Hampshire Safeguarding Adults Board Safeguarding Adult Lead Network

Programme 09. 00 09. 15 09. 20 10: 05 10. 25 10. 40 Arrival, Registration & Refreshments Welcome and Introduction Safeguarding Update Table Top Discussion Break The work of Hampshire County Council Trading Standards, Safeguarding Team 11. 25 MASH Update 11. 55 Modern Day Slavery 12. 50 Questions & Answers 13: 00 Close of Event and Feedback Questionnaire

National and local developments in adult safeguarding

Care Act (2014) statutory guidance • An amended version of the statutory guidance published by the DH on 10 th March 2016. • Main change is the removal of the DASM role - replaced with requirement for allegations management policy re people in a position of trust • Some forms of abuse such as financial and domestic abuse have been expanded to reflect new legislation introduced since April 2015. • Revision tracker

Adult Abuse and Neglect Modern day slavery Domestic Abuse Sexual violence and exploitation Physical Scamming Sexual Financial Mate Crime What are we talking about? Hate Crime Honour Based Violence Organisational Neglect Discriminatory Exploitation by radicalisers Female genital mutilation Psychological/ Emotional Self neglect Forced Marriage

4 LSAB Safeguarding Policy • Refresh of the 4 LSAB multi-agency safeguarding policy in response to the changes to the Care Act statutory guidance. • Policy now updated - new information added re modern day slavery, Prevent, self neglect, risk management, scamming, domestic abuse and the management of allegations against people in a position of trust. • Available on the HSAB website as a web based resource • Website reviewed to make navigation easier – new section on guidance or providers

HSAB Website www. hampshiresab. org. uk

HSAB safeguarding plan – key priorities going forward • Wide awareness of adult abuse and neglect and its impact - engaging local communities • Prevention and early intervention – promoting wellbeing, safety and acting before harm occurs • Well equipped workforce across all sectors • Making Safeguarding Personal embedded across all sectors • Clear, effective governance processes in place across all organisations • Learning from experience - mechanisms in place to learn from serious cases and improve practice and services

Sounding Board Survey A survey of over 175 community and voluntary organisations Responses highlighted further work needed around raising awareness about adult abuse and neglect 2/3 had not seen leaflets or other publicity on adult abuse and were unsure of the reporting process Barriers to reporting: • Not understanding the behaviour is abusive • Fear of repercussions and reprisals • Fear of not being believed of becoming isolated or the loss of relationships. • A lack of confidence, pride, shame and embarrassment Enablers to reporting: • A more personalised approach and access to a trusted person • Greater support for informal carers and also victims of abuse • Fears of being seen as interfering or nosy • Access to advocacy, counselling services, support networks • Assumptions someone else will respond • Invest in rebuilding community spirit and caring for others.

HSAB Training Programme Training event 27 th April 8 th June 21 st July 16 th Aug 28 th Sept 12 th Sept 30 th Nov 7 th Dec Title Safeguarding Topic day Adult Lead (SAL) Multi-Agency Network event Risk Management Topic day Making Safeguarding Personal SAMA Network Safeguarding Adult Lead (SAL) Network event Conference Topic day Multi-Agency Risk Management Topic day Making Safeguarding Personal Duration ½ day course ½ day course Full Day ½ day courses Annual event providing an update on national and local developments and a spotlight on key topics of interest Introduction to the 4 LSAB Risk Management Framework Introduction to Making Safeguarding Personal Annual update on developments and sharing of good practice re allegations management Annual update on national and local developments and a spotlight on key topics of interest Joint conference with the HSCB: Introduction to the 4 LSAB Risk Management Framework Introduction to Making Safeguarding Personal Operational safeguarding leads (all sectors) Responders, decision makers, safeguarding specialists, managers All staff (all sectors) Partner agency SAMA leads Operational safeguarding All staff (all leads (all sectors) Responders, decision makers, safeguarding specialists, managers All staff (all sectors) Kings Community Church, Cedar Hall, Upper Northam Road Hedge End Southampton SO 304 B 7 Kings Community Church, Olive Room, Upper Northam Road Hedge End Southampton SO 304 B 7 Fort Southwick, James Callaghan Drive, Portsmouth, Fareham PO 17 6 AR Kings Community Church, Cedar Hall, Upper TBC Northam Road Hedge End Southampton SO 304 B 7 Kings Community Church, Olive Room, Upper Northam Road Hedge End Southampton SO 304 B 7 Purpose Target Audience Venue ‘Think Family’ and Domestic Abuse

Safeguarding Adult Lead Network • Leads on safeguarding for their organisation. • First point of contact for staff for advice if they have concerns. • Assesses information relating to • Ensures concerns are logged and stored securely • Knows the contact details of relevant statutory agencies e. g. adult services, Police, CCG, CQC, etc. concerns about adults at risk. • Ensures the organisation’s • Decides if concerns should be notified to adult services • Make safeguarding referrals. safeguarding policy and related policies are kept up to date. • Completes the Organisational Safeguarding Self Audit • Liaises with the relevant SAMA and • Annual update event LADO for their sector.

