2. Minutes of previous meeting The minutes of the previous meeting were accepted as a true and accurate record.

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1 ISLE OF WIGHT SAFEGUARDING ADULTS BOARD Friday 31 March 2017, 10:00 13:00 Innovation Centre, St Cross Business Park, Newport Present: Lynn Barker LBa Clinical Psychologist & Co-ordinator for Access and Assessments Eleanor Bell EB Public Health Principal, IoW Council Val Bell VB Commissioner for Housing Needs, IoW Council Lesley Brammer LBr Consultant Practitioner, Adult Social Care, IoW Council Helen Brangan HB Social Worked, Adult Social Care, IoW Council Graeme Burnett JF Southern Housing Group Maria Bunce MB Age UK Fleur Gardiner FG Local Safeguarding Adults Board (SAB) Manager Margaret Geary, Chair MG Independent Chair Amanda Gregory AG Trading Standards & Community Safety Partnership Dezi Hayes DH Social Worker, Adult Social Care, IoW Council Sarah Jackson SJa Superintendent, IoW District Commander, Hampshire Constabulary Sarah Johnston SJo Deputy Director of Nursing, Quality & Clinical Standards Directorate, IoW NHS Trust Loretta Kinsella LK Director of Quality & Clinical Services, IoW Clinical Commissioning Group (CCG) Rachel Lovely RL Care UK Debbie Morris DM Principal Social Worker & Service Manager for Safeguarding, Adult Social Care Fiona O Regan FOR Care Home Support Manager, CCG Kelly Pointing KP Residential Homes Collette Puntis CP Safeguarding Lead, IOW NHS Trust Di Radcliffe DR Domiciliary Care Melanie Rogers MR Director of Quality, Safeguarding & Clinical Services, CCG Alan Sheward AS Executive Director of Nursing Quality, IoW NHS Trust Jo Smith JS IoW HealthWatch Sarah Stringer SS Deputy Head Urgent Care & Community Commissioning, CCG Nikki Shave NS Interchange Manager, Hampshire & IOW Community Rehabilitation Company Joanna Smith JS Healthwatch IoW Locality Manager Carol Tozer CT Director of Adult Social Services, IoW Council Lynn Turner LT Adult Social Care Group Manager, IoW Council Kevin Walton KW Chair, Safeguarding Adult Review Sub-group and Hampshire Constabulary Rachel Watson RW Minute taker MINUTES 1. Welcome and apologies The Chair welcomed everyone to the meeting and introductions were made. Apologies were received from Tony Adams, Mike Corrigan, Adrian Dunsterville, Alex Hyslop, Richard John, Jane Leigh, Nicola Priest and Mandy Tyson. 2. Minutes of previous meeting The minutes of the previous meeting were accepted as a true and accurate record. 3. Matters arising and actions There were no matters arising and outstanding actions were reported on as follows: 1

2 Action 155: SJo and SJa reported that this action was complete. Action 168: SJo and CT reported that this action was complete. Action 172: KP reported that she and Tracy Savage have agreed to meet. This action is now amber. LK drew the meeting s attention to the draft Terms of Reference for the IoW CCG and IoW Council Quality Surveillance Group and stated that the next meeting of the group would on 4 April CT thanked LK for her leadership in setting up the group and the Chair also thanked LK and emphasised the importance of having clarity around services. 4. Sub-Group Reports SAR Sub-group Report KW spoke to the highlight report for the SAR Sub-group with particular attention to the following points: The Family G case has now been completed and the LSCB have placed the review on their website. The LSAB endorse the recommendations in the LSCB report and are committed to progressing the actions contained in it KW informed the meeting that he was aware of the LeDeR Review (an agenda item) and knew who to contact if necessary. He also stated that he was aware that this was a non-statutory process as well as its criteria. Action 186: DM to bring the actions and processes of the ASC review to the next SAR subgroup meeting The Chair asked the meeting if there were any urgent queries concerning any of the other subgroup reports. There were none and the papers were noted. 5. Impact Change Model Managing Transfers of Care SS introduced the presentation and was assisted by Lynn Baker, Lynn Turner and Kelly Pointing in delivering it. Please see Appendix One for the PowerPoint presentation. The following points were discussed: CT stated the importance of this issue from a safeguarding perspective. CT stated that this was a major issue regarding mental health and informed the meeting of a 0.5M funding from Social Care that would be used to upskill staff on properly preparing patients for transfers of care. SJo stated that work was going on regarding delays in producing discharge summaries and also that processes were in place for failed discharges and asked that they be informed when those happened. The importance of bags holding a patient s belongings, relevant care plan documentation and discharge documentation. RL and VB requested that they be included to represent HM Prisons and Housing respectively. The Chair and asked for a progress report at the next SAB meeting on Friday 16 June Action 187: RL, VB to be included in further meetings Action 188: Progress report to be delivered at the next SAB meeting on 16 June Health Trust Update Report AS gave an update on the recent CQC inspection of the IoW NHS Trust. He stated that the inspection focussed on Mental Health, the Ambulance Service, Commissioning and Acute Care (Accident & Emergency, Medical Wards and Coronary Care). He further stated that a Section 31 order had been made regarding mental health patients and services, commissioning, mental health 2

