In accordance with the Care Act 2014, the Kent and Medway Safeguarding Adults Board is required to publish an Annual Report each financial year.This report introduces the Kent and Medway Safeguarding Adults Board’s (KMSAB) Annual Report for April 2018–March 2019.
The Director of People – Children and Adults said that Members had sometimes expressed concern that being part of a Kent and Medway Board could lessen the focus on Medway. Assurance was given that the Independent Chair had strong awareness of Medway specific issues and that she worked closely with the Assistant Director, Adult Social, who was Deputy Chair of the Board. Both Chair and Deputy Chair engaged actively with the local adult safeguarding executive to ensure close working.
The Independent Chair of the Board introduced the Safeguarding Board Annual report. The Board was a strategic body responsible for setting the direction of adult safeguarding in Medway and Kent. It had an annual budget of £261,000. An easy read summary of the report had also been produced. Responsibilities of the Board included challenging partners in relation to effectiveness and quality; undertaking safeguarding adult reviews and; delivering learning following completion. Board priorities had included raising awareness of exploitation, isolation, loneliness, abuse and neglect. Key achievements had included development of a new quality assurance and assessment framework; review and update of key safeguarding policies; training of 661 multi-agency operational staff across Medway and Kent and; design of a training and evaluation framework.
The Board had produced more accessible information for families and monitored a range of complex action plans. It had co-produced, with Medway’s self-advocacy group, some easy read versions of a user guide and had led an adults safeguarding awareness campaign, the theme of which was loneliness and exploitation. This had culminated in the delivery of a number of public information days. A Communications and Engagement group had been established with a Business and Development officer employed to progress this work. This would include more intensive working with the voluntary sector and inter-faith groups.
There had been 1387 safeguarding concerns raised in Medway in 2018/19, which was higher than the previous year. 700 of these were investigated under a Section 42 safeguarding enquiry or other enquiry, an increase of 43% from the previous year. These increases were attributed to improved systems and resource management and the development of the Three Conversations approach. Abuse in Medway health trusts and care homes was below the national average. The most common type of abuse nationally was neglect with the Kent and Medway figure for self-neglect being 26%, below the national average. The national figure for the percentage of safeguarding interventions that saw risk of abuse reduced or removed by a safeguarding intervention was 89%. Medway’s figure was 82%, an increase of 8% from the previous year.
Members of the Committee made comments and asked questions as follows:
Safeguarding Training – It was questioned whether the provision of safeguarding training by care homes was compulsory as only one home out of three that a Councillor volunteered in had offered it to them. The Independent Chair said that safeguarding training had to be provided and this should be being checked as part of Care Quality Commission (CQC) inspections. The Assistant Director – Adult Social Care said that the Council had resource that worked on quality assurance with care and domiciliary care providers. Work undertaken between inspections checked paperwork and ensured that training was being undertaken. Any concerns in relation to specific homes could be reported for investigation. Meetings with the CQC regional lead took place quarterly. The Assistant Director chaired the Medway Quality Surveillance group and attended the Kent and Medway group to ensure that intelligence on the quality of providers was joined up.
Abuse in Care Homes – It was asked what could be done to prevent abuse in care homes and whether safeguarding arrangements were considered as part of the commissioning process. The Assistant Director said that a range of quality information, including safeguarding, was considered as part of the commissioning process and that the Quality Surveillance Group included representation from the brokerage team. The Independent Chair said that there was a need to encourage the regulator to strengthen the inspection regime. The provision of training was important but this did not guarantee that systems and cultures would change and there were insufficient resources available to train everyone.
Transitions Projects – With reference to a local project for 16-25 year olds leaving care, it was asked how such projects were viewed. The Independent Chair said that transitions projects were valued but that there were not enough of them. There was a connection between transition, available support and suicide rates with young care leavers not always being identified and therefore not receiving the support that they needed. Agencies needed to work together effectively to develop plans to effectively support this cohort. The Director of People added that the transition from children’s to adult services was being considered by the Children’s Safeguarding Partnership. A protocol was in place to ensure effective working with adult safeguarding. It had also been requested that the Police, via the Medway Task Force, consider the issue. The Director of Public Health was leading on work to look at how to enhance support for care leavers in relation to their health needs.
Outcome of closed enquiries – It was asked whether there were any differences between the locations of alleged abuse and the locations of incidents that were subsequently found to have actually occurred. The most common location for abuse to occur was in the victim’s own home. A briefing would be provided to the Committee to show outcomes by location.
Care Home Practice – It was asked whether any work had been done to look at care home practice and the impact of low wages and long working hours. The Independent Chair said that while the Safeguarding Board was not a provider, it did work with the Council to measure quality and the impact of projects. Good management and strong leadership were key to homes performing well. The Assistant Director said that where concerns were identified, work would be undertaken with the home, owners and management to agree a clear action plan that would improve quality.
The Committee noted the Annual Report and made comments for these to be referred to the Health and Wellbeing Board when it considers the Annual Report.