Agreed that the minutes of the meeting held on 4 July 2014 be confirmed subject to the following amendment –

Minute 12 – Deprivation of Liberty Safeguards (DoLS).DoLS had not been extended to supported living arrangements and applications relating to this should not be forwarded to the local authority. If a person was deprived of their liberty in a supported living arrangement, the commissioner of the support would need to take legal advice and approach the court of protection for authorisation.

Matters Arising

·         Minute 6 - PSAB Budget.  A small working group would be looking at the different options for the budget.  Research had been undertaken on the regional contributions made by other SAB and from the 5 returns received covered similar areas to what Plymouth were proposing.  They were refining the budget details with financial colleagues and had in principle an agreement from the police and the clinical commissioning group.  The Assistant Director would be advised of the findings and the Board would receive an update at the next meeting.

·         Minute 7 - Care Act Update.  They were waiting for the latest guidance to be released on 16 October 2014 and then would have something to work from.  It was suggested that the Policy and Procedure Sub Group could pick up this piece of work.

·         Minute 9 – Safeguarding Manager Report.  Review of the Terms of Reference and membership was also highlighted in the Devon Audit Partnership report.  Further work on this would take place once the new PSAB Chair was in place.  A meeting would also be taking place with Simon White, Safeguarding Children’s Board Manager.

·         Minute 11 – PSAB Performance Indicators Work Stream.  This item would be looked at today.

·         Minute 12 – DoLS.  A group had not been convened but virtual discussions were taking place.  This was an on-going matter.  The next MCA meeting date was in October.   Karen Grimshaw was part of the Plymouth MCA group but was not involved in Devon’s MCA group.  PCH had raised this as an issue because if we do not have the capacity to respond would expect this group to do this.   Martin Cordy highlighted that Devon and Cornwall in respect to the Cheshire West judgement had the capacity to undertake this across the board on a priority basis and how we accelerate the critical cases for immediate attention.  Martin was leading on this on behalf of Devon and Kernow Clinical Commissioning Groups and would feedback into this Board.

In accordance with the code of conduct the following declarations were made –

There were no items of Chair’s Urgent Business.

Geoff Baines and Julian Mouland provided the Board with an update on the SAB Self-Assessment.  They extended the deadline to 17 October 2014 for the remaining submissions.  They were in the process of pulling together a report on the findings and would complete the report prior to the next Board meeting in January 2015.  They had used a nationally developed tool which fed into the yearly performance assessment prior to the business plan cycle. 

The following comments were made -

(a)           Karen Grimshaw reported that Cornwall had undertaken a self-assessment for many years and used different tools.  Karen made the proposal that all SABs use the same tool.  It was further highlighted that this issue was discussed and the SW ADASS Group have a shared tool for many things.  It was evident that boards and local authorities were recording things in different ways;

(b)          Martin Cordy was requested by Devon to feedback on this process and whether we use this model or the Gloucester model.  We should adopt one model across the piece and there was real efficiency to get this done once across the peninsula certainly in Devon and Cornwall;

(c)           Geoff Baines reported that PCH had completed their own self-assessment which gave them clarity on how they fitted within the city and to identify the common themes for agencies to collaborate on.  It was important to collaborate wherever possible and the pending peer review would help this Board enter the review with a clear understanding of the gaps;

(d)          Karen Grimshaw also added that Cornwall undertake their self-assessment in January which then allows them to programme the work for the SAB for the following year.  Would Plymouth undertake something similar?

Agreed that –

1.         as part of the PSAB Self-Assessment Performance Indicator Update to include the comments made by the Board specifically around aligning the self-assessment to take place January following by PSAB work planning for the year.

2.         the incoming Chair to be briefed on the process to move forward

3.         contact is made with Pete Murphy, ADASS lead in Gloucester on the SW assessment.

Jane Elliot Toncic presented the draft Devon Audit Partnership report with some minor amendments.  The audit was completed in July 2014 followed by the development of the action plan.  The report reflects that the PSAB was between Chairs and some actions would have to wait for the incoming Chair. 

A meeting was planned with the incoming Chair to go through the report and to formulate a plan to address the actions.  The overall results for this Board were that ‘improvements’ were required and discussions need to take place on the PSAB structure, management and financial support and work priorities.

The following comments were made -

(a)           with regard to the PSCB an enormous amount of work takes place outside of the meeting and they were reliant on partner agencies for support which sometimes wasn’t forthcoming.  As the PSAB starts to mirror the children’s board it was important to map out the capacity issues very strongly;

(b)          following the audit discussions had taken place on whether there should be a joint manager for the PSAB and PSCB or a joint role with two separate board managers.  These proposals were written into the safeguarding plan;

(c)           that clear governance links between the different groups was required and the sharing of key messages and the right representation to ensure we can all contribute into safeguarding.  The PSAB work plan would clearly specify the representation between the different boards.

