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You are here: Home Page > Health and Social Care > Bedford Borough JSNA > Vulnerable groups > Safeguarding Vulnerable Adults

Safeguarding Vulnerable Adults

Introduction

All people in the communities of Bedford Borough Council have a right to live a life that is free from violence, fear and abuse. To be protected from harm and exploitation and to have independence, which may involve a degree of risk.

Bedford Borough Council and Central Bedfordshire agreed to work together in a joint Safeguarding Adult Board with a wide range of agencies, to develop, implement, and monitor work to safeguard vulnerable adults from abuse.

The Joint Multi Agency Adult Safeguarding Policy, Practice and Procedures for Bedford Borough and Central Bedfordshire is in place to achieve consistent and robust arrangements for safeguarding vulnerable adults and to implement effective safeguarding plans which minimise the risk of harm and adopt a zero tolerance approach to abuse, maltreatment and neglect.

The policy relates to all those adults, who are resident or temporarily resident in the community of Bedford Borough, who may have care and support needs, whose independence and wellbeing would be at risk, permanently or periodically, if they did not receive appropriate support and who may be at risk of abuse, maltreatment or neglect.

From April 2015 the introduction of The Care Act 2014 put the Safeguarding Adults Board on a statutory footing.  The safeguarding policies and procedures have been amended to reflect the changes in law, terminology and culture of safeguarding practice. The Care Act requires that each local authority must:

 

  • make enquiries, or cause others to do so, if it believes an adult is experiencing, or is at risk of, abuse or neglect. An enquiry should establish whether any action needs to be taken to prevent or stop abuse or neglect, and if so, by whom;
  • set up a Safeguarding Adults Board (SAB); the statutory members are the local authority, police and clinical commissioning group. Members of the SAB must appoint a designated adult safeguarding manager (DASM).
  • arrange, where appropriate, for an independent advocate to represent and support an adult who is the subject of a safeguarding enquiry or Safeguarding Adult Review (SAR) where the adult has ‘substantial difficulty’ in being involved in the process and where there is no other suitable person to represent and support them. They must be informed of their rights to an independent advocate.
  • co-operate with each of its relevant partners (as set out in Section 6 of the Care Act) in order to protect the adult. In their turn each relevant partner must also co-operate with the local authority

 

The Care Act 2014 states that local authorities must make enquiries, or cause others to do so, if they reasonably suspect an adult with care and support needs is or is at risk of being abused or neglected.

The safeguarding duties (three stage test) apply to an adult who:

  • has needs for care and support (whether or not the local authority is meeting any of those needs) and;
  • is experiencing, or at risk of, abuse or neglect; and
  • as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.

 

A formal enquiry under section 42 of the Care Act 2014 may either 1. be coordinated by the local authority (previously known as a safeguarding investigation) or 2. be requested to be undertaken by another agency using formal procedures most relevant to the concern. When such a request is made under section 42 of the Care Act 2014, there is a duty to cooperate and respond.

The purpose of an enquiry is to decide whether or not the local authority or another organisation, or person, should do something to help and protect the adult.

The objectives of an enquiry into abuse or neglect are to:

 

  • establish facts;
  • ascertain the adult’s views and wishes;
  • assess the needs of the adult for protection, support and redress and how they might be met;
  • protect from the abuse and neglect, in accordance with the wishes of the adult;
  • make decisions as to what follow-up action should be taken with regard to the person or organisation responsible for the abuse or neglect; and
  • enable the adult to achieve resolution and recovery

 

The nature and timing of the intervention and who is best placed to lead will be determined by the circumstances. For example, where there is poor, neglectful care or practice, resulting in pressure sores for example, then an employer-led disciplinary response may be more appropriate.  When the local authority causes an enquiry to be carried out by an agency, the process will be agreed with the local authority and could be the agencies’ own internal investigation processes, such as, an incident investigation, serious incident, internal management review, HR procedures, complaints, root cause analysis. If the local authority decides that another organisation should make the enquiry, for example a care provider, then the local authority retains responsibility for the enquiry, for agreeing the timescales and the overall quality of the enquiry. The local authority will need to know the outcomes of the enquiry and agree when the enquiry is concluded.

