg AAdduullttss LLeeaadd NHS North Central London (Haringey)

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33.. NNoorrtthh MMiiddddlleesseexx UUnniivveerrssiittyy HHoossppiittaall NNHHSS TTrruusstt ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss aanndd ootthheerr aarrrraannggeemmeennttss ssuucchh aass mmoonniittoorriinngg aanndd rreeppoorrttiinngg aarrrraannggeemmeennttss . Comprehensive structure in place to ensure the legal and professional safeguarding and protection responsibilities are undertaken for adults potentially at risk. North Middlesex University Hospital (NMUH) has its own Safeguarding of Adults at Risk committee. Governance arrangements are that the committee reports to the Chief Executive through the Executive Management Board, the Patient Safety Board and Patient Safety & Quality Committee. There is active participation in both Haringey and Enfield SABs. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TToo iinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn.. Visit from Independent Chair of Enfield SAB it was recognised how well the Trust works with its partners. It was also recognised that the processes work with the Trust and that work with partners was cohesive and promoted the safety of adults at risk. There is an established Board which has the purpose to provide strategic direction to safeguarding activities across the Trust. The group operates within the London Multi-Agency guidelines. Voiceability, which provides an IMCA service, has joined the group. Governance arrangements are robust. There has been further integration for the benefit of patients with learning disabilities and patients with dementia. The Dementia Board meets monthly. Self-neglect is identified as an area that may present and this is initially captured through inter-professional and multi-agency team meetings. There is a well established End of Life Care inter-professional multi-agency group. There is an action plan, , which enables the Trust to introduce, embed and audit adult safeguarding standards. The Trust produced a comprehensive action plan which covered nine elements. This was agreed through the Trust Safeguarding of Adults at Risk committee and submitted to the Enfield SAB.

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SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 To ensure that the Trust Safeguarding Adults at Risk strategy continues to remain within the current and future pan London procedures, and that all subsequent and inter related Trust policies embrace this format. To maintain and develop training for all staff across the Trust covering all required areas to ensure compliance with our targets and to ensure that our services are fit for purpose whilst ensuring that retraining occurs in a purposeful cycle. To continue to work collaboratively with our multi-agency and inter professional groups to ensure that our patents are protected. To continue to improve our responses to reports of abuse in order that investigations can be clearly undertaken timely with our partners. To make it easier for people to report abuse and make sure they receive a good quality service when they do. To assist adults at risk to recognise and prevent abuse and to put them in touch with a range of support services, including places where they can be safe from harm. To be prepared to further scrutinise and interpret into practical actions following the publication of the final Mid Staffordshire report which is expected later this year. DDeettaaiillss ooff iinntteerrnnaall aarrrraannggeemmeennttss ffoorr pprroovviiddiinngg ssttaaffff ((aanndd ootthheerrss)) wwiitthh ssaaffeegguuaarrddiinngg aadduullttss ttrraaiinniinngg.. The Trust has continued to develop training for all staff in conjunction with Enfield Social Services who provide our level 3 training. The training needs analysis clearly identified the three levels of training required, depending on staff roles and patient contact. This training will continue to be delivered by the Trust and also by our host, LB Enfield. We have identified that there is further development work in relation to a training plan for safeguarding adults and areas will be targeted to have updates in safeguarding adults at all levels. We continue to train staff through face-to-face and e-learning packages. During this year the Trust training compliance figures have increased significantly and we will maintain our training cycle to ensure that this can be maintained. The level 2 training includes Deprivation of Liberty Safeguards and the Mental Capacity Act. These figures are presented to the Patient Safety and Quality Board on a quarterly basis. The Trust continues to participate in the Enfield and Haringey SAB training sub-groups. This ensures that we are able to access training and remain compliant with learning outcomes. PPhhiilliipp BBiirrcchhaamm,, Deputy Director of Nursing and Midwifery NNoorrtthh MMiiddddlleesseexx UUnniivveerrssiittyy HHoossppiittaall NNHHSS TTrruusstt

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44.. BBaarrnneett,, EEnnffiieelldd && HHaarriinnggeeyy MMeennttaall HHeeaalltthh NNHHSS TTrruusstt ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss aanndd ootthheerr aarrrraannggeemmeennttss ssuucchh aass mmoonniittoorriinngg aanndd rreeppoorrttiinngg aarrrraannggeemmeennttss . Barnet, Enfield & Haringey Mental Health NHS Trust (BEHMHT) has a trustwide Safeguarding Adults Committee which meets bi-monthly. The committee allows reporting, discussion and decision making about internal and external matters Assistant Director for Safeguarding Adults represents the Trust at all three of the local authority SABs. A Trust safeguarding adults annual report is presented to the Governance and Risk Management Committee and the Trust Board. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TToo iinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn.. There was a continued drive to make sure that people using BEHMHT services are safeguarded from abuse and that any reported abuse was responded to as per the London multi-agency safeguarding procedures, A service user booklet was developed which provides information about abuse and how to report abuse. The booklet was distributed to all wards and teams. A BEHMHT self-assessment was carried out by the Assistant Director Safeguarding Adults using the Safeguarding Adults Assurance Framework. This allowed a benchmark against the standards. A balanced scorecard has been developed which will be used to report safeguarding activity to the Trust Board. Reports three times a year are planned. A safeguarding adults audit tool has been developed and is now on the Meridian computer system. This will enable team managers to audit one safeguarding case per month. The Trust has been carrying out compliance inspections on all inpatient units and community teams against the criteria in Outcome 7 (safeguarding) of the Case file audits have been carried out.

SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 Ensure that a planned programme of bespoke safeguarding adult training is undertaken and delivered to managers and staff in the Forensic Service.

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Ensure that training in domestic violence is delivered to staff in BEHMHT to raise awareness and gain further understanding of the referral process. As part of a quality measure team managers are to audit one case file per month on the Meridian system. Maintenance of the Trustwide safeguarding adults database. Review of the Trust self-assessment using the Safeguarding Adult Assurance Framework for healthcare services. To get regular reports to enable the tracking of incidences on the Datix system that have been reported as safeguarding cases. Further develop closer working with the Serious Incident and Complaints Manager to ensure the continued integration of the three processes at the time an incident occurs. A planned programme of compliance inspections against the criteria in Outcome 7 of the CQC Regulatory Framework to be carried out by the Practice Standards Leads. As part of the implementation of the Bournemouth Competency Tool, to ensure that the Trust has a system that gives consistency in the use of the tool. Continue to deliver level 1 safeguarding adult training as part of the mandatory training day.

DDeettaaiillss ooff iinntteerrnnaall aarrrraannggeemmeennttss ffoorr pprroovviiddiinngg ssttaaffff ((aanndd ootthheerrss)) wwiitthh ssaaffeegguuaarrddiinngg aadduullttss ttrraaiinniinngg.. The Trust Level 1 training slides have been updated to include the changes set out in the new London multi-agency safeguarding adults procedures. Level 1 safeguarding adults training continues to be offered as part of the mandatory training day and as of 28 February 2012 67 % of staff have been trained to level1.

VVeerroonniiccaa FFlloooodd Assistant Director Safeguarding Adults BEHMHT

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55.. WWhhiittttiinnggttoonn HHeeaalltthh IInntteerrnnaall ssaaffeegguuaarrddiinngg aadduullttss ggoovveerrnnaannccee aarrrraannggeemmeennttss.. TThhiiss ccaann iinncclluuddee ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss aanndd ootthheerr aarrrraannggeemmeennttss ssuucchh aass mmoonniittoorriinngg aanndd rreeppoorrttiinngg aarrrraannggeemmeennttss ..

The Trust is represented at Borough Safeguarding Adult Boards by the Deputy Director of Nursing. The Trust has an Adult's at Risk Steering Committee which is a sub-committee of, and reports to the Quality Committee. It provides assurance to them on all matters relating to adults at risk. The lead nurse is the Prevent lead for the Trust, approved by the Department of Health to provide WRAP training. The Trust collates reports and evaluations from patients on a continual basis. Additionally, there is scrutiny of patient information following concerns and complaints by patients and their relatives.

SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TToo iinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn..

The Trust has re-written the safeguarding adults policy following the Pan London Procedures publication. This links in with other protocols such as the information sharing protocol and the domestic violence protocol. The Lead nurse for safeguarding adults links in with the NCL, SHA, and DH to keep abreast of the safeguarding changes. The Chanel process of Prevent is an appendix to the policy. Provision of reporting to governance committees which indicates areas for patient experience and actions taken as a result, the reports identify themes for both areas; this information is to be used by the Patient Experience Group as part of the integration of feedback into service development. On complex cases involving mental capacity, best interests, mental disorder, consent/refusal/withdrawal of medical treatment, Deprivation of Liberty Safeguards, or the lawful use of restraint, the lead nurse conducts assessments, provides recommendations, and further training to staff. This also includes chairing best interest meetings in complex cases. Training on the MCA is provided by the lead nurse and site manager. 2012 stats: 11 main wards within the hospital with 248 nurses and health care assistants - 152 health care assistants and Nurses trained in MCA/ DOLS. Emergency Department and ITU, 40 nurses trained. Their numbers are not included in the 248. Mandatory training: This shows that adult safeguarding and child protection are joint top out of all mandatory training in the trust at 77%. There is a WRAP approved trainer who is rolling out training to the high-risk areas of emergency medicine, and learning disabilities.

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SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 There is a work plan for 2012-2013 setting out objectives in the following areas. Strategic, operational, safeguarding adults, DOLS, pressure ulcers, domestic violence and Prevent. There are to be quarterly reviews of safeguarding alerts from local authorities and a safeguarding adults Dashboard is to be written. There are a number of training development objectives as well as a review of the pressure ulcer protocol. A domestic violence protocol is also to be written.

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66.. MMeettrrooppoolliittaann PPoolliiccee HHaarriinnggeeyy BBoorroouugghh IInntteerrnnaall ssaaffeegguuaarrddiinngg aadduullttss ggoovveerrnnaannccee aarrrraannggeemmeennttss.. TThhiiss ccaann iinncclluuddee ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss aanndd ootthheerr aarrrraannggeemmeennttss ssuucchh aass mmoonniittoorriinngg aanndd rreeppoorrttiinngg aarrrraannggeemmeennttss .. Haringey Police is involved in safeguarding work with both adults and children on a number of levels. The police manager of the Haringey Public Protection Desk is a member of the SAB; the police manager of the Community Safety Unit chairs the Haringey MARAC and is part of the Haringey Domestic Violence Partnership. Haringey MARAC and is part of the Haringey Domestic Violence Partnership.

the Anti-Social Behaviour Partnership and Community Safety Board. The police safer neighbourhood teams have been active in attending safeguarding adults strategy meetings and taking action to report and investigate allegations of abuse. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TToo iinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn.. MASH is a police lead initiative and the development of the Haringey MASH has been a significant development within 2011-2012. It has brought agencies together and has been helpful in forging new contacts and communication between the police and Haringey Councorging new contacts and com Police representatives met with the Adults & Housing Director and senior managers to discuss safeguarding adults work. An additional meeting was held with safeguarding adults operational staff to explore reporting arrangements and how best to obtain feedback from the police in safeguarding adults referrals. Police representatives worked with Trading Standards officers in the rogue traders sub-group SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 Joint work with Haringey Council to agree a mechanism for safeguarding referrals and obtaining feedback from the police Continuing with the MASH work and exploring how to extend the MASH to adults at risk. Take an active part in the SAB and work to meet the objectives set out in the SAB business plan Continue to work in partnership with other agencies in the areas of Domestic Violence and Community safety. DDeettaaiillss ooff iinntteerrnnaall aarrrraannggeemmeennttss ffoorr pprroovviiddiinngg ssttaaffff ((aanndd ootthheerrss)) wwiitthh ssaaffeegguuaarrddiinngg aadduullttss ttrraaiinniinngg.. Police staff are provided with internal basic safeguarding adults training. Further training can be obtained from Haringey Council and that will be explored in 2012-2013. DDII MM.. PPiillcchh, Metropolitan Police, Haringey Borough

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NNaammee ooff aaggeennccyy LB Haringey DirectorateLLeeaadd ccoonnttaacctt && ccoonnttaaccttddeettaaiillss iinncclluuddiinngg tteell.. && eemmaaiillaaddddrreessss Directorate

PPlleeaassee ddeettaaiill yyoouurr iinntteerrnnaall ssaaffeegguuaarrddiinngg aadduullttss ggoovveerrnnaannccee aarrrraannggeemmeennttss.. TThhiissccaann iinncclluuddee ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss and other arran ements such as monitoring and reporting arrangements. regularly. Equally, the Assistant Director, Adult Social care is a member of the Local regularly. Equally, the Assistant Director, Adult Social care is a member of the Local

Chilinks between the directorates at other levels including work with the LSCB sub-groups and in areas such as transition to adult social care. The introduction ofMASH in 2011-2012 has brought greater opportunities for communication. There arealso links through the local domestic violence partnership.

SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TTooiinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn.. YYoouu mmaayy wwiisshh ttoo pprroovviiddeeeevviiddeennccee wwiitthh yyoouurr ssttaatteemmeenntt.. The LSCB provides information for parents, families and professionals and has adedicated website es in www.haringeylscb.org.uk. There is specific guidance aboutparenting and guidance about mental health and learning disabilities issues. Thereis a link to the safeguarding adults site. Particular achievements in 2011-2012 arethe production of highly regarded Serious Case Reviews as well as training which isaccessible by adult social care staff and online. The LSCB sub-groups have workedto address relevant issues and there is a thriving set of sub-groups including qualityassurance, Best Practice, Domestic Violence and Policy.

SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 A major piece of work planed that will run into 2012-2013 is the s11 review of localA major piece of work planed that will run into 2012

social care, will be involved in the process of a self-assessment which will befollowed up by site visits. A report with recommendations will be produced.

PPlleeaassee ddeettaaiill yyoouurr iinntteerrnnaall aarrrraannggeemmeennttss ffoorr pprroovviiddiinngg yyoouurr ssttaaffff ((aanndd ootthheerrss))wwiitthh ssaaffeegguuaarrddiinngg aadduullttss ttrraaiinniinngg.. YYoouu mmaayy wwiisshh ttoo aattttaacchh rreeccoorrddss oorr rreeppoorrttss ooffttrraaiinniinngg pprroovviiddeedd.. As drelated training. This is accessible for adult social care staff and is available throughthe LSCB website and training booking form. Haringey Council are also to providesafeguarding briefings throughout 2012-2013 for all council staff. MMaarrttiinn GGrraanntt LLLLMM,, Lead Nurse for Safeguarding Adults, Whittington Health

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haringeyscp.org.uk

https://haringeyscp.org.uk



NNaammee ooff aaggeennccyy Housing Services Haringey Council LLeeaadd ccoonnttaacctt && ccoonnttaacctt ddeettaaiillssiinncclluuddiinngg tteell.. && eemmaaiill aaddddrreessss Denise Gandy, Head of Housing Support andOptions PPlleeaassee ddeettaaiill yyoouurr iinntteerrnnaall ssaaffeegguuaarrddiinngg aadduullttss ggoovveerrnnaannccee aarrrraannggeemmeennttss.. TThhiissccaann iinncclluuddee ssaaffeegguuaarrddiinngg bbooaarrddss,, ccoommmmiitttteeeess,, kkeeyy ppoossttss,, nnaammeedd iinnddiivviidduuaallss aanndd ootthheerr aarrrraannggeemmeennttss ssuucchh aass mmoonniittoorriinngg aanndd rreeppoorrttiinngg aarrrraannggeemmeennttss.. Haringey Council Housing Services is part of the Adults & Housing Directorate andas such is part of the same internal governance arrangements as the Adult SocialCare service. There is a departmental management team lead by the Director, MunThong Phung. There is an internal Business Management Team responsible forensuring that the directorate complies with all statutory and compliancerequirements. There is a lead Cabinet Member who meets with senior managers ona regular basis. There is also additional councillor scrutiny of the work. The Head ofHousing Support and Options is a member of the SAB. Housing Services provide two key services that work with adults at risk and othervulnerable people in Haringey. The Hearthstone service is a key part of the localDomestic Violence Partnership providing advice, support and practical assistancefor people experiencing domestic violence. The Vulnerable Adults Team provides aspecialist housing advice service for vulnerable homeless people and those inhousing need. This service is often a key resource for adults at risk. The HousingRelated Support Team fund refuges for people experiencing domestic violence andsupported housing for potentially vulnerable single person households in housingneed and requiring support. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk uunnddeerrttaakkeenn aanndd aacchhiieevveemmeennttss iinn 22001111--22001122.. TTooiinncclluuddee ssppeecciiffiicc eexxaammpplleess ooff wwoorrkk uunnddeerrttaakkeenn.. YYoouu mmaayy wwiisshh ttoo pprroovviiddeeeevviiddeennccee wwiitthh yyoouurr ssttaatteemmeenntt.. As described above, Housing staff play important roles in providing advice andsupport to people affected by domestic violence and in housing need. Hearthstoneassisted 521 survivors of domestic violence and the Vulnerable Adults Team hasassisted over 1,000 people. SSaaffeegguuaarrddiinngg aadduullttss wwoorrkk ppllaannnneedd ffoorr 22001122--22001133 Update briefings for staff on safeguarding responsibilities. Further enhancement of the Hearthstone Service to recognise the particularvulnerability of Eastern European women who are experiencing DV and have alanguage barrier PPlleeaassee ddeettaaiill yyoouurr iinntteerrnnaall aarrrraannggeemmeennttss ffoorr pprroovviiddiinngg yyoouurr ssttaaffff ((aanndd ootthheerrss))

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wwiitthh ssaaffeegguuaarrddiinngg aadduullttss ttrraaiinniinngg.. YYoouu mmaayy wwiisshh ttoo aattttaacchh rreeccoorrddss oorr rreeppoorrttss ooff ttrraaiinniinngg pprroovviiddeedd.. Housing staff are eligible to take up the safeguarding adults training provided by Haringey Council. This includes the online safeguarding courses. Haringey Council are to provide safeguarding adults briefings for all staff during 2012-2013 and Housing staff will be able to take up this offer. Completion of the e-learning module is a minimum requirement for all new Housing staff and frontline staff receive an additional briefing on safeguarding responsibilities for both Adults and Children.

