Proposed SHSCT Structures and Processes In response to

Transcription

1 Proposed SHSCT Structures and Processes In response to Adult Safeguarding in Northern Ireland Regional and Local Partnership Arrangements (DHSS&PS March 2010) June 2010

2 1 Introduction In October 2007 the Adult Protection Project was endorsed by the Southern Health and Social Care Trust s Senior Management Team which agreed to the establishment of a short-life Project Board charged with scoping existing systems and practices in Adult Protection work across the Trust and making proposals for improvements. The Project Board which reflected the multi-disciplinary and inter-directorate nature of Adult Protection work was initially convened at the end of November 2007 and met from December 2007 to March 2008, presenting a final report to the Trust Senior Management Team in August 2008 which made a number of recommendations. A key recommendation contained within the report was the immediate establishment of a Southern Trust Adult Protection Forum. The Forum was convened under the chair of the Trust s lead professional on Adult Protection. The membership of the forum was multidisciplinary and multi agency including the commissioner (SHSSB and latterly the HSCB), PSNI, a representative of the Southern Supporting People Partnership, NIPB and finally a representative from Women s Aid. The Forum developed an action plan to take forward the key recommendations contained within the Adult Protection report. A business case was submitted through the SHSSB HWIP seeking funding for an Adult Protection Coordinator. The bid was successful and on receipt of the additional funding from the Department and the Regional Board the Trust has commenced the recruitment process for protection/safe-guarding specific staff. At the direction of the Regional Adult Protection Forum, the 5 Trusts met to agree a regional job description for two new posts, an Adult Protection Specialist Manager (Band 8a and an Adult Protection Senior Practitioner B7). These posts will be interviewed in June and July 2010 and will form the SHSCT Adult Protection Team. 2 New Arrangements In March 2010 the DHS&PS issued a final guidance document Adult Safeguarding in Northern Ireland - Regional and Local Partnership Arrangements (DHSS&PS March 2010), to all partner organisations involved in Adult safeguarding. This document describes the new Safeguarding Partnerships which are to replace existing Regional and Local Adult Protection fora - the Northern Ireland Adult Safeguarding Partnership (NIASP) the regional body which

3 will be led by the HSC Board - and the five Local Adult Safeguarding Partnerships (LASPs) which will be centred on the five Trusts. The role of the NIASP will be to determine the strategy for safeguarding vulnerable adults, develop and disseminate guidance and operational policies and procedures, monitor trends and outcomes and monitor and evaluate the effectiveness of partnership arrangements. The role of the LASPs will be to facilitate practice, including engagement with service users, families and carers and the wider public, at a local level. The roles and responsibilities of the NIASP and LASPs, the relationship between them and the mechanisms for securing meaningful participation from service users and carers or their representative organisations, are set out in detail within the guidance. The guidance also explicitly states that Adult safeguarding and protection work must be conducted in a way which is person-centred, underpinned by human rights considerations and guided by the principles and approaches set out in Safeguarding Vulnerable Adults, the Regional Adult Protection Policy & Procedural Guidance, published in September 2006 and its associated Joint Protocol, revised and published in July Serious Case Reviews The guidance states that further work will be undertaken to produce SCR Review Guidance which will cover, inter alia, the purpose of, and criteria which trigger, a SCR, the review process and the constitution of a SCR Panel. Such reviews are likely to be undertaken where there is a serious adverse incident or where there is significant public and media interest, with respect to a Vulnerable Adult. Adult Safe Guarding Forum The guidance advises that the NIASP, in partnership with LASPs, should consider the establishment of and provision of support to an ASF. The ASF is a mechanism by which the NIASP and LASPs facilitate much wider user participation in the work of the partnerships. Members of the ASF should be representative of the rich range of interests in Northern Ireland. As a key partner for NIASP and the LASPs, the ASF would, among other things: inform the development and review of strategies, policies and procedures;

