Agenda item

A representative from TSAB will be in attendance to update Members on the Board’s Annual Report 2021/22 and its Strategic Business Plan 2022-25.

The Chair welcomed Darren Best, Independent Chair of the TSAB to the meeting, who was in attendance to update Members on the Board’s Annual Report 2021/22 and its Strategic Business Plan 2022-25.  The following matters were raised as part of the update:

• The role of the TSAB Chair and Mr. Best’s experience to date.
• The implications of the Care Act 2014 in terms of safeguarding responsibilities and the requirement to produce an annual report; mention was made of the various Boards, Forums and Committees to which the information was delivered.
• The reasoning behind the establishment of a single TSAB for the four Tees Local Authorities, the unique approach this offered and the positive outcomes achieved, albeit with some challenge.
• The breadth of partnership work being undertaken across Tees: at present, for example, TSAB had an excellent mix of statutory and non-statutory partners and the number was growing (currently 21, however, HartlePower was to join in the near future).  It was noted that all partners played a very active role.
• The main difference between adult safeguarding and children’s safeguarding was that the emphasis within adults was on Local Authorities to coordinate and operate services, whereas within children’s it was the joint responsibility of Local Authorities, the Police and Health organisations.
• Safeguarding Adults Reviews (SARs) under the Care Act, i.e. how these were administered and the learning that local, regional and national reviews provided.  It was highlighted that a SARs coordinator had recently been appointed and would commence in post on 1 December 2022.
• Priorities for 2021/22, which had been changed to ‘I’ statements: the purpose of this change was to remind of TSAB’s service users by approaching from the perspective of the service user or carer.
• Performance Indicators – it was highlighted that all targets had been achieved this year.
• The challenges identified within the report, including:

-        The very complex environment that adult safeguarding operated in, and that expectations had grown significantly.  Praise was offered to all those working in the sector.

-        Stages of transition (between child and adult services, for example) and how these tended to be a common feature within SARs.

-        There was a need to hear more from service users directly.

-        Staffing and lifelong training needs.  There were pressures within the system and around links within the system – the pandemic had helped to highlight these, but challenges did continue.

-        Abuse - the four main areas of abuse related to neglect, physical, financial and domestic abuse.  However, psychological abuse and self-neglect were not too far behind.  It was indicated that, in terms of statistical data, the Tees Valley reflected the national picture.  Consideration was given as to whether this was a consequence of increased reporting or an increase in cases – the Independent Chair felt it likely to lie somewhere in the middle.  Reference was made to the work undertaken by TSAB’s sub-groups in relation to this area of safeguarding work.

-        In terms of the rising numbers, it was highlighted that this put increased pressure on an already struggling system.

During the discussion that followed, Members asked a number of queries of the Independent Chair and the Director of Adult Social Care and Health Integration.  In response, the following information was provided:

·     In safeguarding terms, neglect and acts of omission included ignoring medical, physical or emotional care needs; failing to provide access to appropriate health, care and support or educational services; and withholding such things as medication, adequate nutrition and heating.  The difference between intentional and accidental occurrences was highlighted; it was indicated that overlooking matters provided a common basis.

·     There had been a 40% increase in psychological abuse, which could occur alongside other forms of abuse, such as domestic and/or sexual abuse.  Psychological abuse could involve daily berating behaviour and undermining a person’s confidence.

·     In terms of staffing and operation of the TSAB, a business unit that sat with Stockton Borough Council coordinated its work.  Social Workers were based primarily in safeguarding within Adult Social Care and acted as care planners and investigators.  The duties around safeguarding was Council-wide: training was provided during induction sessions and also regularly undertaken in directorates outside of Social Care.  It was highlighted that staff in areas such as Public Protection, who interacted with the public daily, were fundamental in recognising and reporting safeguarding concerns.  The TSAB was always looking for new ways to raise awareness beyond the Local Authority (for example: amongst neighbours, couriers and postal staff); recent initiatives carried out by the TSAB’s Communication and Engagement Sub-Group had included advertisements in football programmes.

·     Regarding domiciliary care, it was explained that, historically, these care services were operated by the Local Authority directly.  However, like the vast majority of Local Authorities, Middlesbrough Council now commissioned independent providers.  It was highlighted that the Local Authority had very positive working relationships with providers, with any issues immediately being raised, and that delays in domiciliary care currently being seen in other areas were not being experienced in Middlesbrough.  It was acknowledged that the independent care provider market was as difficult now as it had ever been, and highlighted that salaries in Middlesbrough fared well in comparison to other Local Authorities in the area.  Work was currently taking place to understand the impact around cost of living on staff, and to balance resources in reflection of costs, demand, etc., which was very difficult.

·     It was highlighted that care staff performed a very complex role and required tact, empathy and flexibility to deliver support safely.  There was an enormous reliance upon domiciliary care workers and it was felt that, as a society, the role was often overlooked and did not receive the same recognition awarded to other professions. Exploration work around recruitment and showcasing the role as a career choice was currently being undertaken.

·     A lengthy discussion ensued in relation to residential care, domiciliary care, assessments and subsequent care packages.  It was suggested that this topic be revisited at a future meeting, with a member of the Commissioning Team in attendance to explain the processes and work involved.  Consideration was also given to domiciliary care staff and related appointment and travel time in caring for service users.

·     The remit of Adult Social Care was service users aged 18-plus years.

·     Regarding Roseberry Park and the Council’s role in that facility, it was explained that it was controlled entirely by Tees Esk and Wear Valley NHS Foundation Trust (TEWV); the Council worked closely with the Trust, but had no control over, or administration input into, it.  In terms of admittance, it was explained that some individuals would be admitted on a voluntary basis, whereas others would be compulsory admissions decided upon by the hospital clinicians.

·     The Director of Adult Social Care and Health Integration reiterated the strengths associated in having one single TSAB for the four Local Authorities.  Amongst these were increased numbers from four areas around the table – which meant broader experience; vigorous and robust challenge; and shared knowledge.  It was felt that there was an increased level of effectiveness in a much more complicated safeguarding arena than there ever had been before (reference was made to such matters as trafficking and modern slavery), with significant demands placed on staff in a world of stretched resources.

·     In relation to suicide amongst younger men, it was explained that TEWV viewed addressing this as a strategic priority.

The Chair thanked the Independent Chair for his attendance and contribution to the meeting.

NOTED