Care Act 2014 Consultation Webinar For the Safeguarding Adults Return (SAR) and Surveys Collections January 2015 What is the Care Act? • Act of law, passed by parliament in May 2014 • Represents significant changes to the law regarding the care and support of adults • Includes new laws about safeguarding: – Section 42: Duty to make safeguarding enquiries – Section 43: Duty to have Safeguarding Adults Boards – Section 44: Duty to have Safeguarding Adults Reviews – Section 45: Duty to share information • For more information: http://www.legislation.gov.uk/ukpga/2014/23/contents/enacted 2 Why are we doing a consultation? • HSCIC data collections need to be updated to reflect new policy and practice • HSCIC has to consult with stakeholders to agree what changes are necessary and actionable How were the SAR proposals developed? • Care Act 2014 Statutory Guidance released in October 2014 https://www.gov.uk/government/publications/care-act-2014-statutoryguidance-for-implementation • Draft proforma designed through collaboration between HSCIC and SAR working group • Number of versions drafted and reviewed 3 How can I respond to the consultation? Go to the HSCIC consultation website: http://www.hscic.gov.uk/article/5276/Consultation-on-the-datarequirements-for-the-Safeguarding-Adults-Return-and-Adult-SocialCare-User-and-Carer-Surveys-in-response-to-the-Care-Act 4 Read the support document 5 Respond online, by email or by post 6 Support with responding to the consultation Safeguarding Queries Email the mailbox: safe.guarding1@hscic.gov.uk Speak to Emma Hodges: 0113 254 2442 Survey Queries Email the mailbox: usersurvey@hscic.gov.uk 7 Surveys Collections Jonathan Kilworth Surveys Adult Social Care Survey Every year, includes service users aged 18 and over in receipt of services funded wholly or in part by Social Services. Survey of Adult Carers in England Every two years, includes those aged 18 or over, caring for someone aged 18 or over in receipt of services funded wholly or in part by Social Services. Possible Topics to Consider Wellbeing: the surveys ask questions about Quality of Life; does/should the survey address wellbeing and if so, how? Choice: should the surveys address people’s perception of how much choice they are being given, for example via personal budgets? Short term and Preventative Support: what should the proposed survey of short term support cover, how should it be carried out, if the two existing surveys continue? Consultation respondents: help the consultation reach the appropriate audience! For example, your commissioning team may have a useful and different perspective on surveys in relation to the Care Act. the team responsible for surveys. 9 Safeguarding Collection Emma Hodges Terminology used in the consultation Safeguarding Concern Definition: • The first conversation between a person concerned about abuse or a risk of abuse and a council colleague. • Must be judged to be a safeguarding issue by the council colleague receiving the information to be counted as a safeguarding concern in SAR. Note: A conversation might not be necessary if the person identifying abuse works for the council and also carries out the necessary safeguarding. This should still be counted as a safeguarding concern. 11 Terminology used in the consultation Safeguarding Enquiry Definition: • The enquiries and actions (if any) instigated by the council safeguarding function AFTER receiving a safeguarding concern. • Must be confirmed as a safeguarding issue by the council safeguarding function to be counted as a safeguarding enquiry in the SAR. 12 Notes on safeguarding enquiries • An Enquiry begins when enquiries are instigated and ends when all necessary enquiries are complete and all necessary actions have been agreed (if any). • Enquiries are not the same as referrals • Enquiries can be formal or informal • The old local safeguarding thresholds no longer apply • New universal threshold – Safeguarding enquiries must be instigated if the adult meets the section 42 criteria • Councils are likely to carry out some safeguarding enquiries for adults who don’t meet the section 42 criteria 13 Process Example - Safeguarding Concerns 100 concerns identified by care professionals 100 concerns identified by general public First conversation between the person who identified a concern and the council contact centre / safeguarding function Council colleague agrees it is a safeguarding issue = 180 Safeguarding Concerns Council colleague does not agree it is a safeguarding issue = 20 Non Safeguarding Concerns 14 Process Example - Safeguarding Enquiries 180 safeguarding concerns received by council SG function SG function instigate enquiries (fact finding) From this point forwards they are classed as an enquiry. HOWEVER, may not all turn out to be safeguarding enquiries Confirmed cause for concern = 160 Safeguarding Enquiries Unconfirmed / unrelated to safeguarding = 20 Non Safeguarding Enquiries 15 There are 2 types of Safeguarding Enquiries 160 Safeguarding Enquiries managed by the council safeguarding function Type is determined by section 42 of the care act. Have all the section 42 criteria been met? • The council suspect abuse / risk of abuse • The adult has care and support needs • The adult is unable to protect themselves 130 cases YES = Statutory / S42 Safeguarding Enquiries 30 cases NO = Non Statutory / Other Safeguarding Enquiries 16 Safeguarding Proposals Key things to bear in mind • Usefulness questions - We are asking if it is useful to see this data at a national level not if it is useful to collect locally. • Cost questions - Referring to the compilation and reporting of new or amended data items not the operational costs of becoming Care Act compliant. • The 2015-16 proforma will be available at the end of March 2015 • We don’t expect local systems to be ready to accommodate all of these proposals in April 2015. 