Jane Elliot Tonic reported that ‘Making Safeguarding Personal’ was originally launched in 2011.  This was the recommended pack to cascade through the authority and different agencies with suggestions for implementation.  It was also reported that this was not new and every effort was to put people at the centre of this process.  This was the formal framework for us to work from and want all councils to be signed up by next year.

The Local Government Association had noticed that local authorities were not operating to a clear legal framework as well as not have an understanding of the capacity on the legislation.  They were working with the University of Plymouth on developing the presentation for student social workers and were also developing a multi-agency working group to identify what we want to focus on.

The following comments were made –

(a)           domestic abuse wasn’t covered much and we need to look at the relationship with domestic abuse colleagues.   This was key to the work of this group;

(b)          the interface between children’s and adults was very important and not joined up on domestic abuse. There were a lot more abused older people than children;

(c)           PCH were developing relationships with other agencies and a joint meeting took place yesterday on how we can help each other on the pathways around mental health and support to families in crisis on domestic abuse.  This was a clear area for development;

(d)          domestic abuse was clearly an area of priority for this Board to pick up and to look the linkages with safeguarding children board.  It was felt that the PSAB wanted to look at this area of work before escalating to the Health and Wellbeing Board.

Agreed that –

1.         the Safeguarding Adults Manager email the Board for representation on the multi-agency working group along with the terms of reference for the group.

2.         domestic abuse is identified as a piece of work for PSAB to undertake and to establish the linkages with PSCB.  The Board to receive a further update in January 2015.

Jane Elliot Toncic shared the Peer Challenge timetable with the Board.  It was reported that the incoming Chair making would make every effort to be part of the Peer Challenge. This was the fourth attempt to undertake the Peer Challenge.

It was highlighted that this Peer Challenge was adult focussed and missing the interface with children, whole family approach and the transition from children to adult services.  It was reported that this Peer Challenge came out of the main scope and would value further discussion to include a children focus.

Agreed that –

1.     the Safeguarding Adults Manager to check that all relevant officers are invited to attend the Peer Challenge taking place in December.

2.     the Safeguarding Adults Manager and Tony Staunton to meeting to discuss in further the PSAB interface with the PSCB, the whole family approach and transition from children services to adult services.

Jane Elliot Toncic reported that those people suffering from serious self-neglect had very complex multi issues.  The Policy and Procedure Group had produced a set of principles for agencies to work from.  There were no powers of entry under the Care Act and were looking at the other legal frameworks and human rights.  Risk sharing and risk management was crucial and there was a shared understanding on escalation.  These were early days in developing those principles and working from the guidance have collated the information and go out to consultation.   They had recently undertaken a multi-agency review and the full report would be provided in January 2015.  They were looking to develop a lead officer working group and appoint a self-neglect champion/lead and would welcome expressions of interest.

The following comments were made –

(a)           this was a good framework to review VARM.  The chairs of the multi-agency review recommended to revise VARM and were looking to undertake a review.  There were assurances a full review of VARM would be undertaken;

(b)          they were looking at renaming the process because of the word ‘vulnerable’;

(c)           this was an opportunity for shared frameworks and information sharing;

(d)          it was important to understand that the situation makes the person vulnerable.

It was suggested that a sub group could pick this up and bring key people together to look at the recommendations and to link up with work already underway.  The group needs to be opened out wider to facilitate different groups contributing to the work.  It was further discussed whether a champion role would be of benefit and empower that champion to challenge us on this.

Agreed that –

1.         a Self-Neglect Champion to be identified to develop and lead an officers working group.

2.         the PSAB receive the multi-agency review full report on self-neglect at the next meeting in January 2015.

Jane Elliot Toncic provided an update on the planned partnership conference between PCC and the University of Plymouth.  The preferred date for the conference to take place would be the 13 April 2015.  A number of speakers had agreed to speak including Geoff Baines.  A joint planning team established and conference would take place in the Roland Levinsky Building.  The University would not be charging us for the use of the room and would provide food, communications /advertising of the event at cost.