Resources to support SALs • Care Act Implementation Checklist • Safeguarding Self Audit Tool • Safeguarding Learning and Development Strategy • Guidance on producing an internal safeguarding policy • Engaging Hampshire Communities resources • Alerter Checklist • Publicity material on abuse and neglect • HSAB Website • SAL Network • Risk Management Framework • Responding to Self Neglect and Persistent Welfare Concerns • Allegations Management

Multi-Agency Risk Management Framework

Overview Multi-agency process for managing high risk, complex cases sitting outside statutory s 42 enquiry process. In complex cases, professionals are often dealing with long term and entrenched behaviours requiring a commitment to a longer term, solution-based approach with a focus on building trust and rapport. Provides a collaborative, coordinated and multi-agency response to these ‘critical few’ cases ensuring: v. Timely information sharing around risk; v. Identification and holistic assessment of risk; v. Development of shared risk management plans; v. Shared decision making and responsibility; v. Adult’s involvement and engagement in the process v. Improved outcomes for the adult at risk.

Process • Any agency can initiate the process • Collaborative risk assessment may – it takes the lead coordinating role with responsibility for convening and chairing the initial meeting. • Ensures timely information sharing between agencies – provides a holistic (multi-agency) overview of current risks and to develop a shared management plan. • Adult should, as far as possible, be included and involved in the assessment process and in developing the risk management plan highlight circumstances or risks which would be more appropriately dealt with under another process and a referral should be made • Process continues until the identified risks are either resolved or managed to an acceptable level. • Any on-going support needed to maintain well-being and safety should be agreed before the case is referred back into the ‘business as usual’ process for any on-going work.

Used when circumstances present an unmanageable level of risk to the organisation (not related to abuse or neglect by a 3 rd party) e. g. : • Vulnerability factors place the adult • On-going needs/behaviour leading to lifestyle choices placing them and/or others at risk; • Complex needs and behaviours leading the adult to cause harm to others; at a higher risk of abuse or neglect including mate crime, network abuse, etc. ; • ‘Toxic Trio’ of domestic violence, • Self neglect including hoarding and • Risks previously addressed via a fire safety; • Refusal or disengagement from mental health and substance misuse section 42 enquiry but for which the need for on-going risk management care and monitoring has been identified. and support services; • Complex or diverse needs which either fall between, or span a number of agencies’ statutory responsibilities or eligibility criteria;

When is someone at risk? An adult is considered to be ‘at risk’ when s/he is unable or unwilling to provide adequate care for him/herself and: v. Is unable to obtain necessary care to meet their needs; and/or v. Is unable to make reasonable or informed decisions because of their state of mental health or because they have a learning disability or an acquired brain injury; and/or v. Is unable to protect themselves adequately against potential exploitation or abuse; and/or v. Has refused essential services without which their health and safety needs cannot be met but do not have the insight to recognise this.

Capacity, consent and control • Adult’s right to make apparently unwise lifestyle choices and to refuse support should be respected. • Adult’s decisional and executive capacity to make a decision must be taken into account as well as their ability to understand to manage in practice any risks and safety implications of the choice or decision being made. • Information and advice about how to minimise risks to be given to the person who (with capacity) has refused to accept support • Information also about how they can access reassessment in the future should they change their minds. • Decisions (either by the adult or the agency) should be kept under constant review

Allegations Management

Statutory Guidance March 2016 Removes DASM role - replaced by a new requirements on managing allegations against ‘people in positions of trust’. Local agencies providing universal care and support services must have clear policies for dealing with allegations against people in positions of trust. • Reflect LSAB guidance • Clearly distinguish between an allegation, a concern about quality of care or practice and complaint. • Enable assessment of potential risks and actions needed to safeguard adults with care and support needs. • Includes clear recording and information-sharing guidance and timescales for action • Relates to current or historical allegation or concerns.

4 LSAB Allegations Management Guidance • An overarching framework setting standards around the management of allegations against people in a position of trust. • Supported by clear reporting requirements and arrangements across the whole system - this includes clear information-sharing arrangements and explicit timescales for action. • Individual member organisations are expected to develop its own business process detailing how it will implement this framework internally. • Ratified by all 4 SABs and replaces the joint DASM framework published in May 2015.

