Agenda Item - East Sussex County Council

Agenda Item 5
Report to:
Lead Member for Adult Social Care
Date: 20 December 2010
By:
Title of report::
Purpose of report:
Director of Adult Social Care
Annual Report Safeguarding Vulnerable Adults Board
To advise the Lead Member for Adult Social Care of the multi-agency
arrangements in place to safeguard Vulnerable Adults in East Sussex.
RECOMMENDATION:
The Lead Member for Adult Social Care is recommended to note the Annual Report on the
Safeguarding Vulnerable Adults Board.
1. Financial Appraisal
1.1 There are no financial implications arising from the report. The report describes the services
already provided within the Adult Social Care budget.
2. Supporting Information
2.1 This report advises the Lead Member on the work undertaken by the East Sussex Safeguarding
Vulnerable Adults Board in 2009/10 and outlines the Safeguarding Activity and updates from Partner
Organisations. The Annual Report is attached at Appendix 1.
2.2 The East Sussex Safeguarding Adults Board draws together senior managers from all the lead
agencies with the aim of achieving effective and consistent multi-agency working to ensure that all
safeguarding adults work is effective, responsive and co-ordinated.
2.3 In 2008/09, a new structure of subgroups was developed to deliver four main streams of work
identified to implement the Board strategy and achieve the vision it has set. These subgroups are:
• Communication & Raising Awareness
• Performance Quality & Audit
• Workforce Planning
• Operational Practice
2.4 These subgroups now address many key areas of development and provide multi-agency
forums for discussion and learning regarding adult safeguarding practice and wider policy issues.
2.5 Key issues addressed by the Board in 2009/10 included:
• Ensuring that people with support needs who do not have assistance from trusted family or
friends receive assistance to ensure improved outcomes
• Raising awareness of safeguarding so that the people of East Sussex are aware of and alert to
safeguarding issues
• A well-informed, competent and properly vetted workforce
• Continuing to check how well arrangements work to safeguard individuals from abuse and how
we can continue to make improvements.
• Developing representative robust data for monitoring, reporting and evaluation.

2.6 The Annual Report also includes details about the training provided during 2009/10, a statistical
report about the safeguarding services and updates from partner organisations.
3. Conclusion and Reason for Recommendation
3.1 The Safeguarding Vulnerable Adults Board in East Sussex continues to ensure the high profile
and priority that all professionals and agencies continue to give to ensure safeguards are in place to
support adults who are vulnerable to abuse in East Sussex.
KEITH HINKLEY
Director of Adult Social Care
Lead Officer: Angie Turner, Head of Operations (Safeguarding) 01273 482503
Background Documents: None
Local Members: All

Appendix 1
1

Appendix 1
Contents
Page
Foreword 1
1 National Context 2
Independent Safeguarding Authority
2 Regional Developments 4
3 East Sussex Safeguarding Vulnerable Adults Board 5
Board Work Programme 2009/10
Subgroups Work Programme 2009/10
o Communications & Raising Awareness
o Operational Practice
o Performance, Quality & Audit
o Workforce Planning
4 Safeguarding Adults Team Report 23
5 Safeguarding Adults Summary Performance Management 25
o Safeguarding Vulnerable Adults Referrals by category
o Ethnicity of Alleged Victims
o Gender of Alleged Victims
o Type of Abuse
o Level of Investigation
o Location of Abuse
o Source of Referrals
o Alleged Perpetrator’s relationship to client
o Social Work Team managing the case
o Strategy Meeting held by service
o Outcomes of Investigation for Alleged Victim
o Outcomes of Investigation for Alleged Perpetrator
o IMCA
o ABE Interviews
o Safeguarding Crime in East Sussex
o Complaints information
6 Updates from Partner Organisations 43
Sussex Police
Care Quality Commission
South Coast Ambulance Trust
East Sussex Hospitals Trust
Registered Care Home Association
Trading Standards
East Sussex Downs and Weald and Hastings and Rother Primary
Care Trusts
Sussex Partnership NHS Trust
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Appendix 1
7 Self-Directed Support in East Sussex 58
8 Deprivation of Liberty Safeguards 60
9 Quality Monitoring Team 63
10 Challenges Ahead 64
11 Contributor Organisations 65
3

Foreword
As Chair of the East Sussex Safeguarding Board I am pleased to introduce our Annual
Report for 2009-2010.
The report covers the work of the multi-agency partnership represented at the Board
and outlines progress made during the last year as well as setting out what we aim to
achieve over the coming year.
You will see that during the year there has been considerable activity and
development to support our commitment to this important area of work.
Excellence should and will remain our aspiration, and to achieve this, 2010-11 needs
to be a period of continued development.
This Annual Report continues to look forward, setting further targets and I am
confident that our current accomplishments can be built upon.
Safeguarding vulnerable adults from abuse is a top priority and I remain personally
committed to working with the Board to achieve these aims and to ensure
improvements in safeguarding arrangements in East Sussex continues.
Together we can and will make East Sussex a safer place.
