Our aim in the broadest sense is for the public, volunteers, and professionals to work together to uphold human rights and ensure everyone is treated with dignity and respect, and that people have choice, control, and compassionate care in their lives. Everyone has the right to live their lives free from violence, fear and abuse and all adults have the right to be protected from harm or exploitation. But not everyone can protect themselves.
‘Safeguarding’ is a term used to mean both specialist services and other activity designed to promote the wellbeing and safeguard the rights of adults with care and support needs where neglect or abuse has or is suspected to have occurred. Our responses to concerns are driven by Care Act 2014 statutory guidance and the national Making Safeguarding Personal (MSP) agenda. This includes working with individuals or their representatives to establish their preferred outcomes to concerns and work with individuals to meet those outcomes. Where adults with care and support needs do not have the mental capacity to make specific decisions, we will ensure there is an appropriate legal advocate to act on the individual’s behalf.
Repeat referrals
From April to March 2022, our safeguarding adult repeat referral rate increased slightly from to 8% to 10.2%. The increase will continue to be monitored but is within the agreed key performance Indicator (KPI) agreed with Torbay Council of 15% or lower. The table below provides an overall comparator between 2020-2023.
Asking people their preferred outcomes
In April 2022 we set a target of asking 90% of people experiencing a safeguarding response what their preferred outcomes where. During 2022 to 2023 we did not meet this target, recording that 67.9% of people where asked their preferred outcomes. This is a reduction of 14.1% compared to the previous year. 20.1% of our records did not capture this data and this is therefore a key improvement requirement for 2023-2024.
Where outcomes were expressed 93.6% of people said their outcomes where fully or partially achieved.
Qualitative feedback
Qualitative feedback is important in understanding people’s experiences of safeguarding responses. In Torbay, we commission an independent advocacy group to undertake discovery interviews with people or appropriate representatives who consent to giving qualitative feedback. We developed this process during 2022 and received our first feedback report at the beginning of 2023. The report concluded:
All…felt included, they felt that the process was fully explained and that they had input whilst being heard. The benefits of the safeguarding process were appreciated with more needs identified and acted upon. This led to a very positive response on the outcomes.
Moving forward, we will receive quarterly reports to help us understand people’s experiences to help us further develop our operational responses to safeguarding concerns.
Safeguarding adult enquiries summary
From April 2022 to March 2023, 1159 safeguarding adult concerns were received which is a 16.1% increase on the previous year. The number of concerns which proceeded to Care Act s.42 enquiry increased by 8.8% to 299. The table below provides a comparator during the past three years.
Torbay and South Devon NHS Foundation Trust’s work in this area primarily divides between the adult social care community operational teams who respond to safeguarding concerns and our Quality, Assurance, and Improvement Team (QAIT) which works with care homes and domiciliary care providers to promote high quality care and proactively monitor quality standards.
We also work closely with Devon and Cornwall Police, Devon Partnership NHS Trust, NHS Devon, and the Care Quality Commission both in causing enquiries to be made and maintaining strong local partnership arrangements.
The most common reported types of abuse are neglect, physical, emotional, and psychological and financial. In 2022 we also undertook a large-scale safeguarding enquiry in response to safeguarding adult concerns within a care home which received an inadequate Care Quality Commission rating. The value of an integrated health and social care system was particularly evident in the response to the concerns.
Torbay and Devon Safeguarding Adult Partnership (TDSAP)
TDSAP oversees local safeguarding arrangements and has a structure to support its objective to help and protect adults in its area where there is reasonable cause to believe the adult has needs for care and support, is experiencing or at risk of abuse or neglect and as a result of those needs is unable to protect themselves against abuse or the risk of it.
The structure includes community reference, learning and improvement and performance and quality assurance subgroups. The partnership also has a specific Safeguarding Adult Core Group responsible for commissioning and overseeing safeguarding adult learning reviews. The partnership has an independent chair who oversees local arrangements.
Structure
View the TDSAP organisational structure in an accessible format
Business plan
The TDSAP strategic business plan for 2021-2024 sets four priorities overseen by the board.
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To embed learning from Safeguarding Adult Reviews (SARs) into organisational practice.
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To improve outcomes for people with needs for care and support by finding the right solution for them.
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To work with partners to better understand the risk of hidden harm, especially in the context of COVID.
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To improve involvement and engagement with people in receipt of safeguarding services.
More information on the partnership can be found on the Torbay and Devon Safeguarding Adult Partnership website.
Learning from Safeguarding Adult Reviews
The TDSAP must arrange a Safeguarding Adults Review (SAR) when an adult in its area dies as a result of abuse or neglect, whether known or suspected, and there is a concern that partner agencies could have worked more effectively to protect the adult. Boards must also arrange a SAR if an adult in its area has not died, but the Safeguarding Adult Board (SAB) knows or suspects that the adult has experienced serious abuse or neglect. Boards may also arrange for a SAR in any other situations involving an adult in its area with needs for care and support if it deems it appropriate. The focus of SARs is to identify learning, not to apportion blame.
The partnership commissioned one new safeguarding adult review and published two reviews in 2022-2023. The partnership arrangements support greater collective learning outcomes across the Torbay and Devon footprint.
Advocacy for people unable to make decisions for themselves
We continue to use advocacy services across the three legal frameworks: Independent Mental Health Advocacy, Independent Mental Capacity Advocacy and Care Act Advocacy. This is via a contract with Devon Advocacy consortium. We regularly refer people and have contract monitoring systems in place to monitor uptake of services.
Deprivation of Liberty Safeguards
The Deprivation of Liberty Safeguards (DoLS) procedure is designed to protect your rights if the care or treatment you receive in a hospital or care home means you are, or may become, deprived of your liberty, and you lack mental capacity to consent to those arrangements. For example, where due to the serious onset of dementia an individual’s capacity to act safely is significantly affected. Throughout the past year we planned and prepared for the national implementation of the replacement system Liberty Protection Safeguards (LPS) in response to the Mental Capacity (Amendment) Act 2019. In April 2023 the government announced LPS would be further delayed ‘beyond the life of this parliament’ meaning the existing DoLS system will remain for the foreseeable future.
Safeguarding adults summary
While our performance is good, we must constantly strive to understand emerging issues for safeguarding adults in Torbay and act proactively to maintain our performance. Our board arrangement has assisted in driving a consistent approach in these agendas across our local safeguarding adult partnership. A key message is to promote a zero tolerance of adult abuse and that safeguarding adults is everyone’s business. When adult abuse concerns are raised, we work in a multi-disciplinary and multi-agency context to understand risk and ensure responses are person centred, include the right people, and include the right partner agencies. Our main focuses in the forthcoming year are to continue to embed learning from safeguarding adult reviews and support delivering the strategic priorities of the TDSAP. We must also ensure we are recording if we are asking people their preferred outcomes and extend our use of data to understand other trends and areas for development.