Minutes of the Meeting held on Friday 18 July 2014 in the Filby Room, Police Headquarters, Jubilee House, Falconers Chase, Wymondham, Norwich NR18 0WW Present: Joan Maughan – Independent Chair Michelle Allott – Norfolk & Suffolk Foundation Trust (rep Jane Sayer) Nigel Andrews – Tenancy Support Manager, Norwich City Council Lorraryne Barrett - Head of Service, Community Services, Adult Care (also rep Debbie Olley) Harold Bodmer – Director, Community Services, Adult Care Dawn Collins – Assistant Director of Nursing, Norfolk & Norwich University Hospital Steve Fuller – General Manager, Futures Day Care Centre Ltd Donna Hewitt – Team Manger, Deprivation of Liberty Safeguards, Community Services, Adult Care (re Andrea Wright) Terry Hicks – Assistant General Manager, West Norfolk, East of England Ambulance Service NHS Trust (rep Anneliese Hillyer-Thake) Pete Hornby – Detective Chief Inspector, Norfolk Constabulary (rep Nick Dean) James Kearns – Chief Executive Officer, BUILD Norwich Karina Kennell – Advocacy Manager, Alzheimer Society (rep Jo Cook) Walter Lloyd-Smith – Safeguarding Adults Lead, East Coast Community Health Care Roger Morgan - Quality Assurance Manager, Community Services, Adult Care Linda Naylor – Safeguarding Adults Co-ordinator, Community Services, Adult Care Kate Rudkin – Head of Development and Operations, Age UK, Norfolk Mavis Spencer – Deputy Director of Nursing, NHS England Howard Stanley – Senior Nurse and Safeguarding Adults Lead – Norfolk Clinical Commissioning Groups (also rep Jackie Schneider) Ann Taylor – Head of Social Care – Southern, Adult Social Care (also representing Debbie Olley) Helen Thacker – Manager, Safeguarding Adults, Community Services, Adult Care Anne Tansley-Thomas – Service User Engagement Officer, Norfolk (Observer) Jan Cant – Business Support Officer, Safeguarding Adults, Adult Social Care Item 1 2 Minute Declarations of Interest None reported Apologies for Absence Pip Coker – Chief Executive Julian Support Jo Cook – Head of Social Care (Northern), Community Services, Adult Care Nick Dean – Acting Chief Constable, Norfolk Constabulary Anneliese Hillyer-Thake – Safeguarding Adults & Children Lead, East of England Ambulance Service NHS Trust Peter McGuiness – Service Manager, Red Cross Donna Monk – MAPPA Co-ordinator, Norfolk Constabulary, Vulnerable Person Directorate Anna Morgan – Director of Service Pathways, Norfolk Commuity Health Care Elizabeth Morgan – County Councillor, Deputy Chair, Adult Social Care Committee Debbie Olley – Assistant Director, Integrated Services, Community Services, Adult Care (representative Ann Taylor) Jane Sayer – Director of Nursing, Quality & Patient Safety, Norfolk & Suffolk NHS Foundation Trust (representative Sarrana Burgess) Jackie Schneider – Head of Patient Safety, North Norfolk CCG Mark Talbot – Vice Chair ARMC Helen Thacker – Manger, Safeguarding Adults, Community Services, Adult Care Louise Trainor – Compliance Inspector, Care Quality Commission (CQC) Andrea Wright – Head of Service, Mental health Partnership, Community Services, Adult Care Welcome to New Independent Chair – Harold Bodmer A warm welcome was extended to the newly appointed Independent Chair, Joan Maughan on behalf of the Board by Harold Bodmer. The recent Safeguarding Adults Peer Review has identified key recommendations for ways forward including Joan needing to steer the Board through the challenges to statutory status in April 2015. Joan thanked Harold for his welcome and was very pleased to be given the opportunity to Chair the Board in challenging times. She had noted that the 2 Action Safeguarding Adults Peer Review gave Safeguarding in Norfolk a good press but there needs to be radical thought to ensure that the work and membership of the Board and sub-groups is fit and ready for April 2015 to ensure maximum influence by working together, to take the Safeguarding Agenda forward. Joan was pleased that mentoring arrangements for her new role will be given by Mike Gibbs, Lead of the Peer Review Team. Joan invited the Board to let her know of any expectations they may have of her. 3 4 Confirmation of any part of the minutes that is exempt under the Freedom of Information Act State if Whole report or the Section number(s) involved:- None Exemption(s):- None Approval of Minutes The group agreed that the minutes of the 22 January 2014 represented an accurate record of that meeting and they were to be finalised. Signed as a definitive record of the meeting. 5 ……………………………………. …………….. (Chair of the meeting) Matters Arising from the Previous Meeting Item 4: Matters Arising- Letter to Norman Lamb MP regarding non co-operation of information sharing from service providers It was confirmed that a reply had not yet been received. Chair to write a follow-up letter to Norman Lamb MP Item 4: Matters Arising - Letter to Norman Lamb MP regarding DBS Scheme It was confirmed that a report from officials, as requested b Mr Lamb, on the matter had not been received. Chair to write to request status and details of report. Item 6: WLSAP Report – Payment for Safeguarding Adults Courses It was reported that discussions had been held and confirmed that volunteer organisations are no longer required to pay for training. It was recommended that 3 Joan Maughan Joan Maughan any organisations unable to pay be advised to contact IMPACT directly to discuss. It was reported that work continues to engage