Safeguarding Adults Board
Minutes of Meeting held on Wednesday 15 July 2015
in the Filby Room, Police Headquarters, Jubilee House, Falconers Chase
Wymondham, Norwich NR18 0WW
PRESENT:
Joan Maughan, Independent Chair
Elizabeth Morgan, County Councillor, Norfolk County Council
Harold Bodmer, Executive Director of Adult Social Services
Lorna Bright, Assistant Director – Social Work
Helen Thacker, Head of Service, Safeguarding
Nigel Andrews, Tenancy Support Manager, Norwich City Council
Nick Davison, Chief Superintendent, Norfolk Constabulary
Stuart Horth, Head of Community Safety, Norfolk Fire & Rescue Service (part)
James Kearns, Chief Executive Officer, BUILD, Norwich
Kate Rudkin, Head of Development & Operations, Age UK, Norfolk
Dawn Collins on behalf of Jane Sayer, Director of Nursing, Quality & Patient
Safety, Norfolk & Suffolk NHS Foundation Trust
Ian Sturgess, Domestic Abuse Co-ordinator, Police & Crime Commissioner’s Office
on behalf of Jenny McGibben
William Styles, Governor, HMP Norwich
Sue Doolan, Governor HMP
Mark Talbot, Vice Chair, ARMC
Walter Lloyd-Smith, Safeguarding Adults Lead, East Coast Community Health &
Care
Jackie Schneider, Norfolk CCGs
Howard Stanley, Senior Nurse, Safeguarding Adult Lead, Norfolk CCGs
Julie Wvendth, Detective Superintendent, Norfolk Constabulary
Ray Harding, Chief Officers, District Councils Representative
Julie Shorten, Business Support Co-ordinator, Adult Social Services (Minutes)
Item
Minute
1
1.1
Apologies
Michelle de Oude, Norfolk Community Relations & Equality Board
Christine MacDonald, Healthwatch
Julia Sharp, Norfolk Probation Service
Mark Taylor, , Chief Officer, Norfolk CCG
Jane Sayer, NSFT
Jenny McGibben, Police & Crime Commissioner’s Office
Welcome and Introductions
2
2.1
Action
The Chair welcomed everyone to the meeting and thanked all for
attending. Particular thanks was passed on to Adult Social Services
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Item
2.2
3
Minute
Action
Business Support, Norfolk County Council, for arranging business
support cover for this meeting.
The Chair welcomed Michelle de Oude from Norfolk Community
Relations and Equality Board to the Group, in absentia. Unfortunately
Michelle was unavailable for today’s meeting as she will be taking
maternity leave shortly. Michelle hopes to attend the next meeting and
she plans to send a deputy during her maternity leave period. The
Chair also welcomed Ray Harding, who represents the Chief Officers
of District Councils.
Confirmation of any part of the minutes that is exempt under the
Freedom of Information Act
3.1
State if Whole report of the Section number(s) involved: None
3.2
Exemption(s): None
4
Approval of Minutes
The group agreed that the minutes of the 16 April 2015 represented an
accurate record of that meeting and they were to be finalised.
Signed as a definitive record of the meeting
5
5.1
5.2
6
6.1
6.2
6.3
6.4
6.5
Joan Maughan, (Chair of the Meeting)
Matters Arising from the Previous Meeting
Item 13 - Cllr Morgan asked for an update on the NSAB manager
vacancy. The Chair explained this was one the items on the
Newsdesk, however, she was pleased to confirm that Walter LloydSmith had been appointed. Walter’s start date is 7 September 2015,
however, he had been invited to today’s meeting for awareness
purposes.
Item 5 – Walter advised that the first Self-Neglect Task & Finish Group
has been set up in August.
Action: Nigel to arrange for a Housing representative from
Norwich City Council to attend this meeting.
Newsdesk
Development Day - Joan asked the Board to note Wednesday 16
September in their diaries for the NSAB Development Day, which is
being held at Mattishall South Green Park. The Board were asked to
advise of any other people that should be invited to this event.
Safeguarding Week – Safeguarding Week commences Monday 7
September. Joan asked the Board to review the publicity material
(item 10) in the pack and choose their preferred design, adding
comments if they wished. The posters will be collected at the end of
the meeting. It is hoped that the posters will go to print shortly so they
can be available by mid-August.
Suzie Lockwood from Norfolk County Council’s Comms team will be
working with the EDP.