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NNaattiioonnaall DDeevveellooppmmeennttss AAppppeennddiixx 22 The following are a selection of national safeguarding adults or related developments. 11.. DDoommeessttiicc HHoommiicciiddee RReevviieewwss Statutory guidance was issued by the Home Office under Section 9(3) of the Domestic Violence, Crime and Victims Act (2004) to support domestic homicide reviews. It introduced a duty upon local partners such as the police, local authority, probation service, health service and voluntary sector to establish a review in the event of a domestic homicide. These should be conducted to ensure lessons are learned when a person has been killed as a result of domestic violence. 22.. TThhee AAssssoocciiaattiioonn ooff DDiirreeccttoorrss ooff AAdduullttss SSoocciiaall SSeerrvviicceess (AADDAASSSS)) SSaaffeegguuaarrddiinngg AAdduullttss:: AAddvviiccee NNoottee In April 2011 ADASS published a new advice note to support Directors of Adult Social Services in their leadership role regarding adult safeguarding. The framework has been developed by ADASS National Safeguarding Adults Policy Network. It makes the following recommendations for consideration by Directors of Adult Social Care Services:

Develop or review the safeguarding strategy of the Board, embedding an outcomes focus throughout, and ensuring that procedures are an outcomes focus throughout, and ensuring that Provide an annual report of the effectiveness of the Safeguarding Adult Board to all partner organisations and the public to assess the delivery of outcomes. Review risk enabling and risk management policies and practice to ensure that safeguarding and personalisation are addressed and people can weigh up the risks and benefits of their options. Develop a portfolio of responses to safeguarding situations that support positive outcomes. Review the Workforce Strategy to ensure it supports the workforce to be competent in safeguarding adults Share with partners locally and regionally, to support partner organisations and agencies to ensure that their own leadership of the safeguarding agenda is effective. Share with partner bodies at a national level, e.g. NHS Confederation and ACPO, to develop a partnership approach to safeguarding adults (ADASS to lead)

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33.. AADDAASSSS CCaarreerrss aanndd SSaaffeegguuaarrddiinngg AAdduullttss WWoorrkkiinngg TTooggeetthheerr ttoo IImmpprroovvee OOuuttccoommeess. Following the new principles set out within the vision for Adult Social Care, and Following the new principles set out within the vision for Adult Social Care, and

ADASS published a report setting out seven key messages in relation to carers abusing those in their care and carers being abused by those that they care for. The key messages include Leadership; Partnership; Empowerment; Prevention; Recognition & Reporting; Protection & Proportionality; Learning & Accountability. 44.. LLaaww CCoommmmiissssiioonn ppuubblliisshheess AAdduulltt SSoocciiaall CCaarree iinn MMaayy 22001111 This reviews adult social care law in England and Wales and contains recommendations for reform. The Government committed to consider the conclusions of the report, with a view to introducing legislation in the second session of this Parliament. The report recommends a three level structure containing new statute, regulations and a code of practice. In relation to containing new statute, regulations and a code of practice. In relation to

estrictive solution where it is 55.. SSttaatteemmeenntt ooff GGoovveerrnnmmeenntt PPoolliiccyy oonn AAdduulltt SSaaffeegguuaarrddiinngg MMaayy 22001111 This includes a statement of principles for use by Local Authority Social Services and housing, health, the Police and other agencies for both developing and assessing the effectiveness of their local safeguarding arrangements. It also introduces specific safeguarding outcome principles, which we are encouraged to use to develop our strategic action plan;

Empowerment - Presumption of person led decisions and informed consent. Protection - Support and representation for those in greatest need. Prevention - It is better to take action before harm occurs. Proportionality Proportionate and least intrusive response appropriate to the risk presented. Partnership - Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. Accountability - Accountability and transparency in delivering safeguarding 66.. SSCCIIEE RReeppoorrtt 4411:: PPrreevveennttiioonn iinn AAdduulltt SSaaffeegguuaarrddiinngg MMaayy 22001111

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This report shares findings from research, policy and practice on prevention in adult safeguarding and presents a wide range of approaches that can help prevent abuse. Its key message is that effective prevention in safeguarding needs to be broadly defined and should include all social care user groups and service configurations. It does not mean being over-protective or risk-averse. 77.. TThhee EEqquuaalliittyy aanndd HHuummaann RRiigghhttss CCoommmmiissssiioonn:: HHiiddddeenn iinn PPllaaiinn SSiigghhtt:: IInnqquuiirryy iinnttoo ddiissaabbiilliittyy--rreellaatteedd hhaarraassssmmeenntt Report into disability harassment and its impact. Those serious cases which come to court and receive media attention are just tip of the iceberg. Disabled people often do not report harassment for a number of reasons. There is a systemic failure by public authorities to recognise the extent and impact and abuse of disabled people, take action to prevent it happening in the first place and intervene effectively when it does. There are key safeguarding sections in the report. 88.. TThhee GGoovveerrnnaannccee ooff aadduulltt ssaaffeegguuaarrddiinngg:: ffiinnddiinnggss ffrroomm rreesseeaarrcchh iinnttoo SSaaffeegguuaarrddiinngg AAdduulltt BBooaarrddss SSCCIIEE This report was commissioned by the Department of Health. The report looks at how the boards have been structured, their membership and their strategic goals, vision and purpose. 99.. SSeellff--NNeegglleecctt aanndd aadduulltt SSaaffeegguuaarrddiinngg:: FFiinnddiinnggss ffrroomm RReesseeaarrcchh SSCCIIEE This report comprised of a scoping study on the concept of self-neglect as defined in the literature and interpreted in adult safeguarding practice. The report draws on a systematic review of the literature, workshops with senior managers and practitioners in specialist safeguarding roles, a focus group with adult social care practitioners and interviews with key informants. 1100.. SSCCIIEE:: SSaaffeegguuaarrddiinngg aadduullttss aatt rriisskk ooff hhaarrmm:: AA lleeggaall gguuiiddee ffoorr pprraaccttiittiioonneerrss bbyy MMiicchhaaeell MMaannddeellssttaamm This guide outlines the legal basis for the safeguarding of vulnerable adults at risk of harm in England. It is intended to give practitioners useful legal pointers but every case is different and should be taken on its own merits. 1111.. TThhee EEqquuaalliittyy aanndd HHuummaann RRiigghhttss CCoommmmiissssiioonn:: CClloossee ttoo HHoommee:: AAnn EEnnqquuiirryy iinnttoo OOllddeerr PPeeooppllee aanndd HHuummaann RRiigghhttss iinn HHoommee CCaarree The Commission's inquiry into the home care system in England reveals disturbing evidence that the poor treatment of many older people is breaching their human rights and too many are struggling to voice their concerns about their care or be listened to about what kind of support they want.

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SSCCIIEE:: AAsssseessssmmeenntt FFiinnaanncciiaall CCrriimmeess AAggaaiinnsstt VVuullnneerraabbllee AAdduullttss This assessment, commissioned by the Association of Chief Police Officers (ACPO) Economic Crime Portfolio, has been produced to highlight the current and potential future threats to vulnerable adults in relation to economic crime. s:\hgyf\allf\pip\policy, equalities and partnerships\corporate policy\adults & housing\121114 haringey sab annual report 2011-2012-liz & pw comments.docx

i iClinical Commissioning Groups (CCGs) will be statutory NHS bodies with a range of statutory

duties similar in many respects to those of Primary Care Trusts (PCTs) CCGs become operational on 1 April 2013

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Haringey Local Safeguarding Children Board, Annual Report 2011-12 and Business Plan 2012-13

Haringey Local Safeguarding Children

Board

Annual Report 2011-12 and

Business Plan 2012-13

Haringey Local Safeguarding Children Board,

48 Station Road, Wood Green, Haringey, N22 7TY

Tel: 020 8489 1470

Agenda Item 5Page 75


Foreword from Chair

In writing this report I wish to begin by thanking members of the board for their continued

commitment and contributions with a special thanks to Lorna Reith who has stepped down

as Cabinet Member but did so much to assist the LSCB and support services when Haringey

Council went through the process of transformation from 2008. We have also said farewell

to Sarah Peel who as board manager worked tirelessly to establish a new credibility for the

LSCB following the tragic death of Peter Connelly and reorganisation of services.

As this report makes clear the workload of the LSCB has not diminished a workload I am

afraid again dominated by the need for Serious Case Reviews but against the background of

change and changing legislation. The Munro report has achieved much, simply by

stimulating a debate about child protection and related support services. More broadly

reduced the legislative burden and to a large extent increased public accountability and

scrutiny.

The role of the LSCB has been enhanced but the task of holding a range of diverse and hard

pressed services to account is no less daunting.

Graham Badman, Independent Chair

Page 76


CONTENTS

Foreword from Chair.................................................................................................................. 2

SECTION 1 - SUMMARY .............................................................................................................. 4

SECTION 2 - GOVERNANCE AND ACCOUNTABILITY ARRANGEMENTS ...................................... 8

SECTION 3 - THE WORK OF THE SUB GROUPS, WORKING GROUPS AND SAFEGUARDING

FORUMS ................................................................................................................................... 15

SECTION 4 - BOROUGH PROFILE AND SAFEGUARDING DATA ............................................... 36

SECTION 5 - PRIORITIES FOR 2012- 2013 ................................................................................. 40

APPENDIX 1 .............................................................................................................................. 42

Glossary .................................................................................................................................... 45

HARINGEY LOCAL SAFEGUARDING CHILDREN BOARD BUSINESS PLAN 2012-13.................... 49

Page 77


SECTION 1 - SUMMARY

BACKGROUND

The Children Act 2004 requires every Local Authority to establish a Local Safeguarding

Children Board (LSCB) in order to safeguard and promote the welfare of children through

effective co-ordination and partnership working. As set out in Working Together to

Safeguard Children (2010), the LSCB is the key statutory mechanism for agreeing how

organisations in Haringey will co-operate to safeguard children and ensure the effectiveness

of what we do. Safeguarding and promoting the welfare of children is defined in Working

Together as:

Protecting children from maltreatment

Ensuring children are growing up in circumstances consistent with the provision of

safe and effective care.

The Apprenticeships, Skills, Children and Learning Act 2009 requires the LSCB to produce

and publish an annual report on the effectiveness of safeguarding in the local area to:

Analyse the effectiveness of local arrangements to safeguard and promote the

welfare of children;

Analyse the local area safeguarding context and

Assess the functions of the LSCB are being effectively discharged.

It should recognise achievements and progress by the LSCB and partners and the challenges

that still remain for all the partners. The report must include reviews of:

Lessons learnt about the prevention of future Child Deaths

Progress made in completing Serious Case Reviews and implementing actions and

lessons

Safe Employment of frontline staff and Training on safeguarding and promoting the

welfare of children

The Government has directed that from 2011 the LSCB must send a copy of the annual

report to the Leader and Chief Executive of the Local Authority.

Page 78


2011-12 KEY PRIORITIES

been to reflect the need to ensure that multi-agency practice

around the protection of children from harm is effective. This is defined as covering:

The safety and welfare of all children on child protection plans and subject to child

protection investigations;

The safety and welfare of children with complex needs;

The safety and welfare of children living with compromised care as a consequence of

domestic violence, substance misuse, parental mental illness or learning disability,

culturally influenced abuse, family breakdown, institutional dependency, serious

youth violence, serial violence/anti-social behaviour or endemic criminality

Significant disabilities and/or chronic medical needs; or

A combination of one or more of these factors

This approached was endorsed by Ofsted and the Care Quality Commission in the report

following their joint inspection of safeguarding and looked after children services (February

2011).

to be its focus:

1. Children, young people and their families influence the work of the LSCB

2. Strong governance and accountability arrangements are in place between

the LSCB and other Partnership Boards so that everyone is clear about roles

and responsibilities in relation to safeguarding children

3. Our practice is underpinned by a common strategic approach to the

management of risk at every threshold of intervention

4. A co-ordinated strategic approach to address domestic violence is ensuring

that fewer children and young people have to deal with its impact

5. A co-ordinated approach to practice with young people missing from care,

home and/or school is helping to keep those young people safer

6. All our partner agencies have integrated safe recruitment processes and

allegations of improper professional practice are investigated effectively

7. The LSCB can demonstrate that it makes effective use of the learning that

results from serious and other reviews.

Page 79


Although many areas were progressed the departure of the LSCB Business Manager in

October 2011 had a huge impact on the capacity to progress and meet all its

priorities. Therefore areas not addressed to satisfaction have been included alongside this

priorities.

KEY AREAS OF PROGRESS AND ACHIEVEMENTS IN 2011-12 Haringey LSCB continues to have an Independent Chair and successfully recruited a

new Business Manager who started in February 2011

As part of a group of London LSCBs piloting the SCIE methodology, Haringey LSCB

became the first LSCB to commit to publishing their SCIE Review report, recognising

the importance in sharing their learning not only across partnerships but

across the country

Appointment of a consultant to undertake Section 11 audit of agencies, which also

included an audit of agencies actions to specific recommendations from Inspections.

The Miss U project which works to raise awareness about the risks of running away

for children who go missing from home or care through preventative education in

schools, interventions and group work, will as part of Railway

collaborative work with its corporate partner Aviva, a £300,000 investment over the

next three years will extend the existing Miss U service to Haringey as well as

Camden and Islington. This is a multi-agency approach between Railway Children,

Aviva,

Continuation of a task group with the remit to focus on Domestic violence

Haringey LSCB co-ordinated targeted safeguarding forums for Designated teachers

and Children centres enabling those professionals who work regularly with children

and their families the opportunity to influence and be informed of the work of the

board and strengthen links with frontline children services

The transfer of the Child Death SPOC responsibilities to health following the

departure of the LSCB Business Manager who had been the SPOC, this has ensured

all notifications continue to be responded to as required

The Serious Case Review sub group has commissioned no new reviews in the period,

however did undertake a management review conducted under the SCIE

methodology

Page 80


The LSCB established a Working group to focus on Child Sexual Exploitation, with

recognition of the national 2 year inquiry into the sexual exploitation of children in

gang and group settings being undertak

Commissioner.

