East & North Herts CCG Adult Safeguarding Training Strategy

East & North Herts CCG Adult Safeguarding Training Strategy

Version Control Document Owner Director of Nursing and Quality Document Author Stephenie Evis Version 1 Directorate Nursing and Quality Approved By Quality Committee Date of Approval 7 th March 2019 Date of Review 7 th March 2021 Document History Version Date Reviewer Revision Description 1 2 Strategy Validity Statement This Strategy is due for renewal on the latest date shown above. After this date, Strategy and process documents may become void. Policy users should ensure that they are consulting the currently valid version of the documentation. 1

Contents 1. Introduction and Scope... 3 2. Purpose... 3 3. Statutory Framework... 3 3.1. Supporting Documents... 4 4. Training Delivery Arrangements... 4 5. Content of Training... 4 5.1 Training Values... 4 6. Training Monitoring... 5 7. East and North Herts CCG. 5 7.1 Roles and Responsibilities... 5 7.2 East and North Herts CCG... 5 7.3 Chief Executive Officer/Accountable Officer... 6 7.4 Designated Nurse... 6 7.5 Named Nurse... 6 7.6 Directors and Line Managers... 6 7.7 Staff... 6 8. ENHCCG Governance and Quality Assurance... 6 8.1 CCG Staff... 6 8.2 Provider Services... 6 9. Training Requirements... 7 9.1 ENHCCG Adult Safeguarding Training Matrix... 8 10. Primary Care...12 10.1 Roles and Responsibilities... 12 11. Governance and Quality Assurance... 12 11.1 Existing quality Assurance Process... 12 11.2 Future option... 12 12. Training Requirements for Primary Care... 13 12.1 Primary Care Adult Safeguarding Training Matrix... 14 13. Appendices... 16 Appendix I.17 Appendix II...18 Appendix III..19 2

1. Introduction and Scope This training strategy sets out the expectations of the training CCG and primary care staff should be provided with, dependent upon the nature of their adult safeguarding responsibilities. For greater clarity, training requirements and quality assurance processes have been separated for the CCG and primary care. The CCG s aim for adult safeguarding is: To keep people safe and free from potential or actual abuse or neglect. To be a leading CCG and county in adult safeguarding. Our vision is to work together with partner agencies to prioritise the safety and welfare of adults experiencing, or at risk of abuse or neglect across all commissioned and contracted services and primary care. Education and training is crucial to facilitate the delivery of the CCG s vision for adult safeguarding. This strategy applies to CCG and primary care staff members. This includes staff working on an honorary contract basis, those gaining work experience and third parties undertaking work on behalf of the CCG or within primary care. 2. Purpose The purpose of this strategy is to provide a framework which ensures that the CCG and primary care meet contractual and legislative responsibilities to provide all staff with the knowledge and skills to fulfil their duties in relation to adult safeguarding and work effectively with those from other agencies to safeguard and promote the welfare of adults. The level of adult safeguarding training required is dependent on the staff member s role and responsibilities, and following the completion of their induction programme, should be linked to the annual appraisal process and a personal development plan. The strategy has been formulated using statutory guidance and key principles outlined in Section 3. 3. Statutory Framework This Strategy reflects the statutory guidance outlined in the Care Act 2014 1 and the Care and Support Statutory Guidance (2016) 2 that replaced No Secrets and the previous adult safeguarding procedures and terminology used. In order to help address the variance in training needs across the health economy, the Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate document 3 and the Prevent Training and Competencies Framework 4 are utilised for guidance on competencies, knowledge and skills required for all levels of staff within the CCG and primary care. 1 Department of Health and Social Care (2014) Care Act 2014. 2 Department of Health and Social Care (2016) Care and Support Statutory Guidance 3 Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate document. 4 NHS England (2017) Prevent Training and Competencies Framework 3

