Lewisham Safeguarding Adults Board

Publications

Adult Safeguarding Leaflet

LSAB Abuse & Neglect Leaflet

Adult Safeguarding - Easy Read leaflet

Safeguarding Adult Reviews

Read and download all of the published Safeguarding Adult Reviews Commissioned by Lewisham Safeguarding Adults Board.

New! Friday 26 June 2020 - Safeguarding Adult Review – Mrs A & Miss G

Lewisham Safeguarding Adults Board has today published the Safeguarding Adult Review for Mrs A & Miss G.

Lewisham Safeguarding Adults Board has also produced a LSAB 7 Minute Briefing - Mrs A & Miss G - for Professionals.

Friday 12 June 2020 - Safeguarding Adult Review – Mr Tyrone Goodyear

Lewisham Safeguarding Adults Board has today published the Safeguarding Adult Review for Mr Tyrone Goodyear.

Accompanying this report is a statement from the family of Tyrone.

Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Tyrone Goodyear - for Professionals.


Friday 5 June 2020 - Safeguarding Adult Review - Executive Summary - Lee

Lewisham Safeguarding Adults Board has today published the Safeguarding Adult Review Executive Summary - Lee.

Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing – Lee - for Professionals.


During 2018 Lewisham Safeguarding Adults Board published two safeguarding adult reviews. The full reports and accompanying documents are available to read and download below.

Mr Michael Thompson - Safeguarding Adult Review - Full Report

Statement of the board in relation to the Safeguarding Adult Review - Mr Michael Thompson

Safeguarding Adult Review, Reflection and Development Briefing - Personalising Care and Improving Outcomes


Mr CS - Safeguarding Adult Review - Full Report (Includes board statement)

Mr CS - Safeguarding Adult Review - Practice Briefing

Guidelines On Risk Assessment for Smoking in Care Homes

Find out more about Safeguarding Adult Reviews and How to Make a Referral to the LSAB.

Annual Reports

LSAB Annual Report 2019-2020LSAB Annual Report Front Cover 2019-2020

Our Vision

To ensure adults are safeguarded by empowering and supporting them to make informed choices and decisions.

 

Message from the Independent Chair

Photo of Professor Michael Preston-Shoot - Independent Chair - Lewisham Safeguarding Adults Board

“I write this introduction in the long shadow of the pandemic, the gradual easing of the lockdown and the havoc wrought on people’s lives by COVID-19”.

I must begin by acknowledging the resilience, commitment, determination and courage demonstrated by health and social care workers, uniform officers, wardens and other professionals. The care and support they have offered, and their professionalism in the face of risk, loss, fear and anxiety, has been outstanding. I must also comment on the community response, those neighbours, community organisations and faith groups who have looked out for, and looked after others. 

I write also in the context of Black Lives Matter. I know that all members of Lewisham SAB, and the staff they represent, have demonstrated commitment to counteract discrimination and oppression, to recognise and challenge unconscious bias, and to promote equality. As Black Lives Matters demonstrates, there is more to do and the SAB must renew its commitment to equality in its strategic plan.

The Coronavirus Act 2020 did not alter the adult safeguarding provisions and protections in the Care Act 2014. The SAB has therefore continued to exercise oversight over  adult safeguarding, whilst mindful of the pressure that health and social care providers have been and continue to be under. The SAB has been reviewing how services have been responding to the challenges that the virus has created. There are clearly lessons that will have to be learned in the coming months about the response to the pandemic, locally, regionally and nationally.

This year’s annual report is shorter than usual, mindful not to place additional burdens on partner agencies. Thus, we have not asked partner agencies to provide examples of positive practice this year. We have included, as statutory guidance requires, information about completed Safeguarding Adults Reviews (SARs). Just outside the timeframe for this annual report (June 2020), the SAB has published three further SARs, which may be found on the Board’s web pages. Next year’s Annual Report will provide an update on the actions taken to implement the recommendations from these reviews. 

We have maintained close oversight on arrangements led by the CCG and the Local Authority to reduce the incidence of pressure ulcers. We maintain a close focus on reviews of deaths of learning disabled people, and on learning from the deaths of people experiencing homelessness and/or substance misuse. 

There is, of course, more to do and more that should be done in the name of improvement. We would welcome your feedback. We thank you for the work you do to keep our communities safe and to respond to the needs of adults at risk of abuse and neglect. Finally, I would to express my appreciation for the work of SAB officers, Martin Crow, Vicki Williams and Tiana Mathurine.

Professor Michael Preston-Shoot

Independent Chair

Key Outcomes in 2019-20 

April to June 2019 2
  • Board’s Annual Conference was delivered at Goldsmiths College.
  • Board’s Self Neglect & Hoarding Policy and Procedures were agreed for publication. *
  • Board purchased the Electronic Case Record (ECR) system for use with Safeguarding Adults Reviews (SARs).
  • Learning Event for the Michael Thompson SAR was delivered.
July to sept 2019 2
  • Board’s Compact and Strategic Business Plan 2019-20 was agreed.  
  • Board’s Communication and Engagement Strategy was published (see page 3). *
  • External Section 42 Audit was conducted. *
  • Pan London Safeguarding Audit (SARAT) was completed in Lewisham by Board partners.
  • Review of Out of Borough Placements (linked to the Whorlton Hall serious incident) was conducted. *
Oct to Dec 2019 2
  • Board’s Learning, Training and Development Strategy was approved. *
  • The first of 4 Networking and Safeguarding Champions events was delivered to coincide with National Hate Crime Awareness Week, supported by the Council and Metropolitan Police. *
  • The first meeting of the Board’s Performance, Audit and Quality Sub-Group was held. *
  • Two Hoarding Awareness Workshops were delivered in support of the Policy and Procedures published in April. *
  • Trial of a new Pan London Audit Tool was completed by South London and Maudsley NHS Foundation Trust.
Jan to March 2020 2
  • The Board’s Prevention Audit commenced. *
  • 2 Practitioner Events were delivered as part of ongoing SARs.    
  • The second of 4 Networking and Safeguarding Champions event was delivered to coincide with National Sexual Abuse and Violence Awareness Week. *
  • Domestic Abuse and Violence Summit Task and Finish Group was set up jointly with Lewisham Safeguarding Children Partnership (‘Whole Family’ approach). *
  • The Board approved the creation of a local Modern Slavery Network - supported by the LSAB Business Unit. *
  • Joint Protocol with Lewisham Safeguarding Children Partnership was approved (‘Whole Family’ approach). *

*Objectives from the Strategic Business Plan 2019-20 

Communication and Engagement (CE) Strategy Outcomes

The Board’s CE Strategy was agreed in July 2019.The targets were set for 12 months, so were still being delivered beyond the timeline of this report.

Safeguarding Information

Overview 2019-20

A lack of reporting emanating from the adult’s own home may be linked to a possible lack of engagement with and from some communities. There are high numbers of domestic abuse incidents reported to Police in the Borough, but very few that are being investigated through Local Authority led adult safeguarding enquiries (4%). 