4 help with the development, and promote awareness of, risk indicators; help inform/equip people with information and plans to safeguard themselves; help identify barriers to uptake of access to safeguarding services; facilitate development of user-friendly information about what to do and how to get help when needed; and promote access to and dialogue with local community and particular interest groups. 3 Implications for SHSCT Within the guidance the Trust has the responsibility for core funding the LASP and for providing it with a secretariat and other support services (Para 57). The guidance also states that, at the outset, the LASP should be chaired by the Trust s Executive Director of Social Work or a senior designated nominee (at not less than 3 rd level (Para 20)), on the grounds that existing partnership arrangements are led by senior social care staff (Para 56). The LASP as a body is accountable to the HSC Trust in which it is located, although its members are accountable to the organisations they represent (Para 48). Given all of this, and that the establishment of the NIASP structures are the responsibility of the HSC Board, it is safe to assume that the responsibility for establishing the LASP will rest with the relevant Trust. As the Chair of the LASP is automatically a member of the NIASP the Trust also has all the responsibilities associated with such membership. The responsibilities that such roles and membership places on the Trust are as follows Identify a lead at board/executive level responsible for safeguarding vulnerable adults work within the Trust; to champion the rights of vulnerable adults; and to ensure that safeguarding issues become more central to the work of the Trust; (Brian Dornan Executive Director of Social Work) Nominate a lead manager with responsibility for safeguarding vulnerable adults to act as the Trust s representative on the NIASP and LASP, as specified; (Micéal Crilly, Assistant Director Physical and Sensory Disability) Identify an officer to deputise for the lead manager, should this prove necessary. A deputising officer should only be appointed on the basis of authority to represent and make decisions on behalf of the Trust. (Patricia Trainor, Head of Social Work OPPC)

5 Accept that the Trust is responsible for the contribution made by its own representative; Have a mechanism for considering and responding to the policy, planning and resource implications of issues brought to the attention of the Trust by its NIASP representative. (M Crilly through B Dornan to Trust SMT) If the Trust requires resources to discharge, or change the way they discharge, their safeguarding responsibilities or to respond to any increase in safeguarding activity, the Trust should bid for these in line with their usual process; Provide the NIASP with management information on safeguarding work in general and, in particular, on the level of activity, trends, support provided and outcomes in adult protection work within the Trust on an annual basis; (Performance Management Workstream, quality assured by Adult protection Forum, through M Crilly to NIASP) Submit an annual progress report to Trust Board/SMT to ensure that adult safeguarding and protection requirements are part of the organisation's overall approach to service provision and service development. Reports should be commensurate with the Trust s safeguarding role and be sufficient for it to be assured that it is discharging its responsibilities and partnership commitments appropriately and effectively; (M Crilly, informed by Specialist Safeguarding Team and Adult Protection Forum) Include in the Trust annual report an item about work undertaken in relation to safeguarding vulnerable adults; (Trust PR informed by Communications and Information Workstream) Have a clear, well-publicised policy of Zero-Tolerance of neglect, exploitation or abuse wherever they occur; (Trust HR informed by Communications and Information Workstream) Put in place effective training arrangements for Trust Staff ranging from awareness training for front line staff to the more in depth training required to discharge specialist functions; (Training Workstream supported by Specialist Safeguarding Team) Provide a statement setting out the Trust role and responsibilities in relation to safeguarding vulnerable adults work, including any statutory responsibilities and services provided. (Adult Protection Forum) Identify a Chair for the LASP; (M Crilly) Facilitate the establishment of the LASP through nominating and inviting membership in line with the guidance issued; (As described in section 5)

6 The Trust's Executive Director of Social Work or nominee, with relevant members of the LASP, should put in place a mechanism, which ensures that ownership of safeguarding issues is promoted across all professional groups and service delivery settings in health and social care. They will also ensure that safeguarding issues of general or particular relevance to professional groups and service areas within the HSC Trust are brought to the attention of the relevant Trust Director, in line with established governance arrangements within the Trust; (Adult Protection Forum) Be responsible for core funding the LASP and providing it with a secretariat and other support services; Ensure that the issues applicable to the Trust for safeguarding vulnerable adults are given proper consideration by LASP; (Adult Protection Forum) Establish a mechanism for considering and responding to the policy, planning and resource implications of issues brought to the attention of the Trust by its LASP representative; ; (Adult Protection Forum to SMT) Provide the LASP with management information on safeguarding work in general and, in particular, on the level of activity, trends, support provided and outcomes in adult protection work within the Trust on an annual basis. (Performance Management Workstream) 4 Proposed SHSCT Structures The DHSSPS has provided recurrent funding for a Specialist Adult Protection Manager and associated administrative provision to support the work of each LASP to ensure the smooth running of its operation and management of its resources. The SHSCT propose to use this funding to employ a Specialist Adult Protection Manager at Band 8a, 1.5 wte Senior Social Work Practitioners at Band 7 and 0.4 wte B3 Admin Support. The Band 8a will provide support to the LASP through establishing the necessary procedures and activity reporting mechanisms within the Trust while also leading the Specialist Adult Protection Team. This post holder will also represent Adult Services within the Trust on the Southern Domestic Violence Partnership, developing and maintaining relationships with key voluntary and community sector partnerships. They will also provide the necessary support and mentorship to Trust staff engaged in Joint Protocol/Achieving Best Evidence work in line with regional procedures and following one of the recommendations contained in the Trust report. The Adult Protection Team will provide support and advice to core teams undertaking adult protection investigations and will assist in ensuring the required procedures and processes are followed and that high

