Agenda item

To receive and consider the 2017/18 Annual Report from Brent’s Safeguarding Adults Board (SAB).

Michael Preston-Shoot (Independent Chair, Brent Safeguarding Adults Board (SAB)) introduced the report which provided a summary of safeguarding activity carried out by Brent SAB partners across social care, health and criminal justice in response to the priorities of the Board as out in paragraph 3.4 of the cover report (page 54 of the Agenda pack). Mr Preston-Shoot commented on four sections of The Care Act 2014 which were closely related to the functioning of the SAB:

·         Section 42 – Enquiry by local authority – Members heard that the Board had continued to receive data relating to number of notifications made to the Local Authority and it had scrutinised this information against the information available on National Health Service (NHS) Digital. Findings had indicated that performance in the Borough was better than in other areas, but the Board recognised that there were outstanding challenges related to understanding modern slavery, self-neglect and human trafficking. Furthermore, there were ongoing issues raised by family members and partners relating to feedback they had received following a notification. These were often linked to the standards of adult safeguarding in care homes and the Board continued to monitor the situation.

·         Section 43 – Safeguarding Adults Boards – Mr Preston-Shoot reminded Members that it was a duty for the Local Authority to have a Safeguarding Adults Board with three statutory partners being members – the Local Authority, the Police and the Clinical Commissioning Group (CCG). He said that while he did not have concerns about the membership of the Council and the CCG, there had been ongoing issues related to the engagement of the Police. Mr Preston-Shoot informed Members that he had raised these with a number of senior police officers and he had participated in a three-way discussion with Mike Howard (Independent Chair, Brent Local Safeguarding Children Board (LSCB)) and Carolyn Downs (the Council’s Chief Executive). Mr Preston-Shoot said that he was hopeful that the situation would improve once the tri-borough policing arrangements came into force. However, while the Board’s the engagement of the National Probation Service had been intermittent, the SAB was working well with Trading Standards and the Department for Work Pensions.  

·         Section 44 – Safeguarding Adult Reviews – In 2017-2018 the Board had conducted four reviews which examined different cases. A key concern that had been identified related to care settings that had been classified as housing rather than residential or nursing care as there were gaps in the system for protecting adults from risk. Mr Preston-Shoot added that he was also concerned about some local authority and CCG placements, in cases where the host authority had not been notified that it would receive a placement from outside its boundaries.

·         Section 45 – Supply of information – Mr Preston-Shoot noted that the Board had not had to use its powers under Section 45 to demand information from stakeholders. The SAB had been successful in establishing a performance management framework and analysing heath performance data from the two NHS Trusts operating the Borough. One of the findings had been that the Police in Brent had been dealing with more cases of hate crime and mental health crises than in other areas of London.

The Members of the Committee welcomed the report and asked questions that related to the effectiveness of the adult safeguarding system in Brent; the actions that had been taken to highlight the impact of cuts; and the Board’s community engagement plan. Mr Preston-Shoot explained that although the operational collaboration in the Borough was good, with the majority of the referrals coming through the Multi Agency Safeguarding Hub (MASH), there were concerns related to frontline police officers’ understanding of certain sections of The Mental Capacity Act 2005. These had been addressed by the Independent Chair who had held discussions on ways to strengthen knowledge of statutory areas. Furthermore, joint training sessions had been delivered in collaboration with the CCG and there had been good engagement between the NHS Trusts, the Local Authority, the ambulance trusts and the London Fire Brigade, with the latter offering home visits to elderly residents to conduct fire risk assessments and working closely with the SAB to raise awareness of hoarding and the risks associated with it. 

Referring to highlighting the impact of cuts, Mr Preston-Shoot said that he had raised the question of contributions by the Police and the CCG in his capacity of Chair of the London Safeguarding Adults Board with the Mayor’s Office for Policing and Crime (MOPAC). Moreover, a meeting with NHS England had been organised to discuss achieving consistency in funding allocations and the London SAB would be making a representation to the Department of Health and Social Care. It was noted that the current budget of the SAB was not sustainable so it would be difficult to fund an increased number of safeguarding adult reviews (the approximate cost of a review was £10,000). 