Overview 2019-2020

 Overview part 3

 

Safeguarding Adults Reviews

Safeguarding Adults Boards (SABs) must arrange a SAR when an adult dies either as a result of abuse or neglect, known or suspected, and there is concern that partner agencies could have worked more effectively to protect the adult. (Care Act Statutory Guidance 14.162)

The Case Review Sub-Group

The Sub-Group manages and oversees the Safeguarding Adults Review (SAR)process locally, and is led by the Board’s Independent Chair Professor Michael Preston-Shoot.

The group met 7 times throughout the year and included membership from Lewisham Borough Council, the Metropolitan Police, Lewisham Clinical Commissioning Group,      (CCG) Lewisham & Greenwich NHS Trust and South London and Maudsley NHS Foundation Trust.

A significant amount of work was overseen by the group, and in addition to the cases outlined in this section of the report, other non-statutory reviews and reports were also considered and monitored.

This included the local annual reports for The Learning Disability Mortality Review Programme (LeDeR), and Drug and Alcohol Related Deaths.

 SAR Notifications

The Board received and considered 9 new SAR Notifications during 2019-20, which resulted in 4 new SARs commencing, with one decision still pending due to parallel processes.

In total 14 cases were considered and or monitored by the Sub-Group throughout the reporting period.

Cedric Skyers SAR

The Cedric Skyers SAR was published in 2017, but the local CCG and London Borough of Lewisham Council issued

Guidelines on Risk Assessment for Smoking in Care Homes in September 2019, which is linked to the action plan for this review. This important guidance and the review can be viewed here:

 “Initiate joint work with the London Fire Brigade and care providers in the Borough on risk assessment – specifically to include fire, smoking, immobility, wheelchair use and first aid – to establish mutually clear and consistent standards and expectations”.

 

 

 

LSAB Annual Report 2018-2019Photo of two adults for the LSAB Annual Report Front Cover 2018-2019

Message from the Independent Chair

This is the third occasion I have had the pleasure to welcome you as Independent Chair to the Annual Report of the Lewisham Safeguarding Adults Board (SAB). It is a statutory requirement for each SAB to publish this report and include the details of what it has done to deliver its strategic plan. The report must also provide information about Safeguarding Adult Reviews (SARs) that are ongoing or have been completed, including what has been done to ensure that the lessons from these SARs are translated into the development of policy and practice.

These are challenging times for public and voluntary sector agencies. Organisations are having to manage the ongoing impact of financial austerity alongside not just rising demand for care and support, but also the increasing complexity of needs being presented to the Local Authority and to NHS staff in primary and secondary care. Almost inevitably, it appears, the need to find further savings leads agencies into structural re-organisation, which inevitably has an impact on the strategic and operational relationships that are essential for effective adult safeguarding.

Nonetheless, partners have remained committed to the SAB and to adult safeguarding, as their contributions to this annual report demonstrate. The SAB has held these partners to account for how they ensure that people with care, health and support needs are protected from abuse and neglect, for example by close scrutiny of performance data, inquiry into how the wellbeing of people in residential and nursing care is promoted, and focus on ensuring that the lessons from Lewisham SARs, and from those conducted elsewhere, result in improved practice locally.

The SAB has also been proactive in providing learning workshops, ensuring that those involved in adult safeguarding have the best possible foundations for their practice. I have been really pleased with the take-up of the events for making safeguarding personal, mental capacity act assessments and working with people who self-neglect.

Healthwatch Lewisham and Voluntary Action Lewisham supported the delivery of a conference for voluntary and community sector organisations. This helped to continue the work in raising awareness of key issues, and in promoting practice that seeks to prevent as well as protect people from abuse and neglect.

The annual report gives an account of these and other initiatives that partner agencies have delivered, and what the SAB and its partners plan to deliver in 2019-20 to ‘ensure adults are safeguarded by empowering and supporting them to make informed decisions’.

During the year we said goodbye to Philip Byron the SAB Business Manager, who did much to establish the effectiveness of the Board. We welcome Martin Crow as his successor, working alongside Vicki Williams and Tiana Mathurine. Together they have ensured the smooth running of the SAB. I am grateful to them for their work and to all those who have worked hard to provide effective adult safeguarding services in the Borough.

I hope that you find the annual report informative and helpful.Photo of Professor Michael Preston-Shoot - Independent Chair - Lewisham Safeguarding Adults Board

Professor Michael Preston-Shoot

Independent Chair

Board Membership                                                    

The Board is made up from the following organisations, which includes the statutory partners that must be involved in leading local adult safeguarding arrangements, as well as the other important agencies listed below:

  • Healthwatch Lewisham
  • Lewisham & Greenwich NHS Trust
  • Lewisham Adult Social Care
  • Lewisham Children & Young People’s Services
  • Lewisham Safeguarding Children’s Partnership Board
  • Lewisham Homes
  • Lewisham Joint Commissioning Group
  • Lewisham Public Health
  • Lewisham Public Protection and Safety
  • Lewisham Strategic Housing Services
  • London Ambulance Service
  • London Community Rehabilitation Company
  • London Fire Brigade
  • Metropolitan Police Lewisham
  • National Probation Service, Lewisham and Southwark
  • NHS England
  • NHS Lewisham Clinical Commissioning Group
  • South London & Maudsley NHS Foundation trust
  • Voluntary Action Lewisham

Board Structure

Image of LSAB Structure

The Executive Group was made up from the statutory and funding partners who met to discuss resourcing and other key strategic issues. However, the group did not meet regularly throughout 2018-19 and a decision was made to stand this group down.

The Case Review Group became a formal Sub-Group towards the end of the reporting period, which is linked to the review of the structure in line with the objectives outlined in the Strategic Business Plan for 2019-20.  

Lewisham: Key Facts and Figures

Image of Lewisham Key Facts and figures

There were 125 Safeguarding *Section 42 Enquiries per 100,000 of population recorded in Lewisham in 2018-19 (the London average is approximately 270). See more detailed safeguarding data further down this page.

(The data above has been taken from the *Joint Strategic Needs Assessment (JSNA) for Lewisham, Local Authority statistics, NHS, and Metropolitan Police reporting data.)

Strategic Business Plan 2018-19 Outcomes

The Board had the following Aims during 2018-19:

  1. Stop abuse and neglect

This is a critical feature of the work of the Board. The examples and stories that are outlined further down the page help to illustrate what the partner agencies are doing to help stop adult abuse.

  1. Improve the health and wellbeing of people

This is also a core part of the work of many of the Board’s partner agencies, which includes the public health and trauma informed approach to violence reduction. These strategies are helping to prevent adult abuse and tackle some of the most significant issues in the Borough.

  1. Promote people making choices and having control of their lives

During the last 12 months the Board has conducted a Making Safeguarding Personal (*MSP) ‘Temperature Check’ in conjunction with the London SAB, which was designed to test how well agencies have embedded person-centred approaches to supporting adults at risk of abuse and neglect. This was supported by a training session being delivered to professionals on this subject in January 2019, which followed on from a previous Seminar on Autonomy vs Duty of Care in June 2018.