3 caseloads and the risks to patients under mental health care in the community. He stated that there were also some governance issues. AS further stated that the CQC report would be released into the public domain in the week commencing 10 April 2017 and summed up the report in terms of adult safeguarding themes as follows: The general view was that staff were fully aware of their responsibilities and that they used relevant safeguarding pathways for their areas. There was a clear recognition that staff training was good. There was a clear understanding that staff were aware of the correct escalation processes, that policies and procedures were in place, were accessible and easy to use. In the period until September 2016, 80% of medical staff and 91% of nursing staff had complete adult safeguarding training against a 91% target for the financial year. It was recognised that a joint safeguarding training group had been newly formed in the IoW NHS Trust. There were low numbers of DoLS applications. AS identified the following key risks: Key groups of staff were not up to date with adult safeguarding training, particularly doctors in acute services. Safeguarding concerns were not identified in mental health. There was not sufficient monitoring of adult safeguarding. KPIs were not sufficiently sighted on identifying whether or not a good job was being done giving rise to concerns about communication with the Local Authority. Under reporting on DoLS. AS reported that immediate action had been taken regarding staff training in safeguarding, particularly in mental health and also around a DoLS champion. He further stated that an action plan would be developed once the report was published that would address the recommended actions with themed improvement groups. SJo stated that they now had 1.6 FTE safeguarding practitioner staff and that they are focussing on the ward areas to transfer training into practice. After some further discussion the meeting agreed that a joint review of the final report and the development of an effective improvement plan involving all key agencies should be held before the next SAB meeting on 16 June The Chair thanked AS for bringing the update to the meeting. Action 189: AS to convene a joint review group with all partners to develop an improvement plan in response to the final CQC report 7. Multi-agency working in safeguarding adults; what is working well and what is not Safeguarding Action Plan LB spoke to the subject of multi-agency working in safeguarding adults; what is working well and what is not. She was accompanied by HB and DH. LB listed safeguarding adults team and duty processes and stated the following as examples of what was working well and what was not: The ASC Safeguarding Team ensure that the duty inbox is emptied every day. Positive outcomes have been achieved in joint working with the Hampshire Constabulary. The computer system is a problem with frequent freezing and crashing incidents. Personal safeguarding outcomes are not recorded at the point of referral. Each safeguarding referral takes around ten to fifteen minutes to input on the PARIS system. Partnership safeguarding meetings are hampered by non-attendance which is a drain on resources as well as causing potential delay in delivering safeguarding plans. There is often discord in the outcomes between the points of view of the referrer and the person being safeguarded. There is, currently, a poor understanding of the roles and responsibilities of other agencies. A clearer understanding in this area would help. 3

4 CT summarised three issues as follows: Firstly, there are a huge number of referrals to the safeguarding team and the conversion rate is low, around 40%, when it should be nearer 70%. The problem is that safeguarding incident reporting thresholds are still not clear. It was suggested that the Quality Assurance and Performance sub-group look at referrals that did not reach the safeguarding threshold. The Chair replied that Maggie Bennett and Jane Hughes were doing some work on this issue and that they would be seeking SAB support regarding education on thresholds. Secondly, an analysis of safeguarding alerts is needed to translate data into intelligence and the need to look at alerts coming in from the same place to build a composite picture around the theme of safeguarding adults. Thirdly CT stated that extra questions regarding the sense of safeguarding experienced by people have been added to the annual survey that all safeguarding departments must do. JS stated that the data input time for a safeguarding alert was also a frustration for Providers. Some discussion followed regarding reporting thresholds and the following actions were agreed: The QA&P Sub-group would look at repeat referrals and medication issues as part of their work plan. Jane Hughes and Maggie Bennett would be invited to the next SAB meeting (Friday 16 June 2017) to present their work on thresholds. The Adult Social Care Safeguarding Team would report on whether changes have taken place on this issue at the SAB meeting on Friday 22 September Action 190: Repeat referrals and medication issues to be picked up by the QA&P Subgroup. Action 191: Jane Hughes and Maggie Bennett to be invited to the next SAB meeting (16 June 17) to present their work on thresholds. Action 192: The ASC Safeguarding Team to report to the September SAB meeting on any changes that have taken place, Debbie Morris to lead. 8. HealthWatch Care at Home Adult Social Care Response JS stated that, from the HealthWatch point of view, good progress was being made on the safeguarding action plan developed in response to the Care at Home report. DM spoke to the HealthWatch Care at Home report that looked at the experience of people using homecare and stated that a leadership group met every month on this issue. She reported that work had been done in implementing the Adamlife system that seeks to match self-funders to care available to them. She stated that a launch event would be held and that they were working with Isle Help to improve the directory which is co-produced with Providers and Service Users. DM went on to report on the biggest issue around the home care experience which is the workforce and the need to make a career in home care attractive. She stated that money would be available to do some wider work around workforces and leadership. The Chair thanked DM for her useful report and emphasised the need to think about the link between re-ablement, home care and training. 9. Thresholds for Care Home staff sending safeguarding alerts to the Safeguarding Team This item would be on the agenda for the next SAB meeting on 16 June