The Bedford Borough Council Safeguarding Team has responsibility for receiving safeguarding concerns that occur within the geographical area that Bedford Borough Council covers. Information is gathered regarding the concern and a decision made as to whether a safeguarding investigation known as a Section 42 enquiry, is needed. If a Section 42 Enquiry is required, a referral will be made to the appropriate care management team for investigation. The most relevant care management team in the local authority are responsible for carrying out the safeguarding investigation, including assessment, risk management, and protection planning. Where criminal activity is suspected the police will usually lead on the investigation and this will be determined and recorded in discussion with the adult safeguarding team.

The role of the Safeguarding Team include

  • Receiving safeguarding concerns
  • Collecting initial information on the concern
  • Determining whether a Section 42 Enquiry or alternative action is required.
  • Referring concerns to care management staff for a Section 42 Enquiry, or other preventative action,
  • Providing advice, guidance, direction and monitoring during the investigation phase of a Section 42 Enquiry
  • Ensuring Section 42 Enquiries are completed within the required timeframes and to required standards
  • Auditing of safeguarding activity
  • Providing to the Safeguarding Board management reports and analysis of trends and themes, specialist advice and management and administration of its agenda and subgroups.
  • Raising awareness of safeguarding through forums and public events

 

What do we know?

Safeguarding Activity April 2014 – March 2015

 

Bedford Borough Council Number of Alerts and Referrals (Safeguarding Investigations)

Safeguarding1

 

An adult safeguarding alert is the term used for the reporting period 2014 to 2015, to describe the reporting of suspicious or allegations of abuse, maltreatment or neglect. An adult safeguarding referral is a referral for investigation. The Care Act 2014 introduced new terminology and from April 2015, a safeguarding alert is now known as a safeguarding concern, and a referral for investigation is known as a referral for a Section 42 Enquiry.

Bedford Borough Council received a total of 2038 contacts for 2014- 2015, which includes all safeguarding alerts, information sharing reports, referrals for social care or care management activity/involvement and concerns received by the team. This is an increase of 209 from 2013 – 2014 when 1,829 were received. Out of the 2038 contacts 1,306 were progressed to a safeguarding response and 241 led to a safeguarding referral/investigation, and 735 were of information nature, community care referral or not a safeguarding concern.

This is the 6th year that Bedford Borough has seen continued increases in the number of contacts received by the team. During 2014-15 the total number of Bedford Borough Council alerts which progressed to referral were 241 which equates to 19% of alerts received, which is down 7% based on the 2013-14 conversion rate. The decrease in the number of alerts progressing to a referral  is reflective  of the approach the safeguarding team has taken in ensuring a proportionate response to achieve the best outcome for the individual other than through a safeguarding investigation . This can include care management involvement and action, a provider internal investigation and review and reassessment of services provided.

In the 2013 – 2014 Safeguarding Annual Report, Bedford Borough commented that it had significantly higher amounts of safeguarding alerts per 10000,00 of the population as reported in The Vulnerable Adults Comparator Report 2012/13, than any other local authority in the comparator group. The disproportionately high level of alerts was attributed to Bedford Borough’s policy of recording all contacts received by the team as safeguarding alerts, it was identified that work needed to be done to look at different ways of managing the levels of contacts and alerts received by the team,  and re directing concerns that were not a safeguarding nature. The decrease in actual safeguarding alerts for 2014 -2015 from 1,829 in 2013 -2014 to 1,306 demonstrates the difference in approach where concerns did not indicate abuse or potential abuse. These concerns were managed through different routes such as passing information on the relevant social care team/agency, forwarding referrals to appropriate teams, advising providers to use their HR processes and complaints processes, actions for providers to review support plans or re directing to the Bedford Borough commission team or Care Standards and Review team. A combined approach of more robust screening of safeguarding alerts at the point of receiving, and a more proportionate response to safeguarding alerts progressing to referral, will account for the decrease in alerts and referral for the 2014 -2015 reporting period despite the increase in safeguarding contacts received by the team.

