2014-2015 Independent Chair Ian Davey Page 1 of 10 www.suffolkas.org Quality and Performance Framework Introduction The Suffolk Safeguarding Adults Board (SAB) is a partnership consisting of members from a wide range of organisations that can be statutory, voluntary or privately owned and that work with adults who may be vulnerable or in need of support or protection. As the scope and scale of the SAB is so broad, the board have undertaken to develop this Quality and Performance Framework, the aim of which is to underpin the work that the SAB does and to provide a degree of accountability and transparency across all agencies working to safeguard vulnerable adults as part of the board and its sub groups. www.suffolkas.org Page 2 of 10 The structure of the SAB and its subgroups SAB; (Safeguarding Adults Board) The strategic multi-agency steering group with statutory responsibility for the oversight and co-ordination of safeguarding activity. P&Q Health SCR P&Q; The Performance and Quality subgroup. Responsible for the production of effective management information and performance challenge to the SAB. SAB Policy and Procedure Comms The People's Panel Training The People’s Panel; The Service User group, attended by service users or their representatives and chaired by Suffolk Coalition of Disabled People and Healthwatch. Training; The Training and Development subgroup. Responsible for coordinating the development of multi-agency learning and audit. Comms; The Communications subgroup. Responsible for ensuring effective communication from the SAB as well as between partners and members of the board. Policy and Procedure; The Policy and Procedure subgroup is responsible for the review and development of multi-agency safeguarding policy and process. Health; The Health subgroup. Responsible for co-ordinating health membership of the SAB between the various NHS organisations operating within Suffolk. Page 3 of 10 www.suffolkas.org SCR; The Serious Case Review subgroup. Responsible for the investigation of and learning from Serious Case Reviews. Understanding our model of services (1) Intensive Investigative Work; Adult Protection Team and Suffolk Constabulary (2) Support for Vulnerable Adults from Statutory Services The diagram opposite illustrates the three key tiers of support offered by member agencies of the SAB; the third tier consists of support offered by services who work indirectly with vulnerable adults and who may from time to time be required to make safeguarding referrals, or attend basic awareness training. These organisations are pivotal in terms of preventing circumstances in which abuse may take place. The second tier contains those services that work directly with vulnerable adults but who will make referrals to primary adult protection services and will not investigate cases of alleged abuse directly. These services effectively minimise the risk of abuse for vulnerable adults. The first tier consists of adult protection services and statutory bodies who would undertake investigate or protective work in response to allegations of abuse. Diagram One: The SAB Model of Service The performance and quality assurance model must, by necessity, reflect the shape of service delivery, with tools and measures that reflect the practice of all SAB member agencies. The three spheres of provision highlighted in diagram one will be reflected in the quality and performance tools and reporting that will be presented to the board for oversight. However, the shape and structure of performance must also address several key areas of service provision at each level, as set out in the section below. Page 4 of 10 www.suffolkas.org (3) Services Offered by All SAB Partners In order to more fully understand the necessity to shape and structure the quality assurance and performance monitoring tools that underpin the work of the SAB, it is first necessary to explore the model of services offered across the Suffolk system in support of vulnerable adults. How do we know that Safeguarding in Suffolk works? Training and Development •Audit and Quality Assurance of partner agencies • Ensuring effective supervision and practice standards •Addressing key performance issues at a senior level (including SCR) •Monitoring and ensuring the quality of training and development •Understanding the needs and views of professionals Performance and Workflow Measurement Service User Feedback •Understanding workflow and identifying issues •Measuring the effectiveness of service delivery •Identifying and flagging risk •Understanding the performance of key public facing resources •Understanding the views of our service users •Developing information and services that our customers can understand •Providing effective advocacy for and on behalf of service users Diagram Two: Performance and Quality Quadrants Diagram two, above, illustrates the model of quality assurance and performance management that will be adopted by the SAB in Suffolk. This model consists of four key areas of performance management that are all directly related and when taken together will ensure that the SAB, as the body responsible for co-ordination of safeguarding provision under the Care Act 2014, is able to effectively monitor and manage safeguarding performance as well as provide intelligent and directed responses to concerns as early as is possible. Page 5 of 10 www.suffolkas.org Audit and Quality Assurance The four quadrants represented in diagram two are the responsibility of the various