5 10. Wessex Learning Disabilities Mortality (LeDeR) Programme Pilot LK reported that the CCG in the South of England was doing well in collating information on the deaths of people with LD. She also reported that Tony Adams is a LeDeR trainer and that the CCG are trying to identify other trainers. SJo reported that this issue is on the agenda for the NHS Trust Safeguarding Steering Group and that they have a Community Representative. CT reported that she now attends the LD Partnership Board and felt that it would benefit from support from other statutory agencies. LK asked that any difficulties or concerns with annual health checks for people with LD be relayed to the CCG; she also stated that the full review is available from the University of Bristol website ( The Chair requested that the CCG brings an annual report on the outcomes of this pilot to the SAB. Action193: CCG to bring annual report on the LeDeR scheme to the SAB 11. SAB Budget and underspend proposals FG spoke to the budget papers and asked the meeting for its agreement of two proposals for the 15/16 underspend of 15,134.00: Medication in Care and Resilient Communities Hate and Mate Crime project. The meeting agreed to the use of the underspend for these two proposals. The meeting further agreed to carry forward the underspend from 16/17 to progress the Board s core workstreams in 17/ SAB Business Plan The funding partners present at the meeting signalled their agreement to the proposed contributions in 2017/18. FG reported that, as key aspects of the Business Plan entailed joint work with the LSCB (which met on 24 March 2017), the plan would be electronically circulated for approval once she had met with Jane Leigh, the Manager of the LSCB week commencing 17 th April Action 194: FG to electronically circulate SAB Business Plan for approval once she has met with Jane Leigh regarding joint working. Walkabout The meeting agreed that SAB members would take part with HealthWatch in walkabouts in partner agencies. The Chair stated that sessions on what good looks like in the walkabout context would be provided to anyone volunteering to be part of a walkabout. LK emphasised the necessity of making clear to the relevant agency what would be included in the subsequent report. 13. Annual Report The Chair reported that a draft had been completed and that specific requests would be made to agencies for contributions, she also stated that it should be completed by June Any other business Conference report highlights FG gave a brief report on the highlights of the LSAB-OPCC Conference held on 29 March 2017 and stated that a full report would follow. CT thanked the LSAB Administrative Team and the Chair for an excellent day. She also stated that she would be encouraging similar outreach at the 2017 IoW Festival in the showing of the HealthWatch DVD and the play by Blue Apple. SAB Member s Pack The meeting accepted the SAB Member s Pack; CT asked that the Health & Well Being Board be placed above the SAB on the hierarchy. There were no other comments or queries. Action 195: RW to amend the hierarchy by putting the H&WBB above the SAB 5

6 The Chair recorded the meetings thanks to LK for her contribution to the SAB in her attention to detail and by ensuring that discussions were rigorous. LK replied that she had enjoyed working with the SAB. 15. Dates of next meetings The date of the next meeting is Friday 16 June 2017, 10:00 13:00 at the Innovation Centre, St Cross Business Park, Newport. The meeting closed at

7 Appendix: Acronyms Acronyms Used: This is not an exhaustive list and may be updated from time to time. If you would like an acronym added, please contact Rachel Watson 4LSAB ASC CCG CEO CQC CSA CSE CSP DA DASM DHR DoLS DV FGM H&WBB HMP IoW IT IWR IWSAB LSAB MAPPA MARAC MCA METRAC MSP NHS OPCC QA&P SAB SAMA SAR SARSG SCIE SERAF SHG SHIP SSOG ToR Wessex LeDeR Four Local Safeguarding Adults Boards (Southampton, Hampshire, IoW, Portsmouth) Adult Social Care Clinical Commissioning Group Chief Executive Officer Care Quality Commission Child Sexual Abuse Child Sexual Exploitation Community Safety Partnership Domestic Abuse Designated Adult Safeguarding Manager (now replaced by SAMA) Domestic Homicide Review Deprivation of Liberties Safeguards Domestic Violence Female Genital Mutilation Health & Well Being Board Her Majesty s Prison Isle of Wight Information Technology Island Women s Refuge Isle of Wight Safeguarding Adults Board Local Safeguarding Adults Board Multi-Agency Public Protection Arrangements Multi-Agency Risk Assessment Conference Mental Capacity Act Missing, Exploited and Trafficked Risk Assessment Conference Making Safeguarding Personal National Health Service Office of the Police and Crime Commissioner Quality Assurance & Performance Safeguarding Adults Board Safeguarding Allegations Management Advisor Safeguarding Adults Review Safeguarding Adults Review Sub-group Social Care Institute for Excellence Sexual Exploitation Risk Assessment Form Southern Housing Group Southampton, Hampshire, Isle of Wight, Portsmouth Serious Sexual Offences Group Terms of Reference Wessex Learning Disabilities Mortality Review Programme 7