The intercollegiate levels of competency, knowledge and skills are therefore explicit within this strategy, corresponding to individual roles and responsibilities. 3.1. Supporting Documents Department of Health and Social Care (2014) Care Act 2014. Department of Health and Social Care (2016) Care and Support Statutory Guidance Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate document. NHS England (2017) Prevent Training and Competencies Framework East and North Herts CCG Adult Safeguarding Policy (2017) 4. Training Delivery Arrangements Adult safeguarding training may be delivered in any method that adheres to the requirements set out in the Intercollegiate Document Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. The training must be accessible to all staff, ensuring that specific needs are met such as those related to visual impairment, hearing loss, mobility difficulties, language difficulties or learning difficulties to enable full inclusivity and compliance with the Equality Act (2010) 5. 5. Content of Training This Strategy provides an overview of the training expected to be undertaken. It does not outline any course in detail. CCG and primary care staff are expected to be familiar with local training plans and follow local guidance on applying for courses. All training must be informed by current research evidence, lessons from safeguarding adult reviews, domestic homicide reviews and national and local developments. It must reflect an understanding of statutory responsibility and demonstrate an active respect for diversity, experience of service users and commitment to equality of opportunity. In the absence of a national training passport across all sectors, arrangements should be developed to assess employee s prior skills, knowledge and competence in order to use the training to best clinical effect. Appraisal of training may be undertaken using evaluative techniques with an emphasis on learner feedback that can in turn be utilised to review and modify training packages in accordance with feedback. Version control of the content of successive courses must be auditable. 5.1 Training Values All training should place as the centre of focus the adult, promoting the importance of Making Safeguarding Personal (Care Act,2014). 5 Legislation.gov.uk Equality Act 2010. Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents 4

Training should reflect the principles of collaborative working, valuing the difference in roles, knowledge and skills of personnel. Demonstration of respect with regard to diversity in culture, race, religion and disability and promotion of equality should be evident. 6. Training Monitoring Annual appraisal is essential in determining individuals attainment and maintenance of the required knowledge, skills and competence. Any gaps identified in adult safeguarding knowledge will be addressed within an agreed timescale and built into the individual s training programme. Training activity for CCG staff will be monitored via local mandatory training arrangements and the appraisal process. Training activity for primary care staff will be monitored through the practice process for managing mandatory training. All records of adult safeguarding training should also be retained by the staff member. 7.0 East and North Herts CCG This section lays out the roles, responsibilities and training requirements for CCG staff. 7.1 Roles and Responsibilities 7.2 East and North Herts CCG East and North Herts CCG have a responsibility to ensure that staff have a clear awareness of their individual and corporate responsibilities in relation to adult safeguarding. This is achieved through training staff members to an appropriate level, in line with Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate document, in order to recognise and respond to safeguarding concerns. The CCG must ensure that standards for adult safeguarding training are made explicit within its commissioning arrangements. Training compliance and quality assurance is monitored via provider reporting mechanisms such as Dashboards, Audit and quality meetings. 5

The CCG s Human Resource and Organisational Development and Learning Services must ensure that all job descriptions and employment contracts outline the CCG s commitment to adult safeguarding and mandatory training. 7.3 Chief Executive Officer/Accountable Officer Overall accountability for safeguarding within East and North Herts CCG rests with the Chief Executive /Accountable Officer. The Director of Nursing and Quality is the Governing Body Safeguarding Champion. 7.4 Designated Nurse The CCG s Adult Safeguarding Designated Nurse provides strategic leadership on adult safeguarding across the health economy; working closely with CCG staff, providers, partner agencies and other stakeholders. The Designated Nurse oversees the work of the Named Nurse in developing and maintaining training in line with national guidance and local adult safeguarding priorities. 7.5 Named Nurse The CCG s Adult Safeguarding Named Nurse has the responsibility to develop and maintain adult safeguarding training competencies that are compatible with national guidance and local multiagency policies for all staff, incorporating lessons learned from serious incidents, safeguarding adult reviews and domestic homicide reviews. 7.6 Directors and Line Managers All managers have a responsibility to ensure that staff access safeguarding training pertinent to their role as outlined in this Strategy. Training must be reviewed at annual appraisal and future training needs identified. Staff must be afforded time to attend training as necessary. Safer recruitment practices must be adhered to and Disclosure and Barring Service (DBS) checks undertaken in line with national and local guidance. 7.7 Staff All CCG staff must adhere to this strategy and participate in training relevant to their role within the specified training timescale. Staff should be alert to the potential indicators of abuse or neglect and understand how to act on concerns in line with local guidance. 8. ENHCCG Governance and Quality Assurance 8.1 CCG staff CCG managers have the responsibility to ensure their staff are compliant with their mandatory training. Assurance will be required by the board and NHS England that all CCG staff are trained to an appropriate level in adult safeguarding. This will be monitored through the HR mandatory training processes and reported to each Director in the Mandatory Training Report monthly. 8.2 Provider Services Adult safeguarding requirements are specified in provider contracts. All contracted services will record information in relation to numbers of staff requiring each level of training, in accordance with the Intercollegiate Document, Royal College of Nursing (2018) Adult Safeguarding: Roles and 6