The Library service have been supportive. The Millennium Library in
Norwich will publicise the event on their website.
Claire Crawley Seminar – This seminar is being held in partnership
with Suffolk County Council at the UEA on Tuesday 8 September
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Item
6.6
6.7
6.8
7
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.7
7.8
7.9
7.10
Minute
Action
2015. The Chair asked the Board whether they had any groups of
people whom they thought should be invited. Cllr Morgan suggested
the Safeguarding Forum, Adult Social Services.
Will Styles advised that HMP held similar campaigns where
merchandise was used to publicise contact details. Will agreed to
source merchandise quotes and will forward to Joan and Julie.
Mental Capacity & DoLs – Alison Simpkin has highlighted the
challenges around the lack of psychiatric beds for adults of working
age and older people. The Board needs to give this some serious
thought over the next few months.
HT to invite Alison Simpkin to the next Board meeting
Risk & Performance Subgroup
Kate Rudkin presented the Dashboard and asked the Board to review
the document and provide feedback.
Julie to forward the Risk Register as the papers were not included in
the pack.
The meeting discussed how the data should be presented, for example
by quarter. It was noted that the timing of meetings and the availability
of data should be taken into consideration, as there could be a time lag
which will need to be managed going forward. Kate also asked how
many quarters of historical data were required.
The Board agreed to review the papers and provide feedback
regarding layout, metrics etc. It was agreed that the Dashboard should
be kept simple. Feedback on the layout was very positive.
Joan acknowledged the hard work that the Risk and Performance
Group had been put into the risk register.
Julie Wvendth to catch up with Harold and Lorna regarding the impact
of increased DoLs on the Coroner service and need for Police
attendance.
The intensive GP training could have caused some increase in addition
to the Cheshire West ruling. The Chair will ask Alison Simpkin for an
update on DoLS at the next Board meeting.
The existing Risk Register has been revised to align with the Strategic
and Business Plan. The Risk Register should be interpreted in
conjunction with the Business Plan as numbering from the Plan has
been added, where relevant.
The visual display of the information has been altered by adding colour
boxes to the column headed Target Score.
Jackie Schneider questioned how the Board audits the effectiveness of
our own processes. Helen explained that as a result of the Peer
Review, one action was to introduce an audit of safeguarding cases at
Norfolk County Council. Jackie thought it should be wider across
organisations so that all organisations take responsibility. Joan agreed
that the Board required something it owned for consistency of
measurement.
Action: Joan to follow this up with Jackie and Julie W.
Joan and Walter will look at arranging a smaller group to agree what
appropriate actions were required.
Risk 20 – Joan confirmed that virtual Governance Sub-Committee had
been established.
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Item
8
8.1
9
9.1
9.2
9.3
9.4
9.5
9.6
9.7
9.8
9.9
10
10.1
Minute
Action
Risk 17 – It was noted that there was an increasing reliance of the
voluntary sector. There is concern around the governance and the
contract the organisation might hold. Joan and Howard to take back to
the Business Group meeting. Harold stated that there is a risk as
strategic organisations shrink whilst financial pressures increase, so
that we will be moving out of our territory. We are trying to manage
this as safely as we can. The new model of Community Social work
goes beyond what is in the contract.
Risk 5 – Resource allocation across organisations – whether there is a
dilution of resources and how this impacts on the Board. Staff levels
have improved, however it is unlikely they will increase further,
although referrals will increase.
Risk 6 – Mental Capacity Act – Good progress has been made with
understanding awareness. Joan to request the Mental Health Sub
Group to provide an update in time for the next meeting.
Risk 16 – GP Practices – There is concern about the impact of a
closed list in Dereham. The Board agreed we should seek assurance
from NHS England to ensure they are managing the situation. Joan to
write a letter expressing the Board’s concern.
Risk 14 – Deprivation of Liberty – The Board requested further
information from the Mental Health Sub Group on progress, which will
be reviewed at the next meeting.
Business Group Report
Joan to liaise with Julie Wvendth on how we can pick out relevant
issues for the NSAB.
Peer Review Sign Off
Norfolk County Council volunteered through the Eastern Region of
Authorities to sign up for a Peer Review, as Norfolk had appeared on
the recent CQC Safeguarding Inspection list.
Norfolk County Council felt the exercise was challenging and helpful,
with many of the actions now complete.
Lorna has work on the way to develop a new model of social work for
Adults and Children’s Services.