 

The Health and Social Care Information Centre has not produced a report on data for individual authorities based on the safeguarding adults return so benchmarking data is not available for 2013-2014 or 2014-2015.

Safeguarding2

The number of safeguarding alerts in Bedford Borough not progressing to a safeguarding investigation equated to 1062, this is a 286 decrease from the previous reporting year. The decrease is a result of the higher numbers of contacts being made to the team where a safeguarding response is not needed.  The majority of alerts not progressing to investigation are managed through information and advice and redirecting to community care teams for action and providers reviewing risk assessments and support plans, which is in line with the previous year’s trends. There has been an increase in the number of responses being managed by NHS internal investigations/reports, and this is a result of joint work undertaken with Bedford hospital, the Bedfordshire Clinical Commissioning group, Central Bedfordshire Council and PoHWER, to ensure a proportionate response to concern, identification of the most appropriate route within the hospital and ensuring the person with the best clinical knowledge undertakes the piece of work.

Safeguarding3

 

In Bedford Borough the category Paid Carers/Professional continues to be the main relationship between the person causing harm and the person at risk (44%). This will include staff at nursing and care homes, domiciliary care agencies and health staff. Incidents relate to acts of omission such as medication errors, missed domiciliary care call and poor care which have had a serious impact on the individual. The Bedford Borough Care Standards and Monitoring Team continue to work with registered care providers through a programme of announced and unannounced visits, to ensure standards of care are at an acceptable level and implementing action plans where standards of care are not at the required level. Last year the Care Standards team responded to 180 Quality Assurance feedback forms which they had received highlighting an issue with practice or organisation, the majority of these Quality assurance forms where not related to a safeguarding issue but where practice was not at the expected levels.

.There continues to be a similar pattern with more people in the 18 – 64 age group being subject to abuse from friends, family and neighbours, and as more vulnerable people are supported in the community or rely on friends family and neighbours to provide support. This particularly relates to financial abuse.

Within the Other group will be incidents which involve service user upon service user, these incidents tend to be within residential settings and more predominate in the 18 – 64 age group.

Safeguarding4

 

In Bedford Borough the trends and patterns for type of abuse remain similar with Neglects/Acts of Omission as the main category of abuse. As reported previously this will relate to serious medication error, inappropriate care or lack of care, missed domiciliary care calls and poor hospital discharge that has resulted in harm to the person. Within this category the highest proportion of referrals are for the 75 and over age group, who are most likely to be receiving support, residential care or hospital admission and highlights the vulnerability of this group.

Financial and physical abuse categories show very similar patterns to the previous year with the 18- 64 age group being the predominate age group. Financial abuse tends to take place more when the individual is living in the community and usually by someone known to the person, emphasisng the importance of robust financial support plans for vulnerable individuals living in their own homes.

Safeguarding5

In Bedford Borough the highest level of safeguarding referrals relate to abuse taking place within the individuals own home by a family member or paid carer. As more care is delivered in the community in the form of supported living and extra care housing, this is an area that will need ongoing monitoring to ensure measures are in place to safeguard individuals being supported to remain in their own home, through regular reviews and financial support plans.

There has been a decrease in referrals for Care Homes (nursing and residential), for both the 18-64 age group and the 65+ age group. This is liked to be as a result of a more proportionate response being taken by the Safeguarding team and where appropriate, actions are managed through care management or the home using their complaints process, HR processes or completing an internal investigation/report. 

Safeguarding 6

In Bedford Borough Council, as per previous years the larger proportion of alerts and referral relate to women. This continues to reflect the national picture of greater female life expectancy of females and a higher proportion of incidents relating to females being reported.