Jane Elliot Toncic provided the Board with an update from the PAUSE group.  It was reported that –

(a)           PAUSE were involved in the interview process for the PSAB Independent Chair and were pleased with the appointment;

(b)          the commissioning Quality Assurance and Improvement Team provided supported to PAUSE on concerns they had raised on inconsistencies in care provided by care agencies;

(c)           the PAUSE group would attend a focus group for the Peer Challenge;

(d)          they highlighted that they wanted to be more involved in events to rise their profile.  We have provided them contact details to relevant organisations and venues;

(e)                they had raised concerns on the number of doorstep loans taken out by vulnerable people from large organisations.  It was reported that no checks were undertake on people taking out a loan up to the value of £1k.

Cate Simmons and Morris Watts from Plymouth Community Healthcare (PCH) reported that PCH started as a community interest company 3 years ago.  PCH were providing a higher quality service on safeguarding after coming from a low 3 years ago.  Integration was vital for safeguarding and this approach ensures that child and adult safeguarding was integrated into both the governance and operational practice with PCH.

There were two internal meetings held monthly that were critical to the governance of adult safeguarding and was chaired by a non-executive director who was the lead for quality and safeguarding within PCH.  The two meetings are –

Safety, Quality and Performance Meeting (SQP)

This meeting was established to provide the Board with assurances about safe practice and effective performance as well as looking as the facts and figures and to flesh out what this means and if doing well would replicate in other areas.

Integrated Safeguarding Committee (ISC)

This meeting provides detailed assurance to the SQP about children and adult safeguarding.  At this meeting they look at the progress of Serious Incidents Requiring investigation (SIRI) which considers every aspect of safeguarding.

The following comments were made –

(a)        that NEW Devon CCG had an open invite to the ISC meeting and there was a huge level of support and seeing this report on a quarterly basis was invaluable;

(b)        that any incident such as a fall requires in-depth investigation and sat along this process there was a need to consider any safeguarding issues.  When you look at the root cause analysis you realise there were safeguarding issues and this was sometimes not apparent.  The SIRI process would address this;

(c)        there was a need to identify the issues and the process of bringing the learning back into the system.  2 levels – internally sharing the learning panel process pull out the learning provide training, include in newsletter, externally reported through a national system and commissioning colleagues commenting the work;

(d)        there was a gap and we need to ask all providers to ask themselves the question ‘have your consider safeguarding when an incident has occurred’?  Internally this was well embedded with the CCG and would continue to work with the provider on gaining assurances, the evidence and assess that the learning was embedded.  It was clear that even though the action plan was completed it however did not assess the cultural issues.  CCG were looking to set up a Chief Nursing Officer Group, it would not be a compliance group but a forum to look at the ‘sticky’ issues and to share the learning.  This Board had a responsibility to collectively share the learning and information.  The Annual SAB Report would help us to understand the patterns.

Julian Mouland provided the Board with an update on the current serious case reviews.

Roslyn Azzam reported that the task and finish group had not yet convened and would try and set a meeting in November.  It was also reported that 305 DoLS applications were made to Plymouth City Council since April 2014, a majority of them were regarding people with dementia. 

The following comments were made –

(a)           whether a training issue identified to process the 305 applications and out of those applications how many were valid.  It was reported that 99.9% of applications were upheld;

(b)               that a number of authorisations had raised and it was deemed that the care plan did not meet the threshold.  The lower threshold meant that an application for DoLS had to be made because a discharge was delayed and this had resulted in a significant increase in applications.

Jane Elliot Tonic had three items of any other business, it was reported that –

·         there were no safeguarding leaflets raising the awareness of safeguarding in GP surgeries and for those people working in the community.  There should be posters and leaflets to signpost people to services as well as how we fund this.  The Board felt that it was important to have this information and to get this actioned quickly and whether there was a possibility to link to the conference next and have an awareness week.

·         Links were established with the voluntary and community sector and a nomination had been put forward to sit on the PSAB.

·         A leaflet on Safeguarding the Vulnerable from Financial Exploitation was circulated to Board members.  It was a multi-agency conference and following on from earlier discussions would invite PAUSE to attend.

Agreed that -

1.         safeguarding leaflet is produced and circulated to the PSAB for review prior to the next meeting of the Board in January 2015.

2.         Invite representative from the voluntary and community sector to sit on the PSAB in January 2015.

The next meeting will take place on Friday 30 January 2015 at 1 pm.

The next meeting of the Board will take place on Friday 30 January 2015 at 1 pm.

To consider passing a resolution under Section 100A(4) of the Local Government Act 1972 to exclude the press and public from the meeting for the following item(s) of business on the grounds that it (they) involve the likely disclosure of exempt information as defined in paragraph(s) of Part 1 of Schedule 12A of the Act, as amended by the Freedom of Information Act 2000.

There were no items of exempt business.