Hampshire Adult Protection Annual Report

Foreword

This annual report relates to the period May 2006 to September 2007. An interim report will follow from October 2007 to end March 2008. Thereafter Annual Reports will be published for each financial year.

Hampshire works in partnership with Southampton and Portsmouth on Adult Protection and the three Authorities share one policy and procedure. Until May 2006 when a Hampshire Adult Protection Committee was established Hampshire had relied upon the Multiagency Management Committee (shared with Southampton and Portsmouth) to steer strategic development in this area of work. The separate Adult Protection Committee has been set up to keep abreast of the pace with which Adult Protection is developing both nationally and locally and to ensure that local priorities are addressed.

The period covered by this report has been a period where, having significantly increased awareness of the issue over the previous 2 years Adult Services has, in its role as strategic coordinator for Adult Protection, sought to work in partnership with other agencies to ensure that responses are configured to produce robust responses to situations of abuse. The key work streams over this past 16 months are outlined below along with objectives for the coming months.

Reports set out below from partner agencies illustrate the developing enthusiasm across agencies to ensure that the citizens of Hampshire are protected from abuse.

Nick Georgiou, Chairman, Hampshire Adult Protection Committee

1. Structure

The Multiagency Management Committee (MAMC) and the Hampshire Adult Protection Committee (HAPC) have been mentioned above. The structure of Adult Protection strategic groups across Hampshire is as follows:

Multiagency Management Committee (meets across 3 Local Authorities)

The terms of reference for the Hampshire groups are set out below.

MAMC terms of reference:

1. This is a strategic committee which aims to deliver under the remit of "No Secrets" the policy and procedures. It aims to promote consistency and inter-agency working across Safeguarding Adults/Adult Protection issues.

2. MAMC will have representation from all relevant statutory, independent sector and voluntary organisations as well a representation from service users and carers.

3. Each local authority will have its own Safeguarding Adults Partnership Board/Adult Protection Committee with its own terms of reference reflecting local needs/priorities.

4. MAMC will meet twice a year with each local authority hosting the meetings on an annual basis. The host local authority will be responsible for all aspects of the organisation and administration of the meetings and for producing the MAMC annual report.

5. MAMC will ensure effective links and joint working in a number of key areas of Adult Protection. The 3 co-ordinators will meet every other month to ensure joint working on common area of interest requiring a consistent approach such as:

· Review and development of policy and operational guidance

· Commissioning/contracts

· Information sharing protocol

· Professional training

· Education and Practice

6. Priorities will be agreed at the MAMC. Progress against these will be reviewed annually and new priorities set for the coming year.

Hampshire Adult Protection Committee terms of reference:

· The lead officer for Adult Protection in Hampshire County Council Adults Services will chair the Hampshire Adult Protection Committee.

· It will include representation from all key statutory, independent sector and voluntary organisations as well as representation from service users and carers.

· It will establish representation to and from relevant strategic partnerships

· It will meet 3 to 4 times each year

· It will establish and maintain a strategic plan which will include:

o To represent local developments in contributing to the MAMC review of policies; procedures and protocols

o To ensure that quality assurance processes and data are used to inform forward plans for training; service development; information dissemination; prevention and intervention

o To put in place systems to ensure learning from individual situations of abuse

o A training strategy to support all agencies in developing consistent adult protection training which responds to local needs and lessons

o A strategy to disseminate information on Adult Protection issues to staff; volunteers; service users; carers; general public

o A strategy to develop services and responses for those who have been abused/are at risk of abuse and for perpetrators of abuse/neglect

o Strategies for reducing risk of abuse/neglect across a range of settings including care settings and the community

· The strategic plan is signed up to by all partner agencies at a senior/board level

· An annual report of the Hants APC will include an annual review of progress on the strategic plan highlighting priorities for the coming year

· There will be an annual review of progress on Adult protection within each partner agency within an agreed framework

· Annual reports will inform member organisations at Board level (or equivalent) and inform the MAMC

2. Key Activity in Adult Protection in Hampshire

(May 2006-September 2007)

· Continued work to ensure representation on the Adult Protection Committee (APC) by as many relevant agencies as possible. Current membership of APC attached at appendix A

· A workshop for all members of the APC ran in March 2007 to ensure shared understanding and priorities.

· Work in particular between Adult Services and Hampshire Police to ensure effective joint working. This included workshops for Adult Services and Police teams in each of the three Police Operational Command Unit (OCU) areas in Hampshire as well as a conference across all 6 OCUs (including Southampton, Portsmouth and Isle of Wight)

· Following a joint workshop with CSCI in March 2006 work has been undertaken to ensure that CSCI and Adult Services communicate effectively and appropriately in situations of suspected abuse. Local guidelines have been produced.

· A great deal of training activity has been undertaken. (This is outlined in section 4).