Keith Hinkley
Director, Adult Social Care
East Sussex County Council
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Appendix 1
1 National Context
1.1 The Policy landscape has changed with the enactment of key pieces of legislation,
all playing their contribution in respect of safeguarding the interests of vulnerable
members of the community.
1.2 During 2008, the Government launched a review of “No Secrets” and the East
Sussex Safeguarding Vulnerable Adults Board submitted a multi-agency response
to the consultation document. A summary of responses was published during July
2009 detailing a number of key messages.
• Support for stronger national leadership
• Greater clarity and understanding around safeguarding within the NHS
• Support for legislation to make Safeguarding Adults Boards statutory
• Revision and updating the ”No Secrets” guidance.
A written ministerial statement was subsequently published in June 2010 by the
then Minister of State, Department of Health, detailing the Government’s response:
• To establish an Inter-Departmental Ministerial Group for Safeguarding
Vulnerable Adults
• To introduce new legislation to strengthen the local governance of safeguarding
by placing Safeguarding Adults Boards on a statutory policy
• Publication of National multi-agency guidance to establish the roles and
responsibilities for those involved in safeguarding vulnerable adults.
1.3 Independent Safeguarding Authority (ISA)
A new Vetting & Barring Scheme (VBS) was introduced from October 2009 to
prevent unsuitable people from working or volunteering with children or vulnerable
adults.
The Independent Safeguarding Authority maintains two barred lists and employers,
social services and regulators have a legal duty to refer relevant information to ISA
about individuals who may pose a threat to vulnerable individuals.
The full implementation of this scheme included an intention to register all new and
existing workers with ISA by 2015 so organisations who work with vulnerable
adults would only be allowed to employ ISA registered people in regulated activity.
Registration with the VBS has now been suspended although existing
arrangements under the scheme continue as follows.
• ISA will continue to make barring decisions and will continue to maintain lists
for those barred working with children and vulnerable adults
• Existing requirements concerning Criminal Records Bureau will remain in place
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Appendix 1
• Employers are still legally obliged to refer information to ISA if they have moved
or removed an individual because they have harmed or there is a risk of harm
to members of the vulnerable group.
1.4 The Mental Capacity Act
The Mental Capacity Act (MCA) and the establishment of the new Court of
Protection powers has had significant implications for the safeguarding agenda as
it brought greater powers, introducing “wilful neglect” as a criminal offence. The
MCA provides a framework for acting and making decisions on behalf of people
who lack the capacity to make decisions for themselves. The Government also
added new provisions to the act, the Deprivation of Liberty Safeguards.
1.5 The Deprivation of Liberty Safeguards
The Deprivation of Liberty Safeguards came into effect in April 2009 and work has
been undertaken in East Sussex to plan for the introduction of this aspect of the
legislation. The Deprivation of Liberty Safeguards are in addition to, and do not
replace other safeguards.
1.6 Independence, Choice & Wellbeing
Following the publication of the Green Paper, Independence, Choice & Wellbeing,
and the subsequent White Paper, Our Health, Our Care, Our Say, the Government
issued a policy document, Putting People First (PPF).
The PPF document announced that Self Directed Support (SDS) and Personal
budgets were to be introduced as part of the transformation of Adult Social Care.
In developing our model of SDS we have aimed to support creative approaches to
meeting service user needs, supporting the use of alternative funding sources and
cost free solutions where appropriate.
East Sussex is committed to the principle of wherever possible enabling people to
have choice and take control of their lives, through SDS and a positive approach to
risk enablement.
A systematic risk assessment and risk management process has been introduced,
in which service users are central to the decision making process and staff are
fully supported.
1.7 Care Quality Commission
From April 2009, this new body is responsible for monitoring and regulating the
standards of health and social care services. The Commission for Social Care
Inspection, Health Care Commission and Mental Health Care Commission have
merged from this date.
Safeguarding continues to be one of the new Commission’s main priority.
The East Sussex Safeguarding Vulnerable Adults Board works closely with partner
organisations to translate national policy into guidance which can then be
implemented locally.
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Appendix 1
2 Regional Developments
2.1 The South East Adults Safeguarding Regional group undertakes the following
roles:
• Promotes and shares good practice regionally in relation to Adult Safeguarding,
Mental Capacity and Deprivation of Liberty Safeguards. This is achieved
through benchmarking standards of good practice, sharing policy frameworks
and linking with other networks
• Acts as a consulting body for the development of national and regional policy
• Provides expert advice to other groups
• Provides information and guidance to the Association of Directors of Adult
Social Services (ADASS) national policy group on adult safeguarding.
The Regional Network in conjunction with the Department of Health organised a
Safeguarding Conference in April 2010. The focus of the conference was two fold:
• To introduce the new regulatory framework for regulated services, including
Healthcare Services
• To continue the likely outcome of the “No Secrets” consultation.
This event was well attended by all stakeholders and also provided a means to
explore the issues facing different organisations and to strengthen professional
relationships that underpin the partnership.
The Head of Safeguarding attends the regular regional meetings with other South
East leads linked to the Association of Directors of Social Services, Adult
Safeguarding national workstream.