Approximately 63% of clients receiving a service from Bedford borough are female and this is replicated in the figures above. The overall numbers of alerts for both females and males has only changed marginally during the current reporting period compared to 2013/14.

The percentage of alerts progressing to referrals has dropped with 19% for females and 18% for males and this compares with 35% for females and 31% for males during 2013/14. This reduction is likely to be as a result of more proportionate screening by the safeguarding team at the alert stage.

Safeguarding 7

In Bedford Borough, consistent with the previous year the majority of safeguarding alerts and referrals relate to people aged 18-64 with 16% of alerts progressing to a safeguarding referral. This indicates a high number of alerts that do not meet the threshold for an investigation or can be managed in other more appropriate routes.

Within the 18-64 age group will also be a high number of service users with a mental health issue or learning disability and where an alert relates to a service user upon service user incident, where no significant harm has been caused and this is reflected in the low proportion of alerts leading to a safeguarding investigation

Safeguarding 8

In Bedford Borough the number of alerts and referrals relating to ethnicity remains in line with the previous reports with the largest category being White British, making up 85% of alerts which is a drop of 3% from 2013/14. The 2011 census shows 84% of adults are white British and this figure is reflective of the proportion of alerts relating to White British people.

There has been a reduction in levels of alerts and referrals for all groups, with the biggest difference being in the Black or Black British group where there has been a drop in alerts from 71 to 39 with 7% progressing to a referral. There does not appear to be a reason for this drop but this reduced number may be a recording issue as the number of alerts in the Not Known category has increased from 1 to 43

Safeguarding 9

In Bedford Borough Older person continues to be the category with the highest levels of alerts, followed by learning disability and then mental health which is consistent with the previous year’s reporting. There has been an increase of 12% in alerts received for older persons, with 24% progressing to referral compared to 23% last year. Often alerts for older persons require an immediate response but often will be of a risk nature as opposed to abuse taking place and action will be passed to the most relevant social care support team to action.  The types of alerts for older persons involving paid carers tends to be poor care, medication errors and missed domiciliary care which is similar to previous years. Where financial abuse has taken place, this is more likely to be a family member and the abuse to have taken place within the person’s home. Alerts for older persons involving care homes and domiciliary care agencies are monitored to pick up any emerging patterns and themes which can then addressed.

There has been a noticeable decrease in alerts for people with a learning Disability or Mental health issues. This is due to the high number of information contacts received from the police, ambulance and other agencies where a safeguarding response is not required or appropriate but the concern/contact is passed to the community team for action, referral for services or information, which previously would have been recorded under safeguarding.

Current activity and services

The Bedford Borough Safeguarding team is based at Borough Hall and consists of

10 full time workers, a Team Manager, 2 Safeguarding Advanced Practitioners, a Mental Capacity/Deprivation of Liberty Advanced Practitioner, 1 Best Interest Assessor Advanced practitioner, 1 Best Interest Social worker, 3 support workers and administrative worker.

The safeguarding team is the first point of contact for any safeguarding concern. The safeguarding team makes initial enquires to determine whether a Section 42 Enquiry (safeguarding investigation) or alternative other action is required and refer on to the appropriate care management team for enquiry or action.

All Deprivation of Liberty requests are received and managed by the team who also provide any advice and information relating to any Safeguarding /Mental Capacity Act issues.

The safeguarding team raise public awareness by attending events and forums to promote awareness of safeguarding issues and understanding of what and how to report concerns. The team also carry out awareness sessions in relation to Mental Capacity Assessments and Deprivation of Liberty Safeguards

Potentially as the population increases and in particular vulnerable groups such as an aging population, and with people with disabilities living longer due to better health care, coupled with a greater awareness of safeguarding, alerts will continue to increase, along with requests to assess people under the Deprivation of Liberty Safeguards legislation.