  1. Raise public awareness of abuse and neglect and what to do

The Board delivered a Voluntary and Community Sector Safeguarding Conference on the 8 November 2018 in conjunction with Healthwatch Lewisham and Voluntary Action Lewisham.

This event was very well received and attended by 83 delegates, helping to improve the profile of adult safeguarding related work in the local community by placing an emphasis on self-neglect and hoarding, disability hate crime, domestic abuse and SCAMS prevention.

The Business Unit continues to distribute Newsletters and Bulletins centrally, and partners are involved in numerous projects across Lewisham to help raise public awareness, which forms part of their commitment to this subject as part of their membership of the Board.

  1. Promote prevention of abuse and neglect

Between November 2018 and March 2019 the Board delivered 12 learning events:

Self-Neglect and Hoarding Masterclass x 4Image of little man pointing to 248 classes held

Making Safeguarding Personal x 2

Mental Capacity Act & Deprivation of Liberty Safeguards (DoLs) x 2

Information Sharing x 2

Provider Managers x 1

Basic Awareness x 1

This resulted in a total of 248 delegates accessing these training activities.

The Board conducted and published two Safeguarding Adults Reviews (SARs) in 2018-19, which are designed to generate lessons that can be learned to prevent similar instances from occurring again.

The recommendations and actions that have been developed as a result of these reviews are still being delivered, helping to inform practice developments in the Borough and further afield. These reviews are summarised further down this page.

 

Image of course feedback

The Board has also been developing a comprehensive Self-Neglect and Hoarding Policy and Procedures in the last year, which will help to underpin changes to local systems when the adult *Multi-Agency Safeguarding Hub (MASH) becomes operational in the near future.

The Board also supported London Borough of Lewisham in the development of the Modern Slavery and Human Trafficking Protocol (published February 2019), and will help to further promote and establish the approaches needed to prevent this type of abuse in the coming year and beyond. 

These Policies and Protocols can be accessed here:

LSAB Policy & Procedures

 Image there is no one type of modern slavery

  1. Support people to protect themselves and stay safe

The final evaluation of the Faith Group Champions training delivered to 223 people in 2017-18 was completed in October 2018. This has been used to help the planning of a broader 'Safeguarding Champions’ role to be established, which will encourage professionals, volunteers and community members to support people to stay safe.

  1. Improve the quality of care

The Board co-ordinated a significant amount of activity that was designed to examine the quality of care being provided in the Borough. This included oversight of the:

  • Lewisham Clinical Commissioning Groups Audit Report
  • Joint Commissioning Provider Audits and Annual Safeguarding Assurance Report
  • Deprivation of Liberty Safeguards Audit by Lewisham and Greenwich NHS Trust
  • Deprivation of Liberty Safeguards Audit by London Borough of Lewisham.

This focus on quality will continue and be expanded in line with the Board’s Strategic Business Plan for 2019-20.

Work of the Case Review Sub-Group

Safeguarding Adult Review (SAR) Definition

Safeguarding Adults Boards (SABs) must arrange a SAR when an adult dies either as a result of abuse or neglect, known or suspected, and there is concern that partner agencies could have worked more effectively to protect the adult; or if an adult has not died, but the SAB knows or suspects that the adult has experienced serious abuse.

The Case Review Sub-Group manages and oversees the SAR process locally and is led by the Independent Chair Professor Michael Preston-Shoot.

The group met six times throughout the year and included membership from London Borough of Lewisham, the Metropolitan Police, Lewisham Clinical Commissioning Group, and Lewisham & Greenwich NHS Trust. A significant amount of work was overseen by the group, and in addition to the cases outlined below, other non-statutory reviews and reports were also considered and monitored. This included the local annual reports for the Learning Disability Mortality Review Programme (LeDeR), and Drug & Alcohol Related Deaths. This report also specifically examined the subject of homelessness, which links to Government advice for SARs to be used to examine the deaths of rough sleepers where appropriate.

SAR Notifications

The Board received and considered 5 new SAR Notifications during 2018-19. One of these cases was approved as a statutory SAR and has commenced; one did not meet the criteria; and the other three were still pending a decision at the end of March 2019 due to the need for parallel processes (such as court cases) to conclude, or for more information to be collected.  

Ongoing SARs

One review continued throughout all of 2018-19 but has been delayed due to unforeseen circumstances, and two further SARs were concluded and are outlined below.

SAR Mr. Michael Thompson (published in July 2018)

Mr. Thompson was a 60-year-old Black British man of Jamaican origin who had been living on his own in Lewisham for the previous five years. The review concerns the death of Michael on 3 March 2016.

On that morning a call was made to the London Fire Brigade (LFB) as smoke had been seen coming out of the window of Michael’s flat by a person driving past. LFB found Michael unconscious and called the London Ambulance Service who attended and administered emergency treatment. Michael was taken to Hospital, placed on cardiac support and ventilation, but he was declared dead the following day. A post mortem later gave a provisional cause of death due to inhalation of fumes.

During the 2 and 3 March 2016 emergency services had been called to Michael’s flat by family members and neighbours on three separate occasions because of concerns about his behaviour. It is the circumstances surrounding these contacts with services and the subsequent decisions and actions that were taken that are central to this review.

Key actions that were delivered as a result of this SAR:

  1. Considering Mental Capacity

All clinicians attended training on Mental Capacity Act assessments facilitated by a Consultant Psychiatrist. This subject also featured in a weekly bulletin to clinicians, and the consideration and use of Mental Capacity Act assessments is now regularly audited.

  1. Inter-agency referrals to out of hours mental health services

Protocols and agreements have been implemented to improve the information and assistance available to emergency services working out of hours (evenings, nights and weekends).

  1. Nearest relative & their right to ask for assessment under the Mental Health Act 1983

A leaflet on the rights of the nearest relative to a person in mental health crisis has been created and distributed by mental health and social care services. The wishes of the nearest relatives are also now recorded in all contacts with the mental health service.

SAR Mr. Cedric Skyers (published in July 2018)

Mr. Skyers was a 69-year-old man who was born in Jamaica but had lived in England from being a teenager.

Cedric died on the 13 March 2016 in Hospital after he was transported there by ambulance, after having been discovered engulfed in flames in the smoking shelter located in the garden of the Nursing Home where he had lived for the previous 10 years.

Earlier he had been taken to the shelter in his wheelchair so that he could smoke. The cause of death was recorded as extensive burning. The review examined the wider considerations, circumstances and context of Cedric’s death, in respect of policy, procedure and practice to aid future prevention and learning.

Key actions that were delivered as a result of this SAR:

  1. Smoking and risk assessment guidance in care homes

Guidance is being written which will set out what a good risk assessment should look like. This will include: Consideration of the Mental Capacity Act 2005, documenting any unwise decisions; the use of equipment, including alarms and fire retardant clothing; levels of dexterity/mobility and physical impairment; need for regular review; and the right to privacy versus supervision.