the voluntary sector and training. A paper to be presented at October Board. Item 11: Whistleblowing Policy It was confirmed that a request for a Board Whistleblowing Policy template had not been drafted as it was inappropriate, being the responsibility of all organisations to identify their own. However, 10 organisations’ policies had been reviewed on be behalf of the Board. The Norfolk & Suffolk Foundation Trust were happy for their example to be used by any organisations. Any amendments will be shared. A copy available by request from Jan Cant (jan.cant@norfolk.gov). Item 15: AOB – 2. Major Provider It was reported that following further investigations CQC had re-visited the provider in July 2014, report not yet published. It confirmed that Norfolk CCGs have now lifted suspension of placements and are working to develop stronger links with the service provider. 6 Report to Board: Locality Safeguarding Partnerships. (The Chair thanked all authors of the LSAP reports. There was an expectation that all reports previously circulated have been read. Representatives at the meeting to highlight key matters only and to invite questions from the Board on their full report) Central Locality Safeguarding Adults Partnership (CLSAP): Quarterly report previously circulated to Board. It was reported that the conference, focussing on Female Genital Mutilation will be held on 16 September 2014 and open to all professionals. It was recommended that the group consider using the new website to also promote their conference. The group continue to have a closed section of the meeting, members finding it beneficial to discuss and learn from any complex cases discussed. Northern Locality Safeguarding Adults Partnership (NLSAP): 4 Walter LloydSmith Quarterly report previously circulated to Board. It was confirmed that the group’s request to the Board to consider how referrer’s can have a level of feedback (as appropriate) will form part of the work of the Peer Review Action Plan. Southern Locality Safeguarding Adults Partnership (SLSAP): Quarterly report previously circulated to Board. It was reported that the group looked closely at significant data on care homes in their locality and had added their concerns to the Risk Register. The meeting had it’s first closed section, inviting all to stay, using case details regarding people volunteering and entering into personal relationships, case details did not name individuals. Those who attended found the discussions very useful. A presentation to the group by Becky Booth, Safeguarding Adults Practice Consultant, giving 4 scenarios of “was it” or “was it not” Safeguarding. These were well received and generate lots of questions. Eastern Locality Safeguarding Adults Partnership (ELSAP): Quarterly report previously circulate to the Board. It was reported that their has been key changes in active partnership engagement believed to be due to the increase of workload of partners as their organisations are being reconfigured. The group are keen to explore ways to engage with local hairdressers and what key messages they might be able to deliver. The group’s closed section to facilitate discussion of complex cases produced long and lively debate but concerns shared that, whilst there is a high degree of trust between present members of the group regarding confidentiality, they would not adopt this format for future meetings. Consideration will be given to discussion of cases that do not share individual details. Western Locality Safeguarding Adults Partnership ( WLSAP): Quarterly report previously circulated to the Board. It was reported that group continue to work on their local event “Safeguarding Together” with an 5 emphasis on service user involvement to be held on 17 September 2014 at Kings Lynn Youth & Community Centre. The group formally proposed that volunteer Safeguarding Champions are recruited in all localities as detailed in paper. WLSAP would be happy to pilot the scheme. It was noted that this was a very positive proposal and especially useful for getting feedback from service users and promoting awareness. Concerns were shared that individuals recruited to the role would need to receive appropriate training and a clear role/task description set. Clear terms of reference would need to be adopted to fully support awareness across all organisations and the wider community. Parallels with Health Watch and Dementia Friendly Linda were identified. Naylor/Anne TansleyIt was unanimously AGREED that a pilot recruitment Thomas/Steve of Safeguarding Champions should be achieved. A Fuller letter to be drafted to all potential volunteers. Reports were received and approved by the Board. NB: ALL quarterly reports to the Board for circulation to be received no later than 11 days prior to each Board meeting. 7 Report to the Board – Sub Groups (The Chair thanked all authors of the Sub-group reports. There was an expectation that all reports previously circulated have been read. Representatives at the meeting to highlight key matters only and to invite questions from the Board on their full report) Training and Policy: Quarterly Report previously circulated to the Board. It was reported that a Task & Finish group continue to work on updating the Safeguarding Adults Review – SAR (previously known as the Serious Case Review SCR) process including the Policy, Procedure and SAR referral application route. Momentum for training validation had faltered but it was hoped that a re-launch using the new website 6 would generate more applicants. It was noted that the momentum had reduced because of individual panels needing to be cancelled due to pressure of normal work load. It was proposed that the TVP Panel of 5 members was reduced to a minimum of 3 members for practicality purposes. 