Agenda item

The Committee has requested to consider the annual report of the Oxfordshire Safeguarding Adults Board (OSAB) which was submitted to Cabinet on 17 October.  Cllr Tim Bearder, Cabinet Member for Adult Social Care, Karen Fuller, Interim Corporate Director for Adult Social Care, and representatives of the board have been invited to attend to present the report and to answer the Committee’s questions.

The Committee is recommended to consider the report and to AGREE any recommendations it wishes to make arising from its discussion.

Cllr Tim Bearder, Cabinet member for Adult Social Care, attended to present the annual report of the Oxfordshire Safeguarding Adults Board 2022-23 and was accompanied by Karen Fuller, Corporate Director for Adult Social Care; Anne Lankester, Head of Adult Safeguarding (Oxon Place) – Buckinghamshire, Oxfordshire, and West Berkshire (BOB) Integrated Care Board (ICB); Lorraine Henry, Service Manager - Safeguarding, DoLS & Mental Health.  Apologies were received from the Independent Chair of the Board who had an unavoidable prior engagement and regretted that she was unable to attend.

Cllr Bearder explained that the Council took a lead role with a statutory duty to conduct safeguarding enquiries. 

The Corporate Director set out the six key messages of the Board as follows:

1.    Organisations had continued to see safeguarding as everybody’s business and as a priority through many challenges (e.g., funding, recruitment, retention, sickness, reorganisations, industrial action);

2.    Safeguarding concerns had continued to rise (14% increase on 2021-22) as they had since 2018-19 (a 39% increase between these periods).  This trend was in line with national and regional increases in concerns;

3.    Safeguarding enquiries (Those incidents deemed to meet the Care Act 2014 criteria for safeguarding) had also risen at a similar rate to last year and again in line with regional and national trends;

4.    A person’s own home remained the most likely place for them to experience abuse, with neglect remaining the most common type;

5.    Only 1% of people were unsatisfied with the outcome of the safeguarding work done to protect them;

6.    80% of people deemed to lack capacity had an advocate (family, friend or impartial advocate).

There was an element of positivity in upwards trends regarding safeguarding concerns being raised.  There had been a reduction during the pandemic with people going out less. 

The Corporate Director explained that the 1% dissatisfaction should be viewed in the context of adults with capacity being permitted to make unwise decisions.

The Head of Adult Safeguarding (Oxon Place) explained that the Multi Agency Risk Management (MARM) framework had come out of a thematic review following a series of nine deaths of homeless people in Oxfordshire.  It was designed to support anyone working with an adult where there was a high level of risk and where the circumstances sat outside the statutory adult safeguarding framework but, nonetheless, where a multi-agency approach would be beneficial.  MARM meetings were held with the client’s permission and engagement and, whilst it was early days, primary care practitioners were actively encouraged to use the process where support had reached an impasse.

The Safeguarding Manager explained that whilst numbers of referrals had risen there were fewer than there had been in 2016-17.  The number of enquiries received had been steady and were most often received from friends and family.  There had been an increase in use of impartial advocacy to support service users without capacity.

Deaths amongst the homeless continued to be a priority and the Council was working with other councils and with the Home Office.  A lead on housing had been appointed by the Council.

In discussion with the Committee, the following was raised.

There was a recognition that, regrettably, not all those who needed referral were referred and members asked what could be done to improve that.  It was explained that one of the sub-groups of the Board was the engagement group which included all partners, including Help the Aged and Healthwatch, and that group focused on how to spread the word about accessing safeguarding.  One of the Communications members of the BOB ICB had been co-opted to that group. 

There was online training through the Board and there was usually some contact with agencies for most people.  The enquiries line managed by the Safeguarding Manager’s team sought to provide an easy access to professionals and others supporting people.  There had been a lot of work over the past year auditing to ensure that services were aware of people’s needs.  It was emphasised that safeguarding was everyone’s concern and work was continuing to highlight awareness of that.

There was an informal Homelessness Mortality Review group with Rapid Time Reviews conducted across the system where health, ambulance, and social care partners met to challenge each other robustly to ensure appropriate support and learning. 

The Luther Street Medical Centre was an award-winning GP surgery providing healthcare to people experiencing homelessness in Oxford with a wide range of support and provision.  Members were encouraged to visit the practice.

An Independent Chair offered an impartial element of scrutiny across the system.  There were regular audits of training and understanding and there were Safeguarding Adults Reviews which identified necessary learning and challenge offered by the Board.

Right Care, Right Person was a national directive from the police which ensured that call handlers were able to provide appropriate signposting when it came to emergency mental health or social care for adults.  This appeared to be being implemented satisfactorily with close working across the system, including with Thames Valley Police, with no detrimental impact identified despite careful monitoring.

None of the Homeless Mortality Reviews related to people who had no prior engagement with health services.  The importance of effective data-sharing was highlighted and there were strong data-sharing protocols with a joint data-set being developed to enable a single point of contact. 

The importance of whole system scrutiny was emphasised and members suggested that it would be helpful to draw up a governance/scrutiny map which would show how and where areas of the system received scrutiny.  There were very well-established partnership arrangements with a sense of ownership across the system with external scrutiny and peer review as well.  Members suggested that this external scrutiny should be highlighted.

The importance of clear language which made technical jargon accessible to the public was noted.

Whilst people were living for longer, it was not always the case that they were living healthy lives for longer.  There was a growing recognition of neglect as a concept.  Early intervention was very important and the MARM process assisted in that.

The importance of compassion and sensitivity when it came to language regarding the homeless community and deaths within it was highlighted.  Officers would welcome member engagement on how to improve that.

The Committee AGREED the following actions:

·       A scrutiny map to be provided to the Committee, making clear that there are levels of external scrutiny;

·       The Board to consider how to make some technical language clearer in future reports;

·       The Learning from the deaths of those with a learning disability (LeDeR process) report referenced within the full report should be circulated to members of the Committee.