Transcript Safeguarding workshop

Safeguarding post Winterbourne
Chairs:
Penny Furness-Smith, retiring ADASS national policy lead
Mike Briggs, incoming ADASS national policy lead
Key Speakers:
• Claire Crawley, Safeguarding Policy Lead at
the DH
• Louise Lawton, Safeguarding Lead at CQC
• Cathie Williams, Adult Safeguarding Lead in
the LGA
The workshop is aimed at highlighting the wider
generic lessons and learning around
safeguarding and provides an opportunity to
hear from our key partners in CQC and the
DH.
Background
• National events: Winterbourne view, Southern Cross,
Dignity in Care and individual scandals
• Think Local Act Personal
• Sector-led improvement and ADASS/LGA work on
Safeguarding Standards and Performance
• Emerging national performance framework from
CQC
• NHS reforms
• Economic austerity and public sector squeeze
• Increased awareness of abuse and increased alerts
Challenges
How to balance two opposing forces when:
the aim for people using services is to maximise their personal
freedom
the aim for service providers is to minimise their
liability
SAFEGUARDING FORCES
Regulatory requirements
Users’ wishes
Professionals’ values
Organisations’ liability
Families wishes
Statutory duties
Public interest
The Safeguarding challenges
What needs to change within our organisations and in our approaches to promoting
and managing safeguarding in the communities we serve?
What are the main issues for the commissioners, the providers, the regulators and the
service user?
Where does the local leadership come from? (Safeguarding Adults Boards, Health &
Wellbeing Boards, local authorities, Community Safety Partnerships?)
What will be the impacts of personalisation and more integrated services?
Where does the buck stop?
Safeguarding Standards and
Performance: Summary of Work in
2011/12
Cathie Williams: LGA Adult Safeguarding Lead
Adi Cooper: ADASS Co-National Policy Lead
The context:
• Sector led improvement processes have identified
that whilst all councils that we have had contact with
have some areas of excellence, all have areas they
struggle with and there are some universal areas for
development
• The LGA and ADASS work on standards and
performance in safeguarding has been supported by
the standards and performance policy leads and
TEASC and has strong links with SCIE, RiPfA and
NHSConfed
We aren’t starting from scratch.
We have been building for the
last couple of years…
WHAT WE HAVE:
Vision and purpose
Our vision is that Safeguarding Adults Boards or Partnerships lead work in our
communities to ensure that for adults who are at risk or in vulnerable situations,
the agencies who support them and the wider community together can:
•Develop a culture that does not tolerate abuse;
•Raise awareness about abuse;
•Prevent abuse from happening wherever possible;
•Where abuse does happen, support and safeguard the rights of people who
are harmed to:
1
2
3
stop abuse continuing
access services they need, including advocacy and post‐abuse support
have improved access to justice
We have worked with Local Government Improvement and Development to
pilot, and have endorsed, the set of standards for safeguarding practice that
describe what ideal looks like.
ADASS: adapted from the WIHSC review of In Safe Hands. Wales’ vision also includes work with perpetrators
Standards for Safeguarding
Domains
• Outcomes for and the
experiences of people who
use services
• Leadership, strategy and
commissioning
• Service delivery, effective
practice and performance
and resource management
• Working together
Ownership
• Developed by IDeA…LGA
• Endorsed by ADASS,
NHSConfed, SCIE
• Tested in 4 peer reviews,
evaluated
• Used in 4 further peer
reviews, adapted and used
for Boards’ self assessment,
being used in other contexts
Guidance
For councils
For partners
• ADASS Advice Note April 2011
• From DH on personalisation and
safeguarding
• LGA “Making Safeguarding
Personal”
• Advice Note on the safeguarding
dimensions of Local Accounts,
Nov 2011, ADASS/ LGA
• SCIE: the Governance of
Safeguarding Boards, a Guide to
the Law, Involving People, Self
Neglect
• For the NHS in the form of a suite of
best practice guides
• From ACPO (in draft) for the police
• From the Ministry of Justice for the
police in working with vulnerable
witnesses
• From DH on commissioning services
for women and children who
experience violence or abuse
All of these are available on the Adult
Safeguarding Community of Practice on
the Knowledge Hub:
http://knowledgehub.local.gov.uk/
Priorities for sector based
improvement
For the LGA programme
For safeguarding
(with ADASS and partners)
• Support for currently
“adequate” councils
• Peer challenge and review
accessed by any council
• Undertaking national
improvement and
development where issues
have already been identified
• Developing “warning”
mechanisms for when
councils (start to) fail
• Sector based improvement
and peer support, review
and challenge
• Making Safeguarding
Personal – developing a
range of responses to
safeguarding circumstances
(to contribute to 3rd point on
left)
• Disseminating learning and
effective practice
Learning from Peer Reviews and
other activity
Key messages for leaders of safeguarding
10 years on from “No Secrets”........