  1. Smoking cessation

Residents are offered the chance to stop smoking with the assistance of smoking cessation services, and this offer is repeated on an annual basis by the care home provider.

  1. Risk assessments for the adult

All residents who smoke now have a fully completed risk assessment that is regularly updated.

Both reviews can be read in full here:

LSAB Safeguarding Adult Reviews

National Picture

Image of cart showing the national safeguarding adults picture

Since the Care Act came into force in 2015 there have been around 430 SARs conducted nationally. Approximately 30% of these have been conducted in London.

Work of the Housing Providers Sub-Group

The group met three times during the reporting period and included regular contributions from ten local housing providers, as well as from a range of other organisations.

Throughout the year there were very useful presentations from:

  • Age UK - Scams Prevention and Victim Support Project
  • London Fire Brigade - Support for Hoarders and Fire Safety Visits
  • Lewisham and Greenwich NHS Trust - Community Falls Service
  • London Borough of Lewisham:

            * Adult Social Care (Multi-Agency Safeguarding Hub

            * Violence Reduction Team (Cuckooing and County Lines).

The group have shared case studies and good news stories, and used the forum to improve understanding around relevant policy and practice guidelines; including information sharing and self-neglect (hoarding).

Members have also completed a self-audit process based on the London Safeguarding Adults Board model, which will help to further inform practice and improve the focus on preventing adult abuse and neglect.  

The Board would like to formally thank Sebastian Taylor (Phoenix Housing) for being the Chair of this group throughout 2018-19, and welcome Clare Hopkins (Lewisham Homes) who has now taken on this role.

Cuckooing and County Lines

Cuckooing is a form of home invasion crime in which drug dealers take over the home (like a nest) of a vulnerable person in order to use it as a base for drug dealing. County Lines is a term used when drug gangs from cities start operating in smaller towns, exploiting children and adults at risk of abuse (including human trafficking) to sell drugs. These dealers use dedicated mobile phone lines, known as 'deal lines', to take orders from drug users. This is a growing and significant problem across London and in Lewisham.

*Based on an extract from "Rescue and Response" County Lines Project

Vulnerabilities

Methods

Venues

Certain circumstances in a persons life place at them at greater risk of grooming for County Lines involvement, and gangs look to exploit this:

The gang lifestyle is glorified on social media, promises of cash and clothes are made, and other grooming methods are reported:

These venue types are commonly used, but there is a lack of detailed intelligence on this:

Exclusion from school, or part-time attendance is seen by exploiters positively as the young person has more time to work on a County Line and will not trigger Council action through truancy.

Hook: Young people are used to recruit others, with the recruiter being the ‘Hook’.

Pupil Referral

Units & Schools

Honey Trap: A young woman is used to entice young men as part of ‘grooming’.

Social Media &

Gaming Platforms

Family breakdown can be a risk factor. More attention should be given to young people at these times of crisis.

Broadcasts: These are put out on social media offering young people the opportunity to make a lot of money.

Youth Clubs

Young people on the verge of going into care are at risk, before attracting the attention of Local Authorities and Police during missing periods.

Food: This is bought for young people in ‘chicken shops’ as an early step in the grooming process.

Chicken Shops & Other

Fast Food Outlets

People with drug habits, learning difficulties or who may be naïve are exploited, and especially those not known to Police as ’clean skins’.    

Drugs: Exploited are offered ‘freebies’ to gain control of them leading to regular drug use or debt bondage.

Bus Stops, Parks &

Skate Parks

Work of the Board’s Partner Agencies

Healthwatch lewisham logo

Healthwatch Lewisham

Key achievements in 2018-2019

  1. Enter and View

In accordance with the Health and Social Care Act 2012, Healthwatch Lewisham conducted Enter and View visits to gain insight from service users into how services are experienced, highlight good practice and make recommendations for improvement.

Linked to LSAB Aim 7

  1. Community Adult Safeguarding Conference

Healthwatch supported the planning and organisation of this event where the Chief Executive (Folake Segun) outlined the role of the organisation in relation to adult safeguarding.

Linked to LSAB Aim 4

  1. BAME Mental Health Summit

Healthwatch helped to deliver this Summit in response to the Health and Wellbeing Board’s review of health inequalities and the treatment of mental ill health within the BAME community.

Linked to LSAB Aim 4

  1. Seldom Heard Engagement

This includes engagement with numerous support groups across the Borough to hear about how people experience health and care services.

Linked to LSAB Aim 7

NHS Lewisham Clinical commissioning group logo

Lewisham Clinical Commissioning Group (LCCG)

Key achievements in 2018-2019

  1. Work within nursing and residential homes

The Safeguarding Nurse Advisor (SNA) continued to offer significant support to nursing and residential homes in relation to improving quality standards and safeguarding.

Linked to LSAB Aim 2, 3 & 7

  1. The Multi-Disciplinary Community Pressure Ulcer Panel

This is chaired by the SNA to investigate the causes of community acquired pressure ulcers, and to ensure lessons are learned and that recommendations are taken forward. Care homes are supported through the process by the SNA who also delivers ‘reflection on practice’ groups and unannounced follow up visits to ensure changes of practice are being embedded.

Linked to LSAB Aims 1, 2 & 7

  1. Partnership working

The SNA is a member of the following groups and is involved in development work linked to these forums:

  • Catford Falls Project
  • The South London Health Innovation Group for Community Pressure Ulcers
  • Weekly Multi Agency Safeguarding Conferences (MASCC) chaired by the Local Authority
  • Multi-Agency Quality Assurance and Information Group (MAQUAIG)
  • Catheter Care Project Group.

Linked to LSAB Aims 1, 2 & 6

Lewisham and greenwich nhs trust logo

Lewisham and Greenwich NHS Trust      

Key achievements in 2018-2019

  1. Improving the reporting to LeDeR (Learning Disability Mortality Reviews)

The Adult Safeguarding Team conduct reviews for patients who have died within the Trust, and now report to the newly established internal Mortality Review Committee. The Trust also participates in the South East London steering group and divisional governance meetings.

Linked to LSAB Aims 2 & 7

  1. Preparation for adult safeguarding records to go live electronically across the Trust

The Adult Safeguarding Team has worked in conjunction with the ‘iCare project Team’ to plan and prepare for adult safeguarding documentation to be implemented within electronic patient records. This includes Safeguarding Alerts, Mental Capacity Act Assessments, and all clinical documentation related to adult safeguarding. These changes will also enhance the efficiency of onward referrals to the Local Authority safeguarding team.

Linked to LSAB Aim 7

  1. Introduction of a Level 2 training App for adult safeguarding - Improving access to training

The Adult Safeguarding Team devised a training programme via an App which is available to clinical staff. The programme contains a self-assessment that consists of twenty questions covering all of the content in the App including Making Safeguarding Personal, Safeguarding Adult Reviews, Modern Slavery, Domestic Violence and the Mental Capacity Act 2005.

