SAFEGUARDING ADULTS STEERING GROUP ANNUAL REPORT

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1 SAFEGUARDING ADULTS STEERING GROUP ANNUAL REPORT Report of Paper prepared by Purpose of Paper Action/Decision required Link to Health Care Standards: Link to Health Board s Strategic Direction and Corporate Objectives / Legislative and Regulatory Framework Cardiff and Vale University Health Board Safeguarding Vulnerable Adult Team Lead Nurse Safeguarding Adults, Cardiff and Vale University Health Board. The purpose of this report is to inform and update the Committee of the current status in meeting the UHB requirement to safeguard adults. The Committee is asked to RECEIVE and NOTE the information provided in this paper. Revised Standards for Health in Wales, Standard 11 Healthcare organisations comply with national child protection and vulnerable adult guidance within their own activities and in their dealings with other organisations. The Lead Nurse for Safeguarding Adults discharges the duties of Cardiff and Vale University Health Board in line with the following frameworks, policies and procedures. Welsh Assembly Government (2000) In Safe Hands: The implementation of adult protection procedures in Wales. Cardiff: Welsh Assembly Government Department of Health (2006) Safeguarding Vulnerable Groups Act. The Stationary Office, London Title of Report Page 1 of 23 Name of Meeting

2 The Wales Interim Policy and Procedures for the Protection of Vulnerable Adults from Abuse (2010) Ratified by the SWAP Forum Acronyms and abbreviations DLM - Designated Lead Manager ESR Electronic Staff Record Safeguarding Adults Steering Group Summary The purpose of this report is to provide both Cardiff and the Vale of Glamorgan Local Authority Area Adult Protection Committee with a summary of the activity carried out by Cardiff and Vale University Health Board Safeguarding Vulnerable Adults Team for year ending March Safeguarding Adults workload continues to increase. There are many reasons for this, increased awareness through training, local and national developments as well as The Mental Capacity Act 2005: Deprivation of Liberty Safeguards 2007 and the implementation of the Safeguarding Vulnerable Groups Act (2006). The Named Nurse offers professional advice on legal and ethical issues and escalates cases when appropriate, either to Protection of Vulnerable Adult Policy and Procedures, legal advice or involvement of partner agencies such as the Local Authority and the Police. Cases are becoming more complex requiring considerable time allocation, often resulting in a number of Strategy Meetings involving Multi Agency investigations will bring with it legislative changes to both the Safeguarding Adults and Domestic Violence agenda. These developments are welcomed by the UHB, new legislation to combat violence against women and domestic abuse will ensure that victims of abuse are protected and supported. The Social Services (Wales) Bill aims to place Adult Safeguarding on an equal footing with Safeguarding Children, this send out an important message that adult abuse of any kind will not be tolerated. It is important to note that this has been an extremely busy year in Adult Safeguarding, the team received 173 referrals between the 1 st of April 2012 and the 31 st of March 2013 (compared to 144 in 2011/2012) this includes 11 Professional Abuse referrals. 102 of the 173 referrals were Health coordinated (compared to 73 in 2010/2011 a 28% increase in workload). POVA VA1 s received citing a member of UHB staff as an alleged perpetrator has risen by 30% in 2012/2013 from 49 to 64. Professional Abuse cases have also increased from 1 referral in 2011/2012 to 11 in 2012/2013. Title of Report Page 2 of 23 Name of Meeting