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Appendix 1
3 East Sussex Safeguarding Adults Board
3.1 The East Sussex Safeguarding Adults Board (SAB) is chaired by the Director of
Adult Social Care. Its membership is drawn from senior managers from all the lead
agencies. The Board aims to achieve effective and consistent multi-agency working
to ensure that all safeguarding adults work is effective, responsive and coordinated.
It is anticipated that during 2010-11, national legislation will be introduced to
require each area to have a Statutory Adults Safeguarding Board therefore, a
Memorandum of Understanding will be introduced during this period to reflect any
required changes.
3.2 Board Work Programme 2009-10
The key work strands for 2009-10 were:
o Ensuring that people with support needs who do not have assistance from
trusted family or friends receive assistance to ensure improved outcomes
o Raising awareness of safeguarding so that the people of East Sussex are
aware of and alert to safeguarding issues
o Ensure the development of the Personalisation agenda promotes thorough
needs assessments, supported by risk assessments to inform individual
choices.
o A well informed, competent and properly vetted workforce
o Continuing to check how well arrangements work to safeguard individuals from
abuse and how we can continue to make improvements.
3.3 The East Sussex Safeguarding Board meets on a regular basis and has four
subgroups to carry forward the specific functions of the Board, implement its
Strategy and achieve the vision it has set out. The subgroups are:
o Communications and Raising Awareness
o Operational Practice
o Workforce Planning
o Performance, Quality and Audit
The Safeguarding Adults Board has continued to strengthen with the four
subgroups addressing key areas for development.
These groups have provided multi-agency forums for discussion and learning
regarding adult safeguarding practice and wider policy issues.
The Safeguarding Adults Board agreed to conduct a Serious Case Review during
2009/10 commissioning Marika Dalgliesh, an Independent Chair of the review. The
key findings of this review and action plan will be reported in detail in the 2010/11
Annual Report.
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Appendix 1
3.4 Subgroups Work Programme 2010-11
3.5 Communications & Raising Awareness Subgroup
The communications and raising public awareness sub-group is responsible for raising
public awareness on safeguarding vulnerable adults. We aim to do this in a creative
and informative way. Our communication objectives are to ensure that information is
timely, accurate and accessible for all the people who live in East Sussex.
We’ve had a busy end of year planning a high profile campaign going live in
September 2010 that will ensure the public begin to understand what adult abuse is,
how to spot it and report it. This campaign is pivotal to the Safeguarding
Communication Strategy that sets the direction for the next three years.
Other work has included:
• A Safeguarding Coordinator represented Adult Social Care at a LINk meeting
on Putting People First to discuss safeguarding; in November 2009 an article
providing information on Safeguarding was published in the East Sussex
Seniors Association newsletter.
• In November 2009, following concerns and feedback from Learning Disabled
service users, the Involvement Matters Team commissioned a stakeholder
conference to raise awareness and identify a local commitment/action plan to
reduce hate crime and increase reporting.
• Schools and colleges were identified as key areas to target in relation to hate
crime and so one of the Safeguarding Co-coordinators facilitated awareness
raising workshops at Hastings, Lewes and Eastbourne Colleges of further
education.
• An Introduction to Safeguarding half-day workshop was delivered in January
2010. There were twenty two representatives from East Sussex Seniors
Association, and the Disabled Peoples’ Participation Group. The aim was to
develop understanding and awareness of what abuse is and who to contact as
well as information on the Mental Capacity Act. Information packs were
distributed for forums to take back to their local networks. It was agreed, that
this was an introduction to the subject, however, participants were keen to
develop this further and so a second workshop has been arranged for 16 th
September 2010 to coincide with the Public Awareness campaign.
• January 2010 a Safeguarding Coordinator and Community Relations Manager
were invited by Trading Standards, Buy with Confidence Scheme, to raise
awareness of safeguarding with approved traders
• Links have been developed with the Fire Service, Library Services and Victim
Support Services.
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Appendix 1
3.6 Operational Practice Subgroup
The Operational Practice Subgroup is responsible for promoting consistency of
practice across organisations, seeking feedback from service users, post
investigation to inform changes and development in practice and developing
appropriate services to support individuals through the safeguarding process.
Progress
The group has made significant developments during 2009/10 including:
o A member of the group has taken part in a Department of Health research
project to produce a guide to best practice in Governance in relation to
Safeguarding Adults Boards as well as produce a national framework to
support decision making in cases that involve self-neglect. This work has been
progressed through this subgroup.
o Developing and publishing a Provider protocol to ensure agencies that provide
support to vulnerable adults are aware of their roles and responsibilities and the
appropriate action to take
o Exemplars have been developed on how best to manage risk and these are
used to inform reflective practice workshops with operational teams
o A system for managing risk has also been incorporated in the wider risk
framework for self-directed support.
A plan has been developed to address areas for development during 2010-11
including:
o An update of the Sussex Multi-Agency Policy & Procedures to create an
accessible, user friendly, web-based manual
o Finalising the Sussex Multi-Agency Self-Neglect Policy
o Developing a tool to ensure timely access to clinical and medical advice and
input to safeguarding investigations
o A review of Adult Social Care Practice Standards with a view to introduce the
equivalent across agencies
o Monitoring the impact operationally, of the raising awareness campaign.
