Agenda and draft minutes

To receive any apologies for absence and temporary appointments.

Cllr Waine sent his apologies, with Cllr Simpson substituting. There were also apologies from Cllrs Graham and Leverton.

Cllr Dan Levy also attended online.

See guidance note on the back page.

There were none.

The Committee is recommended to APPROVE the minutes of the meeting held on 9 July 2024 and to receive information arising from them.

The minutes of the meeting on 9 July 2024 were AGREED as a true and accurate record.

Members of the public who wish to speak at this meeting can attend the meeting in person or ‘virtually’ through an online connection. 

To facilitate ‘hybrid’ meetings we are asking that requests to speak or present a petition are submitted by no later than 9am four working days before the meeting i.e., 9am on 13 September 2024.  Requests to speak should be sent to the Scrutiny Officer at scrutiny@oxfordshire.gov.uk.

If you are speaking ‘virtually’, you may submit a written statement of your presentation to ensure that your views are taken into account. A written copy of your statement can be provided no later than 9am 2 working days before the meeting. Written submissions should be no longer than 1 A4 sheet.

There were none.

Dr Jayne Chidgey-Clark, the Independent Chair of the Oxfordshire Safeguarding Adults Board (OSAB), Cllr Tim Bearder, Cabinet Member for Adult Social Care, Karen Fuller, Director of Adult Social Services, Victoria Baran, Deputy Director Adult Social Care, and Steven Turner, OSAB Strategic Partnerships Manager, have been invited to present the OSAB Annual Safeguarding report and to answer the Committee’s questions.

The Committee is asked to consider the report and raise any questions, and to AGREE any recommendations it wishes to make to Cabinet arising therefrom.

Dr Jayne Chidgey-Clark, the Independent Chair of the Oxfordshire Safeguarding Adults Board (OSAB), Cllr Tim Bearder, Cabinet Member of Adult Social Services, Karen Fuller, Director of Adult Social care, Victoria Baran, Deputy Director of Adult Social Care, and Lorraine Henry, Safeguarding Mental Health Service Manager, were invited to present the OSAB Annual Safeguarding Report and answer the Committee’s questions.

The presentation was led by the Independent Chair, who stressed that safeguarding was a collective responsibility, regardless of any staff shortages and budget limitations. A decrease in safeguarding enquiries was also observed. The importance of quicker and more effective learning from reviews to prevent future incidents was highlighted, pointing out recurring issues such as insufficient professional curiosity and poor multi-agency risk assessment. The Independent Chair identified three key priorities for OSAB, derived from over 200 recommendations: understanding barriers to learning, embedding acquired knowledge, and monitoring effectiveness.

The Cabinet Member stressed that professional curiosity was crucial, particularly when staff were overworked and underpaid, and that it was important to grasp the broader context of challenges faced by frontline workers, such as staff shortages and more complex cases.

Members of the Committee made the following observations, and raised a number of questions and concerns, including:

·       What strategies were in place to ensure adequate time was provided for individuals at risk?

The Director of Adult Social Care emphasised that care was individualised, with no fixed time allocated per person. This flexibility ensured that care was tailored to the unique requirements of each person.

·       Members observed that a substantial number of concerns surfaced in both 2022/23 and 2023/24, prompting curiosity about the underlying reasons.

The team had begun to conduct an in-depth review of these cases to understand the nature of the concerns, assess any similarities or differences between the years, and determine whether the issues were resolved or continued. Following this analysis, steps would be taken to address the concerns, prioritising the identification of barriers to resolution and enhancing the safeguarding process for the affected individuals.

·       The objectives and interplay of the Multi-Agency Risk Management (MARM) process and the Multi-Agency Safeguarding Hub (MASH) was explored with the MASH described as a central point where all referrals for adults and children, including those from the police, were received. It served as a coordinating hub for safeguarding concerns whereas MARM was a process intended for individuals who may not have had traditional care and support needs but still presented recurring risks. It involved multi-agency teams discussing the most effective pathway to safeguard the person involved.