The safeguarding team continues to receive a large volume of information and reports many of which are not of a safeguarding concern but require a response because of a risk highlighted or a referral for an assessment of needs. Work is underway with partner agencies to identify those areas where there are frequent contacts for access to assessments services and identify referral pathways for these services

Information received from whistle blowers is taken seriously by the council, and where there is a safeguarding concern this will be acted on. Where the information relates to practice issues or other areas, the concerns are passed to the appropriate agency.

The safeguarding team share local information with relevant agencies to enable action to be taken where concerns are identified. There is close liaison between the Safeguarding Team, The Bedford Borough Care Standards and Review Team and Community teams when safeguarding issues, trends and patterns are identified. Regular meetings are held with the Bedfordshire Clinical Commissioning Group, the Care Quality Commission and community services to share local information about areas of concern as well as good practice.

Ongoing work is in place to improve and strengthen the links with the Local Safeguarding Children’s Boards and the Community Safety Partnerships. Regular meetings and leads have been identified which has led to improved communication and understanding of overlapping agendas on topics of high risk that affect all joint partnership boards, in particular Modern Slavery, Hate Crime, Child Sexual Exploitation and Domestic Abuse. 

The Care Act 2014 and data from 2014 -15 has identified a need to focus on advocacy support, both professional and through family and friends. Monitoring is in place to review the use of advocacy support to identify whether the use of professional and unpaid advocacy is timely, appropriate and achieving the desired outcomes.

Deprivation of Liberty Safeguards

An important role of the team is to manage the requests that Bedford Borough Council as a supervisory body receive to legally deprive an individual of their liberty. The Mental Capacity Act Deprivation of Liberty Safeguards (MCA DoLS) was introduced into the Mental Capacity Act 2005 through the Mental Health Act 2007.  Deprivation of Liberty (DoLS) came into force in England and Wales on 1 April 2009.

DoLS provides legal protection for individuals who lack capacity and who may be deprived of their liberty in hospitals or care homes to protect them from harm. The safeguards are designed to protect the interests of an extremely vulnerable group of individuals and to:

 

  • Ensure people can be given the care they need in the least restrictive regimes
  • Prevent arbitrary decisions that deprive vulnerable people of their liberty
  • Provide people with rights of challenge against unlawful detention

 

DoLS apply to anyone:

  • Aged 18 and over
  • Who has a mental disorder or disability of the mind – such as dementia or a profound learning disability
  • Who lacks the capacity to give informed consent to the arrangements made for their care and/or treatment and
  • For whom deprivation of liberty (within the meaning of Article 5 of the European Convention on Human Rights) is considered after an independent assessment to be necessary in their best interests to protect them from harm.

 

DoLS cover patients in hospitals, and people in care homes

When a hospital or care home (designated as “managing authorities” under the legislation) identifies that a person who lacks capacity is being, or risks being, deprived of their liberty, they must apply to the “supervisory body” for an authorisation of deprivation of liberty. The “supervisory body” is the relevant local authority.

Authorisation should be obtained in advance except in urgent circumstances. The supervisory body must obtain six assessments prior to granting a standard authorisation and there must be a minimum of two assessors involved in the assessment process; an appropriately trained Section 12 Doctor and A Best Interest Assessor (BIA).

On 19 March 2014, the Supreme Court handed down its judgment in a number of cases. The judgment is significant in the determination of whether arrangements made for the care and/or treatment of an individual lacking capacity to consent to those arrangements amount to a deprivation of liberty. The Supreme Court has clarified that there is a deprivation of liberty for the purposes of Article 5 of the European Convention on Human Rights in the following circumstances:

“The person is under continuous supervision and control and is not free to leave, and the person lacks capacity to consent to these arrangements” (referred to as the Acid Test)

The Supreme Court has also determined that a deprivation of liberty can occur in domestic settings where the State is responsible for imposing such arrangements. This will include a placement in a supported living arrangement in the community, placements through Shared Lives Schemes and foster placements for young people aged 16-18years. Where there is, or is likely to be, a deprivation of liberty in such placements this must be authorised by the Court of Protection.