3 Key activity during the last year has included: Liaising with partner agencies such as the Police to ensure that information is shared in order to aid the Police in conducting criminal investigations Undertaking multi-agency audits to inform practice (review of POVA referrals, time frames and documentation). Policy, procedure and guidance development (multi-agency and Health Board level) such as Provider Performance Monitoring Protocol, Home Closure Protocol and managing allegations of professional abuse. Training programme development and delivery (All levels including practitioners and Health Board level) including the development of a local safeguarding programme bringing together child and adult protection issues into a single, one day training event and the development of an e-learning package to support awareness raising. Provision of responses to all Wales consultations to influence strategic direction and policy development. Provision of safeguarding supervision to DLM s and others involved in safeguarding cases with the aim of supporting staff, facilitating learning and promoting best practice. Completing a Joint Management review with Cardiff Local Authority recommended by the Public Service Ombudsman for Wales. INTRODUCTION The purpose of this report is to present the Annual Report of Cardiff and Vale University Health Board Safeguarding Adults Steering Group ending March SAFEGUARDING ADULTS ARRANGEMENTS WITHIN THE UHB At corporate level, Standard 11 seeks to establish what Board approved Safeguarding Adult Policies and Procedures are in place to ensure compliance with National Safeguarding Adult Guidance. The standard also seeks to establish how the Board is assured of compliance with National Safeguarding Adult Guidance when working with other organisations. Throughout , Cardiff and Vale University Health Board has again acknowledged its responsibility to ensure that vulnerable adults entering University Health Board premises, community or hospital, as a patient or as a visitor are safeguarded from harm. The UHB Executive Nurse Director provides leadership of the safeguarding agenda, chairing the UHB Safeguarding Adult Steering Group. The group promotes safeguarding adult issues across the Health Board, reinforces standards of practice, develops guidance and ensures that the safeguarding of vulnerable adults remains a key priority for the organisation. The membership of this group includes representatives from South Wales Police and both Local Authorities, as well as UHB Human Resources and Divisional Title of Report Page 3 of 23 Name of Meeting

4 Nurse representation, demonstrating the commitment of the Executive Board to ensuring robust safeguarding arrangements within the organisation and emphasising corporate responsibility for this area of activity. During the last year the Executive Nurse Director has chaired the Health Board Safeguarding Children Steering Group and the Safeguarding Adults Steering Group providing, written assurance reports on the activities being undertaken to the Quality and Safety Committee. Both groups are multiprofessional, reflecting the ethos of safeguarding being everybody s business. These arrangements will change from April 2013, in line with new ways of working and accountability within the Health Board and also the national approach being advocated by Welsh Government, to bring together these two specific areas of safeguarding. As such, from April 2013, the two groups will merge and become a Health Board Safeguarding Steering Group covering all aspects of safeguarding activity (children, adults, domestic violence and human trafficking). The new group will continue to be multi-professional in its membership and will be chaired by the Assistant Director of Nursing, who will be responsible for providing the Lead Executive with assurance that the safeguarding agenda is being progressed in line with legislative requirements and best practice. In line with the legislative requirements the Health Board has also had an identified Independent Member with lead responsibility for safeguarding who, as a member of the Safeguarding Steering Groups for Children and Adults, has provided scrutiny of the work being taken forward. In addition to this the Health Board Safeguarding teams have co-located to support improved joint working across adult and child protection cases. OPERATIONAL ARRANGEMENTS POVA referrals are led by Designated Lead Managers within each Division. This model reflects both Corporate and Divisional responsibilities associated with safeguarding adults. The Lead Nurse for Safeguarding Adults acts as a central resource, providing expert advice and training to staff as well as supporting the management of complex cases and provides a liaison role with external partner agencies. The transfer of function to the Designated Lead Manager s (DLMs) reflects the breadth of impact of the safeguarding agenda across all areas within the UHB as well as the essential links with partner agencies outside the UHB. The adopted Designated Lead Manager model reflects what is believed to be the most appropriate infrastructure to support the Health Board in effectively discharging its responsibilities related to the safeguarding of adults. The UHB now has 31 trained DLM s who have all received relevant training and who are supported by the Lead Nurse for Safeguarding Adults, on a case to case basis or through the regular DLM forums. Title of Report Page 4 of 23 Name of Meeting