sub-groups of the SAB in terms of the development of tools used to gather appropriate information, as well as in terms of the initial assessment of any outcomes, flagging areas of concern to the board, or the need for further identified work. The board itself is the body responsible for overall direction and strategic oversight across the county. The responsibilities of subgroups are as follows: The responsibilities set out in diagram three are not exhaustive and it is expected that there will be some overlap in terms of roles across the various subgroups. Training and Development •Training and Development Subgroup (Lead) •Performance and Quality Subgroup •The People's Panel Where appropriate, the lead group has been listed against each of the four quadrants, with groups that will work within these quadrants listed underneath. Performance and Workflow Measurement •Performance and Quality Subgroup (Lead) •Health Subgroup Service User Feedback •The People's Panel (Lead) •Communications Subgroup Diagram Three: SAB Subgroup Responsiblities Page 6 of 10 The work of each subgroup will be structured through a range of standardised and agreed tools and processes that cover all of the aspects required by the quadrant model and that mirror the tiers as set out in diagram one. Details of these tools are explored below under the appropriate quadrant, with the lead agency highlighted in diagram three being responsible for their implementation. Tools highlighted in green have already been implemented in support of the SAB, those in amber are in progress and those in white are planned. www.suffolkas.org Audit and Quality Assurance •Training and Development Subgroup (Lead) •Policy and Procedure Subgroup •Health Subgroup •SCR Subgroup Quality Assurance and Performance Management Tools Quadrant One Audit and Quality Assurance Quadrant Two Training and Development Description and Purpose Frequency of Use Tool Description and Purpose Frequency of Use SAB Self Audit Tool Quality assurance and oversight of SAB processes across partner organisations undertaking the selfaudit, with reporting to the SAB on an exception basis at ‘challenge and support’ events for exceptionally good or poor performance. The tool can be tailored to suit the needs of agencies from tier one to tier three. The Policy and Procedure Subgroup is effectively virtual. The group meets to assess and quality assure safeguarding policies belonging to partner agencies as and when required, working with the partner agency lead to develop a ‘SAB approved’ policy. All SAB partner organisations undertake the self-audit on an annual basis, with a rolling timetable of organisations throughout the year. Training and Development Benchmarked Standards and Audit Annual review of all appropriate training courses, or ad-hoc as appropriate. The policy review panel will meet on an ad-hoc basis, as and when required, but is expected to convene bi-annually as a minimum. Ad-hoc, as and when required. Professional Development Surveys All training provided to professionals working with vulnerable adults across Suffolk must be approved by the Safeguarding Adults Board in order to receive the ‘SAB Benchmark’ standard. This will be accomplished via ‘mystery shopping’ of training provision across the county by Training and Development Subgroup members. Professionals working with vulnerable adults across Suffolk are given the opportunity to feedback on any issues and concerns that they might have in terms of safeguarding training provision. This is accomplished via electronic surveys and ‘locality committee’ meetings of practitioners county-wide. Policy Review Panels SCR Reports In the event of Serious Case Reviews being undertaken in Suffolk, the SCR panel will lead on the production of a report in to the incident, developing an action plan and ‘lessons learned’ document. Quadrant Three Performance and Workflow Measurement Bi-annual locality committee meetings, adhoc responses to electronic surveys. Quadrant Four Service User Feedback Tool Description and Purpose Frequency of Use Tool Description and Purpose Frequency of Use Whole System Workflow Report The workflow report captures activity in terms of work to safeguard vulnerable adults across all SAB members. Reporting looks at demographics, levels of need in terms of statutory and voluntary provision geographically and explores the work of the MASH, as well as the adult protection team and police in terms of flagging and investigating instances of alleged abuse. Support for the Training and Development Subgroup and quadrant in terms of volumes of practitioners across partner agencies that have attended offered safeguarding courses, satisfaction with these courses and other relevant information. Monthly ‘Business As Usual’ reporting for the Adult Protection Team within the county council, detailing alerts, referrals and substantiation of safeguarding investigations. Quarterly Report to the Performance and Quality Subgroup, flagged to the SAB if required. Supporting information for the Annual Report. Service User Awareness Sessions Drop in and publicity sessions run by the People’s Panel. Sessions include a representative from the SAB, a service user, as nominated by the panel and the SAB manager. Sessions are offered on a rotating basis at public venues across the county with surveys undertaken with attendees, the results of which are collated and fed back to the board. Monthly Monthly MASH reporting. As directed by the Training and Development