· Links between Adult Protection and Domestic Abuse are developing. Meetings have taken place bi annually over the past two years. The importance of these links has been underlined in June 2007 in the national elder abuse prevalence study. Mutual training has taken place as well as awareness raising of and engagement in respective procedures. A networking event is planned in the coming year to further raise the profile of the importance of making these links.

· Monthly meetings have taken place to strengthen the profile of Adult Protection in integrated mental health services. This work continues.

· Adult Services has worked in partnership with "Daybreak" (a voluntary sector organisation well known for its work with Children and Families and domestic abuse). "Daybreak" secured a comic relief grant to run Family Group Conferences (FGCs) in situations of elder abuse. Adult Services continues to support this work and a number of FGCs have been successfully completed. This Project will run for a further two years after this financial year.

· Work in partnership with Southampton and Portsmouth Adult Services has seen the introduction of a joint framework to ensure consistent understanding and tracking of Adult Protection issues in provider services. This is already underpinned by local procedures in Southampton and Hampshire plans to implement its procedures early in 2008.

· Nationally work is underway to produce a common framework for collecting data on Adult Protection. In the meantime Hampshire has begun to collect monitoring data in greater depth on outcomes of interventions as well as piloting the Adult Protection module in its SWIFT IT system. This module is due to be implemented across Adult Services in Spring 2008.

· Work on revising the Adult Protection Policy and Procedures is in the final stages in partnership with Southampton and Portsmouth. This will be completed by February 2008.

· Within Hampshire County Council Adult Services additional resource has been allocated to this important area of work. At the time of writing 3 safeguarding coordinators have been appointed and will come into post in November 2007. Their objective will be to improve consistency and effectiveness of approach across the County. They will be based one in each of the 3 Adult Services geographical areas.

· Work has begun in partnership with Southampton and Portsmouth to develop a Serious Case Review Protocol so that lessons can be learned from individual serious situations.

· A great deal of work has been undertaken around implementation of the Mental Capacity Act (MCA) and this is significant for Adult Protection. Of particular relevance is Hampshire's decision to include Adult Protection situations in the scope of the Independent Mental Capacity Advocacy Service (IMCA service). The relevance of the MCA for Adult Protection is to be explored in a conference in November.

· A sub group of the Adult Protection Committee has met to produce specific guidance on financial abuse. This was recommended in a Health Select Committee report in 2004 and reflects the high numbers of situations of financial abuse with which we are dealing in Hampshire. The guidance will be produced alongside a conference to be held in November 2007.

3. Annual Statements by Partner Agencies on the Hampshire Adult Protection Committee

3.1 Hampshire Adult Placement Scheme

Role in the work of Hampshire Adult Protection Committee

The manager of the Hampshire Adult Placement Scheme is a member of the committee and as such has regularly attended meetings and the Adult Protection workshop held on 13/3/07.

Professional/legal responsibilities

· The Scheme has a robust internal policy and procedure entitled Adult Protection.

· Adult Protection featured in the Operational Plan for 2007/8 with the objective to maintain "a robust Adult Protection approach which also supports carers".

· Referrals of staff and carers are made for inclusion on the national Protection of Vulnerable Adults register.

· The Scheme has contributed to the revision of the wider Hampshire Adult Services policy and procedure on Safeguarding Adults/Adult Protection.

Monitoring Information

Adult Protection issues in Adult Placement can be raised from three sources as a concern, complaint or Adult Protection referral. Each source is recorded, investigated by the Scheme Manager and reported to the Commission for Social Care Inspection - annually in the case of concerns and minor complaints and immediately in the case of more serious Adult Protection issues. Rarely the Adult Services' Critical Incident Procedure will also be instigated.

Training

· Adult Protection is covered on induction and foundation training of all new carers and Adult Placement staff.

· A mandatory training course entitled "Management of Allegations in Adult Placement" was delivered to all Adult Placement carers.

· Staff have attended national training on the same topic.

· The manager has attended national Action on Elder Abuse training on "Making referrals to the Protection of Vulnerable Adults' Register".

3.2 Hampshire Domiciliary Care Association

Hampshire Domiciliary Care Association (HDCA) continues to work closely with Hampshire, Portsmouth and Southampton on the Safeguarding Adults/Adult Protection agenda.

As the representing body for Domiciliary Providers across the 3 Authorities, we do our utmost to ensure each organisation is responsible for ensuring its staff is able to recognise abuse and the appropriate action to take in the event of suspected abuse or neglect.

HDCA disseminates all information to providers on Safeguarding Adults/Adult Protection and alerts providers to any updates and also has reports/minutes/newsletters on the website for providers to download.

The groups we have representation on are:

Multi Agency Management Committee (MAMC)

This group meets twice a year.

Hampshire Adult Protection Committee. (Hampshire)

Safeguarding Adults Partnership Board and Training Sub-Group (Portsmouth).

