1 Background

1.1 Following the publication of `No Secrets' in 2001, Hampshire County Council, Portsmouth City Council and Southampton City Council agreed to work in partnership to establish a Multi Agency Management Committee, covering all three Social Services Departments. This section of the report is common to each authorities annual report and focuses on the strategic development of the approach to protecting vulnerable adults.

2 Multi Agency Management Committee Report - 2004

2.1 The Multi Agency Management Committee has a wide range of organisations represented on it. The terms of reference and membership at 31 March 2004 are set out in Appendix I.

2.2 Over the past year a number of initiatives have been developed and/or finalised:

2.2.1 The development of `template' in house policy frameworks for providers. Two have been developed, one aimed at residential/nursing providers and a second more general one that could be tailored by a wider range of services, both of these are available on the website.

2.2.2 Leaflets for users and staff have been designed and are in print. They will be available on the website.

2.2.3 A common training strategy has been developed across the three authorities, recognising the various levels of training required by different staff groups. This has been particularly successful and is set out in more detail later in this report.

2.2.4 A requirement for Local Authorities, set out in `No Secrets' is to review and revise the policy and procedures. This was completed during 2003. The new versions are now available on the organisations website for ease of access by providers, staff and the public alike.

2.2.5 The development of an appendix to both the Terms of Inclusion on the Preferred list of Providers and to the Domiciliary Care Contract has been agreed across Hampshire, Portsmouth and Southampton. These appendices highlight requirements around adult protection.

2.2.6 The Multi Agency Management Committee has also been able to look at specific examples of practice in order to examine parts of the policy in more detail.

2.3 The development of the approach to protection of vulnerable adults has been one in which the importance of collaboration and partnership is significant.

2.4 Relationships with Hampshire Police have continued to improve. The development of a police policy has assisted in this with greater clarity of lead officers in each basic command unit. Joint training between Social Services and Police is a high on the agenda for 2004/05.

2.5 Independent providers and the voluntary sector are well represented on the Multi Agency Management Committee and have played an important part in the development of the approach to training, amongst other areas.

2.6 The regulatory function has seen three changes within the life of the Multi Agency Management Committee. The National Care Standards Commission which took over from Local and Health Authority regulation units was itself replaced on 1 April 2004 by the Commission for Social Care Inspection. There is now a protocol for Adult Protection in registered services which was agreed between the National Care Standards Commission and the Association of Directors of Social Services. It is hoped that there may be a period of consolidation in the management of the regulation function so that more robust working relationships can be developed during 2004/05.

2.7 The involvement from Health Colleagues has been patchy. Despite all PCTs being part of the group, attendance has been poor and reliant on provider trusts. There is a need to engage more with Health and whilst more work is going on locally, a strategic approach is needed. The Strategic Health Authority have been invited to participate, but as yet it is unclear whether they will.

2.8 There is more work to be done in relation to Housing and Supporting People. It is anticipated that local and strategic links will be enhanced during the coming year.

2.9 A great deal of work has taken place throughout the last year both strategically and locally. Work on adult protection will continue to gather pace in 2004/05 and local responses are included later in this report.

2.10 The Multi Agency Management Committee is providing a focal point and framework for strategic development, whilst enabling each authority to pursue issues relevant to them. The development of the Protection of Vulnerable Adults (POVA) register in 2004 and the potential implications of new legislation such as the Mental Capacity Bill, together with the recent government interest via the Health Select Committee will mean that the protection agenda will continue to grow.

3 Working together to protect vulnerable adults from abuse in Hampshire.

3.1 There has been significant progress in developing an effective response to the issue of the protection of vulnerable adults from abuse in Hampshire in 2003/2004.

3.2 Hampshire County Council Social Services Department makes a valuable contribution to the Multi Agency Management Committee for adult protection. Glyn Jones, County Manager, chairs this group.

3.3 Within Hampshire, there is an internal Social Services Department adult protection steering group which assists in implementing the strategy locally and ensures that adult protection remains a significant focus on this Department's agenda. Membership of this group is set out in Appendix II. Hampshire Social Services has also set up local adult protection action groups (LAPAGs) along original PCT boundaries. There are seven such groups which enhance multi-agency working on adult protection and which ensure that local practice issues are fed into the Multi Agency Management Committee.

3.4 The post of commissioning officer, adult protection, was established in December 2002 as a temporary appointment and has now been identified as a substantive post. The purpose of the appointment is to support and co-ordinate the implementation of the Policy for the Protection of Vulnerable Adults from Abuse within Hampshire and to coordinate the training strategy. The post has been funded via training budget and the four adults commissioning teams.

3.5 The Department of Health mandatory guidance "No Secrets: Guidance in Developing and Implementing Multi-Agency Policies and Procedures to Protect Vulnerable Adults from Abuse" , March 2000 sets out the main elements which local authority Social Services Departments must include in coordinating local strategies for implementing the policy and procedures and for sustaining a high level of commitment to the protection of vulnerable adults in practice. In Hampshire we have made significant progress in these areas and intend to build on this. As identified in para 2.6, there are plans to enhance our relationship with CSCI.