Competencies for Health Care Staff, as well as training attendance for all levels. This will be monitored by the CCG through quarterly dashboards to ensure compliance and quality assurance. 9. Training Requirements Adult safeguarding training is a mandatory requirement for all CCG staff. The level of required training is proportionate to competencies for the role and must comply with the Intercollegiate Document: Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. The essential training level will be dependent upon whether the staff member has contact with patients/people and their families, the nature of their work and level of responsibility. There is clear guidance from the Royal Colleges about the appropriate competencies and levels of training in adult safeguarding for different members of staff. These are clearly defined and need to be demonstrated for purposes of annual appraisal and revalidation. All newly appointed employees of the CCG must attend an organisational induction programme which specifically outlines adult safeguarding responsibilities and provides an introduction to Prevent (one of the four elements of CONTEST, the Government s counter terrorism strategy.) This induction must be attended within 3 months of commencing employment. For a full listing of CCG adult safeguarding training requirements, by role and responsibility, please see the table in section 9.1. 7

9.1 ENHCCG Adult Safeguarding Training Matrix Refer to Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate document for competencies and learning outcomes. Level of Training Target Group Frequency Access Induction including Basic Prevent Awareness Training (BPAT) All CCG Staff 30 minutes at Induction within three months of commencing in post Face to Face mandatory training via HR department Level 1 and Basic Prevent Awareness Training (BPAT) All CCG staff Over a three year period, staff at level 1 should receive refresher training equivalent to a minimum of 2 hours. e learning (access via ESR) or face to face training and completion of e learning assessment BPAT can be accessed here: https://www.elfh.org.uk/programmes/statutory andmandatory training/ Level 2 and Basic Prevent Awareness Training (BPAT) All CCG staff that have regular contact with patients, their families or carers, or the public. This is the minimum level of competence for all professionally registered healthcare staff. Training equivalent to a minimum of 3 4 hours over a three year period. Training at level 2 will include the training required at level 1 and will negate the need to undertake refresher training at level 1 in addition to level 2 e learning and/or face to face training and completion of e learning assessment BPAT can be accessed on line at: https://www.elfh.org.uk/programmes/statutory andmandatory training/ Quarterly group supervision with Named Nurse for Adult Safeguarding for CCG staff having contact with service users. Level 3 and Workshop to Raise Awareness of Prevent (WRAP) Professionals who contribute to assessing, planning, intervening and evaluating the needs of adults where 8 hours of education and Learning related to adult safeguarding over a three year period and e learning and/or face to face training and completion of e learning assessment 8