Section 4 includes more detail on the work of the LSCB and its partners.

REMAINING CHALLENGES There is a lot of work taking place across agencies but challenges remain in particular:

The need to look at the effectiveness of services providing early intervention

How resource and workforce development issues present challenge, especially

around budget cuts in public services

A challenge for the LSCB will be to focus on how it measures the success and areas

for improvement of its own performance

How the LSCB re-focuses itself in-light of local and national agendas/challenges that

include:

o Any changes to the role and function of LSCBs in light of the Munro Review

o Changes to procedures and practices for agencies working with children and

young people that arise from the Munro Review

o The national need to work to reduce harm from sexual exploitation

o The changes to health service

Ensuring the participation of Lay members and including the voices of children,

young people and communities.

The challenges identified from the sub groups and other areas of the LSCB are detailed

further in the report.

Page 81


SECTION 2 - GOVERNANCE AND ACCOUNTABILITY ARRANGEMENTS

THE ROLE AND FUNCTION OF THE LSCB

The Haringey LSCB operates within a legislative and policy framework created by the

Children Act 2004 and is tasked with co-ordinating safeguarding services and evaluating the

effectiveness of safeguarding within Haringey.

The objectives of the Board are:

To co-ordinate what is done by each person or body represented on the Board for

the purposes of safeguarding and promoting the welfare of children in the area

To ensure the effectiveness of what is done by each such person or body for that

purpose

The functions of the Board are to:

Develop and agree thresholds, policies and procedures

Communicate and raise awareness

Monitor and evaluate

Plan, participate and commission

Undertake functions related to child death

Undertake Serious Case Reviews as necessary

The Boards scope is wide and covers universal, targeted and responsive safeguarding. The

Business plan aims to address all areas, but remains focussed on its core business of

ensuring that children who are suspected or know to be at risk of significant harm are being

protected effectively.

Page 82


STRUCTURE CHART

CHAIRING AND MEMBERSHIP ARRANGEMENTS

The Board is chaired by Graham Badman who has been in post since 2009. As the year ends

there will be changes around the vice chair post when Howard Jones steps down. The LSCB

will be seeking to broaden its membership in 2012-13 when it begins work to appoint two

lay members.

The board currently meets every six weeks, with a total of 7 meetings for the year. A full

attendance chart is at the back of this report. On the whole attendance is good with

agencies sending representatives, however there are some agencies where there is a need

for improvement, this could be achieved by either attending themselves or sending

someone in their absence.

The work of the board is progressed through its sub groups and time limited working

groups. Haringey has five subgroups each of which will have an annual work plan that is

agreed by the board. The groups are as follows:

Haringey Safeguarding Children

Board

Child Death Overview Panel

Serious Case Review Sub Group Training, development and

communication Sub Group

Child Sexual Exploitation Working

Group

Quality Assurance Sub Group

Best Practice Delivery Sub Group

Disabled children policy and practice

review group

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Sub Group

Quality Assurance Deputy Director of Safeguarding, CYPS

Remit To monitor the effectiveness of multi-agency child

protection work through data analysis and audit processes

Child Death Overview

Panel (CDOP)

Assistant Director, Public Health

Remit To review the circumstances surrounding all child deaths

and make preventative recommendations where possible;

to ensure a rapid response to any that are unexpected

Training, workforce

development and

communications

Head of Safeguarding, Quality Assurance and Practice

Development (CYPS)

Remit To oversee the delivery and evaluation of a multi-agency

training programme and monitor the degree to which

-

workforce

Best Practice Delivery Designated Nurse for Child Protection

Remit To turning the learning from serious and other forms of

case review into effective operational practice

Serious Case Review LSCB independent chair

Remit To decide when to undertake a review and to monitor

implementation of action plans.

There is also a working group which reports to the board on Child Sexual Exploitation,

chaired by Tony Kelly, Detective Inspector, CAIT (police) and a working group focused on

disabled children, which reports into the Quality Assurance sub group. In addition, the LSCB

co-ordinated two safeguarding forums, one for designated teachers and another for

children centres and early settings. The co-ordinating of these forums will be taken

ove service in the new year.

Page 84


There is also an executive group of the LSCB Board, which comprises of two leads from each

of the key statutory agencies, together with the Independent chair, vice chair and Business

manager.

RELATIONSHIP BETWEEN THE LSCB AND THE CHILDREN TRUST

partner agencies under section 10 of the Children Act 2004 (the duty to cooperate in making

arra

(CT)

vering all aspects of partnership working and the delivery of frontline

services. The CT was set up to co-

services and to improve outcomes for all children and young people in line with the 5 key

outcomes in the Every Child Matters framework

In May 2010 the new Government announced that it would not enact the legislation that

However they

also announced that Section 10 of the 2004 Children Act would remain in place, so the duty

to cooperate on named statutory partners continues.

Last year the Council commissioned a review of its Haringey Strategic Partnership (HSP).

The review recommended ending the HSP (and replacing it with a core group) and most of

the theme groups. Initially the only standing partnership bodies would be the shadow

Health and Wellbeing Board (sHWB) and the Community Safety Board, on the grounds that

the HWB was due to become statutory and the CSB was already statutory. It was agreed

that the Children Trust could continue to the end 2011/12.

The Children Trust had three meetings in 2011/12. There was a very small executive group

which did continue to meet into early 2012, but that ended in February.

The LSCB chair was a member of the Children Trust. In 2012/13 a decision will be taken on

whether to reinstate the Children Trust.

Page 85


ROLE OF ELECTED MEMBERS AND DIRECTOR OF SERVICES Cllr Lorna Reith joined Haringey Local Safeguarding Children Board in December 2008 and

left her role as lead member for children in May 2012.

ensure that the council were fulfilling its responsibilities to safeguard children. The new

Lead Member for children is Cllr Ann Waters.

FINANCIAL ARRANGEMENTS.

The Board is funded by partner contributions.

2011-12 financial contributions

Agency Contributions

Children Services £174,050

Metropolitan Police £5,000

Whittington Health £31, 720

North Middlesex University

Hospital

BEH MHT

Cafcass £550

Probation £2000

Tottenham Hotspur £2,000

Total £215,320

Expenditure April 2011 March 2012

Item Costs

Salaries £98, 842

Training (September 11 March 12) £13, 733

Consultancy £25, 400

Administration £169

Total £138, 144

There was a significant under spend for this year, a result of a staff vacancy and another

member of staff taking unpaid leave. There were additional monies from central

government to be used to implement Eileen Munro recommendations. As this was not

spent it has been rolled over to be used in 2012/13.

Page 86


Contributions are reviewed annually, contributions from the Metropolitan Police, the

Probation service and CAFCASS are centrally provided. The majority around two thirds of

the funding comes from the Local Authority, Children and Young Peoples service.

Funding for the LSCB meets costs for salaries, training and LSCB activities.

HARINGEY LSCB WEBSITE Website Traffic over three years

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

April

May

June

July

Augus

t

Septe

mber

Oct

ober

Nov

ember

Dec

ember

Janua

ry

Febru

ary

Mar

ch

2009-10

2010-11

2011-12

The overall web traffic to the LSCB website was 42,964 page views and 37,531 unique

visitors (a 32% increase on 2010-11 web traffic). Overall, traffic figures are increasing

steadily over time, although the 2009-10 figures maybe skewed by the media response in

May-June 2009.

The website had 37,531 unique visitors who spent an average of 1:49mins on each of our

web pages (not a bad figure for our type of content and 33% longer than on Haringey

Council external site).

Haringey LSCB asked other London SCBs to share their web statistics and from the couple of

responses received, our overall web page view traffic falls between two (100%) and seven

times (700%) greater.

Summary of Usage:

Page 87


5,138 went to the training page (a 32% increase on 2010-11)

1,976 downloaded the Training Programme from publishing in July 2011 (a 52%

increase on 2010-11)

3,562 people went to the SCR page (compared to 3506 last year)

4,029 people viewed our legislation and guidance page

1,408 views to the new Schools & Early Years page from publishing in June 2011

SECTION 2: CHALLENGES/PRIORITIES:

Strengthening the governance and accountability of the board

o Recruiting of a vice chair

o Appointment of lay members

o Work creatively with partners who are unable to provide financial support to

the work of the board

Strengthening and monitoring links between Schools and safeguarding

o Review the LSCBs role in designated safeguarding forums

Page 88


SECTION 3 - THE WORK OF THE SUB GROUPS, WORKING GROUPS

AND SAFEGUARDING FORUMS

The key aim of the work of LSCB sub groups and working groups as it responds to

national expectations and local need is to impact on local arrangements and outcomes for

children. A summary of each sub work this year is detailed along with its

challenges/priorities as we go into the year 2012 -13.

LSCB SUB GROUPS

CHILD DEATH OVERVIEW PANEL (CDOP)

The CDOP continues to review the deaths of all children who reside in the borough. This has

been a statutory responsibility of Haringey LSCB since April 2008. The purpose of this

process is to learn lessons in order to improve the health, safety and well being of children

and ultimately, hopefully, to prevent further such child deaths in the future.

During the year, there were three panel meetings and, in addition, six smaller rapid

response meetings relating to five specific cases.

Notified cases - In 2011/12 there were 25 deaths notified, however only five of these were

closed as more information was required for the remainder. This was mainly from hospitals,

but there were also a number of inquests pending. The postponement of the CDOP meeting

due to take place in Q4 also reduced the numbers of cases closed.

13 of the children were male and 12 female. 10 babies died within 28 days of birth and

another 8 before their first birthday. The majority of infants died because they were very

premature (six) or had lethal congenital anomalies (six). In the second half of the period,

there were four cases where the provisional cause of death is sudden unexplained death in

infancy (SUDI), but none have yet been closed.

Gender of children who died

Male 13

Female 12

Page 89


None of these children were looked after or subject to child protection plans or any legal

orders and none resulted in a serious case review.

Closed cases - During the 12 months, 10 cases were closed - five from 2010/11 and five from

2011/12. Of these:

four were directly related to prematurity

one child had multiple disabilities

one child a malignancy

one child with multiple disabilities and a possible immunodeficiency died of an

overwhelming infection and

three died as passengers in a road traffic accident (RTA) abroad.

Apart from the deaths related to the RTA, none were felt to have avoidable factors.

However, not having access to the police investigation into the RTA, it is not possible to

comment.

Additional information - This year has seen the addition of a neonatologist to the panel and

this has made discussions about neonatal cases more informative. The panel is also

indebted to the work of the SPOC without whom the panel would not be able to function.

CDOP CHALLENGES/PRIORITIES:

Closure of cases

o It is still proving difficult to close cases. Due to awaiting inquest reports, this

can be unavoidable; however it is still not always easy to obtain copies of

internal hospital reports into cases. Communication with the coroner has

improved.

o The demise of the CEMACH process has meant that information obtained has

not always been adequate. Modifications have been made to data collection

forms to help.

o This year five deaths occurred abroad. Detailed information has not been

available on these, making comments about avoidability almost impossible.

This is a national problem with no easy solution.

Page 90


Learning from child deaths

o A report, encompassing the experience of the panel from inception, will be

prepared later in the year. This will comprise over 140 cases and allow a

more detailed analysis to be made.

QUALITY ASSURANCE SUB GROUP

The Quality Assurance sub group met 7 times this year. At the beginning of the year the

group agreed the name of the group and its remit, changing from the Quality Assurance and

practice review to the Quality Assurance sub group. During this period the group has

focused on developing its quality assurance framework by producing and implementing a

multi-agency score card which is cross referenced with the local data set. This score card

aims to focus the group and enable them to look at how well the partnership is doing. An

area the score card helped the group is to look at the need to recognise from cases referred

to MARAC re: children and young people and domestic violence, the importance of

differentiating between adolescent domestic violence and the impact of DV for children.

The commissioning of an independent person to undertake a Section 11 audit was agreed in

the absence of a Business manager. The remit was to look at the 8 standards including

recommendations specific to Haringey. This audit is being undertaken in 2 phases, using

both strategic and case file audit with a multi-agency assessment team. This audit will be

concluded later in 2012 and findings will be included in the 2012/13 annual report.

Also, the group actioned a review of disabled children subject to child protection plans, the

outcome of this review will also

QUALITY ASSURANCE CHALLENGES/PRIORITIES:

Gaining a clear oversight re:

o Children missing from care and home

o Unaccompanied minors and vulnerable families with NRPF

o Understanding services response to gangs

Page 91


Gathering evidence of engaging children, young people specifically the experiences of

families receiving support

Engaging the voluntary sector

Developing an audit cycle to include single-agency audits

SERIOUS CASE REVIEW SUB GROUP

The SCR sub group met 5 times this year. The key focus of the group is to decide on whether to

commission a review and to ensure action plans are implanted. During this year no new SCRs were

commissioned, although it was agreed in January 2011, that as part of the London SCIE pilot a review

would take place using the systems methodology. This review concluded at the end of the year and

raised the issue of agencies identification and response to Neglect. The findings of this review will be

included in this business plan and the main focus of the LSCBs October safeguarding

conference.

The group is aware of the proposed changes to the SCR process expected to be included in the

Working Together consultation in the Spring 2012.

SERIOUS CASE REVIEW CHALLENGES/PRIORITIES:

Supporting and monitoring the implementation of recommendations from reviews

Responding to proposed changes in undertaking serious case reviews

BEST PRACTICE DELIVERY SUB GROUP

The Best practice delivery sub group met five times over the year and in September 2011

Karen Baggaley, Designated Nurse became the new chair. The Best Practice Group aims to

improve practice across all services working with children from learning from reviews. This

year s work has included:

The group reviewing their Terms of Reference

Completion and review of three audits

Having multi-agency oversight of the Child Protection Conference Pilot Project

Page 92


The updating of Social Worker Practice Standards

Monitoring the development of the multi-agency Pre-birth Assessment protocol

Monitoring and having oversight of the development of the Child Protection

Medicals protocol and,

BEST PRACTICE DELIVERY CHALLENGES/PRIORITIES:

Reviewing the learning from the SCIE review

TRAINING, DEVELOPMENT AND COMMUNICATIONS SUB GROUP

-agency training programme is substantial relative to that of our

counterparts -day child protection

courses is 31 courses per year compared to our 53. It was anticipated that numbers would

fall because of the levels of uncertainty and reductions in the work force in this past

financial year, however, there continues to be a high demand for training.

The LSCB multi-agency training team demand has continued to increase in 2011-12, with

just under a thousand applications (n=966) received and processed, 73% or 701 of whom

were trained over 16 core courses over fifty three (53) sessions with eleven (11) agency

groups attending.

The 2010-11 training programme saw an increase of 19% in courses offered and a total 42%

rise in the number of courses offered in the past three years but only a 23% increase in the

number of learners.

In 2011-12, 75% of those offered places on courses in 2011-12 attended the course offered.

This means that a quarter (25%) of all confirmed applicants failed to attend. This high level

of non-attendance significantly affects the value for money of our training programme. Non-

attendance remains at a similar rate to 2010-11, which was 26%.

These non-attendance figures are particularly high in relation to certain courses. For

example, the Introduction course attendance rate is 62% (non-attendance: 38%) in 2011-

12. Perhaps this can be explained because all new starters in Groups B and C are sent

Page 93


invitations to attend the Introduction as part of their multi-agency safeguarding induction to

Haringey.

Other particularly poorly attended courses, falling to 60% attendance and lower, are:

Child Protection Conferences with 60% attendance (40% non-attendance)

The Safety of the Disabled Child with 46% attendance (54% non-attendance)

Due to these high levels of non-attendance, and in consultations with other London

boroughs who have experienced and since resolved similar problems with non-attendance,

the Training & Development Subgroup has decided to begin charging for non-attendance at

courses beginning September 2012.

The aim of charging is to act as incentive to attend and to ensure that we are using our

training resources as effectively as possible

The highest attendance by an individual agency at multi-agency LSCB courses in 2011-12

ncrease on social care attendance in 2010-11 and a

145% increase over the past two years.