18 Proposal 1- Demographic tables Current return • SG1 tables collect counts of individuals involved in referrals that were opened during the reporting year • Split out by whether individuals known to CASSR and different demographics – age, gender etc. Table SG1a Classification Number of individuals by age 18-64 65-74 75-84 Already known to CASSR Previously unknown to CASSR Table SG1b Classification Already known to CASSR Previously unknown to CASSR Number of Individuals by gender Male Female Gender Unknown 85-94 95+ Age Unknown Proposal 1 – Demographic tables Proposed return • Keep the age and gender categories • Remove the known and unknown to CASSR categories (see proposal 10 of the consultation to give your opinion on this topic) • Replace with metrics determined most useful by the consultation (see proposal 1 of the consultation to give your opinion on this topic) • These changes will apply to all SG1 tables Age Group Table SG1a Metrics 18-64 65-74 75-84 85-94 95+ Age Unknown NUMBER OF SAFEGUARDING CONCERNS NUMBER OF STATUTORY SAFEGUARDING ENQUIRIES NUMBER OF NON STATUTORY SAFEGUARDING ENQUIRIES NUMBER OF INDIVIDUALS INVOLVED IN SAFEGUARDING CONCERNS NUMBER OF INDIVIDUALS INVOLVED IN STATUTORY SAFEGUARDING ENQUIRIES NUMBER OF INDIVIDUALS INVOLVED IN NON STATUTORY SAFEGUARDING ENQUIRIES Gender Table SG1b Metrics Male Female Gender Unknown NUMBER OF SAFEGUARDING CONCERNS NUMBER OF STATUTORY SAFEGUARDING ENQUIRIES NUMBER OF NON STATUTORY SAFEGUARDING ENQUIRIES NUMBER OF INDIVIDUALS INVOLVED IN SAFEGUARDING CONCERNS NUMBER OF INDIVIDUALS INVOLVED IN STATUTORY SAFEGUARDING ENQUIRIES NUMBER OF INDIVIDUALS INVOLVED IN NON STATUTORY SAFEGUARDING ENQUIRIES 20 Proposal 2 – Case detail tables Current return • SG3 tables collect counts of allegations from referrals that concluded during the year • SG3 tables include information about the type of risk, location of risk, case conclusions, the action and result of the referral. • Each of these tables are currently split out by the source of risk Table SG3a Type of risk Source of risk Social Care Support Other - Known to Individual Other Unknown to Individual Physical Sexual Psychological and Emotional Financial and Material Neglect and Omission Discriminatory Institutional 21 Proposal 2 – Case detail tables Proposed return • For all of the SG2 tables, should we collect counts of: – All enquiries – Just the statutory enquiries – Both statutory and non statutory enquiries • The first two options would generate 3 columns of data per table • The third option would generate 6 columns per table Table SG2a Types of risk CONCLUDED STATUTORY ENQUIRIES SOURCE OF RISK Service Provider Other - Known to Individual Other Unknown to Individual CONCLUDED NON STATUTORY ENQUIRIES SOURCE OF RISK Service Provider Other Known to Individual Other Unknown to Individual Physical Abuse Domestic Abuse Sexual Abuse Sexual Exploitation Psychological Abuse Financial or Material Abuse Modern Slavery Discriminatory Abuse Organisational Abuse Neglect and Acts of Omission Self-neglect 22 Proposal 3 – Mental capacity table Current return • SG6 table collects counts of referrals that concluded during the year Table SG6 Number of concluded referrals Was the individual lacking capacity? 18-64 65-74 75-84 85-94 95+ Age Unknown Yes No Don’t know Not recorded Of the concluded referrals recorded as yes in row 1, in how many of these cases was support provided? Proposed return • SG3 mental capacity table to follow the same structure as current return • Decision needs to be made about which metric or metrics to collect: – – – • • All enquiries Just the statutory enquiries Both statutory and non statutory enquiries The first two options would generate 1 table of mental capacity data The third option would generate 2 tables of mental capacity data 23 Proposal 4 – Source of risk categories Current return • SG3 tables have 3 categories for the source of risk Table SG3a Type of risk Source of risk Social Care Support Other - Known to Individual Other Unknown to Individual Physical Sexual Psychological and Emotional Financial and Material Neglect and Omission Discriminatory Institutional Proposed return • Change the ‘Social Care Support’ category to ‘Service Provider’ • To encompass both health and social care workers rather than isolate social care workers 24 Proposal 5 – Type of abuse categories Current return • SG3a table collects the following categories: – – – – – – – Physical Abuse Sexual Abuse Psychological Abuse Financial or Material Abuse Discriminatory Abuse Organisational Abuse Neglect and Acts of Omission Proposed return • Continue to collect the above categories • In addition to these, should we also collect the following new categories: – – – – Domestic Abuse Modern Slavery Self-neglect Sexual Exploitation NB – Some categories overlap each other. A safeguarding incident could be labelled as one or more of these types of abuse. Councils should record all types of abuse that are applicable to each enquiry. 