7 levels of practice are evident in all Adult Safeguarding Interventions by front line staff across the Programmes of Care. The SHSCT has developed a high level of expertise amidst a group of professionals across the Programmes of Care, over this past number of years, through the activity outlined in the Introduction. It is deemed essential to retain this knowledge and expertise and indeed to use it to continue to develop best practice across the Trust. Hence the Trust will establish sub structures populated by these key individuals to ensure high quality implementation of the NIASP and LASP requirements across the professional workforce and to support the work and development of the new Specialist Team. Given the importance of this work from a governance perspective and the increased urgency now being afforded to it through the Departmental guidance, allied to the size of the workload and the level of inexperience of the new Team there is a clear need for high level support from a Senior Manager with experience in this area of work and who has developed strong links with the key organisations across the Southern area. Adult Protection work in the SHSCT has been led by the Head of Social Work (Band 8b) to date. It has been agreed that there will be.5wte dedication of this individual for the period Sept 2010 to the end of March 2011 in the first instance. This will be subject to review of progress in the establishment of structures and partnerships and the development of the required levels of expertise and knowledge within the Specialist Team. The role of this person is to support and supervise the Specialist Adult Protection Manager and their team, in taking forward the development of systems and processes to meet the requirements of the NIASP and the LASP from a Trust perspective. This individual will continue to lead on the Trust sub structures and the development of key linkages and interfaces such as those with MARAC, Child Protection Forum, Domestic Violence Forum, RQIA etc, during this period. Simultaneously this will allow for the high levels of knowledge and expertise to be shared by the 8b with the new 8a. An overview of the proposed SHSCT Sub Structure is outlined at Appendix 1. 5 Establishing the Southern LASP The Departmental Guidance Document is explicit with respect to the membership of both the NIASP and the LASP. Para 51 states

8 The LASP should be made up of members from the main statutory and voluntary and community organisations involved in adult safeguarding work and service providers in the HSC Trust s area, and include representation from service users. Each partner organisation should ensure active participation and representation at a sufficiently senior level so that the LASP is effective in the implementation of guidance, policy and procedures at a local level, including engagement with service users, families, carers and the wider public. Membership will comprise a Chair and 24 members which should include service users and carers or their representative groups and practitioners and managers from a range of disciplines and organisations in the HSC Trust area This Paragraph goes on to identify precisely which organisations should be represented and clarifies further the community,voluntary, faith and user and carer representation in Para 53 The LASP, in consultation with NIASP, should also determine and publish nomination and selection criteria for representation by the voluntary, community, private and faith sectors who with service users and carers or their representative groups are expected to make up one-third of the LASP membership. It is possible that the LASP could draw its voluntary, community and faith sector representation and representation from service users, carers or their representative groups from the suggested Adult Safeguarding Forum arrangements (see paragraphs 23-25). This is a matter for the LASPs. An initial regional scoping meeting arranged by the SHSCT and attended by experienced lead professionals in Adult Safeguarding from 4 of the 5 Trusts, and also attended by the SHSCT PPI Lead discussed the proposed membership of LASP. The view of this meeting was that as the LASP membership reflected the NIASP membership, rather than the HSC Board and each of the Trusts writing to each of the designated partner organisations requesting nominations for involvement in Adult Safeguarding arrangements, one letter should be forwarded to each organisation setting out the NIASP and LASP representation requirements and asking for nominations for all bodies. This would allow the partner organisations to take a more strategic view of their representation and reduce the risk of confusion within those organisations. The arrangements for selecting the one third community, voluntary, faith, user and carer representation was also discussed at the meeting, including the suggestion set out in Para 53 above. The view of the meeting with respect to this was that given the complexity of Adult Protection and the fact that these arrangements are being established for the first time it would