The Peer Review outcomes have been sent to Catherine Underwood
for sharing with the Making it Real group.
There is ongoing work for a stronger community approach, with
information being circulated to various community groups.
Harold is seeking the Board’s approval to sign off the work that has
been completed. Norfolk County Council will continue to concentrate
on the areas to complete.
Joan will take responsibility for the Board for item 3.5. Steve Holland to
be invited to present at the next Board meeting about progress on this
action.
It was noted that a number of actions have been rolled into business
as usual.
Cllr Morgan will liaise with Walter on how we can take this forward.
Safeguarding Adults Board Publicity Materials
The Chair asked for the Board to review the posters in their Board
papers and highlight their preference, including any comments they
wish to make. Feedback has already been sought from residents and
consumers. Please return the posters to Julie Shorten for collation. It
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Item
10.2
11
11.1
11.2
11.3
11.4
11.5
11.6
11.7
11.8
11.8
12
12.1
12.2
Minute
Action
is hoped that the posters will go to print as soon as possible so they
can be available by the end of July/early August.
The Board asked whether the posters were to be printed in other
languages, for example, Polish or Lithuanian. The Chair confirmed the
current posters are a starting point and other languages will be
considered at a later date. It was noted that the INTRAN logo will be
included on the leaflets.
SAR Group Update
Julie Wvendth is now chairing Safeguarding Adults Review Group
meetings. The SAR policy and procedure has recently been published
on the Website. The Board were asked to ensure they and other
agencies were aware of the referral forms and policy. The criteria and
process is listed. SARs will be reviewed by the SAR Group, where as
much agency information is included as possible to aid the decision
making process.
Cases will be logged on receipt, which will allow us to consider reviews
taking place by other bodies and cases being picked up by other
authorities.
Case AA is an agenda item. The SAR is in progress.
Case JD is a single agency review. A presentation will be given at the
SAR Group in September.
Case JC awaits additional agency information.
Case LY is a new referral agreed as a Health/NSFT. A TOR is in
progress and will be circulated for agreement.
Self-referral of young anorexic female. Howard will pick up the liaison
work to consider whether this meets the criteria. The case involves
three agencies.
Case OS involves a death at Norwich Prison. Reviewed through
internal Police network. Independent management report required
whilst in custody. A review is ongoing to establish the facts and to
assess whether the individual’s needs were met.
Sue requested for a central telephone number to be identified, so the
Prisons can inform of a death in custody. Julie W and Sue to discuss
this further.
Case JM – External Police investigation. Closed on register.
SAR AA Update
AA is a complex case that has required an independent report writer.
The case is nearing its final stage and has involved Norfolk and Suffolk
County Councils involvement. This case is strictly confidential and a
number of lessons can be learnt. A final report has been produced. It
was not possible to bring this case to today’s meeting as our Suffolk
colleagues are attending two SARs later this afternoon, so they were
unavailable. The Chair mentioned that the Board will be requested to
attend an urgent Extraordinary Board meeting alongside the Suffolk
Board to consider the SAR report. The meeting is likely to be
scheduled early September and the Board were asked to ensure their
attendance.
It was noted that costs involved in this case will be shared 50/50 with
Suffolk. The three main partners from each county (Health, Police,
Council) will then split the costs between them. Total costs are
estimated at £16-17K.
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Item
Minute
12.3
The meeting acknowledged that it was impossible to predict how many
SARs would be required, however, it was important to make an
allowance in the budget for these costs. The Chair agreed to take this
forward through the Governance Group.
Helen summarised the specific points of the case to the meeting. The
meeting heard that AA received CPA early 2000 following issues of
self-neglect. He managed to live independently. In 2011 his outreach
worker was made redundant following an reorganisation and his level
of support reduced. AA was discharged from CPA in 2013, which was
the beginning of the events that eventually led to his death in 2014.
The report highlights concern with the delayed assessment, the
significant amount of restraint that was used and issues surrounding
the transfer to Ipswich Hospital and the level of medication. The
reports makes recommendations for partners to work together to:
 Effectively support people who self-neglect;
 Involve the person and their family as appropriate in planning care;
 Consider the impact of organisational change on adults at risk;
 Improve the quality of multi-agency risk assessment and joint
decision making when managing complex case;
 Improve information sharing;
 Ensure the appropriate use of all types control and restraint
methods
The final report will be circulated to the SAR panel.