Underpinning principles • A proportionate, fair and transparent process building on current good practice and existing processes. • Each organisation responsible for taking action using their allegations management procedure • Clear reporting arrangements across the whole system built into contracts, commissioning arrangements, grant allocations, etc. • Timely, thorough action when concerns are raised with justifiable and proportionate information sharing • Well understood and managed interfaces with other processes(e. g. LADO, DBS, fitness to practice) and prompt referrals to relevant bodies • Clear recording of decisions and recommendations

Partner organisations responsibilities • Align (or develop) current allegations management processes in line with the standards set out in this framework. • Commissioners to use existing frameworks and processes to ensure allegations management and safe working procedures are in place within the organisations from whom they commission services. • Providers to adhere to reporting requirements and promptly share information about relevant incidents with their commissioners. • Statutory organisations to nominate a Safeguarding Allegations Management Advisor (SAMA) • Non statutory organisations to nominate a Safeguarding Adult Lead (SAL) • Each LSAB is responsible for leading development work in its area to support this

Effective governance • SPOC for allegations or concerns raised by other agencies • Gaining assurance that appropriate systems are in place to demonstrate: • Ensuring managers appropriately identify and manage risks • Management oversight of individual complex cases. • ‘Managing Concerns Meetings’ to assess and determine actions required. • Information sharing with statutory agency SAMAs and LADOs. - Effective risk assessment - Safeguarding actions carried out - Support/update the employee - Recording provides an audit trail - Prompt DBS/FTP referrals - DPA/Confidentiality compliance • Maintaining records of the no. and nature of allegations and using this data to inform service improvement

Interface with s 42 enquiries • Any concerns relating to a person in a position of trust who is alleged to have abused an adult with care and support needs must be reported and responded under the Hampshire Multi-Agency Safeguarding Adults Policy and Guidance. • These concerns could arise from the person’s home / personal life, as well as within their work. • Includes anyone working with adults with care and support needs such as paid or unpaid employees, volunteers, students and personal assistants

Circumstances relevant to s 42 enquiries • A ‘person in a position of trust’ has or is alleged to have abused an adult with care and support needs • A ‘person in a position of trust’ has behaved (or is alleged to have behaved) towards another adult in a way that indicates that they may pose a risk of harm to an adult with care and support needs • Includes situations involving an investigation into a criminal offence, even if the victim of that offence was not a person with care and support needs • A ‘person in a position of trust’ has behaved (or is alleged to have behaved) towards children in a way which means they could pose a risk of harm to adults with care and support needs.

Useful Links • www. hampshiresab. org. uk • www. skillsforcare. org. uk • http: //www. scie. org. uk/adults/safeguarding • https: //khub. net

Any comments or questions?

TABLE TOP DISCUSSION Personal reflection and experience in these area of new and emerging policy.

Financial Abuse

Multi-Agency Safeguarding Hub (MASH) Mandy Grahamsley

What is the MASH? • The MASH acts as a single front door for all children and adult safeguarding in Hampshire County Council area to receive, triage and support or case manage all safeguarding concerns for children and adults at risk. • The Hub supports children and adults at risk to prevent and stay safe from harm, neglect and abuse • It is made up of professionals across the public sector to deliver a true multi-agency approach when dealing with children's and adults’ safeguarding • Adults Health and Care (AHC) MASH screens and gathers information on all safeguarding concerns received by adult services in order to make defensible decisions on next steps • AHC MASH will consult with multi-agency strategic partners to review the risk and take immediate decisions and actions where required. • Where AHC MASH identifies that further information is required or that the concern meets the criteria for enquiries under Section 42 then these are forwarded to community teams to coordinate. • Adults Health and Care (AHC) MASH undertakes strategic developmental work with partner agencies around safeguarding, and delivers training both formally and informally both inhouse and externally

Mash partners Who are our partners sitting in the MASH AHC MASH is comprised of social workers, case workers, senior practitioners, a team manager, administrative assistants, project lead and a service manager. In addition AHC MASH is supported by professionals from across the statutory sector, helping to support adults at risk through effective and efficient partnerships and information sharing. Health Hampshire Police HFRS • Representatives from the health sector help to support with referrals related to health by liaising with other health professionals from the community and hospitals (2 nurses based in the team) • Representatives from Hampshire Constabulary help to deal with referrals related to criminal activity • Representatives from Hampshire Fire and Rescue services support with referrals where there is a concern around fire and safety risks (sit within the team) Hampshire Trading Standards • Representatives from trading standards support with referrals where there are concerns around scams or goods and services supplied to adults at risk (sit within the team) Children’s Services • AHC MASH is co-located with children’s services to support where there is a concern that a child/children may be at risk as a result or in conjunction with concerns around an adult at risk 37