The multi agency policy and procedures were substantially amended and updated in July 2003. These form the basis for effective joint working.

4 Training

4.1 A training strategy has been drawn up which addresses training internal to the Social Services department and training with external agencies.

4.2 Internally four levels of training were included in the strategy from basic awareness of adult protection through to more detailed awareness of the issues, training in investigation and training for managers. The training for managers was of a very high quality. It was attended by around 100 managers from all sectors. A breakdown of progress in the strategy in the other areas of training is attached at appendix III.

4.3 Hampshire County Council Social Services Department is also supporting training in the independent sector, working with Hampshire Care Association and Hampshire Domiciliary Care Association to train at least one person from every care home and domiciliary care provider agency in Hampshire. It focuses on how to recognise abuse and necessary actions under the agreed policy. Each person trained is equipped with materials and information to go back to the workplace and train their workforce. During the first quarter of 2004 105 representatives of the independent care homes sector were trained in this way. A further 120 places will be available between September and December 2004 with the programme continuing over the following twelve months. Hampshire Domiciliary Care Association have 4 courses planned for the summer of 2004.

4.4 Hampshire County Council Social Services Department is also supporting ROCC in undertaking the same training with representatives from organisations in the voluntary and not for profit sector. This work will continue into the coming year with six courses planned for April/May 2004.

4.5 Work has also been undertaken with Hampshire Constabulary to make plans for training within the police to address adult protection and to plan training in the coming year for police and representatives from Social Services locally in the form of joint seminars.

4.6 Some training has taken place within Hampshire Partnership Trust and discussions are underway to extend this.

4.7 There is consistency in all of the above training in terms of training materials used and quality and experience of trainer.

5 Monitoring the prevalence of abuse.

5.1 Statistics for the year April 2003 to March 2004 are set out in the tables below. These are taken from the system in place prior to the development of the database. They are therefore a significant under representation of the true extent of vulnerable adult abuse locally.

Adult Abuse Cases by Care group between 1 April 2003 and 31 March 2004

Adult Abuse Cases by Type of Abuse between 1 April 2003 and 31 March 2004

Adult Abuse Cases by Care group & Type of Abuse

between 1 April 2003 and 31 March 2004

5.2 A database has been developed so that meaningful information can be generated and disseminated. In this way we can understand better the extent of abuse of vulnerable adults in Hampshire as well as learn lessons about the way in which we intervene across agencies and the outcomes of our intervention. This has been in operation since April 2004. Results will be determined quarterly. See Appendix IV for details.

5.3 Finally a case audit is planned so that we can more accurately understand the qualitative aspects of our work in adult protection.

5.4 In order to fulfil our duties under the Race Relations Amendment Act, we have instituted monitoring and reporting arrangements so we can report on the impact of the implementation of this policy on black and ethnic minority communities.

6 Raising awareness of adult protection

We have begun to make links with agencies who can work to both prevent abuse and to provide services where abuse has taken place. Initial links have been made with Victim Support, Hampshire County Council Trading Standards and Hampshire's Domestic Violence Coordinator. In addition a seminar which was held in December was attended by around 50 organisations representing a wide range of representatives from the voluntary sector. Adult protection has also been raised as an issue with Community Safety Partnerships. It is anticipated that these links will be strengthened in the coming year.

Leaflets to inform service users have been developed and will be distributed in November 2004. Developing a communication strategy to raise awareness of adult protection both across agencies and amongst the general public will be a priority in the coming year.

7 Contracting

In Hampshire we have built upon the work on contracts for care homes and domiciliary care agencies (included in the Multi Agency Management Committee report) which aims to enhance protection of vulnerable adults from abuse. The same principles will shortly be issued as an appendix to the Standard form contract.

8 Future developments and priorities for 2004/2005

8.1 A House of Commons Health select Committee report was published 20 April 2004 and its wide ranging recommendations will impact on our priorities locally. In particular we already plan to make financial abuse an area of specific policy development. We intend to link our adult protection procedures and expertise with the experience and expertise of the receiverships team to achieve this. Our developing systems for monitoring adult protection work will assist if, as the report suggests, performance indicators are introduced in relation to adult protection.

8.2 We will respond to the requirements of the Mental Capacity Bill as this progresses. The Bill acknowledges the increased vulnerability to abuse of those who lack the capacity to make decisions. We will respond both to the specific measures for protection within the Bill and to the guidance for good practice which will be outlined in the Codes of Practice and will assist in making judgements in adult protection situations.

8.3 A POVA (Protection of Vulnerable Adults) list held by the Secretary of State, in order to prevent those who are deemed unsuitable to work with vulnerable adults from doing so, was introduced in July 2004. We responded in detail to the consultation process and will need to respond effectively to this new development.

8.4 The Sexual Offences Act which comes into force in April 2004 will impact on powers within cases of sexual abuse of vulnerable adults. There are particular issues within the Act around choice and mental capacity and around abuse by care workers. Staff will need to be aware of these developments in the law and plans are in place to facilitate this.

