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HEREFORDSHIRE SAFEGUARDING ADULTS BOARD Strategic Board Meeting

Date: 21 March 2016 Time: 2.00pm to 4.00pm Venue: The Shirehall, Hereford. Present Ivan Powell IP Independent Chair, HASB Stephen Vickers SV Assistant Director Operations and Support – arrived at

2.50pm Mandy Appleby MA Head of Operations, Adults Wellbeing Paul Hooton PH Director of Nursing, Wye Valley NHS Trust arrived at

14:29 Steve Eccleston SE Head of Protecting Vulnerable People West Mercia

Police Tom Currie TC Assistant Chief Officer National Probation Service Martin Samuels MS Director for Adults Wellbeing Colin Javens CJ Healthwatch Alison Curson AC Deputy Director of Nursing, 2Gether NHS Trust Cllr Patricia Morgan PM LA Anne Owen AO Interim Executive Lead Nurse - CCG Apologies Received Jacqui Bremner JB Herefordshire Carers Karen Halls KH HVOSS John Roughton JR Head of Safeguarding and Review, Children’s Wellbeing Neil Bagley NBa Blackwells Providers Lynne Renton LR Head of Safeguarding - CCG Christine Duggan CD Managing Director - Hereford Housing Arif Mahmood AR Consultant, Public Health Adam Scott AS Assistant Director Childrens Safeguarding and Family

Support. /outlook declined Andrew Bourne AB Chief Officer, Community Rehabilitation Company In Attendance Bill Joyce BJ Interim Business Unit Manager Anne Bonney AB Learning and Development Office HSAB,/HSCB/HCSP Belinda Lewis BL Minutes - Business Support Co-ordinator Jade Brooks JB CCG TDCI Vikki Reay VR West Mercia Police

1. Introductions and apologies received

Action

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2. Declarations of any other business None declared.

3. Chairs up-date Chair attended a West Midlands regional workshop billed as a revision of the West Midlands policy and procedures, and an event to share regional and national learning from SAR’s. The event was not quite as billed. There was a briefing from the West Midlands editorial group (on regional procedures), it is anticipated that the revised guidance will be available from the end of May 2016. The Chair reminded the board that the policy and procedures editorial group have been meeting frequently for some time, and that locally we are already adhering to agreed policy and procedure, any amendments to policy and procedure are implemented in a timely fashion. The SAR workshop was not an event to share learning it was a briefing on differing SAR methodologies currently being promoted by two private organisations. A project is currently underway led by the regional chairs network to explore how a ‘repository’ for SAR’s and promotion of learning from same could be established. This piece of work is being coordinated by Alan Coe Chair from Wolverhampton. Chair explained that he had written to ACC Singer West Mercia and Warwickshire Police who has lead responsibility for the public protection portfolio, which includes adult safeguarding, outlining a number of areas for discussion. (Letter attached) Performance data, the current dataset provided by West Mercia Police is based upon a dataset established at a particular moment in time by a former public [protection] lead. This dataset is no longer fit for purpose and is the subject of ongoing discussion with the police performance unit. There is also some ongoing discussion with regard to the links between the police specialist adult safeguarding officers, and the uniformed cadre of response officers who are most likely to be carrying the more significant proportion of safeguarding matters.

Attachment

3.1

Attendance at Board and Sub Group Meetings: It had been recognised at the HSAB Development Day that the meeting structure should be stripped back as far as business would allow, alleviating the burden on members, which has been done. Attendance at meetings however is still not good. The Chair will send another message out to Board members.

Ivan Powell

Re-inspection of WVT - Inspection report findings from 2014. The new report (January 2016) has again found the same adult safeguarding concerns which were detailed in the report findings from 2014. Whilst assurance had been given by the previous Director of Nursing about progress against the patient care improvement plan, it would seem that the actual oversight of the work had not been robust enough.

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3.2

The Chair has highlighted the re-assurance required and this will go to the CCG to oversee. AO informed that further scrutiny to gain assurance will also be provided through the monthly meetings held with the CCG, CQC and NHS England to scrutinize the improvement plan. The Trust is being re-inspected at the beginning of July which will be the same inspection team to provide consistency. The Chair has tasked himself to ensure that a professional from adult safeguarding is in attendance. It was probably unhelpful that there was no adult safeguarding professional represented within the last inspection team. MS stated that it was important as a Board to give feedback to the report if there are areas that are open to analysis and interpretation and use local knowledge to support the Trust. Equally if there are areas which the Trust needs support where the same themes are emerging the Board is where the robust discussions need to take place. In terms of Adult Safeguarding resilience and MCA. The Chair acknowledged the work and commitment of Cath Holberry; however, there remains concern that a single safeguarding lead is not providing the trust with sufficient resilience.