There was further 13% increase in attendance by early staff as compared to 2010-11

and total of 23% increase over three years, following a drive to increase training rates for

early settings following low referral rates from early years and childminders.

Agency Attendance 2009-2010 2010-2011 2011-12

% Change

between

2009-2010

& 2011-12

Adult's Social Care 5 0 0 -500%

Children's Social Care 75 124 184 +145%

Early Years 59 77 88 +23%

EWS/ Ed Support 42 82 37 -12%

Housing 17 1 0 -95%

Health 70 120 101 +31%

Mental Health 36 26 25 -31%

Other 3 4 0 -300%

Police 5 7 7 +29%

Private 9 50 109 +92%

Probation 3 0 0 -300%

Schools 96 78 80 -17%

Page 94


Haringey Multi-agency Trainers - In addition to the LSCB Training Officer, Haringey LSCB

s to deliver our multi-agency

courses. This gives training a feel for local issues and services, encourages networking across

the services, and gives our trainers an opportunity to develop their skills.

-agency courses are delivered either using internal trainers or the

Training Officer. Combined, internal trainers and the Training Officer delivered 85% of our

training courses and trained 597 learners (85% of the total number of people trained).

TRAINING, DEVELOPMENT AND COMMUNICATIONS SUB GROUPCHALLENGES/PRIORITIES:

Trainers for Schools

o A gap has been identified in the access to LA-provided CP Training for

Schools due to reorganisation of roles over recent years. In order to

support schools to fulfil their whole-school training requirement,

Haringey LSCB has circulated a list of recommended trainers including

independent trainers and a number of Haringey Council trainers who

can be booked, subject to availability. In addition, designated teachers

for child protection are encourage

-13 LSCB Business Plan aims to address the

broader relationship between the LSCB and schools.

TASK GROUPS

DOMESTIC VIOLENCE TASK GROUP

A domestic violence task group that was developed following a Serious Case Review ended

in December 2011, after successfully implementing actions to improve agencies awareness

Voluntary 78 67 60 -22%

Youth Offending Service 25 8 6 -76%

Youth Service 17 10 5 -71%

TOTAL 540 654 702

Page 95


and response to Domestic violence. Work in this area will continue via Haringey co-

ordinator which will include a review of omestic Violence partnership for 3 days

in September 2012.

There will be continued promotion of the issues around DGBV in teenage relationships to

the Gang Action Group and Youth Offending Service.

DV team this year has:

Trained psychiatrists at Barnet Enfield and Haringey Mental Health Trust

Hospital as well as the being

S

to develop good practice

Organised a safety audit visit to the new court premises in conjunction with

the Magistrates Court Legal Bench Advisory Team. This was very well

attended by all relevant Haringey agencies.

Produced local information cards on domestic violence for use by

professionals working with young people

MARAC - Is currently undergoing a review led by the steering group. CAADA (Co-ordinated

Action Against Domestic Abuse), the organisation tasked by the Home Office with

implementing the MARAC in all local authorities across England and Wales, has been

involved in this process.

There were a few recommendations from this review that have now been implemented

including:

the attendance at MARAC now includes the Head of the Safeguarding Adults Service

and a Mental Health Social Worker.

new MARAC representatives to attend MARAC champions training.

DOMESTIC VIOLENCE TASK GROUP CHALLENGES/PRIORITIES:

Work to continue with the children with disabilities service to develop indicators for

good practice guidance for disabled children who witness domestic violence.

Joint seminar to be held later in the year highlighting Teenage partner abuse

Page 96


The DGBV Coordinator is seeking funding from the One Haringey Fund, working with

Victim Support in Haringey to address the issue of there not being enough family

friendly provision.

CHILD SEXUAL EXPLOITATION WORKING GROUP

strategy around Child Sexual Exploitation. This had been signified as critical across the UK by

the

A working group was developed with the following objectives

To dramatically improve crime prevention and victim care for those subject to CSE

and

To address the operational and organisational risks involved by failing to implement

the strategy.

This is a time limited working group who to date has:

A sub-group of senior members of partner agencies was created to address this.

terms of reference for the sub group were devised.

Senior managers from partner agencies (Police, Health, Education and Social

Services) have been tasked to create a business plan for each agency to meet its

commitments, providing actions to meet the plan objectives.

Victim identification and care is the key initial outcome for all agencies. To ensure

that this point is addressed multi-agency awareness training for stakeholders has

been organised.

Haringey has been volunteered to be a pilot site for Operation Vallonia (MPS CSE

initiative) to demonstrate our good practice.

The progress of the business plan, for all agencies, is on schedule. The aim of early

intervention with a multi-agency approach is that it will reduce offences and missing

enquiries. Vallonia will commence in late June 2012 and is likely to provide

investigative links for Operation Valiant to target gang culture and the use of sexual offences

as a weapon.

Page 97


DISABLED CHILDRENS POLICY AND PRACTICE REVIEW GROUP

The Disabled children s policy and practice review groups purpose is to:

Review local and national policy and procedures for the safeguarding and promotion

of the welfare of disabled children in the Haringey area.

Advise on the application of policy in practice

Ensure that policies are up to date and fit for purpose

The group reports into the Quality Assurance sub group. Over the year work has

commenced on compiling an understanding of the factors that relate to the identification

and then the investigation of abuse of disabled children. As a result a number of actions

have taken place including joint training between CAIT and disabled children team social

worker and child protection supervision is now being offered to the therapist that work with

disabled children.

SAFEGUARDING FORUMS

This year Haringey LSCB has continued supporting and co-ordinating the safeguarding

forums. These forums aim to share information and to respond to safeguarding issues that

particularly affect Schools and Children centres.

DESIGNATED TEACHERS FORUM

A specialist forum for designated child protection leads in primary and secondary schools

has been running throughout the year. The aim of the forum is to enable designated

teachers to access information on changes in child care law, procedure and research, to

provide access to the Heads for Service for First Response/ Safeguarding and Support/

education welfare and also to access to peer support. Forums are held every half term.

Initially separate primary and secondary meetings were held. These were amalgamated

from July 2011 to increase participation.

Topics covered in 2011/12 have included:

feedback and learning from Serious Case Reviews;

Page 98


a presentation and Q and A session lead by the head of Housing Options and

Improvement on the impact of Homelessness on children and young people,

together with the current homelessness strategy;

work being undertaken to safeguard children from the Roma community in

Haringey; information on Private Fostering;

Teenage Partner Abuse;

regular updates on the changes to the Child Protection Conference process including

the canvassing of the views of forum; guidance on preparing reports for Child

protection case Conferences; and

discussion around the s11 audit being undertaken across the authority.

The plan for 2012/13 is being developed with Forums to continue meeting twice a term.

AFEGUARDING FORUM

This forum was set up to support

Centres with their safeguarding roles and responsibilities and strengthen their relationships

Forum for child protection leads for the last twelve months. The forum meets at a minimum

once every term with Managers and / or child protection le

It has been a challenging twelve months for the Centres with a range of consultations and

changes to the service delivery model across the Borough.

The Forum has given Centres the opportunities to look at a range of issues and discuss these

Centres wider safeguarding responsibilities are key to the discussions and issues raised at

the forum.

Over the last twelve months the forum has looked at:

The SCIE Serious Case Review conducted by the LSCB

The Munro review of Social Work

Page 99


Supporting social workers who are carrying out assessments

PRIVATE FOSTERING

At the time of this report there were 18 children in private fostering arrangements.

a) Number of notifications each month April 2011-March 2012

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Total

1 3 3 0 0 2 4 3 1 1 5 1 24

Private Fostering notifications by Month

0

1

2

3

4

5

6

Apr-

11

M

ay-

11

Jun-

11

Jul-

11

A

ug-

11

Sep-

11

Oct-

11

Nov-

11

Dec-

11

Jan-

12

Feb-

12

Mar-

12

Private Fostering notif ications by month

Month

No: o

f chi

ldre

n

Series1

It should be noted that some notifications when visited were found not to be private

fostering arrangements for example; the carer had a residence order

b) Age range of children presently in placement

Ages 0-5yrs 6-11yrs 12-

18yrs

1 4 13

Page 100


Age range of children currently in PF arrangements

0

2

4

6

8

10

12

14

0-5yrs 6-11yrs 12-18yrs

Age range

Nu

mb

er o

f ch

ild

ren

Raising Awareness - There was an advertising campaign being run which consisted of JC

Decaux posters across the borough, as well as posters and leaflets available in public

buildings i.e. Libraries, community centres.

In the first two years of setting up the Private fostering team, there was a plan for raising

awareness, through talks to professionals and holding public meetings, having stalls at

community events and mail outs to local schools and GP surgeries. This was fruitful, in that

over this period the team were notified of 47 Private fostering arrangements.

Awareness raising 2006 2009 was extensive and resulted in a high number of notifications.

More recently in 2011 the private fostering arrangements figures have not totalled more

than 28 at any one time. The figure of 47 notifications has not been reached again. Minimal

awareness raising does appear to have had an impact on notifications.

The awareness campaign takes place in January each year, the notifications for February

2012 was showing an increase from the average of approx 2 each month. The highest

number of notifications received for the year was in February. It can be assumed that

awareness raising does encourage notifications.

Page 101


Decrease in numbers is usually due to;

a) children reaching 16years and no longer privately fostered

b) moving to another borough

c) private foster carer seeking SGO

d) moving back to parent(s)

Present Work -In late 2010 and early 2011 the manger and workers in the Private fostering

team moved on. As the fostering service was due to be restructured, it was decided that

rather than having a specialist private fostering team, that this work should be integrated

into the new structure with private fostering cases allocated across the service.

The restructure should be complete by September 2012. Therefore, there have been limited

developments however; this work will be further developed within the new structure.

PRIVATE FOSTERING CHALLENGES/PRIORITIES 2011/12:

To progress participation groups for young people in private foster care if funding

bid is successful

Review awareness raising strategy.

include Private Foster carers in training opportunities open to Local Authority

foster carers i.e. managing behaviour

Multi-agency working

o Inclusion of professionals around private fostering, to extend raising

awareness responsibilities.

o To also link PF issues to other areas i.e. trafficking in order for consideration

by a wider audience in learning and development.

o To also better prepare workers from a range of disciplines to work with PF

families and be able to prompt notifications.

Page 102


LICENSING AND GAMBLING

The licensing objective of the protection of children from harm is a constant consideration

on all applications received under the Licensing Act 2003. Here in Haringey the Police

currently continue to make comments that relate to age verification on the applications, as

well as ensuring that CRB checked people will operate any lost children areas at proposed

large events.

For the year there were 66 licensing applications made of which 48 were new. There were 6

gambling applications of which 3 were new.

HARINGEY MISS U PROJECT

As part of Railway work with its corporate partner Aviva, a £300,000

investment over the next three years will extend the existing Miss U service to Haringey as

well as Camden and Islington. This is a multi-agency approach between Railway Children,

The service works to raise awareness about the risks of running away for children who go

missing from home or care through preventative education in schools, interventions and

group work. The service will provide direct support to young people and families affected by

instances of running away.

The project will help young people access safe places and through collaboration with other

organisations will focus on children and young people living at home and those looked after

by the Local Authority.

based i

of being based in the Screening Time is the access the worker has to colleagues from a range

of other services, which allows the worker to gain a detailed knowledge of children and

young people prior to any interventions being planned and implemented.

The number of children and young people who are reported to the Police as missing varies

each month and the level of concern also varies.

Page 103


In the two months November to December 2011, there were 49 children and young people

reported missing from home and their details passed to the Screening Team.

Of these children and young people, some had a history of being reported missing and some

were young people who were late returning home and it was a one off incident.

carries out the return home interviews.

From starting in Haringey in late November 20111 the Miss U worker has worked with 27

young people offering them a range if interventions.

gives First response management the opportunity to look at trends and practices across the

three North London Boroughs.

ALLEGATIONS AGAINST PROFESSIONALS

During the reporting period of this annual report it is noted that there is a decrease in actual

allegations but an increase in enquiries about potential allegations. It would seem that

more heads of schools, managers and designated officers are better informed about the

LADO role and the need to consult when potential allegations are made. More often than

enquiry and or indeed is not an allegation, but more of a complaint, which is channelled to

the appropriate department.

A Total of 87 allegations were recorded on the allegation data base, this does not include a

large number of referrals that have been dealt with as Single agency investigation and are

deemed to be low level cases that have not met the threshold to be classed as a serious

allegation against a professional.

Page 104


a) Agency referrals

Agency Referrals

0

5

10

15

20

25

30

LB

OH

CY

PS

CY

PS

Ealin

g

CY

PS

Enfie

ld

CY

PS

Ham

mers

mith

CP

YS

Islin

gto

n

School

Child

ren's

Centre

CA

IT

Cate

ring

Serv

ice

Foste

ring

GP

NS

PC

C

Nurs

ery

Oth

er

Tra

nsport

Serv

ice

Polic

e

Agency

Nu

mb

er

of

Re

ferr

als

A significant number of other referrals have been dealt with as an allegation, but during the

investigatory process have been deemed to be of low level and concluded as a single agency

investigation.

The majority of referrals have come via Haringey Screening team often via school

designated child protection officers. The next highest referrers have come directly from

schools.

b) Gender of children

Gender of Children Involved in Allegations

49%

41%

10%

Males

Females

Unspecified

In relation to the Gender of children involved there is slightly more boys than girls.

Page 105


c) Category of allegations

Nature of Allegations

50%

20%

7%

6%

17%Physical

Sexual

Emotional

Neglect

Not recorded

The most common allegation is that of physical abuse. Within this year there were fewer

issues about inappropriate restraint however a number of parents had complained that

their child was assaulted during or just before a restrained.

d) Ethnicity of children

Who the allegations are made against Foster carers foster carers appear to be the largest

group. The majority of such allegations are unfounded.

Ethnicities of Children

0

1

2

3

4

5

6

7

8

African

Carrib

ean

Black

African

Black

British

/Carrib

ean

Black

Carrib

ean

Black

/Black

British

Black

/Black

British

/Ghan

aian

British

(Greek

/Can

adian

)

Mix

ed/W

hite an

d

Black

African

Pak

istani

White/G

reek

Cyprio

t

White B

ritish

White P

olish

White P

ortu

gese

White/A

sian

White/C

arribean

Ethnicity

There was a total of 33 children who's ethnicities were not known

To

tal

Page 106


The ethnicities of the children, the majority of alleged victims are in the White British

category.

However if we look at the break down of those from Black and Minority groups and add

them together it would appear that the larger numbers of alleged victims are from Black

and Minority groups of children.

Gathering information on the ethnicity of professionals needs a focus in the upcoming year,

unfortunately, a large a large number of the ethnicities of the professionals were not

recorded so appear in the data as unknown.

e) Professionals role

f) Outcome of allegation

50% of all allegations that are investigated were found to be unsubstantiated, with a

significant number as unfounded.

Graph representing the job role of the Professional the Allegation was made against

3% 3%

11%

3%

3%

3%

3%

3%

3%

3%

3%

59%

Catering Assistant

Child Minder

Foster Carer

Keyworker

Nursery Practitioner

Teacher

Senior Nursery Worker

Sports Coach

Teacher Assistant

Team Manager

Trustee of the High Level Theatre

Group and also Pastor of a

pentecostal churchOther

Page 107


In the past year the LADO has been called upon on two occasions to attend disciplinary

hearings where allegations of child abuse by a professional was found to be substantiated.

The LADO role also consists of offering consultation and guidance to the various social work

teams, schools and other child care settings.

This year we have seen a significant increase in enquiries about churches and those who

minister others in the community. There have been a number of cases involving children

who have been accused of possessing evil spirits, either by a parent or someone at the

church. The LADO has supported social workers on visits to churches and pastors in order to

address such issues.

COMMUNITY PARTNERSHIP

The role of the Training and Community Partnership Officer (TaCPO) is carried out by the

LADO and consist of offering basic child protection training to community groups, faith

groups, and schools, nurseries and sports establishments.

The TaCPO also offers guidance and advice in relation to policy and procedures within the

above named groups.