5 DLM s had received training to ensure compliance with the Wales interim Policy and Procedures for the Protection of Vulnerable Adults from Abuse (2010) and attend DLM Forums to update themselves on developments and receive support to enable them to undertake the role/action of the Designated Lead Manager within the Safeguarding Adult process. These updates ensure that:- DLM s are aware of any new documentation developed by the AAPC or South Wales Strategic Management Board that are used as part of the POVA process DLM s provide consistent practice across Cardiff and Vale University Health Board DLM responsibilities are reinforced within Cardiff and Vale UHB. Throughout the Lead Nurse for Safeguarding Adults has remained focused throughout on the delivery of expert advice, support and training to managers and practitioners across the organisation, thereby enabling staff to be able to deliver high quality care to adults who are vulnerable. By continuing to build upon the partnership established across the health and social care community, the team has been able to contribute to local, regional and all- Wales developments in the field of adult protection. PARTNERSHIP WORKING The Assistant Director of Nursing represents the UHB on both Cardiff and the Vale Area Adult Protection Committees (AAPC) and the South Wales Strategic Management Board (SWSMB) for Safeguarding Adults. Any changes in National policy/guidance are disseminated down through these groups. The Lead Nurse for Safeguarding Adults has represented the UHB on the All Wales Adult Advisory Group and has been instrumental in developing the All Wales Interim Policy and Procedures. The Lead Nurse for Safeguarding Adults sits on various SWSMB and AAPC Sub Committees and has been responsible for collaborating in many of the procedures and documents that have been ratified in , such as reviewing the e-learning package as well as Level 2 and 3 training. The Lead Nurse for Safeguarding Adults attends the All Wales POVA NHS Lead Professional group for safeguarding adults at risk. The All Wales group aims to bring together those working in NHS organisations across Wales with a lead responsibility for implementing Protection of Vulnerable Adults policies and procedures. It aims to support the development of clinically operational dedicated roles and promote the development of good practice in this vital area of work. The group is linked to the Office of the Chief Nursing Officer at the Welsh Assembly as a recognised Reference Group to the Welsh Nursing and Midwifery Advisory Committee. Title of Report Page 5 of 23 Name of Meeting

6 TRAINING In the review of safeguarding and protecting vulnerable adults in Wales (HIW 2010) HIW recommended that POVA awareness training, should be mandatory for those working in NHS organisations and contracted services and updated training should be undertaken at least every three years. Training should address: The integration of incidents and complaints The sharing of information across and between organisations Providing feedback to patients / service users and their relatives The Importance of Dignity and Respect There are currently three levels of training provided throughout the UHB Level 1 Level 2 Level 3 Induction Training Recognition and Referral Training Designated Lead Manager Training Level 1 Level 1 training is appropriate for: all non-clinical staff working in health care Staff groups include receptionists, administrative, catering, transport and maintenance staff Awareness raising information is provided through Cardiff and Vale Corporate Induction Programme and the UHB Corporate Induction e-learning package, which is accessed via the UHB intranet. All new staff must receive this training on induction. Level 2 POVA Level 2 training, now called Recognition & Referral, is targeted at all staff who have direct and regular contact with vulnerable adults. The aim of the session is to raise general awareness of the issues around vulnerable adults, the potential for abuse, and for participants to develop an understanding of their role and responsibilities in relation to POVA issues, including the completion of a VA1 Referral form. Level 2 training is appropriate for: All clinical staff Staff Groups include health care students, clinical laboratory staff, pharmacists, dental staff, audiologists, opticians, adult physicians, surgeons, anaesthetists, radiologists, nurses in adult acute/community services, allied health care professionals and all other adult orientated secondary care health care professionals, including technicians Level 2 training can be accessed in the following ways: Title of Report Page 6 of 23 Name of Meeting

7 ½ day training accessed through LE&D Prospectus and the Intranet site. It is suggested that all relevant staff attend one taught session and top up when needed via e-learning or attend another taught session if required. E-learning Cascade training delivered through clinical areas, directorates and divisions Training for specific groups where needs are identified through a training needs analysis, clinical incidents or a Serious Case Review Level 3 Level 3 training is essential for all DLM s and is arranged by the Named Nurse for Adult Safeguarding. There are currently 31 trained DLM s within the UHB. In DLM training was also provided to the Welsh Ambulance Trust, Public Health Wales and Velindre NHS Trust. Whole Day Public Protection Training Monthly "Public Protection Days" incorporating POVA, Domestic Violence and Safeguarding Children, are provided monthly by both Safeguarding Teams. Stand alone sessions for Safeguarding Adults and Safeguarding Children are also delivered to departments and clinical areas on request as part of away days or departmental training. GP Training In 2013 three Safeguarding Adults sessions were provided to GP s within Cardiff and Vale as part of their Protected Education Time. All three sessions evaluated well and Safeguarding Adults training will now be included as part of the rolling programme of Protected Education Time. Local Authority POVA DLM s have noted a rise in GP referrals and GP attendance at strategy meetings. Two of the sessions were delivered to the Cardiff East Locality (CELT) multidisciplinary teams who offer support to individuals requiring increased health and social care input in the community (including care homes) to maintain and enhance recovery from acute problems. CELT can also provide input to patients who are being discharged from hospital who need a similar level of enhanced support. Title of Report Page 7 of 23 Name of Meeting