Areas for development identified from the Serious Case Review will be
incorporated in the 2010/11 Work Programme.
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Appendix 1
3.7 Workforce Development Subgroup
Safeguarding Vulnerable Adults Training Annual Report
i) Introduction
The links between Safeguarding training and the training to support the
implementation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty
Safeguards (DOLS), have been strengthened over the last 12 months.
The funding to support MCA/DOLS implementation has been utilised by health and
social care to appoint a dedicated safeguarding multi-agency training co-ordinator for
12 months. This post will report to the East Sussex Safeguarding Board.
The primary aim of the post is to organise and deliver multi-agency SVA training to
health and social care staff. This training will continue to include, and be
complimented by, appropriate levels of MCA and DOL training.
In line with these changes the Workforce Development Subgroup
has broadened its remit to provide strategic direction to current, and future,
safeguarding, MCA and DOLS training in East Sussex.
Public sensitivity around Adult Safeguarding is second only to the protection of
children in terms of the priorities for staff in Adult Social Care. With the introduction of
additional legislation such as the Mental Capacity Act, The Deprivation of Liberty
Safeguards, and Best Interest Assessment the legal complexities and consequences
increase in proportion.
Although Safeguarding Vulnerable adults (SVA) is mandatory training for front line
staff there are increasing concerns that staff face a steep learning curve not only in
terms of individual pieces of legislation but also in terms of how all these individual
pieces of legislation work together into a coherent whole, for example where the
Mental Health Act and the Mental Capacity Act interface.
In addition the principles of Human rights and a concern for the wellbeing of
individuals and their families also continue to underpin practice and inform learning
and development.
For a full list of SVA training see Appendix 1 of this document
ii) E-Learning Programmes (Level 1)
An SVA E-Learning programme was introduced in October 2009 for all health and
social care staff, and other partner agencies working in East Sussex. Reports indicate
very good take up by staff working within the local authority. Take up and usage by
other agencies is more patchy. This may be due to lack of awareness or difficulty in
accessing PC’s to use the programme.
Further publicity is planned for the independent care sector during May/June 2010.
In addition to the SVA programme, ESCC and the PCT has introduced e-learning
programmes on the Mental Capacity Act and Deprivation of Liberty Safeguards and
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Appendix 1
more recently the East Sussex LCSB has introduced a programme of e-learning on
Safeguarding Children. All these programmes are available to staff and volunteers
across East Sussex.
iii) Developing Multi-Agency SVA Training (Level 2)
From September 2010 to March 2011 the Safeguarding training Co-ordinator will be
piloting a series of half-day multi-agency SVA training courses. The courses will be
aimed, initially, at front-line staff working in the local authority, PCT’s and the acute
health Trust.
The courses will be co-delivered by staff from health and social care and replace
existing single-agency, level 2, training.
iv)
The East Sussex SVA Trainers Forum and Training Approval Scheme
In April 2010 the Safeguarding Board agreed to the introduction of a ‘Training
Approval Scheme’ in East Sussex. The scheme will be managed by the Training Coordinator
and enables SVA trainers to seek ‘approval’ for their training by meeting
agreed standards and performance criteria This, in turn, allows those purchasing
training from ‘approved training providers’ to do so with confidence.
v) Safeguarding for Direct Payment employers, Personal Assistants (PA’s)
and Support With Confidence membership
A number of PA’s and Carers have attended Safeguarding workshops offered by
ESCC. One Carer/Employer also went on to attend the full Train the Trainers course
to ensure he could train future PA’s.
A full page article on Safeguarding and who to contact, was included in the first edition
of FOCUS (winter 09) a newsletter sent to all Direct Payment recipients. This also
included information on the e-learning now available as well as information about
safeguarding courses being held.
In the spring issue of FOCUS the e-learning information was repeated. Other
resources are also available and we now have a DVD on Safeguarding that can be
borrowed at no cost. Service users and PA’s can also access the Social Care
Information and Learning Services website which has a number of safeguarding
courses contained in it’s package.
One of the requirements to join Support with Confidence will be to do the e-learning
course on Safeguarding this includes all employees of a business that wishes to be
recognised as a Support with Confidence member.
vi) SVA Competency Framework
East Sussex Adult Social Care department introduced a SVA competency framework
for all staff in June 2009. Since then all staff will have been ‘assessed’ against the
framework and ASC is currently carrying out an audit to measure performance in this
area. In addition the ESCC competency framework has been used by ‘Learn to Care’,
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Appendix 1
a national organisation, to support the development of a nationally agreed
competency framework.
vii) Learning Disability Workforce Development Partnership (LDWDP)
In November 2009 the LDWDP hosted a safeguarding conference for staff working in
Learning Disability services across East Sussex. The event was organised and run by
service users and presented work on harassment and bullying in the community and
that service users needed to feel safer. The conference was well attended and
evaluated.
