Agenda item

To present the Brent Safeguarding Adults Board (SAB) Annual Report covering the period from April 2023 to March 2024.

The Chair welcomed Nicola Brownjohn (Independent Chair, Brent Safeguarding Adults Board) to the meeting, who had been in post since January 2024, and invited her to introduce the report.

Nicola Brownjohn began by highlighting that she had started in post outside of the timescales of the annual report period but hoped to give an overview of the work the Safeguarding Adults Board (SAB) would be looking to do over the coming reporting period. She explained that her role as independent chair was to provide an external view, completely independent from any partners, to take forward and lead the SAB. Continuing to provide an overview of the arrangements, Nicola highlighted that SABs became statutory in 2014 under the Care Act, and within the remit of SABs was to produce an annual report every year, to set strategic priorities, to undertake Safeguarding Adults Reviews (SARs) and to take forward learning. Her role ensured that the safeguarding system in Brent was established and working well, and part of her role was to challenge the partners working within the SAB. The three strategic partners were the Council, health and police, but there were other agencies involved to support the SAB including the Department for Work and Pensions (DWP), Brent’s hospital trusts, Brent’s mental health trusts, voluntary services, and other Council departments such as housing. In concluding her introduction, she highlighted the importance of coming together and working collaboratively.

The Chair thanked Nicola Brownjohn for her introduction and invited comments and questions from the Committee, with the following issues raised:

The Committee began by asking what Nicola had found coming into the SAB that she felt worked very well in Brent, and where she felt there needed to be some more focus. She responded that she had been struck by the positive way partners worked together. When she had joined Brent, she had some ideas for changes which had been taken forward quickly, with partners accepting them and adapting to them well. She had found very good listening and meaningful conversations were taking place between partners, and was pleased at the range of agencies involved with SAB and the commitment from those agencies. Her ‘wow’ factor for Brent’s arrangements was the relationship the partners had with voluntary services. One of the SAB strategic priorities was substance misuse and housing, so she had visited Skylight in Harlesden to look at the services on offer there and had been enthused by the depth of knowledge of the staff and the ‘built for zero’ work being done. In terms of works in progress, she had found when she started there was a gap in terms of understanding the data available. The partnership was very engaged so a subgroup was being launched which would take that work forward, looking at the data and any outlying areas and taking forward areas where there might be further themes to explore.

Noting that the Chair of SAB would have experience from other areas of the country, the Committee asked how Brent compared to other areas she had worked with. Nicola Brownjohn confirmed that she did have experience of other SABs and had also written several SARs over the last 5 years. She felt that Brent was doing relatively well but highlighted there was always a want for continuous improvement and there were things that Brent could improve on. While there were areas for improvement, she had confidence in Brent’s processes. Rachel Crossley (Corporate Director Community Health and Wellbeing, Brent Council) added that, to support the Board and Nicola coming into the role of Chair, Adult Social Care had commissioned an independent review on how Brent managed safeguarding both in terms of the processes and broad arrangements. The review had been positive in the processes and staff understanding of how to deal with issues and had included some recommendations as well which had given some reassurance and enabled the Chair to have independent assurance that the processes worked and that staff had a good understanding of safeguarding.

The Chair asked how the Cabinet Member assured themselves that those processes were robust and heard that the Cabinet Member had regular meetings with the director where any issues of concern would be raised. Any urgent issues would be raised immediately through the Chief Executive and Leader.

In response to whether, as Chair, she felt all the agencies were joined up and working together, Nicola Brownjohn highlighted that often one of the reasons for needing a SAR was because agencies had not worked together in some way or had not been robust in working together. Some SARs that had been audited recently had taken place during the pandemic period, so agencies had recognised the learning from those and she would want to know what the change was now compared to when those SARs had taken place. She was now starting to receive that information from agencies who had reflected on that period and questioned when things had not gone right. Over the next year, she would go back to those agencies and back to the multi-agency group to see what the impact of that learning had been, whether any actions implemented had been sustainable, and if there was more that needed to be done.

The Committee noted that the SAB took evidence from 3 sub-groups to fulfil its duties, and asked what other areas the SAB would want to take further evidence from to help strategic decisions. Nicola Brownjohn responded that she was keen to triangulate all available evidence and build a foundation for that. One area that evidence could be taken from and learned from was SARs. Alongside that, there was also an assurance aspect through the information coming from individual agencies. In the annual report, the 3 strategic partners looked at what they were doing in respect of the strategic priorities and learning from SARs and provided that analysis back to the SAB. She was also starting to build on a third strand of evidence which was hearing from those working out in the community and meeting community groups to ensure the right people were being reached.

The Committee noted that the SAB was looking into data and asked whether that would focus on the availability of data or the type of data. Members heard that the review would be around how the Board looked at and used the data. There was a tendency for the SAB to receive a large dataset, so it was important that partners understood what that data was telling. The work would start with Adult Social Care data and dig down further. For example, the sub-group might look at data around referrals and find a certain theme such as location of abuse that could then be analysed and reviewed. That data would then take the SAB in a direction that could be learned from. Claudia Brown provided a practical example. She explained that Adult Social Care took a lead on safeguarding, so a number of agencies would refer to Adult Social Care (ASC) for a response to a safeguarding concern. It was expected that ASC would be getting referrals from all agencies but if the data showed that was not happening then ASC, working with agencies, could create an action plan around safeguarding criteria and dig deeper to see the reasons behind that and improve those relationships with agencies to get more referrals. In terms of how the partnership worked to gather and share that data, Nicola Brownjohn explained that for the annual review the data was from SARs, and those SARs were being shared at all meetings. The new subgroup would mean that agencies could bring data into that group and if there were any recurring themes that subgroup found then the SAB could look further into that.