The Committee heard that Brent SAB’s community engagement plan had been reconfigured by the Community Engagement and Awareness Sub-Group. The membership of the Sub-Group had been refreshed and a new Chair, representing a third sector organisation, had been elected. Several meetings had taken place and the Sub-Group had devised a strategy of rolling out awareness raising sessions.  These would include lunch time discussions and sessions with faith and community groups – in fact, Mr Preston-Shoot said that he had already attended successful events at a carer organisation and a faith organisation which were interested in finding out how they could protect better the members of Brent’s diverse community. This led to a question about training of frontline staff and Mr Preston-Shoot reflected on a training session on self-neglect which he had presented and remarked that he had been impressed by understanding of adult safeguarding demonstrated by General Practitioners (GPs). Nevertheless, Mr Preston-Shoot acknowledged that sometimes the Board received a high number of notifications of issues as in certain cases frontline staff had been reluctant to make a referral based on a concern they had. Helen Woodland (the Council’s Operational Director of Social Care) emphasised the importance of early referrals to the Adult Safeguarding Team. She added that despite the fact that the Team received a comparable rate of referrals to its counterparts in other local authorities, there had been concerns related to some care homes in the Borough which had not made any referrals and information on these had been passed to the Council’s Quality Commissioning Team. Members heard that Mr Preston-Shoot and Ms Woodland had met with the Care Quality Commission (CQC) inspector covering Brent and it had been decided to establish dedicated meetings to oversee the provision of domiciliary and residential care.

An additional question that was raised as part of the discussion related to the commitment of the Police to the SAB. The Chair of the Committee said that last year he had written a letter to the Deputy Mayor’s Office and that he had not been satisfied with the reply he had received. Mr Preston-Shoot added that Mr Howard and he had raised their concerns with Ms Downs who would escalate the issue in her capacity of Chief Executive of the Local Authority if necessary.

The Chair asked Mr Preston-Shoot to comment on the work that would be undertaken by the SAB in relation to the recent report on the London North West Hospital Trust (LNWHT) published by the Care Quality Commission (CQC) in August 2018. Mr Preston-Shoot said that a year ago he had had a telephone conversation with representatives of the Trust and the CCG to discuss some of the concerns the Board and the CCG had had at the time. The SAB monitored the position for approximately four months as requested by the CCG, following which it provided feedback to the CCG and the Trust on good practices and areas that had required improvement. The recent CQC report would be discussed at the next Board meeting which would be attended by representatives of the Trust and the CCG.

In relation to the reason for the high number of safeguarding adult reviews undertaken by the Board over the last year, Mr Preston-Shoot clarified that the reviews covered different types of cases and commented that it was good that the Board received an increased number of referrals. The SAB may also consider conducting proportionate reviews in future if similar cases were referred. However, reviews required a considerable amount of effort to coordinate the work of multiple stakeholders. Nevertheless, he assured Members that the Board would continue to ensure that learning continued to be embedded in practice among agencies. This led to a question about the increased number of concerns that had resulted in enquiries. In the view of Mr Preston-Shoot, the rising figures demonstrated greater awareness of adult safeguarding issues, especially in relation to new forms of abuse such as human trafficking, modern slavery and self-neglect. As the provision of services shrank, the support available to vulnerable adults had been reduced which had led to a situation in which concerns received by the Safeguarding Adults Team were more complex and more acute. 

A Member of the Committee referred to the work of the Independent Domestic Violence Advisor (IDVA) based at Brent Civic Centre and shared that the experience of some Councillors had been that staff working in the Customer Service Centre were not aware of the presence of an IDVA and did not make referrals to them. They questioned whether every member of frontline staff had received adult safeguarding training. Ms Woodland responded that training had been offered to all frontline staff, but she would not be able to guarantee that that everyone had completed it. Gail Tolley (the Council’s Strategic Director of Children and Young People) clarified that the IDVA role was part of the Children and Young People Department and the IDVA had been commended during the recent Ofsted inspection. The Committee noted that a small proportion of cases of domestic violence were referred to the SAB. Mr Preston-Shoot explained that although the Care Act 2014 included domestic violence as a form of abuse adults could experience, it was addressed through the Safer Brent Partnership. He highlighted that he attended meetings of the Partnership on a regular basis, had delivered a presentation on adult safeguarding and had contributed to discussions when appropriate, providing a point of view focused on safeguarding adults.

RESOLVED:

(i)    The contents of the Brent Safeguarding Adults Board Annual Report 2017/2018, be noted;

(ii)  The Safeguarding Adults Board continues to monitor the standards of safeguarding adults in care settings and pays specific attention to gaps in the system related to unregulated providers which might place adults at risk;

(iii)The Scrutiny Committees notes the variation in funding provided by Brent Clinical Commissioning Group and the local Trust towards the Safeguarding Adults Board;

(iv)The Safeguarding Adults Board takes appropriate measures to ensure that all frontline staff working in the Customer Service Centre receive mandatory training on safeguarding adults and The Mental Capacity Act 2005;

(v)  The Safeguarding Adults Board takes appropriate measures to raise awareness about the role of the Independent Domestic Violence Advisor based at Brent Civic Centre; and

(vi)Brent Council works with Safeguarding Adults Board to provide clear guidance on where the response to domestic violence sits operationally. 

Councillor Hylton left the meeting at 7:40 pm.