Emerging from the conference was an opportunity to build on the experience of a
‘carer’ who supported a relative who was badly treated by both health and social care
providers elsewhere in the country. The carers experience is to be captured on DVD,
with the help of other service users, and will be available to use on SVA training
courses in autumn 2010.
viii) Supporting East Sussex Seniors Association (ESSA)
Training and support has been provided to ESSA to help designated volunteers
promote a greater understanding and awareness of safeguarding issues within the
networks that ESSA represents. This activity is ongoing and a further workshop is
planned for September 2010.
ix) SVA and MCA tools
East Sussex have worked directly with SCIE (Social Care Institute of Excellence) in
it’s development of a range of tools for helping bring the Mental Capacity Act into life
in practice in social care and health organisations across the country. East Sussex
worked on these over 2009 -10 to produce researched and validated tools for MCA
audit at organisational, supervisory, self development and service user levels. These
now show in the suite of SCIE audit tools on the MCA pages of the web link
www.scie.org.uk/mca
Further work with SCIE is currently underway with practical guidance on Deprivation of
Liberty Safeguards for care home managers at a national level, again for e learning
via the SCIE link and expected to be available autumn 2010.
These national tools complement the locally available KWANGO tools for e learning
on MCA DOLS Dementia and Safeguarding
'Knowing You Matter' Film
The film 'Knowing You Matter' was produced locally by East Sussex and had its highly
successful launch on June 28th at Hailsham Pavilion. The film explores loss of
capacity and vulnerability from the service users and carer’s perspectives and reveals
the emotions, losses and what is possible to gain in excellence of safe personalised
care of the vulnerable older person. The film has attracted very positive local and
national media attention and is aimed at raising awareness of personalised caring to
social care staff and those affected by the issues of capacity and dementia.
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Copies of the DVD were made available to everyone attending the launch and
workshop (200) and subsequently to 50 independent care home and health managers
at the DOLS One Year on Conference. The film is available via a You Tube link
http://www.youtube.com/watch?v=oWg18MDDDqE . A hard copy DVD is also
available via Carol Wilkinson at Carol.Wilkinson@eastsussex.gov.uk . The DVD will
be posted out free to any care home, day service, group or individual on the basis that
the recipient will arrange to show it at a forthcoming team or group meeting for
learning, discussion and commitment to raising standards of personalised care in that
service.
Safeguarding Vulnerable Adults Training Courses
1. Induction and ELearning Programmes
SVA, MCA and DOL ELearning programmes now available to all staff and volunteers.
2. Basic SVA Awareness
This training course is aimed at Internal staff who will provide a Level 1/2 SVA function
and is offered to the large numbers of statutory and Independent Sector staff.
3. Investigation Training day
This is a precursor to the Investigation Training and provides an opportunity for people
who struggle to get onto the three day investigation workshop.
The Course covers:
• Best Evidence
• Interviewing a mini ABE course – Non leading questions etc
• The 4 levels of SVA and what they mean
• The SVA flowchart –
• Strategy meetings and best Interest meetings
• How to take contemporaneous notes.
4. Introduction to SVA Investigations
A three day course for CQC, Police and Social Care Staff responsible for SVA
Investigations.
5. Interviewing Vulnerable Adults – Achieving Best Evidence
A five day course provided by Sussex Police for Social Care Staff providing ABE
support to the Police.
6. Chairing Adult Protection Meetings
Several of these courses were provided by a freelance trainer.
7. Managing SVA Investigations
A one day course for Managers responsible for SVA Investigations.
8. Course for Independent Care Sector
Courses are run on a regular basis for Level 1 Investigations training for Provider
Managers and SVA: The Managers Role.
9. Minute Taking for SVA meetings
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A one day course for administrative staff providing minutes to SVA meetings.
10. SVA Refresher
These are supplied at the request of particular services and staff groups.
11. SVA Investigating Managers Workshops
A regular workshop that allows SVA Investigation Managers to develop and maintain
consistency and standards of practice.
Mental Capacity Act (MCA)
1. Mental Capacity Act Training (all staff)
The Mental Capacity Act (2005) provides a statutory framework to empower and
protect vulnerable people who may not be able to make their own decisions. Training
consists of:
• Assessing under the MCA
• Introduction to the
• Best Interest assessment - “Who Decides?”
2. Interface Training MCA / MHA
In response to roles such as the new Approved Mental Health Professionals (AMHP)
and Section 12 Doctors, interface trainings combining how the MCA and MHA operate
together have been offered and were oversubscribed.
Section 12 Doctors require this training for their CPD and would otherwise be unable
to perform their duties as Deprivation of Liberties Safeguards (DoLS) assessors. The
AMPHs are also required to keep up to date on case law in order to maintain their
function as Best Interest Assessors.
3. Deprivation of Liberty Safeguards
Deprivation of someone’s liberty is a very serious matter and should not happen
unless absolutely necessary and in the best interests of the person concerned.
However now that this has become more embedded in practice since 2006, fewer
places on training courses will be needed in the coming year:
• “Understanding DoLS” is a basic induction course for staff
• “DoLS for Registered Managers of Care Homes
• “De-mystifying DoLS” is a high level course covering issues such as Court of
Protection.
