7.1 The chair welcomed Terry Hutt, independent chair of the Safeguarding Adults Partnership Board, to present the report. The independent chair drew member’s attention to the Executive Summary and noted the statistical trend outlined in the report that detailed the year on year increase in the number of Safeguarding alerts. He went on to explain that Southwark is no different than other local authorities; all boroughs are experiencing increasing alerts. He commented that the general feeling is that this is because people are getting better at reporting.
7.2 The trend in Southwark is that more women than men are likely to be the subject of a safeguarding alert. The majority of allegations relate to abuse in peoples home (63%). Over 43% relates to financial abuse and this is the most common type. He explained that the abuse that takes place in peoples homes is often by people’s relatives and sometimes care workers. He reported that financial abuse is a growing trend and this needs a different form of investigation as often the investigators have to talk to banks. He explained the next most common form of abuse is physical, and then it is neglect.
7.3 The independent chair explained that he wanted to talk about the mental capacity act. This about people’s ability to make choices, about the presumption that you can make the choice and about correctly assessing that people have the ability to do that. He explained that the partnership is investing in training. The training takes about 30 minutes and he recommended the committee undertake this.
7.4 The independent chair referred to the committee’s earlier discussions on care homes and noted that the safeguarding report talks about commissioning embargoes. He explained that 30 % of times this is because of safeguarding. This can be because of neglect or poor medicine practice and occasionally physical abuse. He said that good practice in care homes is often about leadership and the role of managers and communication. He commented that his experience is that there is good practice by monitoring officers. He said that this is not all about money and in his view you get good practice when there is good communication between monitoring officers; Lay Inspectors and home care managers. He explained that Southwark will be increasing it safeguarding monitoring of care homes in Southwark.
7.5 The independent chair drew members attention to the pie charts in the report that show the group most at risk of abuse are older people; this is often financial and mostly in peoples homes. He said that the partnership have to be concrete about where and who is being abused. He went on to note that abuse is rarely by strangers and is generally by relatives and sometimes professional care workers. He said the partnerships work is about developing a strategy to tackle these trends.
7.6 The chair invited questions and comments and a member asked who is on the board and how often to they attend. The independent chair responded that they we will add members of the board to the report. He reported that board meeting are generally well attend, however he reported that he does have a concern about one partner which is being dealt with.
7.7 A member asked about the level of criminal prosecutions and if this is the right proportion. The independent chair responded that in terms of proportion Southwark is a little below average .He commented that this is a very difficult issue; often the main witness is the victim and sometimes there are communication difficulty, for example learning difficulties. It about evidence that will hold up in court. He said that criminal action is pursued where we can do it.
7.8 A members asked about the safeguarding and Personalisation and the independent chair responded that the Personalisation agenda is a cultural shift agenda; from a dependency culture to enablement and support. He said for it to work it is about a public shift and developing models and examples that actually work. Personalisation raises safeguarding issues for some of the more unregulated activities that can occur.
7.9 A member asked the independent chair to comment on safeguards in place for a care worker who might have a criminal record or previous employment issues of abuse. The independent chair was asked what systems we have in place. He responded we have very good policy systems and these are used by our contactors. However there have been some instances whereby these policies have not been implemented by outside contractors. Personalization also raises risks as people can employ people have had no checks. We do advise people about risks, but it is a personal choice for people.
7.10 The independent chair went on to say we also need to bear in mind that many people are self funding from care homes. These people do not have many of the protections that the council funded placements have. A member asked how can we ensure that people can buy in that protection, is it a role for Care Quality Commission? The independent chair pointed out that their budget has been cut so their capacity is reduced. He commented that another way is through public information.
7.11 A member asked about more invidious practices such as the over prescription of drugs leading to “chemical coshes”, and asked how this can be picked up on. The independent chair commented that there is more awareness that some groups of people, such as older people with dementia or learning disabilities with challenging behaviour are more at risk. The independent chair explained that formally there was a more rigorous process of regulation but now homes use self assessment. A member commented that this is what got us into the financial mess!