Ivan Powell

4. Case Study Discussion: Recognising and Responding to Vulnerability: TDCI Vikki Reay – Alliance PVP Strategic Team.

The Presentation of the Pilot was well received by the Board. The Pilot will be evaluated by the Worcester University and phase 2 will be rolled-out Warwickshire wide. The evaluation will look at whether this has changed; what is being done front line and engage the College of Policing, to change the training to meet the changing policing environment. The main emphasis is on ‘professional curiosity’ which the college of policing have brought in and not just to follow a tick box exercise. The aim is to encourage and empower the force to have control over their own learning and to find out more for themselves. This will give officers more job satisfaction and raise morale. SE: The force is relying on the youngest and least experienced staff to pick up on these issues. MS: A fascinating presentation; and reflected that following procedure and working on autopilot is something that everyone can reflect on within their own organisations. Easier to re-design processes, risk is not dealing with straight forward items. TC: Heartened to hear about professional curiosity however this only scratches the surface. Professionals still need to understand processes and will need the time to get behind understanding professional practice. MA: Reflected that the issues raised can be shared with the ‘principal social work network’. MA will pass on the links. Outside of the meeting the Chair and SE will discuss the troubled individual, time bounded and inappropriate cases.

5. Minutes of previous meeting actions arising and action log

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The Minutes had previously been circulated to Board members for comment and therefore should already be agreed. For governance purpose the minutes were agreed. Action Log: Triangulation of WVT Report: work is being completed and is on– going. Business Unit Budget: It is important the budget agreement from partners is agreed. The budget to be presented at the next Executive Meeting

6 Crisis Care Co-cordat up-date: Jade Brooks Programme Manager Children and Mental Health Services

‘Professional Curiosity’ highlighted earlier in the meeting is also a part of the work of the interagency group. The first part is to move the agenda on and then take a look back; therefore the action plan is continually evolving. The Board is asked to note the contents of the report and action plan. Areas of discussion:

Staffing in a place of safety. Options are being looked at. It is noted that most service users do not come in on a 136 but through A&E.

Addressing gaps in urgent care pathway (111 services), part of the pilot is to place mental health nurses in police control rooms.

In response the Chair asked if JB had enough strategic intelligence to pull this information together. JB has identified the costs and will be providing a report that recognises the 27/7 volume in A&E. The benefits of providing a place of safety save A&E and police officer time. Links within the community are being explored with the Samaritans and MIND coming on board.

MCA Training for Front line staff. In response TC stated that it was critical to have sign up by all partners. In acknowledging this gap in partnership working TC will work with JB on this. JB has looked at forensic pathways and liaison.

The Chair asked if there was anything the Board could do in support. JB responded there is good attendance with energy and support from all parties. An up-date on the impact of changes will be brought back to the Board at a future date.

7. Executive Report

7.1

Quoracy issues:

Is still a problem for Board and Sub-Group meetings?

AB agreed to look at exploring video conferencing facilities. Police and Probation have access within their organisations to video conferencing.

Definition of Adult CSE

The extent and capacity of services to respond was raised by BJ.

In response LR and MA are already looking at the adult component

Anne Bonney

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7.2

7.3

7.4

and will report back to the Board.

There is only anecdotal information on Adults that are being sexually exploited, patterns are not known. TC asked if there is capacity within the groups to carry out a scope.

Aggregated information could be obtained through WRASAC.

It was agreed that Adult CSE thematic issues need to be known. IP, SV and MA to meet and report back to the Board.

Comms Sub- Group:

BJ reported the TOR are agreed and a very good last meeting had taken place.

What is required are key messages from the Board linked to priority areas, who to communicate to and how.

PAQA:

MCA Audit: The response has been poor this will be followed up by the Chair.

Annual Self-Assessment: Report will go to the April Executive. JCR:

PLR meeting has been held which identified key learning around health. Alison Feher 2gether NHS Trust Lead will be writing the report to present to the Executive in April.

AS is currently looking at the JCR agenda and operating procedures.

Ivan Powell Mandy Appleby Stephen Vickers Ivan Powell

8.