1 member of the Training & Policy Sub-Group; 1 member of the Board; 1 other. Unanimously AGREED. Discussed the potential resources needed for high numbers of training validation applications following a re-launch. Potential for Norfolk County Council Learning & Development Team to support Training Validation to be explored. Discussed funding that may be required for future TVPs. Chair of sub-group to look at realistic figures for costs of panel in 2015 and forward to Chair of Board to be included in Board funding forecasts. Harold Bodmer Walter LloydSmith/Joan Maughan It was noted that Suffolk Safeguarding Adults Board had requested details of Norfolk’s Training Validation process with a view to developing their own. Health: Quarterly Report previously circulated to the Board. It was reported that the group has achieved poor attendance, potentially because of work demands. The group would like guidance from the Board on what it wants from the Health Sub-group. It was noted that the Governance Model of the Board and Terms of Reference etc of individual subgroups/LSAPs would be reviewed by the new Independent Chair and debated at the Board’s Development Day in November. An Action Plan from the recent Norfolk County Council’s Peer Review, including recommendations for the Safeguarding Adults Board, has now been adopted and will be circulated to all Board members to review. Members of the Board were invited to join the Peer Review Action Group, that will meet monthly over the next 12 months, at any time. Mental Capacity Act/Deprivation of Liberty: Quarterly Report tabled. It was reported that there continue to be a high increase in the rate of referrals for Deprivation of 7 Lorrayne Barrett Liberty assessments with more training required for staff. There appears to be no national guidance and inconsistent guidance from neighbouring Counties, including significant additional costs and potential over spends by local authorities. The new burden of making referrals had also impacted on NHS staff. Concerns to be added to the Risk Register. Risk Owner Harold Bodmer. It was noted that blanket applications from service providers were now being refused. Care providers will be advised of the process and application to the Deprivation of Liberty Team via the local authority Quality Assurance Team. More information to be detailed at next meeting. Kate Rudkin Roger Morgan Andrea Wright Discussed concerns that the significant rise of referrals has delayed time from referral to assessment because of lack of resources. It was noted that Hospital and Learning Difficulties referrals take priority with an average 2 to 3 days (up to 1 week) response. Risk & Performance: Quarterly Report previously circulated to the Board. It was reported that the group had been looking at further statistics to identify trends, in particular regarding implications of implementation of the Care Act, increase of Deprivation of Liberty referrals and Section 75 transition period. It was confirmed that Norfolk County Council are working closely with Norfolk & Suffolk Foundation Trust but happy for any concerns to be placed on Risk Register. A full review of the master Risk Register to be a major item for the January Safeguarding Adults Board. Kate Rudkin Risk Register: Risk Register previously circulated to the Board. Discussed High level risks as identified on Risk Register. Risk 6: MCA knowledge gap for medical staff including GPs. It was reported that the Local Medical Council Steering Group is working to sponsor and promote training for GPs and front line practioners. It is expected that 3,000 MCA training places will be 8 Andrea required by the end of the year. A project Manager has now been appointed. Board to be updated at next meeting. Risk 7: Difficulty in accessing mental health referrals within acute and community settings. Chair of Risk & Performance Sub-group to discuss ways forward with NHS Safeguarding leads. Wright/Howard Stanley Kate Rudkin Risk 13: Safeguarding Adults Training Charging Policy It was confirmed that charging for Safeguarding training by voluntary organisations had now been withdrawn. Concerns were shared that this had not been communicated to those that need to access the training sufficiently. It was noted the IMPACT, contracted Norfolk County Council Safeguarding Adults trainers, meet with Linda Naylor and Kate Brown (Learning and Development Team) on a quarterly basis. Details of figures and Linda Naylor other relevant information from the meeting to be reported to the Board. Management Sub Group It was confirmed that the Management Group had met and had set the agenda for the Board meeting. The Chair of the Board will Chair all future Management Meetings. Details of the Management Group Action Plan/activities to be circulated with all future Board papers sent out prior to Board meeting. Reports were received and approved by the Board. NB: ALL quarterly reports to the Board for circulation to be received no later than 11 days prior to each Board meeting. 