Faith and Community group - As part of the ongoing work by the TaCPO to ensure that the

community and faith groups are aware of child protection issues a specific forum was

Outcomes

3% 3%

27%

17%

50%

Founded

Malicious

Substantiated

Unfounded

Unsubstantial

Page 108


developed to attempt to engage leaders of faith and community groups in working in

partnership with the local authority in keeping children safe. Four meetings have been held

to try and bring the community and faith groups together. This is a multi faith group and

community group who are now in the process of establishing a chair for this group and a

community groups who are trained up in child protection and related issues and are willing

to work alongside professionals in order to offer their community knowledge as

consultation and cascade child protection issues within their own communities.

COMMUNITY PARTNERSHIP CHALLENGE/PRIORITIES:

Improve engagement of multi-faith community groups through;

o Supporting the multi faith community groups to establish an identity of their

own before more professionals get involved.

o The future plan is to include the Child Abuse Investigation Team into this

meeting and other relevant professionals such as domestic violence and no

recourse to public funds

Page 109


SECTION 4 - BOROUGH PROFILE AND SAFEGUARDING DATA

The London Borough of Haringey is diverse and fast-changing borough, with a population of

about 225,000 residents (ONS). The resident population is constantly changing with about

19,280 people moving in and 23,300 leaving the borough in 2009/10.1 Haringey has a

relatively young population with almost a quarter of the population under the age of 20,

approximately 53,800 children and young people. The wards with the largest number of

people aged under 20 in Haringey are: Seven Sisters, Northumberland Park, White Hart Lane

and Tottenham Hale. Haringey is the 5th most ethnically diverse borough in the country.

Nearly half of the residents come from Black and minority ethnic (BME) communities and

nearly 81% of our school children; 190 different languages are spoken in our schools. The

proportion of children from BME communities varies from 30% in Muswell Hill to 78% in

Northumberland Park.2

During the year the LSCB through its Quality Assurance sub group has continued to collect

and review data about child protection, safeguarding and promoting the welfare of children,

of the under 18s. The table below provides details of this year and previous years where

data was collected.

SAFEGUARDING DATA

AREA 2009-10 2010-11 2011-12

No: of CAFs completed 795 1002

N/a

No: of Initial contacts to children (social

care) 14355 9556 6722

No: of referrals

3324 2658 2306

No: of S47s started

672 724 680

No: of Initial Assessments completed 1881 2093 2322

No: of Core Assessments completed 1019 1234 1213

No: of children with a child protection plan

as of 31st March 296 320 284

No: of Police protection * - -

74

1 London Borough of Haringey, JSNA 2012

2 London Borough of Haringey, JSNA 2012

Page 110


No: of allegations against professionals

118 74 13

No: of Children Missing/absconding from

care during the year - 46 88

No: of children in Private fostering

arrangements as of 31st March 16 11 19

The 2011/12 figures are provisional pending ratification of data. Final outturns will be available at the end of

July *This number reflects the total number of children in the Haringey area who were PP, not the number of

Haringey children

a) Agencies who made contact with Children Social Care

Agency Total

Secondary health/Hospital/ consultant, Midwife) 2011/12 149

2010/11 178

2009/10 303

Health Visitor 2011/12 60

2010/11 52

2009/10 74

Primary health (including GP, Community Paediatrics & LAS) 2011/12 60

2010/11 82

2009/10 43

Child Minder 2011/12 0

2010/11 0

2009/10 1

Nursery/ Children's Ctr 2011/12 9

2010/11 21

2009/10 2

School 2011/12 285

2010/11 286

2009/10 317

Police/probation/court/prison/Immigration 2011/12 580

2010/11 622

2009/10 915

Housing 2011/12 80

2010/11 90

2009/10 46

Adult Mental Health 2011/12 32

2010/11 31

2009/10 0

Other Adult Providers 2011/12 10

Page 111


CHILDREN SUBJECT TO CHILD PROTECTION PLANS

a) No: subject to each category

0

20

40

60

80

100

120

140

160

180

2009-10 2010-11 2011-12

Neglect

Physical

Emotional

Sexual

Multiple

2010/11 7

2009/10 1

Voluntary Sector 2011/12 75

2010/11 25

2009/10 0

Youth Offending 2011/12 12

2010/11 3

Friend/ neighbour/ family/ member of public 2011/12 90

2010/11 131

2009/10 NK

Total

CATEGORY 2009-10 2010-11 2011-12

NEGLECT

69 89 61

PHYSICAL

11 13 2

EMOTIONAL

49 56 51

SEXUAL

17 8 0

MULTIPLE

ABUSE

150 154 170

Page 112


b) Age and gender of children subject to plans as of 31/3/12

0

10

20

30

40

50

60

70

Unborn 0 - 4yrs 5 - 9yrs 10 -

15yrs

16+

Female

Male

Unknown

c) Ethnicity breakdown of children subject to plans as of 31/3/12

Ethnicity No:

White Uk 47

White Other 63

Asian 17

Black 133

Mixed 43

Other 17

Unborn 2

Gender

Age Group

F M U

No:

0-4years

66 70

136

5-9 years

34 51

85

10-15 years

39 51

90

16+ years

7 2

9

Unborn

2 2

Grand Total 146 174 2 322

Page 113


INSPECTIONS

THE LOCAL AUTHORITY

In January 2011 a two week announced OFSTED inspection of safeguarding and services for

looked after children judged the overall effectiveness of both services in Haringey as

improvement in safeguarding in the borough since 2009.

In October 2011 a two day unannounced OFSTED inspection of contact, referral and

the co-location of staff from the police public protection department, health and education

welfare within the First Response Multi-Agency Team and that Haringey effectively

commissions services to address the needs of the community that it serves and judged the

overall effectiveness of both services in Haringey as adequate with good capacity for

improvement. This represents significant and sustained improvement in safeguarding in the

borough since 2009.

THE POLICE

In December 2011, the child abuse investigation team (CAIT) had their annual internal

review conducted by their continuous improvement team. The outcome of which was they

were not found lacking in any area .

SECTION 5 - PRIORITIES FOR 2012- 2013

These priorities include areas that will be addressed over 2012-13 by the Board. They will be

addressed through the Chair, Business Manager, through the Boards agenda, or addressed

more specifically by either sub groups or task groups.

1. The engagement of Children, young People and their families to influence the

work of the LSCB

2. Strengthen governance and accountability arrangements between the LSCB

and other partnership Boards

3. Implement and review response to identified local safeguarding issues

Page 114


4. Implementation of the New Working Together to Safeguarding Children

Guidance

5. Developing a co-ordinated link between Schools and safeguarding

6. Identification of Children Sexual Exploitation

7. Supporting and monitoring organisations in the identification and response

to Neglect in the borough.

Page 115


APPENDIX 1

LSCB MEMBERSHIPChair Graham Badman (Independent)

Vice Chair Howard Jones (Independent)

CYPS Libby Blake (Director CYPS)

Jan Doust (Deputy Director Early Years & Prevention)

Marion Wheeler (AD of Safeguarding)

Rachel Oakley (Head of Safeguarding, Quality Assurance & Practice

Development)

Linda James (Strategic Manager, YOS)

Police DCI Graham Grant (CAIT- North Sector)

DCI Sandra Looby (Borough Commander)

DI Tony Kelly (CAIT Haringey)

Probation Kate Gilbert (ACO Haringey)

Health Services Andrew Williams (Borough Director NHS North Central London, Haringey)

David Elliman (Designated Doctor for Child Protection and Child Death)

Geoff Isaac (Consultant Psychiatrist, BEH-MHT)

Julie Thomas (Named GP, Haringey)

Karen Baggaley (Designated nurse for child protection)

Maggie Buckell (Director of Operations, Whittington Health

Shaun Colins (Assistant Director, BEH MHT/CAMHS)

Susan Otiti (Assistant Director, Public Health)

Karen Miller (Named Nurse Whittington Health)

Lead Member Cllr Lorna Reith (May 2012)

Cafcass Elaine Redding (Service Manager)

Voluntary

Sector

Pamela Pemberton (started 2012)

Housing Denise Gandy (Head of Housing Support & Options)

Schools Dawn Spence, Head Teacher (until December 2011)

Maria Hadjisoteris, Head Teacher Earlham Grove Primary (until December

2011)

Adults

Safeguarding

Lisa Redfern (Deputy Director, Adult & Community Services)

Legal Services Dorothy Simon (Assistant Head of Legal Services: Social Care) (until May

2012)

LSCB officers Sarah Peel, Business Manager (until October 2011)

Angela Bent, Business Manager (from February 2012)

Shauna McAllister, Training Officer

Samantha Philips, Executive Officer

Page 116


SUBGROUPS MEMBERSHIP

Best Practice

Chair Karen Baggaley (Designated Nurse for child protection)

Health Laura Hayman, Named Doctor NMUH (Bianca Lee from 2012)

Maggie Buckell (Director of operations, Whittington Health)

CYPS Denise Sourris, ISS Manager

Dawn Green, Child protection Advisor

Rachel Oakley (Head of Safeguarding, Quality Assurance and Practice

Development)

Marion Wheeler (Assistant Director of Safeguarding)

Iain Low, Head of S&S

Lisa Blundell Deputy Head of Safeguarding & Support (from May 2012)

Police Joe Derilo (DS, CAIT)

Legal Services Jacqueline Longmore

Serious Case Review

Chair Graham Badman (Independent)

Health Andrew Williams (Borough Director NHS North Central London, Haringey)

David Elliman (Designated Doctor of Child Protection and Child Death)

Deborah Perriment (AD of Safeguarding, BEH-MHT) (from 2012)

Karen Baggaley (Designated Nurse of child protection)

Maggie Buckell (Director of operations, Whittington Health)

CYPS Marion Wheeler (AD of Safeguarding

Debbie Haith (Deputy Director of Children Social Care)

Jan Doust (Deputy Director Early Years & Prevention)

Libby Blake (Director CYPS)

Police Graham Grant (DCI, CAIT North Sector)

Sandra Looby (DCI, Borough Commander, Police)

Legal Dorothy Simon Assistance Head of Legal Haydee Nunes DeSouza (Legal

services) from 2012

Training, Workforce development and communications sub group

Chair Rachel Oakley (Head of Safeguarding, Quality Assurance and practice

development)

Tottenham

Hotspur

Angela Seymour (from 2012)

Health Bridget Owen, Named Nurse CP NC London

Christina Keating, Named Nurse CP NMUH

Jo Carroll Named Nurse CP, Whittington Hospital

CYPS

Shauna McAllister, Training Officer

Page 117


Norma Johnson, Safeguarding lead BEH-MHT

Shubi Raymond

Alison Botham, Head of Early Years

Adults Sue Glenmore, OD Consultant

Quality Assurance sub group

Chair Debbie Haith (Deputy Director, Children Social Care)

CYPS Jeannette Brand, Deputy Head of Disabled Childr

Debbie Cotterill, Senior Performance Officer

Linda James, Strategic Manager, YOS

Iain Lowe, Head of Safeguarding and support

Rachel Oakley, Head of Safeguarding, Quality Assurance and practice

development

Marion Wheeler, AD of Safeguarding

Christine Jorge, Performance Manager

Local Authority Margaret Gallagher, Performance Manager

Health Karen Baggaley (Designated nurse for Child Protection)

Sheena Carr, Public Health

Sarah Parker, Head of Commissioning, NHS London

Jeni Plummer (BEH-MHT)

Graeme Walsh

Police Paul Davies, Met Police

Child death overview panel

Chair Susan Otiti (Assistant Director, Public Health)

Health Chantel Palmer (Named midwife, NMUH)

David Elliman (Designated Doctor for Child Protection and Child Death)

Jo Carroll, Named Nurse Whittington Health

Suzanne Dale, SPOC

Vicky Jones, Neonatologist

Sheena Carr, Public Health

CYPS Sylvia Chew (Head of First Response)

Police Tony Kelly (DI, CAIT)

Page 118


Glossary

CAADA Co-ordinated action against domestic abuse

CAIT child abuse investigation team

CDOP Child Death overview panel

CSB Community safety board

CT Children s Trust

CYPS

DGBV Domestic and gender based violence

HSP Haringey Strategic Partnership

LSCB Local Safeguarding Children Board

MAPPA Multi-agency public protection arrangements

MARAC Multi-agency Risk Assessment Conference

SCIE Social (check

SCR Serious Case Review

sHWB Shadow Health and Wellbeing board

SPOC Single point of contact

Contacts

For more information about the work of Haringey Local Safeguarding

Children Board, please contact the LSCB Team: 020 8489 1470 or email

[email protected]

Page 119

Ha

rin

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cal

Sa

feg

ua

rdin

g C

hil

dre

n B

oa

rd,

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nu

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11

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d B

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lan

20

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Page 120

Ha

rin

gey

Lo

cal

Sa

feg

ua

rdin

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dre

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11

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Page 121

Ha

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Lo

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rdin

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dre

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Rep

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20

11

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an

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sin

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13

Page 122

Ha

rin

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Lo

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Sa

feg

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dre

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nu

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Rep

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20

11

-12

an

d B

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lan

20

12

-13

Th

is b

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ou

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the

ag

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an

d a

ctio

ns

to b

e u

nd

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ak

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by

th

e B

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its

pa

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de

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this

s

afe

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Page 123

Ha

rin

gey

Lo

cal

Sa

feg

ua

rdin

g C

hil

dre

n B

oa

rd,

An

nu

al

Rep

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20

11

-12

an

d B

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nes

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lan

20

12

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P2

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TR

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N G

OV

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TA

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AR

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AR

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KE

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BY

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EN

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wa

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imp

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Qu

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ssu

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13

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20

13

T

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bo

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ass

ure

d t

he

re i

s a

co

-

Page 124

Ha

rin

gey

Lo

cal

Sa

feg

ua

rdin

g C

hil

dre

n B

oa

rd,

An

nu

al

Rep

ort

20

11

-12

an

d B

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nes

s P

lan

20

12

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fra

me

wo

rk i

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ple

me

nte

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ord

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Meeting: Shadow Health and Wellbeing Board Date: February 26th 2013 Report Title: Winterbourne View Response Report of: Haringey Learning Disabilities Partnership

Purpose: To brief members of the Shadow Health and Wellbeing Board (sHWB) on Haringey’s response to the Winterbourne View Report1.

Summary Sir David Nicholson (NHS Chief Executive) and Shaun Gallagher (Acting Director General Social Care); wrote2 to Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs) Chief Executives on the 10th December about the programme of action set out in the Department of Health’s Report into events at Winterbourne View. A number of actions have to be completed by 31 March 2013. PCT Cluster Chief Executives and SHAs are responsible for delivery of these actions. Clinical Commissioning Groups (CCGs) are expected to pick up responsibility from April 2013. To meet the requirements of Sir David Nicholson’s letter of 28 November 2012 and the Winterbourne View Concordat Programme of Action3 of December 2012; a number of key tasks have been identified as follows:

• Development of a comprehensive register of all health funded people with learning disabilities and autism by 21 February 2013.

• Complete reviews of all people in learning disability or autism inpatient beds and to agree a personal care plan for each individual based on their and their families’ needs and agreed outcomes.

• Reviews to include the following :

o A personalised care plan o Evidence of engagement and agreement with families and

carers o A discharge plan (including estimated discharge date) o A named care co-ordinator o An identified lead CCG o Date of a comprehensive physical health check

• By June 2014 alternative, community based care arrangements to be in place for all people who do not need a hospital placement;

1 Winterbourne View Report: https://www.wp.dh.gov.uk/publications/files/2012/12/final-report.pdf

2 (DH) Gateway Reference number: 18516 Transforming Care: A National Response to Winterbourne

View Hospital https://www.wp.dh.gov.uk/publications/files/2012/12/Letter-on-the-national-

response-to-Winterbourne-View-Hospital.pdf 3 Concordat: Programme of Action http://www.dh.gov.uk/health/2012/12/final-winterbourne/

Page 129

• Independent advocacy to be put in place for people not yet ready to move in order to quality assure and monitor current provision;

• Identified independent advocacy to support the move for those people that are moving; and

• Commissioners to plan for local high quality care for people who are able to move back to their local community;

Haringey’s Response The Winterbourne View Report has been discussed and key messages disseminated through Adult Social Care, commissioned organisations and also NHS Commissioning. The report will have a profound effect on the future commissioning and delivery of care for people with learning disabilities who require health and social care support. The following actions have been carried out:

• Discussed response at the Learning Disabilities Executive, Safeguarding Adults Board, and Learning Disability Partnership board as well as full and formal discussion in all service meetings. Following on from this will be the embedding of key findings/policy and suggested improvements into our practice, safeguarding and commissioning plans.