there are safeguarding concerns e.g. Continuing Health Care Team Leaders, Clinical Lead and Assistant Director of Continuing Healthcare. appropriate supervision. Training at level 3 will include the training required at levels 1and 2 and will negate the need to undertake refresher training at levels 1 and 2 in addition to level 3. WRAP training can be accessed on line at: https://www.england.nhs.uk/ourwork/ safeguarding/our work/prevent/ or https://www.elearning.prevent.homeo ffice.gov.uk/mentalhealth Quarterly group supervision with Named Nurse for Adult Safeguarding for CCG staff having contact with service users. Hertfordshire Safeguarding Adults Board hold an annual conference and quarterly forums as well as providing on line training which can be used to supplement core safeguarding adults training. The catalogue can be accessed here: https://www.hertfordshire.gov.uk/servi ces/adult social services/report aconcern about an adult/hertfordshiresafeguarding adultsboard/hertfordshire safeguardingadults board.aspx Level 4 and Workshop to Raise Awareness of Prevent (WRAP) Specialist roles such as Named Professionals Named professionals should attend a minimum of 24 hours of education, training and learning over a three year period. This should include clinical leadership, appraisal, and supervision training National and local seminars and conferences Named professionals should participate regularly in support groups or peer support networks for specialist 9

Named professionals should complete leadership education with a focus on clinical leadership and change management within three years of taking up their post Training at level 4 will include the training required at levels 1 3 and will negate the need to undertake refresher training at levels 1 3 in addition to level 4 professionals at a local and National level, according to professional guidelines (attendance should be recorded) WRAP training can be accessed on line at: https://www.england.nhs.uk/ourwork/ safeguarding/our work/prevent/ or https://www.elearning.prevent.homeo ffice.gov.uk/mentalhealth Level 5 and Workshop to Raise Awareness of Prevent (WRAP) Specialist Executive Level/Director Specialist roles such as Designated Professionals and Prevent Lead Senior managers, executive leads and non executive members with Board Designated professionals should attend a minimum of 24 hours of education, training and learning over a three year period. This should include leadership, appraisal, supervision training and the context of other professionals work An executive level management programme with a focus on leadership and change management should be completed within three years of taking up the post Training at level 5 will include the training required at levels 1 4 and will negate the need to undertake refresher training at levels 1 4 in addition to level 5 Over a three year period, staff should receive refresher training; a tailored National and local seminars and conferences. Designated professionals should participate regularly in support groups or peer support networks for safeguarding professionals at a local, regional, and national level according to professional guidelines (attendance should be recorded) Attendance at a minimum of two NHS England Regional Prevent Forums every financial year; Evidence of partnership working with the areas Channel Coordinator and Counter Terrorism Unit officer(s); Completion of Prevent related training advised by NHS England. Face to Face tailored package 10

Level responsibility for safeguarding Adults package which encompasses Level 1 knowledge, skills and competencies, and basic awareness of prevent (BPAT) as well as Board specific training. 11

10. Primary Care This section lays out the roles, responsibilities and training requirements for primary care staff. 10.1 Roles and Responsibilities for primary care The CQC expects GP practices to have robust systems in place for safeguarding adults at risk. This includes ensuring all primary care staff have received the appropriate level of training for their role, as set out within this strategy and that they all understand the system for reporting concerns. This is applicable to permanent and temporary staff, volunteers, and locum and bank staff. East and North Hers CCG Adult Safeguarding Team support primary care staff in meeting their adult safeguarding duties and supplement statutory training requirements by providing additional updates in relation to current emerging adult safeguarding national or local concerns. Consideration and work is being undertaken to support GP Federations in meeting their adult safeguarding responsibilities. 11. Governance and Quality Assurance 11.1 Existing quality assurance process: NHS England Electronic Declaration (e Dec) Care Quality Commission (CQC). Attendance at TARGET events is monitored by the CCG locality teams. Practices requiring individual support are identified by locality teams or through adult safeguarding processes such as SAR and DHRs. The Primary Care Quality Manager, CCG s Locality Managers and their teams have a duty to support improvements in the quality of primary medical care and a responsibility to support training. The Named Nurse for Adult Safeguarding shares HSAB publications, provides updates at training events and circulates a quarterly newsletter as well as supporting individual practices to implement learning from serious incident reviews, safeguarding adult reviews and domestic homicide reviews. All General Practitioners and associated practice staff are monitored via annual appraisals. Risks and benefits: The risk is that the CCG has limited oversight of the training compliance within primary care. The benefit is that no changes are required to existing contracts. 11.2 Future option: In addition to the existing quality assurance process the adult safeguarding team will send an annual dashboard (example dashboard in appendix III) to all practices to be completed on a voluntary basis. 12