This judgment will have significant implications for the delivery of services to adults with learning disabilities and older people with, for example, dementia and adults with neurological conditions. There will also be an impact on the delivery of services for young people aged 16-18years who are in foster care and transition cases that lack the capacity to consent to the arrangements made for their care and/or treatment. 

The effect of this change in test is that a much greater number of people in care are now under deprivation of liberty and by law must now be assessed under the DoLS procedure. 

The full judgment can be found on the Supreme Court’s website at the following link:

http://supremecourt.uk/decided-cases/docs/UKSC_2012_0068_Judgment.pdf

Nationally there has been a significant increase in the amount of authorisations that Local Authorities have received following the Supreme Court ruling, and this has impacted on resources and has a cost implication.

Managing Authority (Care Home/Hospital) completes a request for an urgent or a standard authorisation. The Supervisory Body (Bedford Borough Council) has 7 days to complete 6 assessments for an urgent authorisation and 21 days to complete assessments if a standard authorisation is requested. There has to be a minimum of 2 assessors; a Section 12 Dr and a Best Interest Assessor (BIA) trained social worker.

Assessments under DoLS will now need to be done on a massive scale compared to previous practice. In 2013/14, Bedford Borough Council completed 59 assessments compared to 872 requests for 2014/15.

In order to meet the increase in demand a number of actions have been taken by Bedford Borough Council which include.

 

  • Increasing the number of Section 12 Doctors and BIA social workers available to undertake the assessments.
  • Rolling programme of training to ensure sufficient social workers within the authority undertake their BIA training.
  • Increased the capacity of the Safeguarding Team to manage and coordinate the significant increase in requests for authorisation
  • Raising awareness of DoLS and when to make an application.
  • Scoping exercise to identify where a deprivation of liberty may be occurring in domestic settings where the State is responsible for imposing such arrangements. This will include a placement in a supported living arrangement in the community, placements through Shared Lives Schemes and foster placements for young people aged 16-18years.
  • Programme of applications to the Court of Protection where there is, or is likely to be, a deprivation of liberty in such placements.

 

Since the decision of the Supreme Court, there has been a vast increase in the number of people deprived of their liberty by the state. The Latest Official Statistics from The Health & Social Care Information Centre’s report: Deprivation of Liberty Safeguards 2014/15 (published May 12 May 2015) highlights for the 116 Councils that submitted data for all four quarters, the number of applications received totalled 113,300 compared to 10,900 in 2013/14.  The increase in authorisation requests amounts to a 10 fold increase compared to requests made in 2013/14. While data demonstrates a 10 fold increase for nationally, Bedford Borough Council (BBC) has encountered a 15 fold increase in DoLS activity.

Following Cheshire West, DoLS activity has had a significant impact on the safeguarding teams and council in terms of management of resources.

 

National & Local Strategies (Current best practices)

The Care Act 2014 came into force on 1st April 2015 and introduced new duties and requirements of local authorities in a number of areas, including safeguarding adults.  It provides, for the first time, a legislative framework for those working in adult safeguarding.

The Care Act Statutory Guidance can be found at:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/366104/43380_23902777_Care_Act_Book.pdf

A number of resources have been produced by SCIE (The Social Care Institute for Excellence) to support implementation of the Care Act. This information can be found at:

http://www.scie.org.uk/care-act-2014/safeguarding-adults

 

Modern Slavery Act 2015

The Bill received Royal Assent on 26th March 2015 and is now an Act of Parliament (law) The Bill consolidates the current offences relating to trafficking and slavery and 

 

  • creates two new civil orders to prevent modern slavery
  • establishes an Anti-Slavery Commissioner
  • makes provision for the protection of modern slavery victims

Modern Slavery can include human trafficking, forced labour and domestic servitude and coercion, deceit and forcing people into a life of abuse and inhumane treatment. This is a complex area which requires all SAB partners to work closely together and share information. This is an area where it is recognised that all partners would benefit from increased understanding and knowledge. 