8 AUDIT Throughout a number of multi-agency audits were completed with both Cardiff and Vale Local Authority POVA Teams. An audit tool was specifically designed for this purpose and reports were drafted by the Policy and Quality Assurance Officers from both Local Authorities and presented at Subsequent AAPC s. The most recent audits focused on the timescales of the POVA process to ascertain compliance with standards. The audit group usually comprised of The Policy and Quality Assurance Officer for Social Services, Operational Manager for Safeguarding and Performance, Named Nurse for Safeguarding Adults in Cardiff and Vale UHB and the Detective Sergeant with POVA responsibility within the Public Protection Unit. An example of an Case File audit completed in February 2013 A list of open cases was requested, current at the time of the audit. A cross section of 25 cases was selected and the audit group succeeded in auditing 17 cases within the time available. Key Findings 1. Although only a snapshot of practice, the audit identified some common themes and areas for improvement. Record keeping with regard to the name and DOB of the vulnerable audit, the name of the relevant DLM and the date the VA1 was received by the Central DLM was consistently good. Timeliness of VA1s being submitted was not always good, although initial evaluations were completed promptly once the VA1 was received in the majority of cases. 2. General commentary reflected limited completion of VA2 and VA4 paperwork; either not on the file or with little information recorded. Health cases tended to include strategy minutes but not VA2 or VA4 paperwork, with the opposite observation being made of Social Services files. Where VA2 and VA4 paperwork was available, however, information recorded was often very limited, sometimes only including basic identification information. Absent or poorly completed documents made it difficult to track decision making at each stage or to evidence if safeguarding actions had taken place. 3. There were a small number of examples of good practice including a set of UHB strategy meeting minutes that included consideration of how best to provide feedback to the vulnerable adult and their family, and circulation of actions following strategy meetings where this was done immediately and given to attendees before they left the meeting. Title of Report Page 8 of 23 Name of Meeting

9 INFORMATION SHARING Secure using the CJSM website has now been established between named members of the safeguarding team and police facilitating domestic abuse reports (PPD1s) to be shared electronically with health professionals. Any reports can be placed on Paris system to streamline safeguarding information for Paris users. KEY ACHIEVMENTS AND DEVELOPMENTS Liaising with partner agencies such as the Police to ensure that information is shared in order to aid the Police in conducting criminal investigations Undertaking multi-agency audits to inform practice (review of POVA referrals, time frames and documentation). Policy, procedure and guidance development (multi-agency and Health Board level) such as Provider Performance Monitoring Protocol, Home Closure Protocol and managing allegations of professional abuse. Training programme development and delivery (All levels including practitioners and Health Board level) including the development of a local safeguarding programme bringing together child and adult protection issues into a single, one day training event and the development of an e-learning package to support awareness raising. Provision of responses to all Wales consultations to influence strategic direction and policy development. Provision of safeguarding supervision to DLM s and others involved in safeguarding cases with the aim of supporting staff, facilitating learning and promoting best practice. Completing a Joint Management review with Cardiff Local Authority recommended by the Public Service Ombudsman for Wales. DOMESTIC ABUSE Cardiff and Vale UHB have a clear and comprehensive Safeguarding Children and Adults strategy and all staff are aware of their responsibilities when taking disclosures or identifying abuse/neglect in these vulnerable groups. It is recognised that the same robust procedures need to be put in place with regards to domestic violence. In March 2012 the UHB s Chief Executive spoke at a conference in Cardiff on International Woman's Day. He presented the UHB's response to the Domestic Violence agenda. The main priorities for Health that he focused on were:- Effective information sharing Frontline leadership through identified leads Title of Report Page 9 of 23 Name of Meeting