Practices that require additional support to meet adult safeguarding training requirements will be identified and contacted by the Adult Safeguarding Team. This will be reported within the adult safeguarding annual report and presented to the CCG Board. Risks and benefits: Only practices who are engaged and motivated in safeguarding will submit the dashboard. The Adult Safeguarding Team may not have the capacity to meet the demand for training and support. The benefit is that no changes are required to existing contracts. 12. Training Requirements for primary care Adult safeguarding training is a mandatory requirement for all primary care staff. The decision on the competency required for a particular staff member is one for each practice to take, since roles and responsibilities for an employee may vary widely between practices. The essential training level will be dependent upon whether the staff member has contact with patients/people and their families, the nature of their work and level of responsibility. The Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate document provides guidance about the appropriate competencies and levels of training in adult safeguarding for different members of staff. These are clearly defined and need to be demonstrated for purposes of annual appraisal and revalidation. All newly appointed employees must have an induction which specifically outlines adult safeguarding responsibilities. This induction must be completed within 6 weeks of commencing employment. For a full listing of adult safeguarding training requirements, by role and responsibility, please see the table in section 12.1. 13

12.1 Primary Care Adult Safeguarding Training Matrix Refer to Royal College of Nursing (2018) Adult Safeguarding: Roles and Competencies for Health Care Staff. Intercollegiate document for competencies and learning outcomes. Level of Training Target Group Frequency Access Induction All Staff 30 minutes at Induction within six weeks of commencing in post Level 1 Safeguarding Adults Optional: Basic Prevent Awareness Training (BPAT) Level 2 Safeguarding Adults Optional: Basic Prevent Awareness Training (BPAT) All staff This is the minimum level of competence for all professionally registered healthcare staff and GP Practice managers. Over a three year period, staff at level 1 should receive refresher training equivalent to a minimum of 2 hours. Refresher training equivalent to a minimum of 3 4 hours over a threeyear period. Training at level 2 will include the training required at level 1 and will negate the need to undertake refresher training at level 1 in addition to level 2 E learning and/or face to face training if available. E learning e.g. Bluestream, is purchased by each practice and can be accessed via the Practice Manager E learning and/or face to face training if available. E learning e.g. Bluestream, is purchased by each practice and can be accessed via the Practice Manager BPAT appropriate to primary care can be accessed here: https://www.elearning.prevent.homeo ffice.gov.uk/mentalhealth e learning and/or face to face training. E learning e.g. Bluestream, is purchased by each practice and can be accessed via the Practice Manager BPAT appropriate to primary care can be accessed here: https://www.elearning.prevent.homeo ffice.gov.uk/mentalhealth Level 3 Safeguarding Adults Recommendation: Workshop to Raise Awareness of Prevent (WRAP) Professionals who contribute to assessing, planning, intervening and evaluating the needs of adults where there are safeguarding concerns 8 hours of education and Learning related to adult safeguarding over a three year period and appropriate supervision. E learning and/or face to face training. E learning e.g. Bluestream, is purchased by each practice and can be accessed via the Practice Manager 14

Domestic Abuse Modern Slavery and Human Trafficking. General Practitioners and Adult Safeguarding Leads. Training at level 3 will include the training required at levels 1and 2 and will negate the need to undertake refresher training at levels 1 and 2 in addition to level 3. WRAP training can be accessed on line at: https://www.england.nhs.uk/ourwork/ safeguarding/our work/prevent/ or https://www.elearning.prevent.homeo ffice.gov.uk/mentalhealth Hertfordshire Safeguarding Adults Board hold an annual conference and quarterly forums as well as providing on line training which can be used to supplement core safeguarding adults training. The catalogue can be accessed here: https://www.hertfordshire.gov.uk/servi ces/adult social services/report aconcern about an adult/hertfordshiresafeguarding adultsboard/hertfordshire safeguardingadults board.aspx 15