Southampton Adult Protection Committee (Southampton)

These groups are generally scheduled to meet four times a year.

Our representatives are:

Pam Butler/Suzy Baldock Hampshire

Jane Rudd/Charlotte Kelly Portsmouth

Pam Butler Southampton

3.3 Hampshire Constabulary

Hampshire Police have invested in new staff this year with dedicated PCs to support interagency working. A growth bid has also been submitted to the Police Authority for an additional Sergeant post which is to be dedicated to Adult protection.

We have recently developed a new Adult Protection policy which is currently out for consultation and will be published later this year.

We have engaged in multi agency training and have organised and participated in conferences to raise awareness and to make links with Domestic Abuse and MAPPA.

3.4 The Crown Prosecution Service

The Crown Prosecution Service is an independent Government department responsible for prosecuting people in England and Wales who have been charged with a criminal offence.

Along with other agencies the CPS role in the area of adult protection has continued to expand and develop. In April 2007 The CPS launched a specific policy relating to Disability Hate Crime whilst a further policy relating to prosecuting crimes against the older person is currently at the consultation stage.

Hampshire CPS recognises the importance of prosecuting crimes which are committed against vulnerable adults. So as to ensure that vulnerable adult witnesses and victims of crime are provided with the most appropriate service Hampshire CPS has now commenced monitoring cases involving vulnerable adults.

Hampshire CPS continues to support and attend the Hampshire Adult Protection Committee. A CPS lawyer regularly attends the committee to provide an up date in relation to successful prosecutions where vulnerable adults have been victims of crime and/or witnesses in Court and also by answering questions relating to the prosecution of crimes against vulnerable adults.

3.5 Winchester & Eastleigh Healthcare NHS Trust

The Trust Protection of Vulnerable Adults Steering Committee established in April 2006 has met quarterly so as to monitor the development of the protection of vulnerable adult practices within the Trust in line with the Trust Policy and the Committee's terms of reference. The Committee's main activity during this period has been to establish an educational strategy and carry this through to completion. The Trust has delivered two series of basic level awareness training within the Trust and an additional programme on the additional responsibilities of managers.

In addition Committee members have met on a regular basis with the Hospital Social Services Team to review cases of alleged abuse brought to the attention of the Hospital Social Services Team by hospital staff.

As a result of these meetings and the introduction of the Mental Capacity Act the Trust Policy is now under review.

3.6 Hampshire Primary Care Trust

Leadership for the Hampshire PCT approach to Safeguarding Adults will be provided by the new Director of Nursing and supported by the role of the three Clinical Governance and Professional Practice Leads. Representation at meetings and conferences has been maintained and will continue to be provided by one of the above.

Reported incidents of Adult Abuse have been, and will continue to be, dealt with in a manner consistent with the local multi agency `Safeguarding Adults' policy and procedures and action taken to help prevent reoccurrence.

An overarching `Safeguarding Adults' policy for Hampshire PCT is being developed to ensure a common approach across the three areas (W,SE, and N). This will be linked to and supported by other Hampshire PCT policies.

Training

Safeguarding Adults

Data for specifically April 2006 to March 2007 is unfortunately not available.

· The training figures for October 2006 to September 2007 indicate that at least 305 staff received training with a further 100 already booked to attend before March 2008.

· Vulnerable Adults training is now mandatory for all staff.

· From April 2008 there will be available a rolling programme across Hampshire PCT to a consistent standard.

Mental Capacity Act

Staff have been attending and more will attend the multi agency Train the Trainer courses with the intention that the information is disseminated to the teams. Senior staff have been identified to attend the Detailed Awareness Training.

Local Induction

Awareness raising sessions for both Safeguarding Adults and Mental Capacity Act have been included in the local induction programmes for all clinical staff in the SE 2006-2007 and will be part of all the local inductions (including the North and West) in 2008.

Monitoring

There are audits planned in 2008 of the impact of the training in Safeguarding Adults on staff to monitor the effectiveness of the current strategy.

Service User Involvement

Hampshire PCT has made a firm commitment to supporting the promotion of service user involvement in Safeguarding Adults.

4. Adult Protection Training in Hampshire

Extensive training has been facilitated both within Adult Services and via the Partnership in Care Training (PaCT) team, which is resourced and funded by Adult Services, within the Independent and Voluntary sectors as follows:

Included in these figures are a small number of staff from other agencies, for example Health and Police, where either Adult Services was seeking to support key staff in implementing training strategies within their own organisations or there was a specific need which could not be met elsewhere. In general Adult Services is keen to support other agencies in developing their training and to commission quality training in line with local policy and procedures.

One basic awareness course was adapted for Managers of Women's' refuges to support work in making the links between Adult Protection/Safeguarding and Domestic Abuse. Likewise Adult Services trainers and strategic manager have attended Domestic Abuse training in order to incorporate lessons from Domestic Abuse into Adult Protection courses and guidance.

