Agenda item

Briefing Note

The Health and Social Care Scrutiny Board (5) received a briefing note and presentation by the Director of Adult Services and Housing, which provided information on the range of approaches and mechanisms in place to keep people safe for both assurance and contribution on potential improvements.

The Scrutiny Board noted that keeping people safe is a fundamental element of the work of Adult Social Care and that this is one of the key commitments in the Adult Social Care offer.  Ensuring the safety and wellbeing of the most vulnerable people, helping people to stay safe from harm and abuse, working alongside other organisations when needed, and supporting people to make their own choices was paramount.  Although this is central to everything the Adult Social Care does, it was recognised that this is a challenging area and that the service is often involved in people’s lives at a time of change, crisis, profound trauma and abuse.

The presentation provided an overview of the ways in which Adult Social Care helps to keep people safe, summarise and identify key issues and provide real examples of the application in practice.

The Scrutiny Board noted that there were 3 specified routes to keeping people safe.  It was further noted that these all have specific criteria so don’t apply to all adults within the community, but in some very limited situations consideration of all 3 of the following areas may apply:

·  Care Act 2014 – provides general duties but predominantly safeguarding.  The Act provides a clear legal framework for how local authorities should protect adults with care and support needs at risk of abuse or neglect.

·  Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) – for people who lack capacity to make decisions.  This is also an area of safeguarding activity where the Council is experiencing increasing demand.  The Council is the supervising authority, assessing and authorising the deprivation in care homes, hospitals etc.

·  Mental Health Act 1983 – for those experiencing acute mental illness requiring detention in hospital. The Act has very specific criteria that is medically led and assessed and authorised by an Approved Mental Health Practitioner, more commonly a social worker.

The presentation provided case studies in respect of safeguarding, mental capacity and DoLS, and how all 3 of the above elements were used.  This provided real life examples of some of the cases Adult Social Care undertake and how the various acts support the service to keep people safe.

Key issues were highlighted in respect of the perception of others, particularly where it is not possible to share the rationale in decision making; increased activity within Adult Social Care, the impact of increased demand on the workforce; and recognising that it isn’t always possible to remove all risks and ensure the complete safety of individuals, who may chose to remain in an unsafe or risky situation.

Members of the Scrutiny Board asked questions and received responses in relation to the following matters:

·  In respect of impact on workforce, whether there have been issues in relation to the retention or recruitment of staff.

·  The impact on individuals and professionals involved in cases of DoLS where the service user refuses to accept the outcome of the assessment.

·  What Key Performance Indicators are used, where they can be located and how they are used to measure performance.

·  How safeguarding is assured when individuals are brought into care homes.

·  The impact of high staff turnover with regard to safeguarding.

·  Winter planning to ensure the safeguarding of individuals and whether there was likely to be an increase in referrals with relatives and neighbours raising concerns, particularly in light of the cost of living crisis.

The Scrutiny Board placed on record their congratulations to the Cabinet Member for Adult Services on her commitment and leadership on this agenda, as had been acknowledged by the Independent Chair of the Adult Safeguarding Board.  Officers were also thanked for their proactive work and willingness to discuss challenging issues within this service area.  The Board further recognised that whilst the Adult Social Care Service would do their best to mitigate the current challenges, assurances could not be given that the impact of the cost of living crisis would not be felt by the service and service users.

The Scrutiny Board recommended that additional mechanisms to enable the collection of service user’s views be explored.

RESOLVED that the Health and Social Care Scrutiny Board:

1.  Reviewed and commented on the work of Adult Social Care, understanding the approaches and mechanisms that are in place in line with the service’s commitment to keep people safe.

2.  Recommend that additional mechanisms to enable the collection of service user’s views be explored.

3.  Congratulations the Cabinet Member for Adult Services on her commitment and leadership on this agenda, as had been acknowledged by the Independent Chair of the Adult Safeguarding Board.