Agenda item

The Health & Social Care Sub-Committee is asked to: -

1.     Note the Croydon Safeguarding Adult Board Annual Report 2021-2022.

2.     Consider whether there are any considerations or concerns it may wish to submit to the Cabinet during its consideration of the Annual Report.

3.     In particular, give consideration as to whether the Annual Report provides sufficient reassurance on the performance and effectiveness of the Croydon Safeguarding Adult Board.

The Sub-Committee considered the Annual Report for 2021-22 from the Croydon Safeguarding Adults Board, as set out on pages 35 to 78 of the agenda, with a view to reassuring itself on the performance of the Board, prior to the report’s consideration by the Cabinet. The Independent Chair of the Board, David Williams, introduced the report.

The Chair asked about the effectiveness and key strengths and weaknesses of the Partnership. The Corporate Director Adult Social Care & Health stated that the commitment of the partners was a particular strength, with strong participation across many sub-groups from the partners; it was recognised, however, that data collection and the building of the scorecard still required additional work. The Cabinet Member for Health and Adult Social Care agreed on the importance of good up-to-date qualitative data and proper data sharing between the partners. The Detective Superintendent for Public Protection commented on the willingness of the partners to learn from each other and to engage with the action plans resulting from Safeguarding Adult Reviews (SARs) but felt that transitions between the Children and Adult Safeguarding Boards could be strengthened and would be a key area of focus for the partnership going forward. The Director of Public Health added that data interpretation was important, and that this had come a long way, although the differences in safeguarding legislation for children and adults could make it difficult to deliver a joined up multiagency approach. Members heard that increasing inequality and vulnerability in Croydon, and nationally, remained a key challenge. The Independent Chair explained that the engagement and commitment of partners were key to the success of the partnership, and that work to improve data collection would be prioritised. The Director of Safeguarding at Croydon Health Services restated that closing the gap in the transitions between the Children and Adult Safeguarding had been identified as an area for ongoing improvement work.

Members queried the inclusion of 2011 census data in the report and asked why more recent estimates had not been used that excluded children. The importance of good data was highlighted, and it was noted that the Mayor of London 2019 demographic predictions broke down ethnicity for white adults into ‘White – other’ and ‘White – British’; it was stressed that White – other’ was a significantly large group and that inclusion of the distinction in the report was important to allow for meaningful comparisons. The Sub-Committee commented on the ‘what has been done’ section of the report and noted that this was largely composed of assertions. Members asked for quantitative data that demonstrated outcomes the Board had achieved. The Corporate Director Adult Social Care & Health responded that the ‘Voice of the People’ (VOTP) group had been established to work with residents with lived experience to provide a strong voice in Adult Safeguarding; the group had been the first established in London and had since been rolled out London-wide as an example of best practice. Members asked that for future reports that there was quantitative data to show this was making a difference in the form of measurable outcomes that could help to provide reassurance to the Sub-Committee. The Director of Safeguarding at Croydon Health Services responded that this kind of data in health settings could be tricky to capture but thanked Members for this challenge. Members heard an example of an outcome from a SAR of a policy change that meant that practitioners were no longer using family members as translators; the Sub-Committee were grateful for this example and asked for more similar information to be included in future Annual Reports.

The Sub-Committee asked for greater inclusions of trends and comparisons over previous years and to other similar local authorities for future Annual Reports; it was stated that this could help to provide greater reassurance to Members. The Chair asked for insight from the partners about what the situation of Croydon was compared to other similar boroughs. The Detective Superintendent for Public Protection explained that scrutiny of the ‘front door’ had helped to identify areas of over referral from the police which could overwhelm Adult Social Care, and improvements had been made as a result to make the ‘front door’ more effective. The Corporate Director Adult Social Care & Health explained that work was being done with the South West London Integrated Care System (ICS) and Association of Directors of Adult Social Services (ADASS) through the Independent Chair to understand the regional and national picture. Members heard that there would likely be an inspection of Adult Social Care in the next year by the Care Quality Commission (CQC); the safeguarding workstream would be a priority area for scrutiny but it was thought that adult safeguarding was not a high-risk area for Croydon. The Director of Public Health stated that metrics would be revisited for the next Annual Report.