8.1

Strategic Plan – Focus on prevention: Ivan Powell – Independent Chair SAB. The findings from the peer review were that the Board needed to have a greater focus on prevention. Prevention duties mainly fall to the LA. The Strategic Plan was circulated to the meeting and the matter was thoroughly debated. What was identified in the discussion was that services and agencies were already carrying out prevention work and strategies were already in place. It was felt that this had not been properly articulated to the Peer Review. SV confirmed that the service is empowering people to live independent lives, strategies are in place to keep people well. From a practice point of view the evidence is that this is in their best interests, even when most vulnerable. There is information available to support this and what neglect looks like. CJ highlighted the Direct Payment scheme which allows him to get on with his life and be very independent. However awareness needs to be raised within the community if a crisis arises and where to get support. It was agreed that this could be picked up as part of the MSP Review. Action: Alex Fitzpatrick (Commissioning Officer) to be asked to consider this under the ‘WISH’ programme. It was agreed that a narrative and ‘comms’ around the work that is already being done to include CSE, is required. The public need to be aware of what neglect looks like and have access to information. The message is keeping everyone safe and independent.

Business Unit

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8.2

The WISH Service link signposting services as highlighted by Cllr PM to go out with the minutes. In conclusion, the Peer Review reflected well on MSP however SV noted that what has not worked well is the externalisation of the work. The MSP Review will pick this up and reflect on work that is already being done on the preventative story. A strategy and a prevention lead will be available. The Chair reflected on the very useful discussion held.

Business Unit

- MSP: Additional Item: (Document was circulated at the meeting) The review was launched in January and this is being undertaking by an internal MSP group. The LA made a conscious decision to launch internally and systems were adapted to suit the MSP system. The Board were asked to note the contents of the document.

9. Scorecard Quarter 3

9.1

The production of a Board Scorecard is still a problem area. This was a criticism of the Peer Review for not having this information in place. It was noted that this is problem throughout the country; however, the Board were positive about the data received at today’s Strategic meeting and will continue to build on this. The CSE Thematic Scorecard was presented by AB to the Board as an example of data that had been collected which looked at key outcomes and indicators and mapped information. The scorecard had been presented and was well received by the Children’s Executive earlier in the month. It was noted that Performance Reporting at SMT by Children’s and Adults is carried out as part of the ‘day job’ however what the Chair requires is performance from multi-agencies. SV stated that strategically training is a risk and is more important than data. The aim is to get workforce training that is good quality and meets the framework mandated across the services. In conclusion, the Chair stated that as a Board there is a commitment to have relevant data available for assurance. AB and LR have spent a lot of time on this. The Chair AB and LR will have further discussions on this item.

Ivan Powell Anne Bonney Lynne Renton

11. AOB – No items presented. The Meeting finished at 14:46.

DATE OF NEXT STRATEGIC BOARD MEETING

9 JUNE 2016

9.30 – 12.30PM

PLOUGH LANE – FOWNHOPE AND MORDIFORD

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PAGPAGE

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ITEM ACTION RESPONSIB

LE PERSON

DUE DATE

2 3.1 Attendance at Board Meetings. The Chair will send another message out to Board members.

Ivan Powell Before 9 June

2016

2 3.2 WVT Trust Re-inspection: The Chair to ensure that a professional from adult safeguarding is represented within the Team.

Ivan Powell Before July

2016

3 5 Business Unit Budget: The budget to be presented at the next Executive Meeting

Agenda Item

Business Unit

9 June 2016

4 7.1 AB to look at exploring video conferencing facilities. Police and Probation have access within their organisations to video conferencing.

Anne Bonney Before 9 June

2016

7.2 It was agreed that Adult CSE thematic issues need to be known. IP, SV and MA to meet and report back to the Board.

Ivan Powell

Stephen

Vickers

Mandy

Appleby

Before 9 June

2016

7.3 PAQA Sub Group: MCA Audit: The response has been poor this will be followed up by the Chair.

Ivan Powell Before 9 June

2016

5 8.1 WISH PROGRAMME: CJ highlighted the Direct Payment scheme which allows him to get on with his life and be very independent. However awareness needs to be raised within the community if a crisis arises and where to get support. It was agreed that this could be picked up as part of the MSP Review. Action: Alex Fitzpatrick (Commissioning Officer) to be asked to consider this under the ‘WISH’ programme.

Business Unit Before 9

January 2016

6 8.2 The WISH Service link signposting services as highlighted by Cllr PM to go out with the minutes.

Business Unit Actioned

6 9.1 Scorecard: The Chair AB and LR to hold further discussions on this item.

Ivan Powell

Anne Bonney

Lynne Renton

Before 9 June

2016