• An action plan (see Appendix 1) has been developed in response to Winterbourne View;

• A project team made up of health and social care staff has been set up to manage the review and move on options for people;

• It has been agreed that the CCG and the Local Authority will jointly review all current placements by June 2013;

• Arrangement will be made for everyone who is in hospital inappropriately to move to community based support as quickly as possible and no later than June 2014;

• In Haringey, it is further proposed that once all reviews are completed by June 2013 outcomes will be presented at a consultation event to which Multi-agency Safeguarding Adult Board Partnerships and partner agencies will come together and focus on strategic and front line response to the outcomes of the review. Each partner agency will be tasked to identify outcome measures, and performance improvements which will then be reported on at subsequent Safeguarding Adult Board meetings.

The Winterbourne View Review has resulted in a Concordat between

Commissioners and providers of health care and Local Government

Agencies. The Concordat is a commitment to change and improve services

delivered to people with challenging behaviour.

Adult Social Care’s commissioning, safeguarding and market development

Page 130

approach has for sometime recognised the need for change and has in

recognition developed a number of work streams that will fit seamlessly with

the approach, vision, mandate and commitments published in the

Winterbourne View Review.

People who use services, family carers, advocates, service providers and a

wide range of professionals’ from multi disciplinary backgrounds have been

and are invited to participate in Adult Social Care’s service reviews and

commissioning and procurement processes many of which are currently

organised and used to promote the return of people placed in residential

services outside the London Borough of Haringey.

It is an aim within Adult Social Care that family carers participate in reviews,

work with multi agency review teams in making recommendations and with

people who use services to help commission and remodel service provision

within Haringey.

The focus of much of this work has been organised into work streams that

includes safeguarding, service redesign, transforming care, promoting

independence, choice and the de-commissioning of poor performing services

and re-commissioning of high-quality, well specified service provision .

To ensure the existing work commitments, strategy and commissioning plans

seamlessly combine with and complement the vision and aims stated in the

Concordat, a work plan has been drafted that accounts for all the existing

work commitments and key actions identified in the Concordat.

Legal/Financial Implications None

Recommendations That the Board agrees Haringey’s Joint Work Plan in response to the

Winterbourne View Report

For more information contact: Name: Beverley Tarka Title: Head of Service, Learning Disabilities Partnership Tel: 020 8489 3353 Email address: [email protected]

Use of Appendices: Appendix 1 Work Plan

Page 131

HLDP Winterbourne Response Action Plan

Haringey Council’s Adult Social Care Response to the Winterbourne View Review

Programme of Action and Work Planning

Introduction

In response to the recently published Winterbourne View Review (Concordat:

Programme of Action, December 2012) and in line with the existing commissioning

work streams and planned redesign of services’ in Haringey, a single over

overarching work plan has been developed.

It is also intended that the attached work plan merges the Councils’ existing work

commitments and planned intentions regarding how and in what form services will be

delivered to Adults with a Learning Disability and people who challenge services in

the future.

Winterbourne View Review

The Winterbourne View Review has resulted in a Concordat between commissioners

and providers of health care and Local Government agencies.

The Concordat is a commitment to change and improve services delivered to people

with challenging behaviour. The document sets out its vision for a whole systems

change by stating:

‘All parts of the system –commissioner, providers, the workforce, regulators

government, all agencies, councils and providers, the NHS and the police - have a

role to play in driving up standards for this group of people. There should be zero

tolerance of abuse or neglect.’ (DH Winterbourne View Review: Concordat: Programme of Action 2012)

The signatories of this Concordat have committed to a mandate that requires a

complete commitment to joint working, which is drafted in the Concordat as:

‘We commit to working together, with individuals and their families and with the

groups that represent them, to deliver real change.’ (DH Winterbourne View Review: Concordat: Programme of Action 2012)

This vision and mandate for change is support by a list of key actions and

commitments that the signatory’s will be monitored and measured against.

Page 133

HLDP Winterbourne Response Action Plan

Work streams

Adult Social Care’s commissioning, safeguarding and market development approach

has for sometime recognised the need for change and has in recognition developed

a number of work streams that will fit seamlessly with the approach, vision, mandate

and commitments published in the Winterbourne View Review.

People who use services, family carers, service providers and a wide range of

professionals’ from multi disciplinary backgrounds have been and are invited to

participate in Adult Social Care’s service reviews and commissioning and

procurement processes. Many of which are currently organised and used to

promote the return of people placed in residential services outside the London

Borough of Haringey.

It is an aim within Adult Social care that family carers participate in reviews, work

with multi agency review teams in making recommendations and with people who

use services to help commission and remodel service provision within Haringey.

The focus of much of this work has been organised into work streams that includes

safeguarding, service redesign, transforming care, promoting independence, choice

and the de-commissioning of poor performing services and re-commissioning of

high-quality, well specified service provision .

Strategic Approach

To ensure the existing work commitments, strategy and commissioning plans

seamlessly combine with and complement the vision and aims stated in the

Concordat, a work plan has been drafted that accounts for all the existing work

commitments and key actions identified in the Concordat.

Page 134

HLDP Winterbourne Response Action Plan Page 3 of 14

Haringey Learning Disabilities Partnership- Response to Winterbourne View Review – Work Plan Haringey’s Joint Work Plan is in response to the Winterbourne View report and has a focus:

• to review all people placed in out of borough hospital/Assessment and Treatment Units (ATU’s)by June 2013 ;

• to review all people in in-borough hospital/ATU’s;

• to respond immediately to any safeguarding concerns;

• to plan for local high quality care including independent advocacy to support change for people who are able to move back to their local community;

• to put in place independent monitoring advocacy for people not yet ready to move to quality assure current provision. Once all reviews are completed by June 2013, outcomes will be presented at a consultation event where multi-agency Safeguarding Adult Board Partnerships and partner agencies will come together and focus on strategic and front line response to the outcomes of the review. Each partner agency will be tasked to identify outcome measures, and performance improvements which will then be reported on at subsequent Safeguarding Adult Board meetings.

Project Sponsors Lisa Redfern: Deputy Director Adult and Community Services (LR)

Sarah Price, Chief Operating Officer, Haringey Clinical Commissioning Group (SP)

Project Leads Beverley Taka: Head of Learning Disabilities Partnership (BT)

Peter White: Commissioning Manager, London Borough of Haringey (PW)

Clinical Lead Dr Ken Courtenay : Consultant Psychiatrist Dr Sujeet Jaydeokar: Consultant Psychiatrist

(KN) (SJ)

Safeguarding Lead Sue Southgate: Manager Adult Safeguarding Team (SS)

Clinical Staff Haringey Learning Disability Partnership (HLDP)

NHS Continuing Health Care Assessors (NHSCHCA)

Finance Finance Officer: London Borough of Haringey (FLBH)

Finance officer: NCL NHS (FNHS)

Support Officers

Housing Services: London Borough of Haringey (HSLBH)

Patrick O’Neill: Deputy Service Manager (PON)

Sebastian Dacre: Project Officer (SD)

Page 1

35


1. Commissioning Approach

Activity Key actions Who Time Scales

RAG Status

Progress/comments

1.1

Attain mandate from Deputy Director of Adult and Community Services and Chief Officer, Haringey Clinical Commissioning Group Social Care for an agreed action plan which responds to the Winterbourne View Report

Project planning documentation, including work plans with time scales Incorporate key aims, findings and recommendations from Winterborne View Hospital Concordat (programme of Action) in all commissioning, purchasing and procurement activities

BT/PW December

2012

Key strategic aims and commissioning work plans have recognised and assimilated the aims and plan for action from the Concordat

1.2 Form Project Board Identify project sponsor and project board members

PW/ LRLBH /BT/

SP CCG

December 2012

Identified

1.3 Communication and consultation plan Identify key stakeholders and method of communication

PW/BT January 2012

In progress, but will be assimilated with existing work and communication plans

1.4

Develop individual project and work plans for all commissioning areas identified as relevant to the Winterborne View Hospital Concordat

Draft individual work plans for each commissioning project identified. Link actions to time bound outcomes

PW January 2013

In progress

1.5 Agreed Register of people with learning disabilities in NHs funded care.

NHS CCG representatives SD/LB/DC

January 2013

In progress

1.6 Respond to all safeguarding concerns with action plans and reference to the wider commissioning strategy

Curocare identified and prioritised. Other Hospital and assessment and treatment services will be identified and included

LR/SP December 2012 - ongoing

Move on mandate agreed by senior officers In progress

1.7 Safeguarding measures in place. Regular “Establishment Concerns” meeting under Haringey Pan London

BT/SS Nov 2012 - ongoing

In progress

• Rota of unannounced visits by all

Pag

e 1

36


Safeguarding Procedures involving CQC and placing authorities in place .

placing authorities

• Service improvement Plan developed and ongoing monitoring.

• Voluntary embargo on future placements.

• Move on plans for majority of residents from all placing authorities.

1.8 Communication with families and Carers re our response to Winterbourne View Review

Ongoing communication and engagement with families and carers

BT/PON ongoing

Initiated. Face to face meeting. Telephone liaison.

1.9 Meet with families/advocates to discuss options for move on

Communication will be on-going as part of our communication plan

BT/PW Ongoing

In progress

1.10 Capacity assessment and best interest meetings

Involve residents, families, carers and professionals from multi disciplines

PON January 2013

In progress

1.11 Discussions with high performing providers not currently active in the Borough

Identify viable move on options for Curocare residents

PW ongoing

In progress

1.12 Involve families, advocates and carers in all commissioning activities

Selection of providers and development of new market in Haringey.

PW/BT On-going approach

In progress

1.13 Alternative accommodation Move on completed for Curocare Residents

Project Team

Feb/March 2013

Work is progressing

1.14 Agree quality of life template for people placed OOB in hospital and Assessment and Treatment Units

Review Template Developed Clinical staff of HLDP

December 2012

Completed

1.15 Implement quality of life reviews for people placed Out of Borough in hospitals and Assessment and Treatment Units

Develop plan for individual review. Clinical Staff

June 2013

Plan for reviews completed

1.16 Identify people able to move on to supported accommodation from out or borough placements.

Out Of Borough (OOB) Placement group set up. Agreed terms of reference of the group mirrors the aims of the

BT/PW June 2013 Terms of Reference for OOB group

developed and has been operational for over a year

Page 1

37


Winterbourne concordat

1.17 Commission independent advocacy to monitor people unable to move on

Implement commissioning plan, complete PID and business case, develop personal budgets into RAS, co-ordinate approach with independent project board

PW July 2013

This is in progress and is part of a commissioning work plan that is currently being consulted upon internally

1.18 Develop a move on plan for people able to move from long term residential services

Liaison with families people who use services and their advocates, include capacity assessments and best interest assessments and meetings

BT/PON Up to June

2014

In progress

1.19 Equalities Impact Assessment Draft equalities impact assessment and attain sign off from LBH and CCG

PW January 2013

1.20 Environment Impact Assessment Draft environmental impact assessment and attain sign off from LBH and CCG

PW January 2013

1.21 Communication Include in all project planning including the PID and Business Case

PW January 2013

In progress, ongoing

1.22 Benefits Realisation plan Draft plan to include non cashable benefits

PW March 2013 Develop alongside PID and Business

cases’

1.23 Highlight reports To be generated prior to each project board meeting.

PW Fortnightly

In progress

1.24 Shared Drive Set up shared drives for all commissioning projects and publishing of project documents

PW and IT

January 2013

1.25 Develop Project Initiation Document and business case

Project planning and project products to be determined

PW January 2013

Templates and plans completed

Pag

e 1

38


Page 1

39


2. Physical Resource and Capacity


RAG Status

Progress/comments

2.1 DOH/GLA Care and Support Specialised Housing funding

Review existing sites and opportunities for funding bids

PW/MP

Jan 18th

2013 Deadline date for submission of bid

2.2 Agree a model of supported housing appropriate to people who are discharged from hospital /ATU’s.

Will require local specialist developments to be set in motion.

PW/LD Team

March 2013 In progress

2.3 Project the potential capital costs and available capital associated funding that might be required.

Identify the possible local impacts that might result from a change of use to the proposed sites for investment including consulting the local community and building regulation restrictions

PW/ PDLBH

Feb/ March 2012

In progress

2.4 Identify council owned stock that can be used for supported living developments.

Council’s owned stock and what the re-development or capital costs might be to the Council

PW/BT/HfH

January 2013

Progressing

2.5 Agree timescales for the readiness of use of Council housing stock

Continue to meet and work with Homes for Haringey to identify available stock and housing for use as residence for people currently placed out of Borough

PW/BT/HfH

January 2013

Progressing

2.6 Agree specifications for the properties with Homes for Haringey

These will be undertaken with Homes for Haringey

PW/BT/HfH

April 2013

Progressing

2.7 Submit Capital bids for works to be carried out

Joint approach to be undertaken PW/ HfH

April 2013

2.8 Works completed HfH August 2013

Pag

e 1

40


3. Workforce


RAG Status

Progress/comments

3.1 Commissioning Activity Personnel identified Business case to be completed

PW January 2013

In progress

3.2 Review Team Clinical staff identified PON January 2013

3.3 To be approved by Health and Wellbeing Board

Joint plan for high quality local care and support services for people based on revised local JSNA and joint health and wellbeing strategy.

BT July 2013

3.4 Workforce Strategy Ensure staff development and future recruitment meets the needs of people coming back into borough

PON

June 2014 Under review

Page 1

41


4. Review Joint Commissioning Opportunities


RAG Status

Progress/comments

4.1 Integrated commissioning approach with NHS CCG

Map the commissioning priorities NHS CCG has with those of LBH concerning the development of supported living alternatives for people.

BT/PW March 2013 On-going

4.2

Contact commissioners from London Boroughs’ of Islington, Camden, Enfield and Barnet. Purpose to identify joint commissioning opportunities

Opportunity to identify and share physical resources available for specific needs

PW March 2013

This is progressing through a number of cross borough commissioning groups organised for the purpose of identifying joint commissioning opportunities

4.3 Scope treatment and care pathways with NHS commissioners and NHS care providers

Map health care pathways with social care pathways to include the delivery of day opportunities as well as supported accommodation

PW/BT CCG rep

March 2013

4.4 Long Term Management complex needs Commission for quality local care BT/PW July 2013 –ongoing

Pag

e 1

42


5. Review good practice and LD supported accommodation market


RAG Status

Progress/comments

5.1 Review existing models of supported living within other London boroughs

Contact commissioners from neighbouring London Boroughs to scope out good practice, CQC requirements for the purpose of comparison, staffing structures, and skill based deployed.

PW March 2013

Existing structures and links have already been developed and are being used as opportunities to compare, contrast and benchmark

5.2

Identify current third sector provider market currently delivering LD supported living (medium to high support needs) to determine capacity and ability of market to tender for supported living accommodation.

Map current ‘London’ market and its ability to tender for supported living for people.

PW April 2013 This is being progressed through a market develop approach to commissioning

Page 1

43


6. Finance


RAG Status

Progress/comments

6.1

Contact finance LBH management and CCG and request nominated individuals from the finance team to participate as active members on a project board.

Outline the role of finance in terms of the time required to participate as a project board member

PW/FLBH/FCCG

January 2013

6.2 Financial modelling of existing spend on supported living accommodation.

Agree with finance the range of cost of current supported living provision and compare spend with neighbouring boroughs Get some limited time commitments from finance

PW/FLBH/FCCG

Feb 2013

6.3 Financial modelling of supported living accommodation against current hospital/ATU’s

Review physical re-modelling of supported living accommodation, project future savings against current capital and revenue spend Future commissioning and financial remodelling must include provision for people who need secure accommodation. Cost comparisons must also include capital and revenue over the life of new developments against the current set of arrangements

PW/FLBH/FCCG

July 2013

6.4

Business case and reporting to Health and Wellbeing boards and Learning Disabilities Partnership Board , LD Executive, Cabinet and Elected Members

Support from finance with presenting financial data

PW/FLBH/FCCG

open

Pag

e 1

44


7. Governance


RAG Status

Progress/comments

7.1 Monitoring , evidence based reviews and outcome measurements

Develop outcome measures. Project Board to ensure governance

BT March 2013

Project board established and will meet monthly; HEF outcomes measurement framework currently in advanced stage of development.