9 Recommendations

9.1 PRC are asked to note this report and action for 2004/05.

Section 100 D - Local Government Act 1972 - Background Documents

The Following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt of confidential information as defined in the Act.

None

Appendix I

Terms of Reference for Multi-Agency Management Committee.

- establishing a clear communication network

- determining agreed policy and ensuring all agencies agree

- ensuring that there are consistent monitoring and review processes and procedures across Southampton, Hampshire and Portsmouth including analysis of agreed management information

- co-ordinating agency activity

- ensure that there is a co-ordinated approach to training

- determine work plan as identified in No Secrets

Membership of Multi-Agency Management Committee 2003/04

Annie Howard Southampton City Council, Social Services

Bob Ferguson Hampshire Care Association

Bob Maker Hampshire Police

Cathy Fennell North Hants PCT

Chris Martil Portsmouth City Council, Social Services

Debbie Clarke Southampton City PCT

Diana Wooldridge Winchester Area Community Action

Diane Wilson Portsmouth NHS Trust

Didi Berry Southampton City PCT

Eric Smith Southampton City Council

Fran Williams Portsmouth Health Care Trust

Gill Dunnachie Black Water Valley & Hart PCT

Glyn Jones Hampshire County Council, Social Services

Heather Wood New Forest PCT

Helen Jones Portsmouth Hospitals NHS Trust

Iain Mellis East Hants PCT

Jane Lawson Hampshire County Council, Social Services

Janet Montague Brown Mid Hants PCT

Julia Potter Chief Housing Officers Group

Lynne Alford Hampshire Domiciliary Care Association

Mike Smith Eastleigh & Test Valley South PCT

Neil Lovell Hampshire Partnership Trust

Nigel Kier ROCC

Sally Trinder Portsmouth City Council, Social Services

Sara Goodinge CSCI

Stephen Chandler Hampshire Partnership Trust

Sue Lee Southampton City Council, Social Services

Sue Price Blackwater Valley & Hart PCT

Susan Newcombe Portsmouth Council of Community Service

Suzy Baldock Hampshire Domiciliary Care Association

Tom Chan Surrey Hampshire Borders NHS Trust

Appendix II

Membership of Social Services Department Adult Protection Steering Group 2003/04

Alison Ridley - Team Manager, Out of Hours - Glen House

Jane Braithwaite - Service Manager, Physical Disabilities - Winchester/Aldershot

Christa Turk - Personnel and Training - Head Quarters

Maureen Condon - Mental Health Development Manager, Hampshire Partnership Trust - Hampshire

David Drew - Team Manager, Hart Older Persons Team - Alton Area Office

David Ullah - Qualified Care Manager, Eastleigh Area Office

Barrie Dawes - Service Manager, Older Persons Residential Team

- Head Quarters

Debbie Witt - Care manager, Older Persons - Basingstoke

Mark Ellynn - Commissioning Team, Physical Disabilities - Head Quarters

Glyn Jones - County Manager, Physical Disabilities - Head Quarters

Nikki Griffiths - Learning & development adviser, personnel & training -

Head Quarters

Hilary Hubbard - Social Worker/ Care Manage, Learning Disability Team

- Hythe Area Office,

Jane Lawson - Adult Protection Officer - Head Quarters

John Cornes - Team Manager, Learning Disabilities Team

- Basingstoke Area Office

Liz Dockerty - Team Manager, Older Persons Team - Aldershot Area Office

Martin Garbett - Home Care Team Manager - Winchester/ Andover Area Office

Mike Tiller - Service Manager, Learning Disabilities - Fareham & Gosport

Helen Neilson-Smith - Social Worker/ Care manager - Fareham & Gosport

Peter Ross - Team Manager, Older Persons Team - Eastleigh Area Office

Carol J Robinson - Senior Practitioner, Mental Health - West New Forest

Sandra Grime - Development Manager, Older Persons - Head Quarters

Appendix III

Adult Protection

Training delivered / current capacity against strategy targets

Appendix IV

Hampshire County Council - Adult Abuse Abstract

Worksheet Description of Management Information

1 Adult Abuse by Area and Care Group

2 Adult Abuse Cases by Area & Ethnicity

3 Adult Abuse by Area & Location

4 Adult Abuse by Area & type of Abuse

5 Adult Abuse by Area & Decision of Planning Meeting

6 Time Taken between Planning Meeting and Referral

7 Adult Abuse by Area & Outcome of Case Conference

8 Time Taken between Case Conference and Referral

9 Source of Referrlas by Area of Client

10 Adult Abuse by Care Group & Type of Abuse

11 Adult Abuse by Location & Type of Abuse

12 Adult Abuse by Planning Meeting decision & Type of Abuse

13 Adult Abuse by Case Conference outcome & Type of Abuse

14 Alleged Abuser by Gender, Care Group & Area

15 Alleged Abuser by Gender, Relationship & Area