13. Appendices Appendix I: Equality Impact Assessment Appendix II: Privacy Impact Assessment Appendix III: Example of an Adult Safeguarding Training Dashboard. 16

Appendix I: Equality Impact Assessment Screening Form Very occasionally it will be clear that some proposals will not impact on the protected equality groups and health inequalities groups. Where you can show that there is no impact, positive or negative, on any of the groups please complete this form and include it with any reports/papers used to make a decision on the proposal. Name of policy / service What is it that is being proposed? What are the intended outcome(s) of the proposal Explain why you think a full Equality Impact Assessment is not needed On what evidence/information have you based your decision? How will you monitor the impact of policy or service? How will you report your findings? East & North Herts CCG Adult Safeguarding Training Strategy The CCG proposes to introduce an Adult Safeguarding Training Strategy, in line with local and national change. The outcome of the proposal will be to ensure consistent, clear guidance for all staff employed within the CCG (to include staff working within primary care) regarding roles and responsibilities and training requirements in relation to adult safeguarding. Equal opportunity for all CCG staff was taken into consideration when updating this strategy. It is not felt that the strategy update will result in any likely harmful effects on persons protected by the Equality Act. The strategy update does not constitute a major policy/change that would significantly affect how functions are delivered. The training will be accessible to all staff, ensuring that specific needs are met such as those related to visual impairment, hearing loss, mobility difficulties, language difficulties or learning difficulties to enable full inclusivity and compliance with the Equality Act (2010) 6. Training evaluation questions to establish whether the strategy is working for everyone. This will enable provision of a platform for improvement. CCG Due Process Having considered the proposal and sufficient evidence to reach a reasonable decision on actual and/or likely current and/or future impact I have decided that a full Equality Impact Assessment is not required. Assessors Name and Job title Date 6 Legislation.gov.uk Equality Act 2010. Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents 17

Appendix II: Privacy Impact Assessment Initial Screening Tool 1. Policy PIA Completion Details Title: Proposed Existing Names & Titles of staff involved in completing Date of Completion: Review Date: 2. Details of the Policy. Who is likely to be affected by this policy? Staff Technology Does the policy apply new or additional information technologies that have the potential for privacy intrusion? (Example: use of smartcards) Identity By adhering to the policy content does it involve the use or re-use of existing identifiers, intrusive identification or authentication? (Example: digital signatures, presentation of identity documents, biometrics etc.) By adhering to the policy content is there a risk of denying anonymity and de-identification or converting previously anonymous or de-identified data into identifiable formats? Multiple Organisations Does the policy affect multiple organisations? (Example: joint working initiatives with other government departments or private sector organisations) Data By adhering to the policy is there likelihood that the data handling processes are changed? (Example: this would include a more intensive processing of data than that which was originally expected) If Yes to any of the above have the risks been assessed, can they be evidenced, has the policy content and its implications been understood and approved by the department? *Ticking Yes to any section will require completion of the full screening tool for advice contact Head of Governance. Patients Yes No Public Please explain your answers Assessments Completed by Name: Stephenie Evis Position: Named Nurse for Adult Safeguarding Date: Assessment to be reviewed by Head of Information. Head of Information name: Date: Comments: 18

Assessment to be reviewed by SIRO or Caldicott Guardian. Name: Role: Date: Comments: Appendix III: Example of an Adult Safeguarding Training Dashboard. Q 1 Q2 Q3 Q4 MEASURE/ACTIVITY INDICATOR/DEFINITION THRESHOLD Training Risk Management % of eligible staff trained at Level 1 % of eligible staff trained at Level 2 % of eligible staff trained at Level 3 % of eligible staff trained in MCA & DoLS Number of Adult Safeguarding referrals made Hertfordshire Aspirational target: 95% COMMENTARY (GP Practice) APR to JUN JULY to SEPT OCT to DEC JAN to MAR 19