Information on modern slavery can be found at: https://www.gov.uk/government/collections/modern-slavery

June 2015 Note for adult safeguarding boards on the Mental Health Crisis Concordat

Published by LGA and ADASS, The Mental Health Crisis Care Concordat is a national agreement between services and agencies involved in the care and support of people in crisis. It sets out how organisations will work together better to make sure that people get the help they need when they are having a mental health crisis. The Mental Health Crisis Concordat was published by the Government in February 2014. The signatories include the Local Government Association, ADASS, NHS, Police, MIND, the Home Office, Department of Health and the Care Quality Commission. The LGA and ADASS have published a note for adult safeguarding boards on the Mental Health Crisis Care Concordat.

Making Safeguarding Personal

Making Safeguarding Personal (MSP) is a sector led initiative which aims to develop an outcomes focus to safeguarding work, and a range of responses to support people to improve or resolve their circumstances. It is about engaging with people about the outcomes they want at the beginning and middle of working with them, and then ascertaining the extent to which those outcomes were realised at the end. Information can be found at:

http://www.local.gov.uk/web/guest/adult-social-care/-/journal_content/56/10180/6074789/ARTICLE

The Care Act 2014 statutory guidance states that safeguarding should be personal; it should be person led and outcome focussed; it should enhance involvement, choice and control as well as improving quality of life, wellbeing and safety. The person should always be involved from the beginning of the enquiry unless there are exceptional circumstances that would increase the risk of abuse. Thinking about outcomes in adult safeguarding means focusing on what people who have experienced the process say, and the extent to which the outcomes they wanted (their wishes) have been realised. It is vital that the views of the person are sought and recorded. These should include the outcomes that they want, such as feeling safe at home, access to community facilities, restricted or no contact with certain individuals or pursuing the matter through the criminal justice system

The focus of safeguarding work is not about proving an allegation. It is about whether:

 

  • the wishes of the person have been achieved
  • risk has been addressed
  • a difference has been made

Sexual Exploitation

The Care Act 2014, as well as national cases of child sexual exploitation across the country,, have heightened awareness of these areas and the impact on vulnerable adults. They have also highlighted the need to develop an understanding of the victims of these crimes, the professional responses, operational effectiveness and strategic partnership effectiveness.

Bedford Borough Council have established a child sexual exploitation panel to gain understanding of what is happening in the local area. In January 2015 an independent Bedfordshire wide review of CSE was commissioned which will provide strategic recommendations for improvements in the work of the LSCBs, CSPs and SABs.

Self Neglect

The Care Act statutory guidance states that safeguarding partnerships can be a positive means of addressing issues of self-neglect.

 Interventions that work tend to be based on multi-agency multi-disciplinary assessments and include building of trusting relationships, consensus and persuasion, and practical support with daily living. Monitoring should focus on outcomes, not only on services provided. In most instances, concerns about self neglect are best supported by the agency responsible for the person’s needs, whether they are environmental health, housing, physical health, mental health or other needs. The person should always be at the centre of any decisions made to support them. A safeguarding concern must be made in situations of severe self neglect where here is high risk and it is proportionate to do so – for example where there is no clear lead agency. The role of a safeguarding enquiry in this instance will be to coordinate a multi-agency forum to share information, assess risk and establish a lead agency to work with the person concerned.

Information about self neglect can be found at:

http://www.scie.org.uk/publications/reports/69-self-neglect-policy-practice-building-an-evidence-base-for-adult-social-care

Prevent

Channel is a multi-agency approach to identify and provide support to individuals who are at risk of being drawn into terrorist-related activity. The process forms a key part of the Government’s Prevent Strategy. The process provides a mechanism for safeguarding vulnerable individuals by assessing the nature and extent of the potential risk they face before they become involved in criminal activity and, where necessary, provide a support package tailored to an individual’s needs. Terrorism is a very real threat to all our communities and terrorists seek to exploit those who are most vulnerable. That is why it is vital that we all work together to support those who are at risk of radicalisation – regardless of faith, ethnicity or background. All Channel referrals undergo a screening process and vulnerability and risk preliminary assessment. Those appropriate for Channel will be referred for assessment by a multi-agency panel which decides how best to support the vulnerability. For further information see the NHS England Protocol for Prevent Referrals.