Page 1

45


8. Project Tools


RAG Status

Progress/comments

8.1 Project Initiation Document

• Project approach

• Project scope

• Research

• Project method

• Project planning

• Project dependencies

• Interfaces

• Dependencies

• Evaluation plan

• Communication plan

• Risk assessment/log

• Contingency plan

• Milestone plan

PW/All Open

This project approach will applied to all commissioning projects undertaken. Purchasing and procurement activity incorporated into PID.

8.2 Business case

• Current situation

• Workforce analysis

• Need and demand

• Utilisation

• Consultation

• Opportunities

• Project categorisation

• Scope

• Strategic fit

• Proposal and alternative

• Resources

• Communication

• Value analysis

• Cashable benefits

• Non cashable benefits

• Conclusions

• Recommendations

PW/All Open

A business case approach will be taken and used to evidence, analyse and recommend the best commissioning and purchasing approach to each and all individual commissioning projects.

Pag

e 1

46

Meeting: Shadow Health and Wellbeing Board Date: 26th February Report Title: Bringing the HWB and Community Safety Partnership together to focus on alcohol-related violence in the borough Report of: Jeanelle de Gruchy, Director of Public Health

Purpose To bring together members of the Health and Well Being and Community Safety Partnership Boards to discuss and examine:

• What is known about alcohol-related violence in the borough (presentation)

• What are the gaps in our knowledge?

• What are we doing about alcohol related violence?

• Who needs to be involved in tackling this issue

• What more could we be doing? It is proposed that the focus of the session be on preventing and responding alcohol related violence and in particular domestic and sexual violence which is strongly associated with alcohol and a concern at a regional and local level. Summary Violence is strongly related to health inequalities with the poorest fifth of society suffering five times the rate of hospital admissions due to violence compared to the most affluent fifth1 .Alcohol is a risk factor in many different types of violence, including domestic violence, child abuse, sexual violence, youth violence and elder abuse. About half of all violence is thought to be committed by individuals who are under the influence of alcohol2. Preventing violence and/or dealing with alcohol related violence is both a public health and community safety issue. The move of Public Health into the local authority, the addition of violence related indicators to the Public Health Outcomes Framework (PHOF) and the creation of the HWBB present both the opportunity and the impetus to address this issue more effectively. The session may also facilitate the closer alignment of the respective board’s strategies and action plans and make better use of resources in the broadest sense.

Legal/Financial Implications N/A

Recommendations • The HWBB are asked to consider this proposal

• To confirm if they agree with the focus and or/suggest a different focus

• On the basis of this a draft programme will be put together for agreement by the Board and a subsequent date will be set for a session in the summer.

1 Bellis, M.A. Hughes. Wood, S. et al (2011) National five-year examination of inequalities and trends in emergency hospital admissions for violence across England. Injury Prevention 17:319-25. 2 Chaplin, R, Flatley, J, Smith, K. (2011) Crime in England and Wales. London: Home Office


For more information contact: Name: Marion Morris Title: Drug and Alcohol Strategy Manager Tel: 0208 489 6909 Email address: [email protected]

Use of Appendices:

Page 148

Meeting: Shadow Health and Wellbeing Board Date: 26 February 2013 Report Title: Performance Summary Sheet and Exception Reporting Report of: Jeanelle de Gruchy, Director of Public Health

Purpose To share with the board a proposed template for a performance summary sheet to work in conjunction with the main performance report and a template for exception reporting on targets that we are not meeting

Summary Prior to the last Health and Wellbeing Board Meeting a report was circulated detailing the performance of the outcome targets. Suggestions for changes to the report were made which have been auctioned. In addition the board requested: A Summary sheet An exception Reporting mechanism The above are presented here for your approval. The details of which are as follows: Summary Sheet: Key measures from the outcomes report for each outcome to include: Trend data Target Performance indicator London Benchmarking Exception Report: Actions currently in place to improve performance Suggested actions to improve performance

Legal/Financial Implications None

Recommendations That the board accepts the proposed templates for a summary sheet and exception reporting that will be reported to the board to an agreed reporting timetable

For more information contact: Name: Jeanelle De Gruchy Title: Director of Public Health Tel: 020 8489 2828 Email address: [email protected]

Use of Appendices: None

Page 149

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Meeting: Shadow Health and Wellbeing Board Date: 26th February 2013 Report Title: Commissioning Strategy Plan and Operating Plan

2013/14 Report of: Haringey Clinical Commissioning Group

Purpose To share the Commissioning Strategy Plan (CSP) and year one operational delivery of the plan i.e. the Operating Plan to facilitate shared agreement of the Strategic Overview and Local Priorities.

Summary This paper/presentation provides an overview of the CSP and key priorities for delivery based on national planning guidance and alignment to the NHS Outcomes Framework. The Operating Plan provides more detail of how the CCG will deliver the CSP and its commitments to the Mandate and NHS Constitution within the 2013/14 financial year. The CCG is also required to identify 3 local priorities for which measurable improvement in performance during 2013/14 will result in a “quality premium” payment. The three local priorities are to be agreed with the Shadow HWBB. This paper will summarise how the CCG plans to meet these commitments and work in partnership with the HWBB to address key shared, agreed local priorities & reduce health inequalities.

Legal/Financial Implications The financial implications for the CCG are associated with the 2013/14 allocation and associated running cost reduction. Financial risks are also associated with agreement of 2013/14 provider contracts, ability to deliver in year planned savings as identified in the QIPP programme and potential for acute provider over-performance.

Recommendations The Shadow Health and Well Being Board is asked to:

• Note the Strategic overview for Haringey CCG i.e. the CSP

• Note the Operating Plan priorities and commitments to the Mandate & NHS Constitution

• Discuss and agree three local priorities for delivery in 2013/14

For more information contact: Name: Sarah Price Title: Chief Officer Tel: 020 8489 1213 Email address: [email protected]


Use of Appendices

Page 156

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Page 165

1

Meeting: Shadow Health and Wellbeing Board Date: 26 February 2013 Report Title: Haringey CCG Equality Delivery System Objectives

2013/14 Report of: Haringey CCG

Purpose This report informs the Shadow Health and Wellbeing Board of the feedback from LINK members on how Haringey CCG’s proposed Equality Delivery system objectives should be prioritised, and in light of this, which objectives the CCG will be implementing in 2013/14.

Summary Based on feedback from LINK members and the CCG’s current state of organisational development, the CCG will implement the following objectives in 2013/14:

• Introduce robust governance structures and the Equality Delivery System equality assurance framework

• Build strong relationships with diverse groups and communities to understand their needs, priorities and experiences.

• Develop an inclusive working culture which values diversity and supports staff to feel confident to challenge any harassment, bullying or perceived victimisation

Legal/Financial Implications None.

Recommendations The Health and Wellbeing Board is asked to NOTE Haringey CCG’s Equality Delivery System objectives for 2013/13.

For more information contact: Name: Sarah Price Title: Chief Officer, Haringey CCG Tel: 020 8489 1213 Email address: [email protected]

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2

Use of Appendices:

The five proposed Equality Delivery System objectives, as set out in Haringey CCG’s Equality, Diversity and Human Rights Strategy 2012-16, are attached as an appendix.

Page 168

3

HARINGEY CCG EQUALITY DELIVERY SYSTEM OBJECTIVES 2013/14 1. INTRODUCTION

Haringey CCG’s Equality Diversity and Human Rights Strategy, which was approved by the CCG’s Governing Body meeting on 18 October 2012, sets out the CCG’s approach to promoting equality and diversity and how it will meet its Public Sector Equality Duty (PSED).

The CCG is committed to promoting equality, diversity and human rights for service users and our staff and to involve local people in the continuing development and monitoring of this strategy to ensure that we commission the right health care services, provide well-trained staff to deliver, and ensure our providers meet the equality duties set out in the Equality Act 2010 and promote people’s rights. The CCG’s commitment to eliminate discrimination and health inequalities is embodied by our vision of “enabling the people of Haringey to live long and healthy lives with access to fair, well co-ordinated and high quality services” and our aim to “promote wellbeing, reduce health inequalities and improve health outcomes for local people.” Underpinning the above, the CCG’s Patient and Public Engagement Strategy will play a key part in improving the way that it works with patients, carers and the public to listen to their views and involves them in decisions about commissioning and developing and improving health services.

2. EQUALITY DELIVERY SYSTEM (EDS) OBJECTIVES

Through the adoption of the NHS Equality Delivery System (EDS) the CCG aims to demonstrate to the people we serve how we are meeting the aims of the PSED. The CCG has therefore developed a four year strategy, with an accompanying draft action plan, based on proposed EDS objectives. These draft objectives are:

• Introduce robust governance structures and the EDS assurance framework

• Build strong relationships with diverse groups and communities to understand their needs, priorities and experiences

• Commission targeted prevention, early intervention and self-management programmes

• Improve access to and provide a patient-centred approach to delivering primary and community services


More details on these objectives are contained in Appendix one.

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The action plan and objectives will be reviewed annually and the objectives updated to reflect new and emerging issues.

3. PRIORITISING EDS OBJECTIVES FOR 2013/13

To help to determine how the CCG’s proposed objectives should best be prioritised for 2013/14, members of Haringey LINk were invited to provide feedback on their respective importance at this stage of the CCG’s organisational development. In addition to writing to LINk members, details of the proposed EDS objectives and how people could respond were also placed on the LINk and CCG websites in January 2013. Respondents were asked to prioritise the first four proposed objectives as the fifth one (to develop an inclusive working culture) is essentially an internal objective which the CCG is already committed to taking forward.

4. RESPONSES FROM LINk MEMBERS

Four responses were received, as follows.

4.1 Joanna Bornat, LINk member

All of the proposed EDS objectives were considered as being equally valid and therefore no preference was expressed for their prioritisation.

However, a number of general comments were made. Scepticism was expressed about the meaningfulness of 'robust governance structures' if the CCG Governing Body meets in public, rather than as a public meeting; More detail was sought about how equality issues will be monitored by local people and how the structure will work from patient level upwards and downwards to patients and their GPs, especially when there are difficult financial choices to be made. The perceived current uncertainty about what kind of Healthwatch body will replace LINk was also highlighted as an issue.

4.2 Lloyda Fanusie, LINk Board Member

It was advocated that the proposed objectives should be prioritised in descending order as follows:



• Improve access to and provide a patient-centred approach to delivering primary and community services

• Commission targeted prevention, early intervention and self-management programmes.

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The following feedback was also provided:

• The CCG should actively seek the participation of all people with varied needs, including people who act as advocates on behalf of others

• The CCG should avoid being dogmatic about its definitions of ‘easy’ and ‘hard to reach’ groups, as individuals within these are not homogenous. By the same token, generalising about the divide between the east and west of the borough can often camouflage a more nuanced reality

• When considering targeted prevention schemes, the CCG should particularly aim to identify and reach people who are ‘lost’ in the system

• As resources are finite, it is imperative that time and effort are not wasted on duplicating activity

• Consideration should be given to more ‘peer to peer’ research about access issues, on the basis that this will be more productive

• Staff training should not only be delivered by accredited organisations, as valuable perspectives can also be provided by trainers who have qualified from “the university of life”

• The value and importance of equality in diversity, with a strong focus on flexibility should be reinforced.

4.3 Mhairi McGhee, Haringey Disability First Consortium (DFC)

Consortium members believed that the primary priority should be to “build strong relationships with diverse groups and communities to understand their needs, priorities and experiences” with particular focus on the following associated actions:

• Proactively engage[ing] with service users and residents in areas of high deprivation

• Engaging with locally excluded groups and communities [and] develop[ing] appropriate communications and engagement plans that recognise the value of community feedback

• Using technology and techniques best suited to different population groups.

The CCG was also asked to note that the majority of DFC’s membership does not use computers as a means of communication. Non-disabled service users from marginalised and deprived groups also find that new media do not provide genuine engagement due to the financial and practical constraints of using shared resources (e.g. computers in the library or college) and prohibitive costs of consumables (e.g. the costs of printing, broadband, programme/hardware updates). The CCG was therefore urged not to rely on new media or to consider it a panacea, as it often reinforces inequalities rather than removing those structural barriers.

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4.4 Nuala Kiely, Haringey User Network (HUN) coordinator

The fact that the proposed EDS directives are closely linked to the current Joint Health and Wellbeing Strategy outcome 3 was welcomed as confirmation that there is local partnership working towards a common aim of improving the well-being of Haringey residents.

4.5 General comments

The DFC and HUN both expressed disappointment that they had not had more time to engage with their members before responding. The DFC also requested that future information is provided in plain English in accordance with Haringey Learning Disabilities Partnership guidance, to ensure that it is accessible.

5. PRIORITISATION OF OBJECTIVES

Feedback from respondents indicated either a preference for the first two objectives (ie to Introduce robust governance structures and to build strong relationships with diverse groups and communities), or an acceptance of the objectives in their totality.

In light of this response and the CCG’s current stage of organisational

development, the CCG will therefore implement these following objectives in 2013/14:




As stated earlier, the third objective is one which the CCG is already

committed to taking forward. Progress against these objectives will be reported at future Health and

Wellbeing Board meetings. 6. CCG RESPONSE TO ADDITIONAL COMMENTS The CCG has been in a transitional phase and it acknowledges that its

patient and public engagement with the local community is something which needs to be strengthened, particularly those who have historically been less engaged. We will work with patient groups, Healthwatch, HAVCO and local voluntary, faith and community groups to achieve this. In order to embed this within the organisation, we have developed a Patient and Public Engagement Strategy which we will shortly be consulting on.

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Due regard will be given to ensuring that communications material is accessible and is made available in appropriate formats for different audiences.

The CCG’s equality performance will be graded by stakeholders on an annual basis, against specific Equality Delivery System outcomes and we are currently in the process of arranging this meeting with LINk.

An Equalities and Diversity Annual Report will be published to

demonstrate our achievements over the previous 12 months.

Going forward, we will also ensure that future engagement on our EDS objectives is carried out in a more timely fashion.

7. CONCLUSION

As a relatively new, developing organisation Haringey CCG is committed to promoting the principles of equality, diversity and human rights for service users and our staff and will work closely with our stakeholders in the future to ensure that our equality objectives help to deliver this in a meaningful way.

Page 173

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g

(as a

bo

ve)

A r

ed

uctio

n in ineq

ua

litie

s in

rela

tion t

o a

ccess

Equ

alit

y m

easure

s a

re

incorp

ora

ted into

all

pro

vid

er

contr

actu

al a

nd p

rocure

ment

arr

angem

ents

. E

nsure

rob

ust

contr

act m

anagem

ent

pro

cesses a

re in

pla

ce t

o

drive q

ualit

y s

erv

ices

Localit

y b

ase

d g

overn

ance

arr

angem

ents

are

recog

nis

ed

and w

ork

P

rogre

ss to

be r

evie

wed

on a

n a

nnua

l basis

/1st

revie

w d

ue

Marc

h 2

013.

1 2 3 4

C

ontinu

e w

ork

to e

nsure

equa

lity m

onitorin

g is

takin

g p

lace.

Im

ple

menta

tio

n o

f th

e

ED

S d

em

onstr

atin

g th

at 4

or

more

pro

tecte

d g

roups

have b

een c

onsulted

P

ub

lish e

qualit

y

obje

ctives a

nd a

nnu

ally

re

port

on p

ositiv

e

outc

om

es d

em

onstr

ating

an u

pw

ard

in

dic

ato

r

Page 175

2

Pro

po

se

d E

DS

o

bje

cti

ve

s

Ac

tio

ns

O

utc

om

es

Tim

eli

ne

ED

S

ou

tco

me

s

Me

as

ure

s o

f S

ucc

ess

Bu

ild

str

on

g

rela

tio

nsh

ips w

ith

d

ivers

e g

rou

ps

an

d

co

mm

un

itie

s t

o

un

ders

tan

d t

heir

n

eed

s, p

rio

riti

es a

nd

exp

eri

en

ce

s.