8 Ratification of SAR1 (previously circulated to the Board) It was confirmed that the SAR1 had been drafted following recent consideration of 3 possible Safeguarding Adults Review (SAR) cases when it was identified there was no robust protocol for raising a SAR. The draft SAR1 was in line with the Norfolk Children’s Board’s referral document as recommended by Norfolk County Council’s senior 9 Joan Maughan/Linda Naylor Solicitor (Pam Carey). It was expected that the SAR1 would be made available on the new website. Discussed the importance of making it clear the purpose and step by step process for making a SAR referral. NB: it is not the route for making a Safeguarding Adults referral. The SAR1 form should detail the purpose and criteria of an SAR – draft to be amended accordingly and circulated to all Board members for comment by 6 August 2014. 9 Peer Review Key findings Feedback – Harold Bodmer A sincere thank you was extended to colleagues and organisations of the Board who participated in the recent Peer Review requested by Norfolk County Council. It had been a very valuable exercise, interviewing approximate 200 people over a 1 week period. Key messages in the feedback report were A swift response to safeguarding alerts MASH adds value and has built a very good working relationship between the Police and Social Services Adult safeguarding has a sound foundation in Norfolk with no major issues Adult safeguarding has been largely protected from Council cuts but there remain issues regarding overall resources Adult safeguarding continues to be under the shadow of Children’s services Safeguarding Adults Board is ripe for a revamp and to be made ready for the implementation of the Care Act Practice and culture too process driven It was noted that the feed back report had been OK but not Excellent. Outcomes included Swift response to referrals Increase in individual transition plans Appointment of more effective IMCA service provider 10 Linda Naylor/ALL Good process for handling residential home closures Inconsistent feedback to referrers More rigorous and systematic auditing required More wider links and engagement with communities, including Community Safeguarding Partnerships Better user involvement Better use of advocacy service Inconsistent application of threshold Not using the rich experience of Health professionals and voluntary sector Discussed links within Safeguarding Adults by NHS partners and the complex arrangements and representations they have within their structure. Concerns were shared that the outcome of the report highlighted limited engagement with Health. It was felt that this miss represented Health’s involvement in Safeguarding in Norfolk. The Peer Review report did not capture Health’s significant past and present activity. It was noted that NHS England (Mavis Spencer) or CCG Safeguarding Lead (Howard Stanley) representatives on the Board were not interviewed. Did the Peer Review team interview the right people? Individual Board members were uncomfortable for not being part of the Peer Review process. A lack of involvement by Housing providers and District Councils were also identified in the report. This to be added to the Peer Review Action Group’s Action Plan at next meeting. Peer Review Action Group – Action Plan to be circulated to all Board members. It was recommended that Board members wishing to share any comments should send them to Jan Cant (jan.cant@norfolk.gov.uk) in time for the next meeting (18 August 2014). Board members were invited to join the Action Group at any time. An expectation was shared that all Board members read the document and give comments to be fed into the Action Group. A summary of commentary to be included in any update in order for the Board to respond. It was noted that the Adult Social Care Committee have over arching ownership of the Peer Review Action Plan. 11 Lorrayne Barrett ALL It was confirmed that, although there is a new advocacy service referrals to the service are not being made. 10 Care Act Update (previously known as Care Bill) It was reported that the Board’s Policy and Procedures, including Safeguarding Adults Review, had recently been reviewed in line with the new Care Act. Further review will be required when a final guidance document is issued. It was recommended that all organisations review their own policies and procedures accordingly. ALL It was noted that the advocacy element of the Act will need to be promoted within Norfolk as well as being a countrywide issue. 11 Communications Strategy It was confirmed that under the new Care Act, and identified in the Peer Review, that the Board has a responsibility to have good communications with its partners and the public. Presently the Board does not have a strategic approach to communications. It was recommended that the Board appoint a Task & Finish Group to look at how the Board needs to communicate Safeguarding Adults in Norfolk, in particular to the general public, and the most vulnerable and hard to reach communities. It was important that each LSAP was represented in the Group. A specific task for the group will be to produce a costed communications strategy. Informative costing for a Communication Strategy/Sub-group would need to be achieved. It was noted that the Chair (supported by Linda Naylor) will be attending the next Norfolk Chairs Meeting on 30 July 2014 when their will be opportunity to consider collaborate strategies that may include communications. Following the meeting, Chair to provide the Task & Finish Group with a Draft Terms of Reference. Task and Finish Group nominations Roger Morgan Howard Stanley 12 Joan Maughan Steve Fuller (Western LSAP) Walter Lloyd-Smith (Eastern LSAP) Michelle Allott Mavis Spencer Ann Taylor (Southern LSAP) Anne Tansley-Thomas Lorrayne Barrett Jo Cook (or nominated representative NLSAP) Mark Talbot (or nominated representative CLSAP) Meeting to be convened as soon as possible. Linda Naylor/Jan Cant 12 Housing Sub-Group It was confirmed that the inaugural meeting of the new Housing Sub-Group will be held on 4 August 2014 from 10am to 12 noon at the Henderson Business Centre, Norwich. 