In terms of whether the relationship between Housing and Adult Social Care was robust enough to fulfil the Council’s duty of care in regards to safeguarding cases, Claudia Brown (Director Adult Social Care, Brent Council) confirmed that there was a relationship there. There was a Joint Housing and Social Care Panel that picked up complex cases from housing and those cases were discussed at the panel with social workers getting involved where necessary. In addition, there was a high-risk panel for very complex cases, such as where the Housing and Social Care Panel might have already tried interventions that had not worked. That was a multi-disciplinary panel with health, social care, mental health representatives, district nurses and many different disciplines to move cases forward. Externally, if there was an issue in a Housing Association for example, Housing would broker that relationship between Social Careand the Housing Association to move that case on and provide support wherever necessary, and those cases in Housing Associations could also be brought to those panels.

The Committee asked how the strategic priorities were agreed. Officers advised that this was done through a range of avenues through looking at the data being presented and any common or recurring themes. The Annual Report strategic priorities had been the same for the past few years, but when partners had reviewed those priorities they had found that self-neglect and substance misuse and housing were still coming up regularly so the partnership decided to maintain those. The SARs also helped to inform priorities and one priority was around embedding the learning that came out of SARs. While the priorities had been reset, the SAB was aiming to be much more definite about what that work would look at, how it would achieve impact, and how the data could be tested. A Performance and Audit Subgroup would be set up to look at individual cases and the data coming out of that group would then go to the SAB. For example, if the Performance and Audit Subgroup found that referrals for self-neglect had reduced then the SAB would ask partners why that might be the case. The self-neglect toolkit had launched some time ago so the Performance and Audit Group would begin with auditing around that.

The Committee asked partners what more could be done by each partner so that the collective partnership was delivering better for adults in Brent. They heard that all partners were each attending the subgroups required of and expected of them, and it was hoped they could do more of that and take areas within those groups forward. Also in terms of escalation, checking what their organisations knew about escalation, whether they were aware of the high risk panel and how referrals to the panel could be made, and that partners were moving things forward. Sue Sheldon (Assistant Director for Safeguarding Adults and Children, NHS NWL) felt the partnership was working very well but one thing health could improve on was to share more meaningful data with SAB and share that data in more effective ways. Andrew Brien (Detective Superintendent, NW BCU – Metropolitan Police) highlighted he had only been in post for a few days but after speaking with Detective Chief Inspectors, his predecessors and new colleagues he had found that there was a very good working relationship with partners in Brent and agreed that one area for improvement would be around the sharing of data. All partners highlighted the importance of challenge, openness and accountability in ensuring the partnership worked and felt that was there in Brent. Rachel Crossley added that an effective partnership needed to have good working relationships further downstream than Board level as well in order to work. This meant challenging and championing staff throughout the organisations the Board worked with and embedding those colleagues in the work of the SAB. Linked to that, work was needed to ensure the messaging on the SABs key priority areas was disseminated collectively.

Noting the different skillsets of each of the partners, the Committee queried how decisions were made and who had the final say. They were advised that when there were SARs, a multi-agency case review subgroup would discuss whether or not the case met the criteria to do an independent SAR and undertake that learning. The group looked at the case of the individual and what window of time partners could provide information on in that person’s life. As such, deciding whether to refer the case to a SAR was a mutual decision which would then be presented to Nicola Brownjohn as Independent Chair to ratify whether or not Brent would do the SAR and what areas the SAR would look into. On a case level outside of the SAR process, Adult Social Care would lead that and make those decisions with input where necessary.

Members advised officers that when, as councillors, they co-ordinated operations with different agencies and there was a need for police presence, it was sometimes difficult to get police presence due to the demand pressures the police were under. They asked whether that was the experience of partners in their safeguarding operations and what the most common level of blockage was for police attendance. Claudia Brown responded, highlighting the introduction of ‘right care, right person’, a police initiative to ensure that police attendance to incidents was appropriate and that they were the last port of call. Police would still attend life and death situations and where there was a potentially dangerous situation. For Adult Social Care, the majority of cases requiring police attendance were when doing a Mental Health Assessment, and the police would attend those cases as appropriate. If there were other incidents requiring police assistance, such as an inability to gain access to a property, then the police would attend. As such, when Adult Social Care had required police presence they had attended. The Safeguarding Team had developed links and built relationships with the police so that when there was a case they were concerned about they were able to have that open communication with the police about it.

Noting that there had been two SARs in the reporting year, and the aim to do rapid learning and training from SARs in future, the Committee asked how that would be embedded across partners. Nicola Brownjohn explained that work would be led by the multi-agency case review subgroup. There were action plans in place so that team leaders could ensure those actions were taking place and ensure there was evidence of that. She highlighted the importance of being definite of the completion dates of those actions in order to fully monitor their impact. Reporting from the case review subgroup would then come to the SAB and if there were any concerns that some actions had not been taken then that could be escalated to the SAB Exec Group.

The Chair thanked those present for their contributions and drew the item to a close. He invited members to make recommendations with the following RESOLVED:

i)              To recommend that an Internal Communications Strategy was drawn up for data sharing between partners.