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Appendix 1
1. Adult Social Care Assessment and Care Management
SVA Training Review April 2009 – March 2010
Learning and
Development
Priorities
Links to
Business
Plan/
Performance
Indicators
Attended by Learning activity Evaluation/
impact on practice
To ensure
practitioners and
managers respond
appropriately to
any adult
protection
concerns identified
by, or reported to,
them
Ensure
vulnerable
adults are
protected from
abuse ad
exploitation.
Ensure
practice
meets the
standards set
by
“Safeguarding
Adults” (ADSS
~ 2005)
ASC KD1,
KD2, KD11.
Outcomes:
Freedom from
Discrimination
and abuse,
Improved
Quality of Life,
Choice and
Assessment and Care
Management staff
150 staff attended
9 staff attended
23 staff attended
31 staff attended
25 staff attended
Introduction to
Undertaking Adult
Protection Investigations
4 x 3 day courses.
ABE
3 x 1 week course with
Sussex Police
Chairing Adult Protection
Meetings
2 x 1 day courses
SVA Minute Taking for
Administration Staff
2 x ½ day courses
SVA Investigating
100% agreed that the training
met their development needs
100% of staff agreed that the
course met their development
needs.
100% of staff agreed the courses
met their development needs
100% of staff agreed the courses
met their development needs
100% of staff agreed the courses
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Appendix 1
Control
18 staff attended
managers workshop
(Managers and Senior
Practs)
2 x 1 day courses
met their development needs
36 staff attended
1 x 1 day
SVA for Travellers
SVA for Investigation
Managers Workshops
3x ½ day workshops
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Appendix 1
2. Adult Social Care Learning Disability Services
SVA Training Review April 2009 – March 2010
Learning and
Development
Priorities
Safeguarding
Vulnerable Adults
Links to
Business
Plan/
Performance
Indicators
Care
Standards Act
2000
Our Health,
Our say care,
Our say
Other
indicators
(see above)
Attended by Learning activity Evaluation/
DPS staff
46 attended (OP and LD
Services)
Adult Protection Refresher
3 x Half days
impact on practice
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3. Adult Social Care Older People Services
SVA Training Review April 2009 – March 2010
Learning and
Development
Priorities
Workforce
Development to ensure
staff are knowledgeable
and skilled in order to
protect vulnerable
adults
Links to
Business Plan/
Performance
Indicators
Care Standards.
Skills for Care
requirements.
National Service
Framework.
GSCC Code of
Practice
No Secrets
Attended by Learning activity Evaluation/impact on practice
All DPS staff.
Courses run
jointly with LD
services
63 staff
attended
Safeguarding Vulnerable
Adults Refresher (½ day)
x 6 days
For staff who require updating to
meet CQC & NMS requirements
and ensuring staff are familiar with
new multi-agency policy and
levels 1-4, including the new
competencies
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4. Adult Social Care Mental Health Services
SVA Training Review April 2009 – March 2010
Learning and
Development
Priorities
To ensure
practitioners and
managers are able
to recognise and
respond to any
Safeguarding
Vulnerable Adults
concerns
Links to
Business
Plan/
Performance
Indicators
Ensure that
vulnerable
adults are safe
and protected
from abuse
and
exploitation
and that the
safeguarding
policies and
procedures
are followed.
Attended by Learning activity Evaluation/
All NHS and Social
Services front line staff
+ staff in
Supported
Accommodation and
Carers
30 staff attended
13 staff attended
18 staff attended
Safeguarding in an Adult
Mental Health Context-
5 x 1 day workshops
SVA refresher for
Investigation Managers
workshops
1x ½ day workshops
Safeguarding Competency
in the Mental Health
context
1x 1 day workshops
impact on practice
All staff said that they benefited
from the course
100% of staff agreed the courses
met their development needs
15 staff attended
Safeguarding Children in
Mental Health
1 x 1 day workshop
17

Appendix 1
To ensure the
department meets
the Legislative
Requirements of
the Mental
Capacity Act 2005
and Deprivation of
Liberty Safeguards
and that existing
policies and
procedures are
changed to
accommodate the
new legislation
Support the
delivery of the
National
Service
Framework for
Mental Health
and enable
the County
Council to fulfil
its Statutory
functions
under the
2007 Mental
Health Act and
2005 Mental
Capacity act
including
Deprivation of
Liberty
Safeguards
Appropriately
experienced care
managers and social
workers from across
adult social care
Best Interest Assessor
module at Brighton
University in March 10
4 staff attended
CPD workshops for
qualified Best Interest
Assessors
One in house workshop
4 th Dec 09 for 10 staff
One day workshop at
Brighton uni for 10 staff on
30 th March 10
One day workshop and
update
Module on going
Well evaluated
Well evaluated
18

Appendix 1
5. Independent Care Sector
SVA Training Review April 2009 – March 2010
Learning and
Development
Priorities
Courses for
frontline staff
Improve
safeguarding
awareness in the
Independent Care
Sector
Links to
Business
Plan/
Performance
Indicators
To raise
awareness of
adult
protection
Attended by Learning activity Evaluation/
All care staff to be
aware of Adult protection
issues and familiarise
staff with the pan-
Sussex SVA policy and
procedure
201 staff attended
All Managers,
supervisors and trainers
of care staff
57 staff attended
Managers or senior staff
managing a service that
protects adults
96 staff attended
Staff who have attended
Introduction to SVA
64 staff attended
SVA Awareness
18 x 1 day trainings
SVA Train the Trainers
6 x ½ day trainings
SVA The Management
Role
6 x 1 day trainings
SVA Level 1
Investigations
4 x 1 day trainings
impact on practice
100% staff indicated that the
courses met their learning and
development needs.