What value does AHC MASH add to the customer? • • A timely and proportionate response to safeguarding concerns which are consistent and coordinated, identifying S 42 duties and providing a risk assessment and recommendations for further actions. Immediate multi agency assessment of risk with immediate agreement on protection planning Through prompt multi agency strategy discussion and the interrogation of alternative electronic records AHC MASH is able to identify potential risks which enables multi agency preventative action to be taken without delay Through immediate access to colleagues in emergency services, potential risks to service users, members of the public, the council and members of staff, are able to be quickly identified and necessary action taken to minimise these. This includes ‘blue light’ responses Closer partnership working leads to greater accountability and better decision-making, leading to a reduction in the number of inappropriate referrals and re-referrals. This in turn reduces duplication and time wastage Improved efficiency and reduction in the duplication of work across agencies through immediate and concise communication Clear focus on a customer-led journey commensurate with Making Safeguarding Personal principles to allow for an effective early intervention from all agencies 38

AHC MASH main focus and approach to safeguarding adults at risk Person Centred Approach Proportionate Fewer Enquiries • Working towards the outcomes that the person wants to help them manage the risk of abuse and/or neglect • Greater emphasis on ensuring that the person is fully involved with all decisions. • Greater autonomy for practitioners to determine the best approach • More ‘tools’ to help provide the relevant response • Greater emphasis on using professional judgement to determine if abuse occurred or not • Enquiries will only be needed when certain criteria are met

AHC MASH - Business Process • Currently AHC MASH manage all referrals to Adult Services where there is a safeguarding concern relating to an adult. • Referrals are received from a number of sources with the largest numbers being received from Police and Ambulance referrals. • In the first half of 2017 AHC received 10, 015 contacts compared to 8, 527 during the same period of 2016. • AHC MASH is seeing on average a 20% increase in referrals month on month compared to similar periods in 2016 and it is predicted these rates will continue to rise. • Currently AHC are resolving and closing 70% of all referrals with no further action required by adult services. • Of the remaining 30% of referrals, the current business process is to forward these referrals to community teams with recommendations. • Of these referrals a high proportion of concerns relate to service users not previously known to adult services. 40

AHC MASH - Current Activity AHC MASH Contacts Month Dec Contacts 2016 2017 % increase Nov Jan 1617 1670 3. 28% Oct Feb 1584 1435 -9. 41% Sept March 1259 1723 36. 85% Aug April 1266 1540 21. 64% May 1318 1812 37. 48% Jun 1483 1981 33. 58% May Jul 1469 1700 15. 72% April Aug 1508 1668 10. 61% Sept 1625 Feb Oct 1413 Jan Nov 1465 Dec 1713 2017 Jul Jun 2016 March 0 500 1000 1500 Number of contacts 2000 2500 41

Referrals by Source 1000 900 800 700 Number 600 Police Ambulance service referrals 500 HFRS referrals Housing referrals 400 Res/Nursing 300 200 100 0 Apr-17 May-17 Jun-17 Jul-17 Aug-17

Safeguarding duties apply to an adult who: • Has needs for care and support (whether or not the local authority is meeting any of those needs) and; • Is experiencing, or at risk of, abuse or neglect; and • As a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse and neglect.

REPORTING AN ALERT • Ensure immediate safety of the individual • Preserve any evidence and support the person making a disclosure • Avoid asking leading questions. Record what is said. • Log the nature of alleged abuse, any information given or witnessed, actions taken, who was present at the time, dates and times of incident • Report to appropriate line manager or supervisor. Record decisions and rationale. • If a criminal offence is suspected, contact the Police • Refer to Adult Services

Information Gathering • Details of the alleged victim - name, contact details, DOB, gender, ethnicity • Principal language, any disability, any communication issues. • Name and contact details of GP. • Reasons for the concerns, the context of these, and how they came to light. • An impression of the seriousness of the situation. • Any concerns or doubts about the person’s mental capacity. • Action already taken to protect the person. • Whether the service user is aware of, and has consented to, the referral. • What the service users views and wishes are. • Whether the alleged perpetrator is a known vulnerable adult.

Useful numbers/websites • Hantsdirect - Adults Health and Care 0300 555 1386 • Safeguarding Telephone Enquiry Advice Line 01962 847214 • Hampshire Safeguarding Adults Board • www. hampshiresab. org. uk/ • Hantsweb Protecting People from Abuse https: //www. hants. gov. uk/socialcareandhealth/adultsocialc are/safeguarding

Modern Day Slavery

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