These processes formed part of a comprehensive safeguarding framework, ensuring that at-risk individuals were identified and supported through coordinated efforts from multiple agencies.  Additionally, it was noted that the Oxfordshire MARM process had been commended by other local authorities due to its significant positive outcomes, highlighting interest in how the process operated.

·       Members noted the significant reduction of the number of open enquiries, compared to the previous year, especially the number of enquiries open for over 12 weeks. 

Despite the substantial  ...  view the full minutes text for item 21/23

Cllr Tim Bearder, Cabinet Member for Adult Social Care, Karen Fuller, Director of Adult Social Services, Victoria Baran, Deputy Director Adult Social Care, and Lorraine Henry, Safeguarding Mental Health Service Manager, have been invited to present a report on the Deprivation of Liberty Safeguards (DoLS) and to answer the Committee’s questions.

The Committee is asked to consider the report and raise any questions, and to AGREE any recommendations it wishes to make to Cabinet arising therefrom.

Report to follow.

Karen Fuller, Director of Adult Social Care, Victoria Baran, Deputy Director of Adult Social Care, and Lorraine Henry, Safeguarding Mental Health Service Manager, were invited to present a report on the Deprivation of Liberty Safeguards (DoLS) and to answer the Committee’s questions.

The Deputy Director of Adult Social Care provided a summary of the state of the DoLS service, explaining that DoLS was created to protect people in care homes or hospitals who could not consent to their care, allowing them to challenge their situation. A 2014 Supreme Court ruling expanded the definition of deprivation of liberty, increasing those under DoLS. The DoLS service required a complex assessment process, needing both a doctor and a qualified social worker or occupational therapist. While acknowledging that the completion rate for DoLS assessments was below the national standard, efforts were being made to improve through additional staffing and external agency support.

Following the presentation, members raised a numbering of comments and queries, including the following:

·       Measures taken to enhance the quality of the services provided.

NHS Digital supplied data on the number of DoLS assessments carried out by various local authorities, which helped to analyse trends and compare performance. This identified areas needing improvement and offered a national benchmark for Oxfordshire. To tackle the backlog, an external agency was hired to handle 500 of the oldest pending best interest assessments. Efforts to boost efficiency included using shorter documents, which still complied with the legal requirements, to raise the number of completed assessments.

Members asked about the assessment procedure for those who enter care unexpectedly.  It was explained that the assessment was only appropriate where someone was already under continuous supervision and could not consent to their care.  The Council used a tool to manage the risk, ensuring high-priority cases were quickly assessed. A best interest assessor and a section 12 doctor handled urgent cases within seven days of referral.

In the case of continuing care circumstances, the DoLS assessment was conducted annually, even when there was little likelihood of change.

·       It was noted that rescheduled DoLS referrals had increased 22% nationally, over the last two years, whilst the rate in Oxfordshire was 43%. Members sought clarity on why this was so much higher in Oxfordshire.

The increase was linked to factors like the impact of COVID-19, which altered care home admissions and care provision, affecting DoLS referrals. Many postponed entering care homes until after the pandemic by opting for private care.

Additionally, better understanding and awareness among social workers about the DoLS process led to more accurate and timely referrals. Training for care home staff and social workers also enhanced the DoLS assessment identification and referral process.

The Committee is recommended to identify items for its consideration and AGREE its work programme for forthcoming meetings, taking account of the Cabinet Forward Plan and of the Budget Management Monitoring Report.

The Committee AGREED that the following items should be included in the forward plan:

·       A DoLS update;

·       Inequalities;

·       Prevention;

·       CQC Assurance;

·       Recruitment and retention;

The Committee is recommended to NOTE the progress of previous recommendations and actions arising from previous meetings, having raised any questions on the contents.

The action and recommendation tracker was NOTED.

Attached is the draft Cabinet response to the Committee’s report on Adult Social Care Assurance Update which is expected to be agreed on 17 September 2024. The Committee is asked to NOTE the response.

The Committee NOTED the Cabinet to the report on Adult Social Care Assurance Update, which was agreed by Cabinet on 17 September 2024.