19

Appendix 1
6. Adult Social Care Mental Capacity and Deprivation of Liberty Safeguards
SVA Training Review April 2009 – March 2010
With the recent implementation of the Mental Capacity Act and the Deprivation of Liberty Safeguards, the impact of these new pieces of
legislation on Safeguarding has meant that these Acts and their interface with the Mental Health Act training has become significant in the
previous 12 months. Large numbers of staff have attended these trainings from Adult Social Care, Section 12 GP’s, front line Health staff,
and the Independent Sector
Learning and
Development
Priorities
Safeguarding
vulnerable adults
training.
Awareness
training.
Introduction to
investigation
training
Links to
Business
Plan/
Performance
Indicators
Care
Standards.
Skills for Care
requirements.
National
Service
Framework.
GSCC Code
of Practice
No Secrets
Attended by Learning activity Evaluation/
ESCC/Health/Independe
nt sector.
276 staff attended
Awareness training, to
give staff an
understanding of what
SVA is and what to do.
Intro to investigation, to
give staff that may be
called upon to investigate
abuse.
impact on practice
Update and give awareness to
staff.
To give staff the ability to protect
and collect evidence.
MHA and MCA
interface training,
for AMHP’s and
BIA’s
MCA training
Introduction to the
MCA and
Assessing under
ESCC staff
19 staff attended
ESCC/Health/independe
nt sector.
291 staff attended
Understanding of the two
acts relationship. 1 course
so far.
To give all staff an
understanding of the
Mental capacity act and
there responsibilities
Awareness of legal powers of
each act for staff development.
To alter practice and give
understanding of the legal
requirements set by the law.
Understanding of roles and
responsibilities as defined by the
20

Appendix 1
the MCA
Deprivation of
liberty Safeguards.
Introduction to
DoLS. DoLS for
registered
managers. DoLS
for assessment.
ESCC/Health/Independe
nt sector/Police/CQC
540 staff attended
under the act.
Total of 21 sessions.
DoLS intro To give a
general understanding for
staff. DoLS reg to give an
in-depth understanding to
Reg Managers. DoLS
Assess. To give specialist
training to assessment.
Total of 36 sessions
law.
7. E learning and Safeguarding Vulnerable Adults
Over the period April 2009 – March 2010 a number of e-learning programmes have been introduced which have added to the “face to face
training” provided for ASC staff in East Sussex and partner organisations. The SVA e learning was accessed by the following number of
people:
Organisation/partner
organisation
Number of staff accessing e learning
programme April 2009 – March 2010
East Sussex County
1901
Council
Independent Sector staff 249
PCT staff 59
Hospital Staff 28
21

3.8 Performance, Quality & Audit Subgroup
The groups’ role is to establish systems for monitoring, reporting and evaluation for
performance across organisations, linking annual reporting to improvement planning and
a measurable work programme.
A key function of this group is to ensure representative robust data is included in the
relevant Quarterly reports, Bi-annual reports and the Annual Safeguarding Report to the
Board. Members are responsible for safeguarding performance monitoring and evaluation
processes to be established within their own organisations.
Themes and trends will be identified through the Performance information and reported to
the Safeguarding Board to inform Performance improvement actions that are incorporated
into annual work programme.
The group has been in operation for one year, and the last years work has focused on
reviewing systems recording to improve information management moving forward, and
providing a baseline of information from which to identify themes and trends to improve
performance.
Outcomes include:
• 5 Levels of Management information in operation, ( practioners, team, service
level, departmental and board level)
• Quarterly reports provided to Managers, and Bi-Annual report provided to the
Safeguarding Board.
• Revised recording process that will include information on Self funders, and
components of multiple abuse cases.
Priorities include:
• Audit of Staff Competency framework.
• Review of Minimum Data Set of Safeguarding information to ensure it remains fit
for purpose.
• Monitor the delivery of Serious Case Review Action plans to ensure performance is
improved.
• Consider data from partners organisations, such as police and health.
• Monitor impact of Communications Campaign through data set.
22

4 Safeguarding Adults Unit Report
Appendix 1
4.1 Roles and Development of the Team
The team’s role is one of support and scrutiny in relation to best practice in adult
safeguarding work. This includes a significant level of development work. Although the
team’s focus is predominantly on Adult Social Care, given the nature of safeguarding
work, there is a significant amount of partnership working.
Following the inspection in 2008, the team has continued to develop with the
successful recruitment of four Safeguarding Co-ordinators posts. The team has
developed a work plan to focus its activity and completed a significant amount of work
during 2009-10.