The Chair discussed the David Bennett case, who died as a result of
restraint. There needs to be more explicit information as to what is/not
acceptable restraint. Joan has met with the family, who are aware of
this case and she will meet with them again following the Extraordinary
Board meeting.
Due to the confidential and sensitive nature of AA’s report, the Board
agreed to hand back the paperwork at the end of the meeting.
Human Trafficking
Amanda Murr gave a presentation on Human Trafficking and Modern
Slavery. The report will be circulated at a later date.
The meeting heard that Human Trafficking numbers within Norfolk are
relatively low. The presentation explained the different types of
trafficking and the signs to look out for. Exploitation can include sexual,
domestic, forced labour, criminal, organ removal, forced begging/
benefit fraud/marriage etc.
Modern slavery can take many forms, including the trafficking of
people, forced labour, servitude and slavery.
Action: JM to forward AM contact details for her to link in with to
raise public awareness.
The Board discussed the need for training to raise awareness. Julie W
will put Community Champions to do work with LSAPs. There will be a
significant connection with District Councils, with localities linking with
Districts.
Joan to contact James to start engagement with the voluntary sector.
Dementia/Alzheimer’s in Care Homes
In Jenny McGibben’s absence, the Chair asked the Board how
reassured they were about the quality of care and services for
Dementia/Alzheimer sufferers in the community or residential care.
12.2
12.3
12.4
12.5
13
13.1
13.2
13.3
13.3
13.4
13.5
14
14.1
NSAB – 15.07.15
Action
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Item
14.2
14.3
14.4
15
15.1
Minute
Action
The Chair pointed out that Norfolk had one of the highest number of
elderly residents in the country, many of which live alone in old age.
The Chair shared that Jenny had some resource that could carry out a
data gathering exercise from CQC reports and health reports. Joan
agreed to follow this up with Jenny. Ian is happy to support as this is
something that is already on his radar.
Lorna commented that there has been an increase in referrals which
indicates an awareness. Care homes are struggling with this increase.
Joan agreed to contact Willie Cruickshank to discuss this further and
work with Jenny on a proposal for the Board on how to take this
forward.
It was noted that some shops have signs displayed advising they are
dementia friendly.
Any Other Business
Open Space – Stuart questioned which route the Fire Service should
take for counter-terrorism and radicalisation referrals. There are two
routes and two different sets of documentation, namely Prevention and
Safeguarding.
Action: James to speak with Mike Fawcett regarding the need for
clarity. Stuart/James to discuss this further and produce a report
on how this can be resolved.
Date of next meeting
Thursday 15 October 2015, 10.00-13.00, The Filby Room, Police
Headquarters, Jubilee House, Falconers Chase, Wymondham
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Item
5.2
6.2
6.6
6.7
6.8
7.2
7.3
7.4
7.6
7.7
7.8
7.9
7.10
Action Log
Item 5 – Walter advised that the first Self-Neglect Task & Finish Group
has been set up in August.
Action: Nigel to arrange for a Housing representative from
Norwich City Council to attend this meeting.
Safeguarding Week – Safeguarding Week commences Monday 7
September. Joan asked the Board to review the publicity material
(item 10) in the pack and choose their preferred design, adding
comments if they wished. The posters will be collected at the end of
the meeting. It is hoped that the posters will go to print shortly so they
can be available by mid-August.
Will Styles advised that HMP held similar campaigns where
merchandise was used to publicise contact details. Will agreed to
source merchandise quotes and will forward to Joan and Julie.
Mental Capacity & DoLs – Alison Simpkin has highlighted the
challenges around the lack of psychiatric beds for adults of working
age and older people. The Board needs to give this some serious
thought over the next few months.
HT to invite Alison Simpkin to the next Board meeting
Julie to forward the Risk Register as the papers were not included in
the pack.
The meeting discussed how the data should be presented, for example
by quarter. It was noted that the timing of meetings and the availability
of data should be taken into consideration, as there could be a time lag
which will need to be managed going forward. Kate also asked how
many quarters of historical data were required.
The Board agreed to review the papers and provide feedback
regarding layout, metrics etc. It was agreed that the Dashboard should
be kept simple. Feedback on the layout was very positive.
Julie Wvendth to catch up with Harold and Lorna regarding the impact
of increased DoLs on the Coroner service and need for Police
attendance.