25 Proposal 6 – Risk tables Current return • The categories in table SG3c combine information about the action taken and result of action taken Source of risk Table SG3c Action and Result Social Care Support Other - Known to Individual Other Unknown to Individual No Action Taken Action taken and risk remains Action taken and risk reduced Action taken and risk removed Issue with current return • Not enough options in the table to cover all eventualities • Examples: – – Action may be taken even if no safeguarding risk is identified (adult at risk could be referred for care assessment or review) A risk could be identified but no action is taken (source of risk might pass away therefore removing the risk) 26 Proposal 6 – Risk tables Proposed return • Separate the information about action taken and the result of action taken • Have two tables on this topic area rather than one • Table SG2e would only include cases where a risk was identified Table SG2c Risk Assessment Outcomes: Was a risk identified and was any action taken / planned to be taken? Risk identified and action taken Risk identified and no action taken Risk assessment inconclusive and action taken Risk assessment inconclusive and no action taken No risk identified and action taken No risk identified and no action taken Table SG2e Risk Outcomes: Where a risk was identified, what was the outcome / expected outcome when the case was concluded? CONCLUDED STATUTORY ENQUIRIES SOURCE OF RISK Service Provider Other Other - Known Unknown to to Individual Individual CONCLUDED STATUTORY ENQUIRIES SOURCE OF RISK Service Provider Other Other - Known Unknown to to Individual Individual Risk Remained Risk Reduced Risk Removed 27 Proposal 7 – Action table Current return • The type of action taken as a result of the safeguarding concern is not currently collected Proposed Return • It might be useful to have a table of actions • If people agree with this, which actions should we include? Table SG2d Action Taken CONCLUDED STATUTORY ENQUIRIES SOURCE OF RISK Service Provider Other Other - Known Unknown to to Individual Individual Relating to the adult at risk: Assessment of care and support needs Review of care and support needs Moved to different location Management of access to the source of risk Management of access to finances Regular reviews Referred for counselling Referred for training Other action Relating to the source of risk: Assessment of care and support needs Review of care and support needs Moved to different location Management of access to the adult at risk Management of access to finances Regular reviews Referred for counselling Referred for training Police action Disciplinary action Other action 28 Proposal 8 – Case conclusion table Current return • Table SG3d collects information about case conclusions Source of risk Table SG3d Conclusion Social Care Support Other - Known to Individual Other Unknown to Individual Fully Substantiated Partially Substantiated Inconclusive Not Substantiated Investigation Ceased Proposed return • It is proposed that case conclusions are no longer collected • Case conclusions are felt to be out of step with current policy • Outcome measures should focus on the wishes of the individual 29 Proposal 9 – Making Safeguarding Personal (MSP) Making Safeguarding Personal • MSP is about having conversations with people about how we might respond in safeguarding situations • Aims to enhance involvement, choice and control as well as improving quality of life, wellbeing and safety. • The Care Act advocates a person centred rather than process driven approach Current return • Information about MSP is not currently collected Proposed Return • It might be useful to collect data on MSP Table SG4 For each enquiry, was the individual or individual's representative asked what their desired outcomes were? Number of concluded enquiries 18-64 65-74 75-84 85-94 95+ Age Unknown 95+ Age Unknown Yes No Don’t know Not recorded Number of concluded enquiries Of the enquiries recorded as Yes in row 1 of this table, in how many of these cases were the desired outcomes achieved? 18-64 65-74 75-84 85-94 Fully Achieved Partially Achieved Not Achieved 30 Proposal 10 – Known to CASSR Current return • As discussed in proposal 1, the SG1 tables are currently split out by whether individuals were known to the council as shown below Proposed return • Cease collecting information about whether individuals were already known to the council 31 Proposal 11 – Community service category Current return • Table SG3b currently has a location category of ‘Community Service’ Table SG3b Location of risk Source of risk Social Care Support Other - Known to Individual Other Unknown to Individual Care Home Hospital Own Home Community Service Other Proposed return • Split out the community service category into two separate categories: – – • In the community (excluding community services) In a community service The community service category would relate to locations such as a day care centre and the community category would relate to any other area of the community, for example, a pub. 32 Any Questions? Please get in touch! Safeguarding Queries Email the mailbox: safe.guarding1@hscic.gov.uk Speak to Emma Hodges: 0113 254 2442 Survey Queries Email the mailbox: usersurvey@hscic.gov.uk 33