15 housing providers have been invited to join the group and the first meeting will endeavour to gauge what issues they may have and their understanding of Safeguarding in Norfolk. An update report will be given at the October Board meeting. 13 Nigel Andrews Known costs of Board (paper tabled) It was confirmed that the Board need to be clear on realistic figures for funding the Norfolk Safeguarding Board and its activities. The tabled paper set out known costs for 2014 and an estimated cost for 2015. It also included a “Shopping List” of funding expectations moving forward. Board members were invited to consider items that should be added to the shopping list and send details to either Linda Naylor (linda.naylor@norfolk.gov.uk) or Jan Cant (jan.cant@norfolk.gov.uk) by 15 August 2014. It was reported that CCGs, with the implementation of the Care Act, would consider looking to support the activities of the Norfolk Safeguarding Adults Board and be likely to increase their financial contribution. The CCGs will require a break down of what funds would be requested and the purpose for which funds would be used. They will be setting next years budgets shortly and will need information as soon as 13 ALL possible. It is believed that Police budgets will also be set soon. 14 It was confirmed that Norfolk county Council will not reduce their financial commitment to Safeguarding Adults but will be supporting a greater contribution form partners for additional funding. East Anglia Quality Surveillance Group (QS Group) update – Howard Stanley It was confirmed that the QS Group has met and a paper will be presented at October Board meeting. 15 16 Howard Stanley Strategic Work Plan from July 2014 It was reported that the Chair and Linda Naylor had been working on the Board’s Strategic Work Plan, fed by LSAP and Sub-Group Work Plans. This will form a dynamic exercise at the Board’s Development Day in November. The Strategic Work Plan will cover the next 3 years and will need to be owned by all Board members. A preparation document for the Development Day will be sent out will be sent out shortly. Any Other Business Linda Naylor 1. Website It was confirmed that the Board’s website is now live with each LSAP and Sub-group having a dedicated page. Any information that Board members wish to have included on the Website to forward details to Linda Naylor (linda.naylor@norfolk.gov.uk) for discussion. 2. Telephone Call to 0344 8008020 It was reported that when calling Adult Social Care to raise a Safeguarding Referral you do not speak to a person at the first stage and it is quite unclear what buttons you need to press to speak to a member of staff to make a referral. It was recommended that a change to the first stage message is made to ensure that the telephone route Linda Naylor for making a referral is clear. Linda Naylor to explore. 3. Retirement – Linda Naylor The Board were informed of the retirement in November 2014 of Linda Naylor, Safeguarding Adults Co-ordinator. 14 It was confirmed that following recommendations from the Peer Review that the Co-ordinator’s post would be reviewed to reflect future changes, in particular statutory status, before applicants were invited to apply for the vacancy. 3. Frequency and Future Meetings Discussed the potential to increase Board meetings to 6 per year with additional topic focussed days. It was noted that dates and venues for quarterly meetings would be identified as quickly as possible with additional meetings agreed during the year. It was confirmed that there was an expectation that Management Group would need to meet more frequently, with the potential for “virtual meetings” where necessary. It was AGREED that the Management Group’s Action Plan/details of activities should be regularly circulated to inform all Board members. 17 Discussed the potential to increase LSAP meetings which would be problematical for present membership. Consideration could be given to an additional 2 meetings to be used for subject specific discussion. Date of Next Meetings 16 October 2014 Wednesday 21 January 2015 Thursday 16 April 2015 Wednesday 15 July 2015 Thursday 15 October 2015 NB: All meetings will be held from 10am to 1pm. All meetings will be held in Filby Room, Police Headquarters, Jubilee House, Falconers Chase, Wymondham Norfolk NR18 0WW Parking is available at Waitrose (across the road from Police Headquarters). Please park in the numbered bays closest to the footpath leading to the Police Headquarters. No identification/parking permit is required on your car. All LSAP Chairs’ meetings will be held from 9am to 10am on the morning of each Board in the Barton Room. 15 Lorrayne Barrett