10 Policy development (service users/patients and staff) Working with specialist service providers and partners to maximise opportunities to up-skill staff Consistency of standards and levels for training Integrating Domestic Abuse awareness into key training programmes Risk assessment and early recognition training Implementation of Routine Enquiry Ensuring frontline staff have the tools they need to support victims of abuse in all its forms. Continue to build upon multi-agency partnerships. To ensure that the UHB delivers on the above points a decision has been made to set up a Domestic Abuse sub-group as part of the Safeguarding Children/Adults Steering Group. This sub-group will be responsible for driving the domestic abuse agenda within the UHB and will deliver a work plan and report to the combined steering group. A NEW APPROACH TO SAFEGUARDING AND PROTECTING CHILDREN AND ADULTS AT RISK IN WALES In October 2012 the Deputy Minister for Children and Social Services published the summary of responses to the consultation on the Social Services (Wales) Bill which took place in the spring and early summer. Over 500 people were engaged at a range of public events across Wales, including vulnerable groups such as disabled and looked after children, care leavers and young carers. The Bill will be a pivotal delivery mechanism for implementing key aspects of Welsh Assemblies agenda, effective safeguarding can only be achieved through consistent multi-agency action. Title of Report Page 10 of 23 Name of Meeting

11 USER EXPERIENCE The ability to record, track and monitor the number of vulnerable adult related incidents which have occurred in the organisation in the last twelve months is an important aspect of compliance with Standard 11. Likewise understanding what action has been taken and what lessons have been learnt as a result of incidents is also essential. SUMMARY OF HEALTH DATA It should be noted that although the number of referrals to POVA citing UHB staff as the alleged perpetrator has increased, a large proportion of cases are disproved after the initial investigation. It is not possible to report accurate annual figures as some cases can roll over into a following year and Police investigations and prosecutions can sometimes take over two years to complete. However in five members of staff were disciplined and had their contracts terminated by the UHB compared to where no staff were dismissed. Between the 1 st of April 2012 and the 31 st of March 2013 The Safeguarding Adults Team received 64 Health led VA1 s citing staff as alleged perpetrator an increase of 30% on Most of these VA1 s were allocated to the Divisional DLM s. A small number were coordinated by the Lead Nurse for Safeguarding Adults. All 64 POVA referrals indicated that the alleged abuse either occurred on UHB premises or named a member of staff as the perpetrator. Following further investigations, information gathering and Strategy Discussions with partner agencies, 24 of these cases were closed at Strategy Discussion or at a follow up Strategy Meeting. 40 of these 64 Health coordinated cases were or are being addressed via the UHB Disciplinary Policy, Root Cause Analysis Investigations or criminal investigations by the Police. Cardiff and the Vale of Glamorgan, Police Public Protection Unit s are currently involved in 4 criminal investigations (staff are suspended from work). In all cases the alleged abuse being investigated by the Police is physical abuse. There are currently 24 cases that are being addressed via the UHB Disciplinary Policy/ Root Cause Analysis Investigations. A further 10 members of staff are excluded from work whilst these disciplinary investigations are undergoing. The referrals concern 2 incidents of inappropriate sexual relationship with a patient. 9 alleged incidents of physical abuse, 4 incidents psychological abuse and 6 incidents of neglect (3 cases involve two service users). Cardiff and Vale University Health Board Safeguarding Adults Team received 173 referrals between the 1 st of April 2012 and the 31 st of March 2013 (compared to 144 in 2011/2012) this includes 11 Professional Abuse Title of Report Page 11 of 23 Name of Meeting

12 referrals. 102 of the 173 referrals were Health coordinated (compared to 73 in 2010/2011 a 28% increase in workload). Health Led POVA Referrals 01/04/2010 to 31/03/2013 Year Total Referrals Health Led Referrals POVA Referrals During the Year From 01/04/2012 to 31/03/2013 Month Health Ref LA Cdf LA VOG Prof Strat Referrals Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Total Referrals Health Led VA1 Gender / Age Totals Male Female Totals Title of Report Page 12 of 23 Name of Meeting

13 Gender Female 49% Male 51% Health and Local Authority Referrals 2012/2013 Health Ref LA Ref Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Title of Report Page 13 of 23 Name of Meeting

14 Local Authority Breakdown LA VOG 28% LA Cdf 72% Health Referrals Health Referrals Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Title of Report Page 14 of 23 Name of Meeting