Subgroup. Initially quarterly. Service User Feedback Surveys Ad-hoc / Monthly collection of results. Monthly Comms Panel Online and postal surveys of service users across all agencies. Survey Monkey used to develop a tool through which all service users across all partners can feedback on their experiences. Content of survey developed in conjunction with People’s Panel. The communications panel convenes to assess the quality and readability of all public facing SAB documentation. The panel is responsible for making recommendations on change and improvements from a service user’s perspective. Training and Development Report Adult Protection Report Page 7 of 10 Bi-monthly www.suffolkas.org Tool Underpinning Tools Responsibilities of the SAB Tool Description and Purpose Frequency of Use Strategy The strategy for the SAB looks to outline the work of the board on a three year cycle, identifying the work that the board is looking to undertake over the medium term and the results that will be expected during the period. The strategy is the foundation of the annual report and SAB Strategic Work Plan, produced on an annual basis. The SAB Annual Report is produced each year and reflects the work of the SAB and its subgroups in each twelve month period. The report details progress made against the SAB’s Strategic Work Plan for the year and outlines the aims of the board for the coming twelve months. The Annual Report contains updates from each subgroup, as well as an exploration of the work and focus of partner agencies from across all three tiers of service provision. The Annual Report is the place in which longer term trends in terms of workflow and performance reporting are explored in a transparent way for service users and the public. The strategic work plan is refreshed annually and use of the document that underpins the work of the SAB and its subgroup in each twelve month period. The work plan is arranged around a series of key outcomes that the board is looking to achieve, with individual activities outlined against these. Tri-annually Annual Report Annual document, reviewed quarterly. The Strategic Work Plan is further devolved in to individual subgroup plans that identify the work that each group will lead on during the year. The Work Plan is reviewed at each SAB meeting on an exception basis, with those items requiring the attention of the board being flagged up via a risk heat map. What does the SAB see routinely? Due to the wide range of tools in use to measure, monitor and improve quality and performance across all SAB partners, it is not possible for the SAB itself to have oversight of all aspects of quality and performance at each meeting. As such, the board is presented with a quarterly balanced scorecard, Page 8 of 10 www.suffolkas.org Strategic Work Plan Annual reflecting the quadrants in diagram two, with exception reporting provided against areas where performance has become a concern, that is similar in shape, style and content to existing safeguarding reporting within the county council. Exception reporting to the SAB is the responsibility of the Performance and Quality subgroup. Below is an illustration of the quarterly scorecard, as viewed by the SAB (note; measures are placeholders and out turns are not real figures): Quadrant One Audit and Quality Assurance Measure Out Turn % of all SAB organisations in the year to date achieving over 80% at self-audit Direction Travel 70% 25% of Measure % of staff who feel confident in their training to safeguard vulnerable adults in the year to date % of staff who reported that policies and procedures for their organisation were easily accessible and clear in the year to date % of SAB organisations required to undertake the self-audit who did not 8% complete Quadrant Three Performance and Workflow Measurement Measure Number of MASH Alerts in the quarter Number of Safeguarding Referrals in the quarter Out Turn Direction Travel 200 100 2:1 40% Ratio of Alerts to Referrals in the quarter % of Safeguarding Substantiated in the quarter Referrals Out Turn Direction Travel 80% 55% of Quadrant Four Service User Feedback of Measure % of service users surveyed who feel safe in the year to date % of service users reporting that they understood what the term ‘Adult Safeguarding’ means in the year to date Bounce-rate from www.suffolkas.org as a percentage of total users in the year to date Out Turn Direction of Travel 65% 40% 53% The quarterly balanced scorecard gives the board a clear overview of safeguarding activity in the county. Each measure is an assessment of either Page 9 of 10 www.suffolkas.org % of SAB organisations in the year to date returning an ‘all-red’ self-audit section Quadrant Two Training and Development success or volume, with the direction of travel indicating whether the percentage, ratio or number has increased or decreased. The RAG rating of each out turn identifies for the board whether the measure requires further investigation. Measures that are red will require exception reporting as directed via the Performance and Quality subgroup of the SAB. The SAB may request further information on any aspect of service provision that sits outside of those measures identified in the scorecard and may request the addition, amendment or deletion of measures as required to further the work of the board. The wider array of tools used to monitor continuing quality and performance may also be requested by the board on either a routine or ad-hoc basis. www.suffolkas.org Page 10 of 10