Plans to include Police colleagues from Public Protection Units (3 per operational Command Unit in Hampshire) are in place and due to run in autumn 2007.

It is estimated that trainers trained in this period will have trained around 3000 staff in basic awareness. A number of evaluation strategies are in place that confirm this is a reasonable assessment of the volume of training delivered.

Evaluation for voluntary and not for profit organisations

Where voluntary sector organisations identify a training need that falls outside the basic level ROCC deliver, requests are forwarded to the PaCT team.

NB ROCC is a coordinating/umbrella organisation for voluntary and not for profit organisations.

5. Report on Statistical Information

Appendix B contains a selection of tables from the statistics collected by Hampshire for the whole year April 1 2006 to March 31 2007. The statistics for the period April to September 2007 will appear in the next annual report.

Set out below are some key trends from the statistics. The number of cases of abuse reported in Hampshire Adult Services Department between 1 April 2006 and 31 March 2007 was 421. This is slightly down on the previous year when 469 cases were reported. Between 1 April 2007 and 30 September 2007 232 cases have been reported. The detail of these 2007 statistics will be reported in the next interim report. Trends from these statistics remain constant over the past two years and in line with national statistics:

· Most common types of abuse are physical abuse and financial abuse.

· The most common location for abuse to take place is in a person's own home and the next most common location is in a care home and then a nursing home.

· The abuser is most often a relative or friend of the abused. However there are still significant numbers of paid carers identified as abusers.

· Those referring/alerting Adult Protection situations to Adult Services come most often from provider services.

· In the whole period covered by this report 130 referrals came from the person being abused, their relative or friend. This is out of a total 653 cases referred.

· Since April 2006 we collect information on outcomes at a stage 6 weeks after the initial referral and then again at 6 months after that referral. The statistics show that there is often more than one outcome in a situation and that there is a wide range of different outcomes. Around 40 different outcomes were recorded including: advice/information given; counselling/support; police action; Court of Protection/ Public Guardianship Office referral/action; CSCI action; referral to POVA List; Management Action; Disciplinary Action; removal of either the abused person or the abuser; health assessment; carer assessment/services; preventive measures put in place; advocacy provided; Victim Support involvement.

This wide ranging list of potential outcomes underlines the need for ensuring involvement of a wide range of agencies strategically and in practice and the need to ensure appropriate training is available to those organisations.

The qualitative findings of the National Prevalence Study: UK Study of Abuse and Neglect of older people: Qualitative Findings (2007) states: "The diversity of experience and the broad range of factors affecting resilience and long term outcomes ...suggest that maintaining broad coverage of high quality services (benefits, housing, health, social care, transport) to older people and their families is likely to be one of the most effective ways of responding to elder mistreatment". Maintaining the input of a wide range of agencies via the Adult Protection Committee is important in continuing to enable a broad range of responses.

6. Key Objectives for October 2007 to March 31 2009

· New Adult Protection Coordinators in post and demonstrating clear outcomes.

· Revised policy and procedures in place.

· Clear strategy for Service User involvement in place and running.

· Representation from all key agencies on Adult Protection Committee.

· Re launch of local Adult Protection Action Groups on new Adult Services area boundaries.

· Serious Case Review Panel up and running.

· Responding to national developments including: Safeguarding Vulnerable Groups Act; National Data Collection developments.

Appendix A

Membership of Hampshire Adult Protection Committee:

Hampshire County Council Adult Services

Hampshire Police

(Hampshire Probation)

Hampshire Primary Care Trust

Hampshire Partnership Trust

(Surrey and Borders Partnership Trust)

Acute Health Trusts:

Winchester and Eastleigh Healthcare NHS Trust

Basingstoke and North Hampshire Foundation Trust

Frimley Park Hospital Foundation Trust

(Hampshire Ambulance)

Voluntary sector organisations representation via ROCC

Hampshire Care Association

Hampshire Domiciliary Care Association

Supporting People

Direct Payments

Strategic Housing Officers Group Representation

Commission for Social Care Inspection

Victim Support

(Drug and Alcohol Team)

(Service User/Carer representation)

Adult Placement

Crown Prosecution Service

Department of Work and Pensions

For those organisations listed in ( ) representation is currently being sought/discussed.

Appendix B

Statistics recorded by Hampshire Adult Services April 2006 to March 2007

Alleged Abuser by Gender, Relationship to Client and Area of Client between 01 April and 31 March 2007

*Please note that the total figure may not match the total number of cases as a client may have been abused by more than one person.

Adult Abuse Cases by Outcome of 6 Month Review & Care Group between 01 April 2006 and 31 March 2007

* Please note that the total figure may not match the total number of cases as a client may have been abused more than once.