Linked to LSAB Aim 7

South london and maudsley nhs foundation trust logo

South London and Maudsley NHS Foundation Trust (SLaM)

Key achievements in 2018-2019

  1. Quality Indicator Dashboard

The Adult Safeguarding Leads in the Boroughs that SLaM operates within now have access to the Quality Indicator Dashboard. This allows them to view and analyse relevant information linked to adult safeguarding, which in turn supports them in identifying themes and gaps in practice, to be used in creating learning and development objectives.

Linked to LSAB Aim 7

  1. Domestic Abuse 

The Trust now has Domestic Abuse and MARAC Steering Groups involving staff from all of the areas SLaM delivers services in. The Trust also conducted a domestic abuse audit during the reporting period that focussed on practitioner’s awareness and documentation.

Linked to LSAB Aims 5 & 7 Image giving an explanation of radicalisation - PREVENT progreamme

  1. Training delivery

SLaM continues to exceed training targets for Prevent and Safeguarding Adults Level 1 & 2.

Linked to LSAB Aim 5

London borough of lewisham logo

London Borough of Lewisham - Adult Social Care (ASC)

Key achievements in 2018-2019

  1. Development of ‘call over’ meetings

These monthly meetings help to improve the quality and consistency of safeguarding practice and performance across ASC. They examine information and case work records, and involve discussions with Safeguarding Adult Managers to explore these issues in greater detail.

This resulted in 32% more enquiries being conducted on time and also led to the development of a 10 day safeguarding case file self-audit tool; an agreed escalation process when there are delays in receiving reports from other agencies; and changes being proposed to the Council’s Case Management System.

Linked to LSAB Aims 2 & 7

  1. Implementation of routine internal audits of Safeguarding Casework

A working group led by the Principle Social Worker were involved in the development of a casework/ safeguarding audit tool for *ADASS, which was then used to develop a local version. The results of these audits help to support practice, identify training needs and to address any gaps in competency levels.

Linked to LSAB Aim 7

  1. Hoarding and Self-Neglect Policy Development Officer                                                    

This post was funded and created (currently being recruited) to enable the post holder to help implement and embed the new LSAB policy across all partner agencies, ensuring that effective local arrangements are in place to support adults in relation to self-neglect.  

Linked to LSAB Aims 2, 3, 4, 5 & 6

Metropolitan police service logo

Metropolitan Police Service – South East Basic Command Unit (BCU)

Key achievements in 2018-2019

  1. Safeguarding under the SE BCU

Staff investigating Domestic Abuse (DA), Child Abuse and Rape offences have been brought together into one Safeguarding team. Bringing these teams together enables us to provide a more joined up approach, providing victims with earlier, improved contact and reassurance.

Linked to LSAB Aim 6

  1. Prevent & Change Panel

This project aims to increase the safety of DA survivors and their children by working directly and indirectly with prolific domestic violence perpetrators. Police work with partner agencies to disrupt and deter perpetrators from offending, and also conduct specific 1-2-1 work with victims.

Linked to LSAB Aims 1 & 6

  1. *Domestic Violence Prevention Notices/Orders (DVPN/O)

The BCU has obtained the 2nd highest rate of DVPN/O’s across the Metropolitan Police Service (37 applied/issued). This has been achieved by having a dedicated DVPN/O

Officer who works alongside Independent Advocates to support victims during the 28 day enforcement period, with further funding also used to support those most at risk.

Linked to LSAB Aim 6

london fire brigade logo

London Fire Brigade (LFB) - Lewisham

Key achievements in 2018-2019

  1. Home Fire Safety Visits (HFSV’s)

The LFB in Lewisham completed 2077 HFSV’s which was above the annual target, with 92% of those people involved (1716) being described as vulnerable or in ‘priority places’. Work has also been conducted in conjunction with the police in regard to the threat of arson linked to domestic violence cases, resulting in 12 arson letterboxes being installed and 6 sets of fire retardant bedding being issued.

Linked to LSAB Aim 6

  1. Welfare Concern reporting

A total of 70 safeguarding/welfare concerns were referred to LFB Lewisham, with hoarding being a prominent factor involving 23 (33%) of cases, which were also commonly linked to mental and or physical impairment, and poor living conditions.

Linked to LSAB Aims 4 & 6

  1. Fire Safety Sprinklers

£20,000 was given to Lewisham Homes from LFB’s Community Safety Investment Fund to contribute to sprinklers in a local housing development. This links to a worrying trend in the increase in non domestic fires in Regulatory Reform Order (RRO) properties. These are properties such as Care homes, Houses of Multiple Occupation (HMO), commercial properties or shops with dwellings above, that that can commonly involve adults most at risk of abuse and neglect.

Work continues between LFB and trading standards to identify rogue landlords or premises which do not have the required level of fire precautions. As a result 3 enforcement notices were issued to registered care homes in the Borough, who were compliant upon re-inspection. (This links to the Cedric Skyers SAR).

Linked to LSAB Aim 6

Lewisham homes logo

Lewisham Homes

Key achievements in 2018-2019

  1. Improved the response to hoarding and self-neglect

Hoarding UK were commissioned to deliver training and policy and procedures were reviewed in line with the LSAB guidance. An internal safeguarding panel was also established to review cases, increase accountability, share decision making and improve consistency.

Linked to LSAB Aim 6

  1. Implemented a system of tenancy risk rating and sustainment

Safeguarding concerns are identified earlier, and more preventative work is being conducted.

Linked to LSAB Aim 5

Adults Stories

EileenImage of Eileen

The Safeguarding Team within Lewisham and Greenwich NHS Trust (LGT) were approached by the Consultant Respiratory Nurse for support and advice regarding Eileen.

This patient was receiving oxygen therapy at home and it had been noticed on a recent home visit that there was evidence of smoking cigarettes in the home, which could be posing risks to others in the household as well as neighbours. It was not clear whether Eileen had the mental capacity to make decisions regarding these risks.

A home visit was arranged along with London Fire Brigade Officers and it was found that Eileen did have the mental capacity to make informed decisions and that she had stopped smoking, although other family members had been smoking around her.

Eileen and her son worked with the Fire Brigade and the Nurses, and together they formulated a risk management plan.

Eileen and her son were able to explain the risks of smoking while using oxygen therapy and said they would discuss this with other extended family members.

Smoking cessation information was offered, and as a result of the interventions the Respiratory Nurse Team felt that the risk of a smoking and oxygen related clinical incident had been significantly reduced. The team also felt more confident in conducting a Mental Capacity Assessment and in working with other partners to protect adults from abuse and neglect.

DavidPhoto of David

A neighbour alerted Optivo Housing (member of the LSAB Housing Sub-Group) about their concerns regarding David after going inside his property. He was dirty, had been wearing the same clothing for a long time, and there was a strong smell coming from around his home. 