The intensive GP training could have caused some increase in addition
to the Cheshire West ruling. The Chair will ask Alison Simpkin for an
update on DoLS at the next Board meeting.
Jackie Schneider questioned how the Board audits the effectiveness of
our own processes. Helen explained that as a result of the Peer
Review, one action was to introduce an audit of safeguarding cases at
Norfolk County Council. Jackie thought it should be wider across
organisations so that all organisations take responsibility. Joan agreed
that the Board required something it owned for consistency of
measurement.
Action: Joan to follow this up with Jackie and Julie W.
Joan and Walter will look at arranging a smaller group to agree what
appropriate actions were required.
Risk 20 – Joan confirmed that virtual Governance Sub-Committee had
been established.
Risk 17 – It was noted that there was an increasing reliance of the
voluntary sector. There is concern around the governance and the
contract the organisation might hold. Joan and Howard to take back to
the Business Group meeting. Harold stated that there is a risk as
strategic organisations shrink whilst financial pressures increase, so
that we will be moving out of our territory. We are trying to manage
NSAB – 15.07.15
Page 8 of 10
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NA
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ALL
HT
JS
ALL
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8.1
9.7
9.8
9.9
10.1
11.7
11.8
12.3
13.3
13.4
13.5
14.2
14.3
this as safely as we can. The new model of Community Social work
goes beyond what is in the contract.
Risk 6 – Mental Capacity Act – Good progress has been made with
understanding awareness. Joan to request the Mental Health Sub
Group to provide an update in time for the next meeting.
Risk 16 – GP Practices – There is concern about the impact of a
closed list in Dereham. The Board agreed we should seek assurance
from NHS England to ensure they are managing the situation. Joan to
write a letter expressing the Board’s concern.
Risk 14 – Deprivation of Liberty – The Board requested further
information from the Mental Health Sub Group on progress, which will
be reviewed at the next meeting.
Joan to liaise with Julie Wvendth on how we can pick out relevant
issues for the NSAB.
Joan will take responsibility for the Board for item 3.5. Steve Holland to
be invited to present at the next Board meeting about progress on this
action.
It was noted that a number of actions have been rolled into business
as usual.
Cllr Morgan will liaise with Walter on how we can take this forward.
The Chair asked for the Board to review the posters in their Board
papers and highlight their preference, including any comments they
wish to make. Feedback has already been sought from residents and
consumers. Please return the posters to Julie Shorten for collation. It
is hoped that the posters will go to print as soon as possible so they
can be available by the end of July/early August.
Self-referral of young anorexic female. Howard will pick up the liaison
work to consider whether this meets the criteria. The case involves
three agencies.
Case OS involves a death at Norwich Prison. Reviewed through
internal Police network. Independent management report required
whilst in custody. A review is ongoing to establish the facts and to
assess whether the individual’s needs were met.
Sue requested for a central telephone number to be identified, so the
Prisons can inform of a death in custody. Julie W and Sue to discuss
this further.
The meeting acknowledged that it was impossible to predict how many
SARs would be required, however, it was important to make an
allowance in the budget for these costs. The Chair agreed to take this
forward through the Governance Group.
Action: JM to forward AM contact details for her to link in with to
raise public awareness.
The Board discussed the need for training to raise awareness. Julie W
will put Community Champions to do work with LSAPs. There will be a
significant connection with District Councils, with localities linking with
Districts.
Joan to contact James to start engagement with the voluntary sector.
The Chair shared that Jenny had some resource that could carry out a
data gathering exercise from CQC reports and health reports. Joan
agreed to follow this up with Jenny. Ian is happy to support as this is
something that is already on his radar.
Lorna commented that there has been an increase in referrals which
indicates an awareness. Care homes are struggling with this increase.
NSAB – 15.07.15
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JM
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JM
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JW
JM
JM
JM
14.4
15
15.1
Joan agreed to contact Willie Cruickshank to discuss this further and
work with Jenny on a proposal for the Board on how to take this
forward.
It was noted that some shops have signs displayed advising they are
dementia friendly.
Any Other Business
Open Space – Stuart questioned which route the Fire Service should
take for counter-terrorism and radicalisation referrals. There are two
routes and two different sets of documentation, namely Prevention and
Safeguarding.
Action: James to speak with Mike Fawcett regarding the need for
clarity. Stuart/James to discuss this further and produce a report
on how this can be resolved.
NSAB – 15.07.15
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