9 be preferable to engage with a number of key agencies, representative of the Adult POCs who have had some experience of Adult Protection and all of whom have a local presence. When the structures become embedded, the NIASP and LASPS would be in a better position to follow the suggestion laid out in Para 53. Hence the meeting proposed that these organisations could be asked to provide nominations in the same way as the identified partner organisations, they are Age NI Mencap Disability Action Praxis Woman s Aid Victim Support Carers (NI) NICEM It is evident that this list is not fully inclusive of the all the possible community/voluntary sector organisations that could undertake a valid partnership role within the NIASP/LASP. For example the Alzheimers Society is not included. Indeed some of these organisations may have difficulty in providing 6 nominations for the NIASP/LASPs. Hence the RHSCB may wish to add additional groups and have membership across two to three LASPs or that a recruitment process is the most effective way forward. Current Trust Leads in Adult Safeguarding should consider individuals who have been through the Adult Safeguarding process over this past 3 years with a view to identifying someone with experience of the process and who has the confidence to contribute, or to be supported to contribute, in such a forum. If no one can be identified each Trust could use their current PPI structures and processes to create an Adult Protection User Forum which nominates someone to sit in the LASP and continues to be available to that individual as a support and as a constituency group. This leaves only representation from the the Faith Communities. The view of the meeting was that the HSC Board should write to all the main Churches asking each to provide one nomination which then could be allocated to the NIASP and each of the five LASPs. The Southern LASP would thus include the following Representation 1. Chair Micéal Crilly AD Phys Dis 2. SHSCT Social Work Head of SW OPPC

10 3. SHSCT Medical Rep SHSCT SMT Nomination 4. SHSCT AHP Rep SHSCT SMT Nomination 5. SHSCT Nursing Rep SHSCT SMT Nomination 6. SHSCT Training Rep Head of Social Work Training 7. PSNI HSC Board Letter 8. GPs Representative from Dr Beckett 9. Southern LCG HSC Board Letter 10. PBNI HSC Board Letter 11. SSA HSC Board Letter 12. NIHE & Sheltered Acc. HSC Board Letter 13. Independent Sector HSC Board Letter 14. District Councils 1 Rep from all Councils in SHSCT 15. Patient and Client Council HSC Board Letter 16. Age NI HSC Board Letter 17. Mencap HSC Board Letter 18. Disability Action HSC Board Letter 19. NIAMH HSC Board Letter 20. Woman s Aid HSC Board Letter 21. Victim Support HSC Board Letter 22. Carers (NI) HSC Board Letter 23. NICEM HSC Board Letter 24. Service User Trust selection as described 25. Faith Community HSC Board Letter The Southern LASP would then meet by Dec 2010 with a view to agreeing TOR, membership commitment, internal organisational requirements to facilitate required involvement, meeting schedules and working groups required and their membership. Responsibilities of the LASP The role of the LASP located within each of the HSC Trust areas is to implement locally the NIASP s guidance and operational policy and procedures ensuring a high standard of professional practice. Its main tasks are: a) to work within, and contribute to the NIASP Strategic Safeguarding Plan, and ultimately the framework for planning, commissioning and performance management of health and social care services having due regard to the objectives of partner organisations; b) to contribute to delivery of the annual Safeguarding Work Plan;

11 c) to implement the NIASP s guidance and operational policies and procedures; d) in partnership with the NIASP to measure how and to what degree the objectives, performance indicators and outcome measures set by the NIASP have improved outcomes for vulnerable adults in the locality; e) to monitor and evaluate how well local services work together to safeguard vulnerable adults. This should be done in partnership with the NIASP and form part of the NIASP annual Safeguarding Work Plan; f) to encourage and develop good working relationships between different services, professionals, and community, voluntary and private sector groups with the aim of developing trust and mutual understanding; g) to ensure that each partner organisation has a clear, well-publicised policy of Zero-Tolerance of neglect, exploitation or abuse wherever they occur; h) to ensure that there are strong and effective links between the LASP and MARAC, PPANI and SSAFA Forces Help (where there is a large service base in the area) at local level; i) to develop and maintain strong links with local child protection structures; j) to properly integrate adult safeguarding strategies with other relevant strategies and procedures, e.g. child protection; domestic violence; sexual violence and abuse; human trafficking; and the assessment and management of individuals who may be a risk to themselves or others due to mental disorder; k) to advise the NIASP and LASP s constituent organisations on resource needs; l) to develop an outline training plan, contribute to the NIASP training and development strategy and to the delivery of training and development programmes on a multi-agency/disciplinary basis and, in partnership with NIASP, to assess how identified training/development needs are being met;