Pro

active

ly e

ngag

e w

ith s

erv

ice

users

and r

esid

en

ts in

com

munity

socia

l housin

g in a

reas o

f h

igh

depri

vatio

n

Eng

ag

ing w

ith locally

exclu

ded

gro

ups a

nd c

om

munitie

s, such a

s

the h

om

ele

ss a

nd g

ypsy/ tr

ave

ller.

D

evelo

p a

ppro

pri

ate

com

munic

ations a

nd e

ngag

em

ent

pla

ns that

recogn

ise t

he v

alu

e o

f com

munity f

eed

back.

Usin

g t

echno

log

y a

nd tech

niq

ues

best suited t

o d

iffe

rent pop

ula

tio

n

gro

ups.

Develo

p s

trate

gie

s in lin

e w

ith loca

l part

ners

e.g

. H

arin

ge

y C

ou

ncil,

the

Health a

nd W

ellb

ein

g B

oard

, H

ealth

wa

tch,

volu

nta

ry a

nd

third

secto

r org

an

isations

Pro

active

ly e

ngag

e in t

he

develo

pm

ent of

JS

NA

s a

nd

join

t hea

lth a

nd w

ellb

ein

g s

trate

gie

s t

o

inte

gra

te c

om

mis

sio

nin

g a

nd w

ork

in

share

d g

overn

ance a

nd

pro

cesses w

ith H

arin

ge

y C

ouncil

A

ll pro

tecte

d g

rou

ps in

vo

lved

in e

nga

gem

ent an

d

consulta

tio

n p

rocesses

Pla

nn

ed e

ve

nts

/consu

ltatio

ns

Com

munitie

s f

eel e

nga

ged

and e

mpow

ere

d a

s

com

munic

ations b

ecom

e

more

meanin

gfu

l

Join

t pla

nne

d e

ve

nts

acro

ss

hea

lth a

nd s

ocia

l care

A

ctive p

atients

in p

art

ners

hip

gro

ups e

nga

ged

in

the

develo

pm

ent of

ke

y docum

ents

and p

lans.

P

rogre

ss to

be r

evie

wed

on a

n a

nnua

l basis

/1st

revie

w d

ue

Marc

h 2

013.

2.1

2.2

2.3

2.4

T

he C

CG

has a

ro

bust

enga

gem

ent str

ate

gy

whic

h inclu

des t

he

pro

vis

ion o

f re

ason

able

adju

stm

ents

it w

ill n

ee

d to

em

plo

y in e

nga

gin

g

eff

ectively

e.g

. ra

nge o

f fo

rmats

of

docum

ents

, ensurin

g inte

rpre

ter

support

where

re

qu

ired,

tim

es o

f enga

gem

ent etc

C

CG

has a

cle

ar

unders

tand

ing o

f th

e

dem

ogra

phic

s o

f th

e

peop

le it

is s

erv

ing,

ide

ntify

ing a

ny g

roups

whic

h a

re m

arg

inalis

ed o

r seld

om

involv

ed in

enga

gem

ent

E

vid

ence s

ho

ws t

hat

the

w

hole

of

the

loca

l com

munity is e

qu

ally

ab

le

to a

ccess s

erv

ices a

nd

has the

sam

e q

ualit

y o

f experie

nce.

Page 176

3

Pro

po

sed

ED

S

ob

jecti

ve

s c

on

tin

ues

Set

up e

nga

gem

ent fo

rum

s w

ith

patient re

pre

senta

tives f

or

majo

r care

path

wa

y, serv

ice r

ede

sig

n

work

str

eam

s a

nd s

yste

ms.

Actively

com

munic

ate

com

mis

sio

nin

g d

ecis

ions a

nd

respond t

o f

eed

back

Arr

angem

ents

for

hand

ling

com

pla

ints

an

d c

oncern

s r

ais

ed

with t

he C

CG

de

liver

outc

om

es

equ

ivale

nt to

th

ose s

et o

ut

in the

sta

tuto

ry f

ram

ew

ork

for

com

pla

ints

hand

ling.

Ana

lyse

an

d a

ct

on

info

rmation f

rom

engagem

ent

to tra

nsla

te into

pri

orities f

or

impro

vem

ent in

serv

ices,

access a

nd o

utc

om

es

Local and

natio

na

l gu

idelin

es

for

handlin

g a

nd m

onitori

ng

com

pla

ints

are

in p

lace

.

Work

with p

art

ners

such a

s

HealthW

atc

h t

o e

nsure

th

e

seld

om

heard

com

munitie

s

are

ab

le t

o f

eed

back

com

pla

ints

P

atients

, care

rs a

nd

com

mu

nitie

s c

an r

ead

ily

access P

rim

ary

an

d

secondary

care

serv

ices

access o

n u

nre

asona

ble

gro

un

ds.

Evid

ence o

f a r

obust

inclu

siv

e c

om

pla

ints

sys

tem

in p

lace f

or

com

pla

ints

.

Page 177

4

Pro

po

se

d E

DS

o

bje

cti

ve

s

Ac

tio

ns

O

utc

om

es

Tim

eli

ne

ED

S

ou

tco

me

s

Me

as

ure

s o

f S

ucc

ess

Co

mm

issio

n t

he

follo

win

g t

arg

ete

d

pre

ven

tio

n, earl

y

inte

rven

tio

n a

nd

self

m

an

ag

em

en

t p

rog

ram

me

s

Deliv

er

targ

ete

d p

hys

ica

l d

isabili

ty

and lon

g term

conditio

ns

pro

gra

mm

es for

people

with M

enta

l H

ealth p

roble

ms

D

evelo

p a

n inte

gra

ted c

are

syste

m

- p

rovid

e b

ett

er

coord

inate

d c

are

, id

entify

and s

upport

more

vu

lnera

ble

pa

tie

nts

an

d d

eliv

er

more

equitab

le

an

d s

up

eri

or

hea

lth

outc

om

es

To im

ple

ment case m

anagem

ent

for

people

with lon

g term

cond

itio

ns

impro

vin

g s

elf m

anagem

ent and

in

depe

nde

nce

T

o d

eve

lop a

com

pre

hensiv

e f

all

path

wa

y

To im

pro

ve a

ccess to C

AM

HS

Tie

r 3 s

erv

ices

Pro

gra

mm

es d

em

onstr

ate

, in

cre

ases in take

-up,

with

pre

va

lence d

ecre

asin

g o

ve

r tim

e, natio

na

l a

nd local

targ

ets

bein

g m

et and w

here

possib

le e

xcee

ded

, pa

tie

nt

experie

nce s

urv

ey

dem

onstr

ate

incre

ase

d

confidence a

nd s

elf

managem

ent. D

ecre

ase in

hospital adm

issio

ns.

We a

im to r

educe h

ea

lth

ine

qua

litie

s b

y w

ork

ing

thro

ug

h localit

y-based

netw

ork

s

P

rogre

ss to

be r

evie

wed

on a

n a

nnua

l basis

/1st

revie

w d

ue

Marc

h 2

013

1.1

1.2

1.3

1.4

1.5

Im

pro

ved a

ccess to

ph

ysic

al dis

ab

ility

and

Long

Term

Conditio

ns

serv

ices f

or

peo

ple

with

menta

l hea

lth

co

-m

orb

iditie

s t

o p

rom

ote

re

hab

ilita

tio

n a

nd

recovery

. M

on

itori

ng, re

vie

win

g a

nd

respond

ing

to p

atient

experie

nce

Im

pro

ve p

atient

experie

nce

S

erv

ice s

takehold

ers

enga

ged

/reduction

in

secondary

care

atten

dances a

nd r

educe

the n

um

ber

of

falls

in

old

er

pe

ople

R

eduction in T

ier

4

pla

cem

ents

Page 178

5

Pro

po

se

d E

DS

o

bje

cti

ve

s

Ac

tio

ns

O

utc

om

es

Tim

eli

ne

ED

S

Ou

tco

me

s

Me

as

ure

s o

f S

ucc

ess

Imp

rov

e a

cc

ess

to

an

d p

rov

ide a

pati

en

t cen

tred

ap

pro

ach

to

d

eliv

eri

ng

pri

mary

an

d c

om

mu

nit

y

serv

ice

s:

Identify

are

as o

f lo

w u

pta

ke o

r non

-access to s

erv

ices, such a

s M

enta

l H

ealth,

Learn

ing D

isa

bili

tie

s a

nd

dem

entia a

nd s

cre

en

ing

pro

gra

mm

es s

uch a

s c

hild

hood

imm

unis

ation,

pro

gra

mm

es,

cerv

ical, b

reast an

d b

ow

el cancer

scre

enin

g.

W

ork

with c

om

munitie

s a

nd

loca

l heath

ad

voca

tes to c

o-d

esig

n

outr

each a

ctivitie

s t

o a

ddre

ss

priority

are

as o

f lo

w u

pta

ke e

.g.

teen

age p

reg

nancy r

ate

s,

child

hoo

d im

mu

nis

ation f

or

MM

R

booste

r a

t ag

e 5

T

o im

pro

ve a

ccess to a

nd a

ddre

ss

ine

qua

litie

s in p

rim

ary

medic

al

serv

ices thro

ugh

the

Prim

ary

Care

S

trate

gy.

To im

pro

ve a

ccess to u

rge

nt

prim

ary

care

serv

ices r

ed

ucin

g

depe

nde

nce o

n h

ospital se

rvic

es

for

urg

ent care

. T

o s

trength

en e

xis

ting p

ractice

part

icip

ation

gro

ups a

nd to

esta

blis

h a

pa

n-H

ari

nge

y N

etw

ork

fo

r engag

em

ent.

Patients

hea

lth

ne

eds a

re

assessed, and

resultin

g

serv

ices p

rovid

ed

, in

appro

priate

an

d e

ffective

w

ays

Serv

ices a

re c

om

mis

sio

ned

, desig

ned a

nd

pro

cure

d to

meet th

e h

ea

lth n

eeds o

f lo

cal

com

munitie

s, pro

mote

we

ll-bein

g,

and r

educe h

ea

lth

in

equa

litie

s

Pro

gre

ss to

be r

evie

wed

on a

n a

nnua

l basis

/1st

revie

w d

ue

Marc

h 2

013

1

.2

1

.3

2

.3

In

cre

ased u

pta

ke o

f serv

ices.

In

cre

ased u

pta

ke o

f serv

ices.

Im

pro

ved s

core

s r

ela

tin

g

to a

ccess in P

rim

ary

Care

P

atient

Exp

erie

nce

Surv

ey`

Reduce

d a

ttend

ances in

A&

E m

inor

activity

Every

patient

has a

ccess

to a

pra

ctice p

art

icip

atio

n

gro

up.

Page 179

6

Pro

po

se

d E

DS

o

bje

cti

ve

s

Ac

tio

ns

O

utc

om

es

Tim

eli

ne

ED

S

ou

tco

me

s

Me

as

ure

s o

f S

ucc

ess

Dev

elo

p a

n in

clu

siv

e

wo

rkin

g c

ult

ure

w

hic

h v

alu

es

div

ers

ity an

d

su

pp

ort

s s

taff

to

feel

co

nfi

den

t to

ch

allen

ge

an

y

hara

ssm

en

t, b

ull

yin

g

or

perc

eiv

ed

v

icti

mis

ati

on

Ensure

ro

bust

equa

lity a

nd

div

ers

ity

ana

lysis

is in

tegra

l in

the s

taff

tr

ansitio

n p

rogra

mm

e

Develo

p e

ffective c

om

munic

ation

and e

ng

agem

ent p

lan t

o p

rom

ote

sta

ff p

art

icip

ation in t

he E

qualit

y

Deliv

ery

Syste

m for

them

selv

es

and s

erv

ice u

sers

In

clu

de s

essio

n o

n E

qua

lity,

div

ers

ity a

nd C

ulture

and v

alu

es

into

sta

ff tra

inin

g to s

upport

the

impro

vem

ent of

sta

ff s

urv

ey r

esults

Ensure

CC

G h

as in p

lace

com

pete

nt

Eq

ualit

y, D

ivers

ity a

nd

Hum

an R

ights

lea

ders

hip

that can

consis

tently d

eliv

er

S

taff

feel consulte

d a

nd

enga

ged

in

the

tra

nsitio

n

pro

cess. F

eed

ba

ck s

uggests

th

at sta

ff f

eel fa

irly

tre

ate

d a

s

evid

enced b

y r

obust

impact

assessm

ent and u

ltim

ate

ly

the r

ight

ind

ivid

ua

ls g

et

the

right jo

bs.

C

CG

is a

ble

to e

vid

ence th

at

thro

ug

h th

e c

olle

ction a

nd

user

of

sta

ff p

rofilin

g d

ata

that

sta

ff f

rom

all

pro

tecte

d g

rou

ps

have e

quity in t

he le

ve

l of

pers

ona

l d

evelo

pm

ent

CC

G w

ork

forc

e p

lan

nin

g

assesses the o

vera

ll capab

ility

an

d c

ap

acity w

ith

in

its e

xis

ting w

ork

forc

e to

deliv

er

the e

qua

lity a

nd

hum

an r

ights

outc

om

es s

et

out

in t

he a

uth

orisation

work

book, E

DS

an

d t

he N

HS

O

utc

om

es F

ram

ew

ork

.

Pro

gre

ss to

be r

evie

wed

on a

n a

nnua

l basis

/1st

revie

w d

ue

Marc

h 2

013

3.1

3.3

3.4

3.5

4.2

4.3

T

he w

ork

forc

e p

rofile

substa

ntially

matc

hes the

local dem

ogra

ph

ic f

or

all

com

munitie

s a

t all

leve

ls.

C

reate

d a

resp

ectf

ul

environm

ent at

work

w

here

peo

ple

are

confident

that

senio

r m

anagers

are

com

mitte

d

to u

pho

ldin

g r

esp

ect an

d

va

lues.

P

ub

lish

ed a

nn

ual eq

ua

lity

data

and

info

rmation e

.g.

annu

al E

DH

R r

ep

ort

, w

ork

forc

e p

rofile

dem

onstr

ating p

rogre

ss

Develo

ped

Com

pete

ncy

Fra

mew

ork

for

Equalit

y

and D

ivers

ity lead

ers

at

all

leve

ls.

Ensure

the

deliv

ery

of

a r

obust, o

pe

n

and tra

nspare

nt a

ppro

ach

to

th

e a

gend

a

Page 180

7

co

nti

nu

ed

A

cti

on

s

Ou

tco

me

s

Tim

eli

ne

ED

S

ou

tco

me

s

Me

as

ure

s o

f S

ucc

ess

Dev

elo

p a

n in

clu

siv

e

wo

rkin

g c

ult

ure

w

hic

h v

alu

es

div

ers

ity an

d

su

pp

ort

s s

taff

to

feel

co

nfi

den

t to

ch

allen

ge

an

y

hara

ssm

en

t, b

ull

yin

g

or

perc

eiv

ed

v

icti

mis

ati

on

Ensure

CC

G h

as in p

lace

com

pete

nt

Eq

ualit

y, D

ivers

ity a

nd

Hum

an R

ights

lea

ders

hip

that can

consis

tently d

eliv

er.

E

DH

R S

pecia

list to

sup

port

th

e C

CG

by p

rovid

ing

str

ate

gic

vis

ion

ing

, le

ad

ers

hip

and o

pera

tio

na

l de

livery

com

pete

nce e

.g.

a. A

ble

to r

esp

ond

to d

ivers

e

and c

hang

ing

com

munity

needs

b. R

obust

EQ

IAs p

rovid

ed t

o

serv

ice p

lann

ing a

nd

im

pro

vem

ent

Pro

gre

ss to

be r

evie

wed

on a

n a

nnua

l basis

/1st

revie

w d

ue

Marc

h 2

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3.1

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