A Housing Officer arranged a visit to meet David following these concerns, where it became apparent that he had health issues affecting his breathing, linked to a heart condition which made him exhausted quickly.

During the visit David stated that he was struggling to contain the mess in his home as he had allowed it to get so bad, and the Housing Officer noticed there was no cooker or fridge in the property, and only a small amount of food in the cupboard.

Following a discussion with David and liaison with the Local Authority, the Tenancy Sustainment Officer arranged to deep clean the property, which David agreed he would be able to maintain. A cooker and fridge freezer were also installed following an application to the Helping Hands Fund (Optivo budget).

This support has helped to improve David ‘s health due to living in a cleaner environment and now having the ability to store and cook food.

This has also meant that he has been able to maintain his tenancy and improve the relationship with his neighbour. This help has prevented the risk of self-neglect from escalating and needing a statutory safeguarding response. 

AnnaPhoto of Anna

Anna is an 81 year old living in a residential care home for people with Dementia.

Lewisham Council (Adult Social Care) received a report from the out of hours Doctors service to say they had been called to review Anna following an incident with another resident. The Police were contacted and they made a decision based on the needs of both clients that they would not pursue the matter. Adult Social Care conducted a safeguarding enquiry and initiated closer supervision of the other resident, who was later admitted to hospital following a mental health review. Anna was monitored closely by staff and supported by her family, and a multi-agency safeguarding case conference was held with family members, the care provider, and health services.

Although Anna was assessed and found to lack the mental capacity to be directly involved in the safeguarding investigation, her family acted as advocates and were involved throughout. Clear outcomes were established based on the views and wishes of the family, which ensured that the ‘adult’s voice’ was very clearly present, and that Making Safeguarding Personal (MSP) principles were used to guide the enquiry process.

The multi-agency response ensured that therapeutic support was provided for Anna and her family, and that measures were identified to help prevent further instances from reoccurring.

Despite the negative impact the incident had on Anna’s family, they felt that the action that had been taken, and the way that this had been delivered, was positive.  

JamesPhoto of James

James threatens to jump from heights and walks on train tracks, sometimes both, and is often highly intoxicated during these incidents and therefore at high risk of accidental suicide. Interventions from Police, London Ambulance Service and mental health services had not worked, and he was not open to support from drug and alcohol services due to his previous behaviour. The financial impact of James’s presentation was around £2,200 per month, on top of an estimated cost of £100,000 per incident in delays to the rail network.

A multi-agency *Serenity Integrated Mentoring (SIM) plan was created involving more intensive mental health support, police liaison, diversion into other activities, as well as enrolment into the Recovery College (mental health support service) as a precursor to alcohol rehabilitation.

These interventions resulted in James spending his first Christmas in ten years outside of a mental health hospital, and providing safer crisis management choices for him.

All of the agencies involved in the SIM plan are using it effectively whilst continuing to seeking support and advice, which is improving the professional response from each agency, and the overall multi-agency effect in protecting James and preventing adult abuse and neglect.

James is positively engaging with the SIM programme and taking steps towards his recovery, including possibly entry back into employment.

**We have not used the actual names or photographs of the adults involved, but the other details are real**

Safeguarding Data 2018-19

This is Local Authority Data regarding concluded Section 42 Enquiries (unless stated)

Image of how much adult abuse was reported Image of what types of adult abuse were reported
image of what is the age and ethnicity of victims Image of where did adult abuse occur

Strategic Business Plan 2019-2020

The Board has created a new one-year Strategic Business Plan for 2019-20 in consultation with partner agencies and utilising community feedback. This is summarised below.

This not only reflects local issues in Lewisham, but seeks to address some of the most prominent national challenges that are currently being faced in relation to preventing adult abuse and neglect.

The objectives will form the basis of the collective work programme for partner agencies to contribute to through the work of the Board over the next 12 months, and will be delivered through planned activities, whilst also building on existing good practice and local networks.

The priorities and aims will also influence each separate partner agency, who are committed to embedding this overall strategy into their broader organisational approach to safeguarding adults.  

LSAB Vision for the future shown in a table

Jargon Buster

ADASS (The Association of Directors of Adult Social Services)

A charity and association that aims to further the interests of people in need of social care by promoting high standards of social care services and influencing legislation and policy.  

BAME (Black, Asian & Minority Ethic)

A term used to described the ethnicity of a wider group of individual ethnic minority groups.  

Conversion Rate (Safeguarding Concern to Section 42 Enquiry)

This describes when a Safeguarding Concern (see below) becomes a statutory Section 42 Safeguarding Enquiry (also see below). This can help to ascertain the level or quality at which Concerns are being submitted, with a high conversion rate being seen as positive indicator.  

Domestic Violence Prevention Notices/Orders (DVPN/O)

A DVPN is an emergency eviction notice which can be issued by the police to a perpetrator when attending to a domestic abuse incident. This allows the victim a degree of breathing space to consider their options with the help of a support agency.

Joint Strategic Needs Assessment (JSNA)

JSNAs are the means by which leaders work together to understand the health and wellbeing needs of people in the local area, and to decide on the priorities in delivering services.

Learning Disability Mortality Review Programme (LeDeR)                                           

The LeDeR programme was established in May 2015 to support local areas across England to review the deaths of people living with a learning disability, so that the learning from those deaths can be used to help prevent further occurrences.  

Multi-Agency Safeguarding Hub (MaSH)

The main aim of the adult MaSH in Lewisham will be to improve the quality of information sharing and decision making between the statutory agencies, so that a more co-ordinated response to Safeguarding Concerns can be delivered and achieved.

Safeguarding Concern

A sign of suspected abuse or neglect that is reported to, or identified by the Local Authority.

Section 42 Enquiry (Section 42)

The action taken or instigated by the Local Authority in response to a reported concern that abuse may be taking place.

Serenity Integrated Mentoring (SIM)

This is a model of care where specialist Police Officers work alongside community mental health professionals to support people struggling with complex mental ill-health problems.

Making Safeguarding Personal (MSP)

MSP is an initiative which aims to develop a person-centred and outcomes focus to safeguarding work in supporting people to improve or resolve their circumstances.

If you see or hear something that concerns you, or you suspect somebody is being abused, or someone tells you they are being abused. Report it without delay:

See it report it image

Call the Police on 101 or 999 in an emergency

Contact the Adult Social Care Team Monday to Friday 9am - 5pm:

Tel: 020 8314 7777 (select option 1)

Email: SCAIT@lewisham.gov.uk

Out of hours service: 020 8314 6000  

Contact details for the deaf / impaired hearing community

Minicom: 020 8314 3309

Text Message: 07730 637 194

Glide: 07730 637 194

If you are unsure, talk to adult social care team, they will listen to you and give you good advice. You can talk to them without giving your name.

What not to do

  • Don’t promise to keep abuse a secret
  • Don’t alert the abuser, this might make matters worse and make it more difficult to help the person at risk
  • Don’t delay reporting abuse, report this straight away.