12 m) to promote public awareness about adult safeguarding and protection services in keeping with the NIASP public communication and information strategies; and n) to provide an annual report to the NIASP. The LASP as a body is accountable to the HSC Trust in which it is located and must work within the agreed NIASP Strategic Safeguarding Plan and associated Safeguarding Work Plans, guidance and adult protection operational policies and procedures, which they do not have the discretion to amend. 6 Partnership Organisations The guidance emphasises the expectation that all partner organisations will participate in and contribute to the LASP while also ensuring that each organisation has the required structures and processes in place to ensure that Adult Safeguarding is appropriately managed within that organisation. These expectations are highlighted in the following statements within the guidance. Each partner organisation will identify a lead at board/executive level responsible for safeguarding vulnerable adults work within the organisation; to champion the rights of vulnerable adults; and to ensure that safeguarding issues become more central to the work of the organisation. In addition, each organisation will nominate a lead manager with responsibility for safeguarding vulnerable adults to act as that organisation s representative on the NIASP and LASP, as specified. Each partner organisation will provide a statement setting out its role and responsibilities in relation to safeguarding vulnerable adults work, including any statutory responsibilities and services provided. Members are accountable to the organisations that they represent which, in turn, are responsible for taking any action properly falling within their respective remits. Each partner organisation must accept that it is responsible for the contribution made by its own representative. Each representative is responsible for ensuring that the issues applicable to their organisation for safeguarding vulnerable adults are given proper consideration. Each partner organisation must have a mechanism in place for considering and responding to the policy, planning and resource implications of issues brought to the attention of the organisation by its representative.

13 LASP members are accountable to the organisations they represent. Each partner organisation should accept that it is responsible for monitoring the performance of its own representative. Each partner organisation must accept that it has a responsibility to contribute to the effective working of the partnership and is responsible for the contribution made by its own representative. Each representative is responsible for ensuring that the issues applicable to their organisation for safeguarding vulnerable adults are given proper consideration by the LASP. Each partner organisation must have procedures in place for considering reports from its LASP representative and for responding to the policy, planning and resource implications of issues brought to its attention by its LASP representative. Each partner organisation must, however, accept that it has a responsibility to contribute to the effective working of the partnership and is responsible for the contribution made by its own representative. Each representative is responsible for ensuring that the issues applicable to their organisation for safeguarding vulnerable adults are given proper consideration by LASP. Partner organisations must have a mechanism for considering and responding to the policy, planning and resource implications of issues brought to the attention of the organisation by its LASP representative. Organisations which require resources to discharge, or change the way they discharge, their safeguarding responsibilities or to respond to any increase in safeguarding activity should bid for these in line with their usual process. Information, collected, collated and analysed by the LASP will be of benefit in this regard. 7 Key Actions and Timescales The letter accompanying the guidance sets out a number of key actions with associated timescales: 1. Partner organisations will be asked to confirm their named representatives to the NIASP and each of the LASPs before the end of August The NIASP and LASPs will have met at least once by the end of December The HSC Board and Trusts should move to appoint the Regional Adult Protection Officer and the five Specialist Adult Protection Managers by June 2010 at the latest. 4. The first NIASP strategic plan will be published in March 2011.

14 5. The DHSSPS and NIO will take delivery of the first NIASP report in June Proposal SMT and Trust Board are asked to endorse the above arrangements.

15 Appendix 1 SHSCT Adult Protection Structure SHSCT Trust Board RHSCB Executive Director of Social Work SHSCT Executive Level Lead Brian Dornan Adult Safeguarding Forum NIASP Directors of Adult Programmes of Care SHSCT Adult Protection Forum Chair Patricia Trainor All SHSCT Front Line Staff in Adult POCs Southern LASP Chair Micéal Crilly Adult Abuse Team Specialist Adult Protection Manager B8a and 1.5wte Senior Practitioners B7 Training Workstream Performance Management Workstream Communications and Information Workstream