• Everyone has examples of excellent practice and all
have some areas they are struggling with
• There has been huge effort put in to establishing and
clarifying structure and process: the next stages
have to be about focusing on people and the
outcomes they want
• Collaborative leadership – supporting, integrating
and holding partners to account
• Health and Wellbeing Boards, Community Safety
Partnerships, Children’s Safeguarding and
membership of Trust Boards and Police Authorities
Challenges:
• Practice that gets the best possible balance of
people’s right to life and a life free of inhuman
and degrading treatment with their right to
privacy, autonomy and a family life
• Proportionality and balance in the
safeguarding system…..
Safeguarding is everybody’s business
People look out for
each other in our
communities
Community safety
and other services
include “vulnerable”
people
The Council, with
NHS Boards and
the Police Authority
lead this
Care and justice service
standards safeguard
people’s dignity and rights
and enable them to manage
risks and benefits
The safeguarding
board manages
delivery across
agencies
Safeguarding is
personalised. There are
effective specialist services
to safeguard “vulnerable”
people, work with abuse
and support other staff
There is support and empowerment for people experiencing abuse
Development Areas
Outcomes
rather than
process or
output
Personalisation and
safeguarding are two
sides of the same coin
A portfolio of responses:
alternatives to increased services
or monitoring – counselling, peer
support, family group/network
conferences, mediation, building
self esteem, peer support etc
Access to justice:
criminal, civil, social
and restorative
Work with
people causing
harm or abuse
Skills base –
confidence to tailor
the process
Making Safeguarding
Personal Test-Beds
Focus on outcomes
What is it you would wish
for from safeguarding?
What outcomes do you
want? Three wishes….
Let’s weigh up the risks
and benefits of a number
of options…..
….a golden thread that links
practice at the interface with
people needing social care
and at risk of harm with the
effectiveness of boards….
I do want to feel and
be safe but….
….guilt, fear of
consequences, shame,
I’m trapped, I have no-one
else, I’ve lived like this for
so long I can’t see any
alternative ….
We have engaged with the Zero
Based Review but we know and
will know a lot about how much we
do but not much about what
difference we make or how
effective practice and Boards
are…
MEASURING AND MANAGING
OUR PERFORMANCE:
Examples of outcomes measures for
the future?
• People feel safe and in control
• “Vulnerable” people are safeguarded in the community and in
establishments such as care homes and hospitals
• Fewer people are harmed or abused in our communities and institutions
• There is greater reporting/referral of harm or abuse: people recognise harm
and abuse in the community and in institutions and know what to do about it
• People define the outcomes they want and how they should be achieved
• People are supported to identify and weigh up the risks and benefits of their
options
• People don’t have to choose between an abusive relationship or no human
relationships
• People have access to justice: social, civil, criminal or restorative…..
• Number and % of people referred for services who define the outcomes they
want (or outcomes that are defined through Best Interest Assessments or with
advocates if people lack capacity)
• Number and % of expressed outcomes met
Next Steps:
• Supporting peer review and challenge and work on “tipping
points”
• Developing a wider range of responses to safeguarding:
Making Safeguarding Personal, the test beds and further
research and development in order to secure an evidence
base of what works in adult safeguarding and with whom.
This will also involve supporting skills development.
• Eliciting and sharing learning through a variety of means
• Engaging with broader sector led improvement in adult social
care, and
• Continuing to integrate safeguarding and personalisation
• Implementing new legislation