Think Family

Consider risks to others which may include children or other adults with care and support needs. Should there be a concern that a parent may be neglecting children in their care, concerns should be reported to Children’s Social Care.

Contact the Children’s Multi-Agency Safeguarding Hub Monday to Friday 9am - 5pm:

Tel: 020 8314 6660

Out of hours service: 020 8314 6000

Download a copy of LSAB Annual Report 2018-2019

Annual Reports

The Care Act 2014 requires each Safeguarding Adults Board (SAB) to publish an annual report. 

The Care Act (Schedule 2.4 (1) a–g) defines the minimum content of an annual report:

As soon as is feasible after the end of each financial year, a SAB must publish a report on:

  • What it has done during that year to achieve its objective,
  • What it has done during that year to implement its strategy,
  • What each member has done during that year to implement the strategy,
  • The findings of the reviews arranged by it under section 44 (safeguarding adults reviews) which have concluded in that year (whether or not they began in that year),
  • The reviews arranged by it under that section which are ongoing at the end of that year (whether or not they began in that year),
  • What it has done during that year to implement the findings of reviews arranged by it under that section, and
  • Where it decides during that year not to implement a finding of a review arranged by it under that section, the reasons for its decision.
  • The performance of member agencies and how effectively, or otherwise, they are working together should be included in the report.

The annual report must be sent to:

  • The Chief Executive and leader of the local authority which established the SAB,
  • Any local policing body that is required to sit on the SAB,
  • The local Healthwatch organisation,
  • The chair of the local health and wellbeing board.

Annual reports should form the basis for the consultation on the strategic plan for the coming year.

A SAB should seek assurance from its members that the annual report has been considered within their internal governance processes.

Strategic Business Plan

The Partnership Compact and Strategic Business Plan describes how organisations and their representatives on the Lewisham Safeguarding Adults Board will work together in partnership to safeguard the residents of Lewisham in 2019-20. 

Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action.

The Board’s priorities in 2019-20 are to:

  1. Prevent adult exploitation, abuse and neglect
  2. Develop intelligence led, evidenced based practice
  3. Strengthen partnership working.

 

The detailed Aims and Objectives for 2019-20 (page 11) are set out inside the full document published here:

 Lewisham SAB Partnership Compact & Strategic Business Plan

One of these Objectives was to create a Communication and Engagement Strategy which outlines how the Board will effectively communicate and meaningfully engage with a wide cross-section of communities and agencies across the Borough, to meet the Board’s statutory requirement to create a portfolio of evidence linked to community awareness of adult abuse and neglect. This will promote the work already being delivered across Lewisham, and help the Board plan how to continue developing a ‘whole community approach’ to the prevention of adult abuse and neglect.

 

This Strategy is published here:

Lewisham SAB Communication & Engagement Strategy

Board Meeting Minutes

On this page you can find minutes of the Lewisham Safeguarding Adults Board meetings.

Policy and Procedures

The introduction of the Care Act 2014 put adult safeguarding on a statutory footing for the first time, embracing the principle that the ‘person knows best’. It laid the foundation for change in the way that care and support is provided to adults, encouraging greater self-determination, so people maintain independence and have real choice.

There is an emphasis on working with adults at risk of abuse and neglect to have greater control in their lives to both prevent abuse and neglect from happening, and to give meaningful options for dealing with it should it occur.

For professionals who work in Care & Support settings the Care Act provides clearer guidance, and supports pathways to working in an integrated way, breaking down barriers between organisations.

The Association of Directors of Adult Social Services (ADASS), NHS London, the Metropolitan Police, and the London Clinical Commissioning Council have produced London Multi-Agency Adult Safeguarding Policy & Procedures Lewisham Safeguarding Adults Board follows these procedures.

New! LSAB Single Agency Adult Safeguarding Policy Template

This good practice template can be used and modified by any agency. The template outlines the sections that need to be inserted by the agency to include their individual procedures, details and arrangements (Version One July 2020).

Download the LSAB Single Agency Adult Safeguarding Policy Template

Self-Neglect and Hoarding Multi-Agency Policy and Procedures from the LSAB

Read our policy and procedures on self-neglect and hoarding.

Lewisham Modern Day Slavery Protocol

London Borough of Lewisham Modern Slavery Statement 2019

Lewisham Modern Day Slavery Protocol 2019

Information Sharing

Adult Safeguarding: Sharing Information

Sharing the right information, at the right time, with the right people, is fundamental to good practice in safeguarding adults.

Frontline professionals and volunteers should always report safeguarding concerns in line with their organisation’s policy. Policies should be clear about how confidential information should be shared between departments in the same organisation.

For Safeguarding purposes sensitive or personal information sometimes needs to be shared between the Local Authority and its safeguarding partners (including GP’s, health, the police, service providers, housing, regulators and the Office of the Public Guardian). This may include information about individuals who are at risk, service providers or those who may pose a risk to others. It aims to enable partners to share information appropriately and lawfully in order to improve the speed and quality of safeguarding responses.

The Care Act emphasises the need to empower people, to balance choice and control for individuals against preventing harm and reducing risk, and to respond proportionately to safeguarding concerns. The Act deals with the role of the safeguarding adults board’s (SAB’s) in sharing strategic information to improve local safeguarding practice. Section 45 ‘the supply of information’ covers the responsibilities of others to comply with requests for information from the safeguarding adults board.

Sharing information between organisations as part of day-to-day safeguarding practice is already covered in the common law duty of confidentiality, The EU General Data Protection Regulation (GDPR) the Data Protection Act, the Human Rights Act and the Crime and Disorder Act. The Mental Capacity Act is also relevant as all those coming into contact with adults with care and support needs should be able to assess whether someone has the mental capacity to make a decision concerning risk, safety or sharing information.

It remains the responsibility of organisations and the professionals they employ to ensure that they have a basis for processing that meets common law requirements and the requirements of the GDPR; and for public bodies that they are acting within their powers.

 

Download the 7 Golden Rules Poster

    Why do we need to share adult safeguarding information?

    Organisations need to share safeguarding information with the right people at the right time to:

    • Prevent death or serious harm,
    • Co-ordinate effective and efficient responses,
    • Enable early interventions to prevent the escalation of risk,
    • Prevent abuse and harm that may increase the need for care and support,
    • Maintain and improve good practice in safeguarding adults,
    • Reveal patterns of abuse that were previously undetected and that could identify others at risk of abuse,
    • Identify low-level concerns that may reveal people at risk of abuse,
    • Help people to access the right kind of support to reduce risk and promote wellbeing,
    • Help identify people who may pose a risk to others and, where possible, work to reduce offending behaviour,
    • Reduce organisational risk and protect reputation.

    False perceptions about needing consent to share safeguarding information

    Some frontline professionals and their managers can be over-cautious about sharing personal information, particularly if it is against the wishes of the individual concerned. They may also be mistaken about needing consent to share safeguarding information. The risk of sharing information is often perceived as higher than it actually is. It is important that professionals consider the risks of not sharing safeguarding information when making decisions and that these decisions are recorded.