Members asked about referrals to safeguarding and the suggestions that these had decreased, in part, due to the Croydon Adult Support Team having been able to divert people to other services where safeguarding was not needed. The Sub-Committee asked if the training the Croydon Adult Support Team had received allowed them to properly pick up on safeguarding issues, and if there were any figures for those who had been directed away from safeguarding services in error. The Corporate Director Adult Social Care & Health explained that the ‘front door’ had changed to include experienced staff and social workers to perform triaging on the referrals that were coming into the safeguarding service. There was a daily meeting with the Section 42 Team to review cases to see if they required a full Section 42 enquiry or an alternative service or assessment. The Corporate Director Adult Social Care & Health stated that they were confident in the training staff had received and that robust processes were in place with experienced staff at the ‘front door’.

The Sub-Committee asked about how awareness and trust could be increased and suggested the publication of outcomes. The Corporate Director Adult Social Care & Health stated that safeguarding was everybody’s business, and that training was provided through a number of different avenues alongside the publication of SARs; learning from SARs rolled out further than professionals and included the voluntary sector. The Cabinet Member for Health and Adult Social Care added that all councillors had been offered training on adult safeguarding as it was a complex area. Members commended this but highlighted the importance of raising public awareness; the Cabinet Member for Health and Adult Social Care explained that there was work being undertaken to raise awareness through churches, localities programmes, residents’ associations and other groups.

In response to questions about what training was provided by the Partnership on mental health, Members heard that the Metropolitan Police had an internal mental health team that provided training to other officers and that this included training on neurodivergence and autism. The Corporate Director Adult Social Care explained that there was a full multiagency training programme on safeguarding in Croydon, that was open to professionals and the voluntary sector; data on attendance could be provided to Members at a later date. The Independent Chair explained that there had been extensive conversations with the chair of the Training and Development Sub-Group about measuring training outcomes.

Members enquired about residents with mental health issues and the likelihood they would have exposure to the police before other partners and asked how information on these individuals was shared to provide the best possible response. The Detective Superintendent for Public Protection explained that there were residents with mental health issues who the police had repeat contact with, but that often members of the police mental health team would go out to visit these people with other officers to provide on the job training. Multiagency meetings took place to discuss those the police had repeated contact with to agree the best way forward to ensure the safety of the individual, residents and practitioners. The Sub-Committee heard that there was a threshold for safeguarding that needed to be met that included a health and care need and, where there was criminal activity, the police would be involved but that not every individual met this threshold. Where these individuals did not meet the threshold there were other avenues that could be taken including mental health assessments and referrals to their GP.

Members asked about the commitment to safeguarding of practitioners in the partnership and heard that there was always room to improve and new learning coming out of SARs that needed to be shared. The Designated Nurse for Safeguarding Adults (South West London) explained that for health, it was important that staff received the appropriate level of training for their level of responsibility.

Conclusions

1.    The Sub-Committee accepted that data analysis had been of lower quality than desired but were reassured that the partnership recognised this and were working to improve data capture and quality.

2.    The Sub-Committee was of the view that the Chair and Vice-Chairs should meet with the Corporate Director Adult Social Care & Health, the Independent Chair and Director of Public Health to do a piece of work aimed at providing reassurance to Members on the work of the Partnership in Croydon.

Recommendations

1.    The Sub-Committee recommended that information in the report from the 2011 Census was replaced with more up-to-date information or predictions, and that ethnicity data distinguished between ‘White – Other’ and ‘White – British’.

2.    The Sub-Committee requested the inclusion of more quantitative data in the next Croydon Safeguarding Adult Board (CSAB) Annual Report including trends and comparisons over previous years and with other similar local authorities.