15 Divisions where alleged abuse Occurred Therapies Mental Health Specialist Services Surgery Women & Children Unschedule d Care / Medicine OPAIC POVA Outside of Division Health Led VA1's 2012/2013 (Excluding Professional Abuse Cases) Break Down of Perpetrators Patient 8 Family 7 Carer/Support Worker 2 Visitor 2 Unknown 8 Staff 64 Total 91 Title of Report Page 15 of 23 Name of Meeting

16 Type of abuse for THE 64 Health Led VA1 referrals Types of abuse by UHB Staff Financial 1% Sexual 6% Emotional 22% Physical 42% Sexual Physical Neglect Neglect 29% Emotional Financial Type of abuse Sexual 2 3 Physical Neglect Emotional 3 14 Financial 0 1 Total Title of Report Page 16 of 23 Name of Meeting

17 Division where staff alleged perpetrator (Total 64) Therapies Mental Health Specialist Services Surgery Women & Children Unscheduled Care OPAIC WAST Series VA1 s received citing a member of UHB staff as an alleged perpetrator has risen by 30% in 2012/2013 from 49 to 64. Professional Abuse cases have also increased from 1 referral in 2011/2012 to 11 in 2012/2013. Staff Perpetrators by Division Division Surgery 2 1 Women & Children 2 2 Mental Health OPAIC/Primary Community Care 6 5 Unscheduled Care/Medicine Therapies/Clinical Directorate 1 2 Specialist Services 4 7 WAST 1 1 Total Title of Report Page 17 of 23 Name of Meeting

18 Division Police Investigation Ongoing Investigations A Number of Cases are carried over from Health RCA Disciplinary Investigation Information Gathering Police/Health Ongoing Proved Disproved Staff Employment Terminated Criminal Prosecution Mental Health Unscheduled Care Specialist Services Diagnostics 2 2 and Therapies OPAIC Surgery 1 1 Woman and Children Professional S/M Total Health Data Between the 1 st of April 2012 and the 31 st of March 2013 The Safeguarding Adults Team received 64 Health led VA1 s citing staff as alleged perpetrator an increase of 30% on Most of these VA1 s were allocated to the Divisional DLM s. A small number were coordinated by the Lead Nurse for Safeguarding Adults. All 64 POVA referrals indicated that the alleged abuse either occurred on UHB premises or named a member of staff as the perpetrator. Following further investigations, information gathering and Strategy Discussions with partner agencies, 24 of these cases were closed at Strategy Discussion or at a follow up Strategy Meeting. 40 of these 64 Health coordinated cases were or are being addressed via the UHB Disciplinary Policy, Root Cause Analysis Investigations or criminal investigations by the Police. Cardiff and the Vale of Glamorgan, Police Public Protection Unit s are currently involved in 4 criminal investigations (staff are suspended from work). In all cases the alleged abuse being investigated by the Police is physical abuse. Title of Report Page 18 of 23 Name of Meeting

19 There are currently 24 cases that are being addressed via the UHB Disciplinary Policy/ Root Cause Analysis Investigations. A further 10 members of staff are excluded from work whilst these disciplinary investigations are undergoing. The referrals concern 2 incidents of inappropriate sexual relationship with a patient. 9 alleged incidents of physical abuse, 4 incidents psychological abuse and 6 incidents of neglect (3 cases involve two service users). Number of Staff Currently Suspended from Work Division Ongoing Investigations Suspended from Work Mental Health 11 8 Unscheduled Care 5 1 Specialist Services 6 - Diagnostics and 3 2 Therapies OPAIC 1 1 Surgery 1 1 Woman and Children 1 1 Total REFERRAL RATES FROM VA1 referrals received by UHB Safeguarding Adults Team POVA cases DLM Health coordinated Cases addressed under UHB Disciplinary framework Staff dismissed/ resigned (referred to ISA ) Title of Report Page 19 of 23 Name of Meeting

20 DOMESTIC VIOLENCE DATA During , 92 (86 between ) referrals were made by staff in the Emergency Unit UHW. The details of how the referrals were passed on to the appropriate agency is shown below. Total of Completed Referrals from the Emergency Unit Referrals signposted on to the partner agencies Health Visitor 24 Midwife 7 Police 35 POVA 1 Social Services 9 Women's Aid 10 Advocacy 2 Refused 4 Total DA Referred to Agency Health Visitor Midwife Police POVA Social Services Women's Aid Advocacy Refused Title of Report Page 20 of 23 Name of Meeting