    How to address false perceptions

    • Raise awareness about responsibilities to share information (profession or work role-specific guidance may help),
    • Encourage consideration of the risks of not sharing information,
    • Brief staff and volunteers on the basic principles of confidentiality the EU General Data Protection Regulation and data protection,
    • Improve understanding of the Mental Capacity Act,
    • Provide a contact number for staff and volunteers to raise concerns,
    • Be clear in procedures about when to raise a safeguarding concern,
    • Assure staff and volunteers that they do not necessarily need to have evidence to raise a concern.

    Complex networks between safeguarding partner agencies

    The local authority has the lead responsibility for safeguarding adults with care and support needs, and the police and the NHS also have clear safeguarding duties under the Care Act 2014. Clinical commissioning groups and the police will often have different geographical boundaries and different IT systems. Housing and social care providers will also provide services across boundaries.

    The Care Act 2014 (Section 6 [7]) places duties on the local authority and its partners to cooperate in the exercise of their functions relevant to care and support including those to protect adults. The safeguarding adults board should ensure that it ‘has the involvement of all partners necessary to effectively carry out its duties’.

    Below is a simple flowchart of the key principles for information sharing. You can also download this flowchart.

      Sharing information to prevent abuse and neglect

      Sharing information between organisations about known or suspected risks may help to prevent abuse taking place. The safeguarding adults board has a key role to play in sharing information and intelligence on both local and national threats and risks. The board’s annual report must provide information about any safeguarding adults reviews. This can include learning to inform future prevention strategies. Designated adult safeguarding managers ‘should also have a role in highlighting the extent to which their own organisation prevents abuse and neglect taking place’.

      What if a person does not want you to share their information?

      Frontline workers and volunteers should always share safeguarding concerns in line with their organisation’s policy, usually with their line manager or safeguarding lead in the first instance, except in emergency situations. As long as it does not increase the risk to the individual, the member of staff should explain to them that it is their duty to share their concern with their manager. The safeguarding principle of proportionality should underpin decisions about sharing information without consent, and decisions should be on a case-by-case basis.

      Individuals may not give their consent to the sharing of safeguarding information for a number of reasons. For example, they may be frightened of reprisals, they may fear losing control, they may not trust social services or other partners or they may fear that their relationship with the abuser will be damaged.

      If a person refuses intervention to support them with a safeguarding concern, or requests that information about them is not shared with other safeguarding partners, their wishes should be respected. However, there are a number of circumstances where the practitioner can reasonably override such a decision, including:

      • You have a lawful basis for sharing without consent under the GDPR & Data Protection Act 2018,
      • The individual lacks the mental capacity to make that decision – this must be properly explored and recorded in line with the Mental Capacity Act,
      • Other people are, or may be, at risk, including children sharing the information could prevent a crime,
      • The alleged abuser has care and support needs and may also be at risk,
      • A serious crime has been committed staff are implicated,
      • The person has the mental capacity to make that decision but they may be under duress or being coerced,
      • The risk is unreasonably high and meets the criteria for a multi-agency risk assessment conference referral,
      • You have a legal obligation.

      If none of the above apply and the decision is not to share safeguarding information with other safeguarding partners, or not to intervene to safeguard the person:

      • Support the person to weigh up the risks and benefits of different options,
      • Ensure they are aware of the level of risk and possible outcomes,
      • Agree on and record the level of risk the person is taking,
      • Offer to arrange for them to have an advocate or peer supporter,
      • Offer support for them to build confidence and self-esteem if necessary,
      • Record the reasons for not intervening or sharing information,
      • Regularly review the situation,
      • Try to build trust and use gentle persuasion to enable the person to better protect themselves.

      If it is necessary to share information outside the organisation:

      • Explore the reasons for the person’s objections – what are they worried about?
      • Explain the concern and why you think it is important to share the information,
      • Tell the person who you would like to share the information with and why,
      • Explain the benefits, to them or others, of sharing information – could they access better help and support?
      • Discuss the consequences of not sharing the information – could someone come to harm?
      • Reassure them that the information will not be shared with anyone who does not need to know,
      • Reassure them that they are not alone and that support is available to them.

      If the person cannot be persuaded to give their consent then, unless it is considered dangerous to do so, it should be explained to them that the information will be shared without consent. The reasons should be given and recorded.

      It is very important that the risk of sharing information is also considered. In some cases, such as domestic violence or hate crime, it is possible that sharing information could increase the risk to the individual. Safeguarding partners need to work jointly to provide advice, support and protection to the individual in order to minimise the possibility of worsening the relationship or triggering retribution from the abuser.

      What if a safeguarding partner is reluctant to share information?

      There are only a limited number of circumstances where it would be acceptable not to share information pertinent to safeguarding with relevant safeguarding partners. Safeguarding adults boards set clear policies for dealing with conflict on information sharing. If there is continued reluctance from one partner to share information on a safeguarding concern the matter would be referred to the board. It can then consider whether the concern warrants a request, under Clause 45 of the Care Act, for the ‘supply of information. Then the reluctant party would only have grounds for refusal if it would be ‘incompatible with their own duties or have an adverse effect on the exercise of their functions’.

      Useful Links

      On this page we have listed links to organisations that we think you will find helpful

      Action on Elder Abuse

      Age UK Lewisham & Southwark

      British Medical Association

      British Transport Police Mental Health Team Hotline

      Care Act Factsheets from GOV.UK

      Care Quality Commission Safeguarding People

      Carers Trust

      Crimestoppers UK

      Department of Health

      Disclosure and Barring Service

      Gangmasters and Labour Abuse Authority

      General Medical Council

      Get Safe online 

      Health & Care Professionals Council

      IAPT (Improving Access to Psychological Therapies) - NHS

      NHS Digital

      Housing and Safeguarding Adults Alliance

      Independent Age - Advice and support for older age

      Iranian and Kurdish Women’s Rights Organisation

      Jargon Buster

      Lewisham Council - Adult Social Care

      Lewisham Council Public Safety

      Lewisham Wellbeing Map

      Mayors Office for Policing and Crime

      Metropolitan Police Lewisham Borough

      Ministry of Justice

      Neighbourhood and Home Watch Network

      Nursing & Midwifery Council

      Office of the Public Guardian

      Patient - Safeguarding Information

      Regulatory Alert To Charities - Safeguarding

      Revenge p*rn helpline

      Safety Net

      Skills for Care

      Social Care Institute for Excellence

      Social Care Institute for Excellence - Safeguarding

      Survivors UK - Male Rape & Sexual Abuse

      Victim Support

      The Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS) Safeguarding Network have worked with key partners to bring together a consolidated list of key safeguarding resources for council, care provider and wider partners' staff.

      The Department of Health have produced a range of factsheets that provide an overview of the Care Act and the duties and powers of local authorities under the Act.

      The factsheets accompany Part 1 of the Care Act and reflect changes made to the Care Act statutory guidance in March 2016.

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