Information about Prevent and counter terrorism can be found at:

https://www.gov.uk/government/publications/2010-to-2015-government-policy-counter-terrorism/2010-to-2015-government-policy-counter-terrorism

Deprivation of Liberty Safeguards

Since the decision of the Supreme Court in P v Cheshire West and Chester Council (& Ors) and P and Q v Surrey County Council (Cheshire West), there has been a vast increase in the number of people deprived of their liberty by the state. The increase has been tenfold across the country, and there has been a raft of associated guidance and new forms developed. The Law Commission are reviewing the legislation with a consultation starting July 2015. The government asked the Law Commission to draw up proposals for reform in 2014 after the landmark Supreme Court ruling triggered a surge in deprivation of liberty cases, and the highly-critical House of Lords committee report described the DoLs as “not fit for purpose”. The Law Commission wants its proposed replacement for the Deprivation of Liberty Safeguards (Dols) to be simpler for professionals to use without compromising human rights protections. The commission is also considering whether the new scheme should introduce more safeguards to a person’s liberty earlier in the care planning process. This would contrast with the current system where the DoLS decision-maker is asked to authorise care decisions that have already been made by a care provider or social worker. The consultation on the Law Commission’s proposals will last four months, commencing summer 2015, with draft legislation being published in 2016.

The Law Commissions proposals for the revised “Protective Care” system can be found at:

http://www.lawcom.gov.uk/project/mental-capacity-and-deprivation-of-liberty/

The Law Society has issued comprehensive guidance on the law relating to the deprivation of liberty safeguards. The guidance was commissioned by the Department of Health and aims to help solicitors and frontline health and social care professionals identify when a deprivation of liberty may be occurring in a number of health and care settings. The guidance provides a summary of 27 deprivation of liberty legal cases, including seven it advises should not be followed, in a bid to help social workers, best interest assessors and other professionals comply with the landmark Supreme Court ruling. For further information please see: http://www.lawsociety.org.uk/support-services/advice/articles/deprivation-of-liberty

The Social Care Institute for Excellence (SCIE) launched a new online MCA directory in February 2015. The directory is a repository of MCA materials; guidance, tool-kits and information leaflets. Information is accessible for all sectors. For information please see: http://www.scie.org.uk/mca-directory

Anecdotally, this can take up to 1 hour per authorisation and this will have significant ramifications for signatories.

Review of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards:

The government asked the Law Commission to draw up proposals for reform in 2014 after the landmark Supreme Court ruling triggered a surge in deprivation of liberty cases, and the highly-critical House of Lords committee report described the DoLs as “not fit for purpose”. The Law Commission wants its proposed replacement for the Deprivation of Liberty Safeguards (Dols) to be simpler for professionals to use without compromising human rights protections. The commission is also considering whether the new scheme should introduce more safeguards to a person’s liberty earlier in the care planning process. This would contrast with the current system where the DoLS decision-maker is asked to authorise care decisions that have already been made by a care provider or social worker. The consultation on the Law Commission’s proposals will last four months, commencing summer 2015, with draft legislation being published in 2016.

The Law Commissions proposals for the revised “Protective Care” system can be found at:

http://www.lawcom.gov.uk/project/mental-capacity-and-deprivation-of-liberty/

Over the next 12 months the focus will be on embedding the principals of the Care Act including making safeguarding personal, and a growing awareness of sexual exploitation, modern slavery and self-neglect. As well as responding to and monitoring the ongoing impact of the Supreme Court ruling on Deprivations of Liberty Safeguards.

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