21 SUMMARY has once again been a busy year for the Cardiff and Vale University Health Board Safeguarding Adults Team as the workload continues to increase. There are many reasons for this, increased awareness through training, local and national developments as well as The Mental Capacity Act (2005), Deprivation of Liberty Safeguards (2007) and the implementation of the Safeguarding Vulnerable Groups Act (2006). The Team offer professional advice on legal and ethical issues and escalates cases when appropriate, either to Protection of Vulnerable Adult Policy and Procedures, legal advice or involvement of partner agencies such as the Local Authority and the Police. Cases are becoming more complex requiring considerable time allocation, often resulting in a number of Strategy Meetings involving Multi Agency investigations will bring with it legislative changes to both the Safeguarding Adults and Domestic Violence agenda. These developments are welcomed by the UHB, new legislation to combat violence against women and domestic abuse will ensure that victims of abuse are protected and supported. The Social Services (Wales) Bill aims to place Adult Safeguarding on an equal footing with Safeguarding Children, this send out an important message that adult abuse of any kind will not be tolerated. Adult protection relies on effective interagency working, primary legislation needs to be introduced which would enable true multi-agency working. The recent reviews of guidance in England and Wales indicate that safeguarding systems in the NHS are underdeveloped and are not owned by health organisations. There are strong arguments that joint working requires specific legislation such as a duty to report, investigate and share information. True multi-agency working would imply joint policies and procedures that are owned by partner agencies, not just Social Services and Health but include regulatory bodies such as CSSIW, Health Inspectorate Wales, CPS, GP s and the Police. Finally the UHB is aware that education and training are key in effective identification and prevention of abuse, and the development of the GP training sessions and the public protection day along with the updating of the e- learning package ensures that UHB staff who have contact with adults at risk of abuse are aware of the correct referral process to the Safeguarding Team. Title of Report Page 21 of 23 Name of Meeting

22 The Safeguarding Vulnerable Adults Team discharges the duties of Cardiff and Vale University Health Board in line with the following frameworks, policies and procedures: The Standards for Health Service in Wales 11 (Safeguarding Children and Safeguarding Vulnerable Adults) Putting Things Right (2011) the way in which NHS organisations in Wales deal with complaints, claims and incidents Wales Adult Protection Forum (2010), Interim Policy & Procedures for the Protection of Vulnerable Adults from Abuse, WAPF, Cardiff. Department of Health (2007) Mental Health Act. The Stationary Office, London Department of Health (2006) Safeguarding Vulnerable Groups Act. The Stationary Office, London Department of Health (2005) Mental Capacity Act. The Stationary Office, London South Wales Adult Protection Forum (2004) Inter-Agency Policies and Procedures for responding to Alleged Abuse and Inappropriate Care of Vulnerable Adults in South Wales, SWAP Forum Welsh Assembly Government (2000) In Safe Hands: The implementation of adult protection procedures in Wales. Cardiff: Welsh Assembly Government RECOMMENDATION The Committee is asked to RECEIVE and NOTE the report. IMPACT ASSESSMENT Health Improvement Workforce Financial The attached annual report outlines key areas of work which supports the statutory requirements for safeguarding adults The UHB workforce will be trained to support the delivery of good practice within adult protection requirements. To ensure safeguarding adults is a priority for Divisions The work of the SASG aims to protect UHB from adverse outcomes for adults and reduce financial claims Title of Report Page 22 of 23 Name of Meeting

23 Legal Equality Environmental will bring with it legislative changes to both the Safeguarding Adults and Domestic Violence agenda. The work of the Safeguarding Adults Team has a positive impact upon the equality and Diversity agenda promoting equity of service for all. No issues to note. RISK ASSESSMENT Clinical/Service Promote consistent response to safeguarding adults across UHB Financial Reputational Implications if reduction in safeguarding team to fulfil statutory responsibilities. Heightened levels of staff engagement in safeguarding adult agenda to ensure UHB meets its statutory requirements and avoid adverse media. CONSULTATION AND ENGAGEMENT SOURCES OF INFORMATION & EVIDENCE Title of Report Page 23 of 23 Name of Meeting

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