Agenda item

The Health and Social Care Sub-Committee is provided with the Croydon Safeguarding Adults Board Annual Report for 2022/23. The Health & Social Care Sub-Committee is asked to:

1.    Note the Croydon Safeguarding Adult Board Annual Report 2022-2023.

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 a report set out on pages 13 to 60 of the agenda which provided an overview of the work performed by the Croydon Safeguarding Adults Board between 1 April 2022 to 31 March 2023. The purpose of the Croydon Safeguarding Adult Board (CSAB) Annual Report was to detail the activity and effectiveness of the Board. It ensured that the statutory partners (Council, Health and Police), residents and other agencies were given the opportunity to provide objective feedback on the work and effectiveness of local arrangements for safeguarding adults. The report covered the 2022/23 priorities demonstrating what had been achieved and the work which needs to continue throughout 2023/24.

The Independent Chair of the CSAB, David Williams; the Council’s Corporate Director for Adult Social Care & Health, Annette McPartland; the Council’s Director of Adult Social Care Operations, Simon Robson; Sally Innis from NHS South West London and Fiona Martin from the MET Police attended the meeting for this item, to introduce the report and answer questions arising.

David Williams commended and introduced the report to the Sub-Committee,  highlighting that it was an independent, multi-agency report and had been approved by the CSAB as required by the Care Act. It was also acknowledged that officers working on the report had a meeting with Sub-Committee members and all suggestions, especially concerning the CSAB Annual Reports’ accessibility, made by the Members were agreed and would be implemented before the report was published.

Annette McPartland added during the introduction of the report that Nick Sherlock, Head of Safeguarding had retired recently and that the Council had successfully recruited an officer to take over the role. The recruitment process was a multi-agency one and people with lived experience were involved in the process. The newly appointed officer started their work on 3 November 2023. Annette McPartland also thanked Nick Sherlock for his hard work and contribution to Croydon.

Following the introduction of the report, the Sub-Committee had the opportunity to ask questions on the information provided. The first question concerned the lack of Prevention of Future Death Notices received. In response it was acknowledged that this was a borough-wide issue. The CSAB had been working with the Coronial Practice to identify issues that were stopping the relevant stakeholders from receiving them. It was further clarified that the notices should be delivered and in response it was assured that the CSAB was working to resolve this issue. In response to a question about the timescale for resolving the obstacles and receiving the notices, it was advised that this would be investigated, and a response would be provided. It was also explained that at the moment the CSAB had identified it need to improve its understanding of the reporting process.

The next question concerned the number of Safeguarding Adult Reviews (SARs) over the year. It was confirmed that in the 2022-23 only two SARs were completed. The process usually took around six months to complete. In addition to that the process could be slowed down by deaths that occurred in the Borough. 

It was questioned how the Sub-Committee could be assured that the recommendations deriving from SARs were being cascaded and embedded in the services. It was explained that the CSAB used a live action plan which was reviewed on a regular basis with the executive partners. Also, each action was monitored through an assigned RAG (Red, Amber Green) rating. Part of the assurance process was asking executive partners to provide examples for relevant actions. For example on the implementation of new roles in the Croydon Health Service NHS Trust (CHS) which were developed to fill the gaps identified in transitional safeguarding.

The next question focused on the voice of the people in relation to temporary housing arrangements (e.g. B&Bs) and the elevated risk of exploitation. It was explained that housing and homelessness was very challenging in Croydon. The Council was actively trying to minimise the risk for individuals who went through appropriate assessments and had special needs (especially mental health-related). It was highlighted that supported housing and housing differ considerably in terms of managing the markets. When there were any safeguarding concerns, the dedicated quality assurance team would investigate the provider and improve the living situation.

As a follow up, it was questioned what was being done to improve the quality of service provided by the eight housing service providers in the borough who were identified as being inadequate. It was confirmed that there was close cooperation with the commissioning team that would or would not place residents in with these providers. It was also highlighted that some of those inadequate service providers were not operating anymore. However, they could not have been removed from the list until they were deregistered with the Care Quality Commission (CQC). In addition, Councillors were provided on a monthly basis with a report covering any concerns raised in relation to the providers. There was a protocol for provider concerns and there were quality monitoring officers who worked closely with the CQC. There was also evidence that the development system worked resulting in some of the providers improving over time. It was noted that there were many care agencies registered in Croydon, but the Council did not use the services of many of them.

Further reassurance was provided by the Cabinet Member for Health & Social Care, Councillor Yvette Hopley, who explained that she reviewed this area regularly and was assured that there was a very strong team in place to monitor placements. Also, as many inadequate providers had been removed from the list in recent years, it meant that there were more ‘good’ providers in the Borough.

The next question asked for further information on the number and response time of safeguarding referrals and how it compares to the national average. It was advised  that the response time had been reduced in comparison to the previous year. It was highlighted that it was a statutory responsibility for the CSAB, and it was delivered through joint work with stakeholders like FJC (formerly Family Justice Service). It was very important to ensure that help was delivered in a timely manner, for those people who met the statutory threshold.

As a follow-up, it was questioned what support was available for someone who did not meet the statutory criteria. It was advised that this would depended on an individual’s needs. For instance, a social care or healthcare worker may be assigned to them, to ensured that they were signposted to available support and to provide a follow-up check on them. It was highlighted that it needed a partnership approach to ensure the appropriate level of support was provided. Reassurance was given that the questions around this topic were asked routinely, and there was Red Threat support available.

A question was asked about the ethnicity of those being referred and the significant gap in regard to the British Asian population in the borough. It was confirmed that CSAB were aware of this gap and was planning to work with third sector  organisations such as the Asian Resource Centre to address the issue. There was also plans to make sure resources were presented in a more accessible way.

Further information was requested on the changes made to arrangements for police interventions in regard to mental health crises. Assurance was given that there would be more police attendance than had been represented in the media, but there would be considerable changes which would be in place by the end of October. The Police worked very closely with stakeholders like local authorities and mental health agencies. The change would ensure that the right professionals were available to respond to a person experiencing a mental health related crisis, while ensuring that they were not criminalised. However, the Police would still attend if there was an immediate threat to an individual or the public. In the upcoming weeks there would have conversations about what it meant in practice for the relevant stakeholders.

It was confirmed that South London and Maudsley NHS Foundation Trust (SLAM) supported this new approach and that it was being delivered through a partnership approach. However, where concerns were raised, there would be further work with the Police to ensure that everyone in the partnership felt confident about the changes. The Sub-Committee acknowledged that the issue of police intervention in these circumstances was controversial and that there were two schools of thought – some preferred the Police not to be the first respondents, while others preferred the Police to be available to ensure that there was no risk for others. SLAM provided training around the Mental Health Act, which was agreed should be available to the Police.

At the conclusion of the item, the Chair thanked the attendees from the Croydon Safeguarding Adults Board for their attendance at the meeting and their engagement with the questions of the Sub-Committee.

Actions

Following its discussion of this item, the Sub-Committee agreed the following action to be followed up outside of the meeting: -

1.    That an update on the timeline for the Prevention of Future Death Notice implementation will be requested.

Conclusions

Following its discussion of this item, the Sub-Committee reached the following conclusion:-

1.    Following its review of the Croydon Safeguarding Adults Board Annual Report, the Sub-Committee concluded that there was reasonable evidence to provide reassurance that the partners were working well together.

2.    Following the changes to the mental health interventions, the Sub-Committee welcomed confirmation that mental health training provided by South London and Maudsley NHS Foundation Trust would be available to Police officers.