Team Plan
• An audit tool has been developed whereby case files are randomly audited on a
monthly basis by the team. Where issues are identified, these are raised with
practitioners in team meetings and individually
• Service user interviews are undertaken post investigation to ensure individuals that
have experienced abuse can feedback on how these arrangements worked for
them
• The team undertake work that is related to the Safeguarding Adults Board and its
four subgroups
• The Safeguarding Coordinators have developed Reflective Practice workshops in
relation to support and guidance to promote best practice
• Supporting the development and review of a more robust recording and reporting
system
• Regular workshops for Investigating Officers and Investigating Managers across a
range of services have been held
• The Operational Management for the Deprivation of Liberty Safeguards (DOLS)
team which involves undertaking assessments, authorising assessments and
reviews and ensuring a dedicated point of contact for all applications
• Supporting the training programme for Level 1 Provider training and Investigating
Manager training.
4.2 Multi-agency work and development work
• One of the Safeguarding Co-ordinators represents Adult Social Care at the
MARAC meetings led by Sussex Police to coordinate information related to people
who are at risk due to domestic violence. The Head of Safeguarding represents
Adult Social Care at the MARAC Steering Group. Both groups meet monthly.
• A number of regular safeguarding meetings exist involving the team and a range of
partner agencies including Sussex Police, Sussex Partnership Foundation Trust,
Safer Communities Partnership and the Local Safeguarding Children’s Board.
23

Appendix 1
These forums help to ensure a consistent approach to safeguarding work and to
understand the context of the work of all agencies involved.
4.3 Raising Awareness Sessions/Partner Agency Workshop
The team has attended the following forums as part of raising awareness:
• Library Service Presentation
• Presentation at Hate Crime Conference
• Awareness raising session at Hastings College
• Lesbian, Gay, Bisexual and Transgender Helpline launch
• Presentations to newly qualified Social Workers
• Victim Support workshop
• Workshops for Lewes/Eastbourne College
• Trading Standards Business Breakfast
• Presentation to East Sussex Fire & Rescue Service
• Presentation to the Learning Disability Partnership Board
• Panel Member at the LINK Forum
24

5 Safeguarding Vulnerable Adults Summary
Performance Management
4. Safeguarding Vulnerable Adults Performance Management
Summary
4.1 The following information refers to specific elements of Safeguarding data.
An “alert” refers to an individual reporting a suspected instance of abuse. If
an alert goes onto be investigated, this is called a “referral”. Not all alerts
go on to become a referral. If for example, as a result of further evidence
gathering, it is found that no form of abuse has taken place, a referral will
not take place.
4.2 This section summarises the Safeguarding activity from April 2009 to
March 2010. It sets out activity information relating to the number of alerts
and referrals for investigation, the sources of the alert and a break down of
the information by a number of different categories.
4.3 In 2009/10 there were 2,117 alerts recorded in East Sussex. This is an
increase of 536 alerts compared to 2008/09. The number of alerts in East
Sussex has continued to rise since 2007, highlighting improvements in
people’s level of understanding of safeguarding and their ability to
communicate their concerns.
4.4 The largest increase in alerts relates to people with a learning disability,
increasing from 548 alerts in 2008/09 to 737 alerts in 2009/10, an increase
of 189 alerts. This is possibly as a result of a successful hate crime
campaign that took place with the aim of developing service provider’s
knowledge of hate crimes against people with learning disabilities. The
event was extremely well attended and provided some insight into the
experiences of people with learning disabilities who have been the victims
of hate crime.
4.5 Not all alerts are required to be investigated, whilst there has been a
decrease in the percentage of alerts investigated in 2009/10 with 70.6% of
alerts investigated compared to 84% in 2008/09, the overall figures mean
that in 2009/10 there were an additional 171 investigations completed
compared to the previous year.
4.6 The 13.4% drop in alerts that went on to become referrals is attributable to
improvements that have been made in the processes involved in
identifying which alerts need to become a referral, allowing an increased
focus on the investigations that need to be undertaken.
Table 1: Number of Alerts and Referrals for investigation
2007/08 2008/09 2009/10
Category of
Vulnerable Adult
Total
alerts
Total
alerts
Total
referrals for
investigation
% of alerts
referred for
investigation
Total
alerts
Total
referrals for
investigation
% of alerts
referred for
investigation
Older People (65+) 405 726 673 92.7% 860 729 84.8%
Mental Health 99 143 110 76.9% 212 177 83.5%
Learning Disability 503 548 403 73.5% 737 376 51.0%
Physical Disability 76 121 104 86.0% 208 148 71.2%
Other Vulnerable
Adult 21 43 33 76.7% 100 64 64.0%
Total 1104 1581 1323 84.0% 2117 1494 70.6%
25

Appendix 1
Ethnicity of alleged victims
4.7 The ethnicity of the alleged victims in East Sussex is broken down into 20
categories. Table 2 shows the breakdown of the ethnicity of alerts for
alleged victims as well as the number of alerts in 2009/10 that went on to
become referrals.
4.8 The highest alert rate has been reported in the White British category with
1,813 alerts, making up 85.6% of the alerts, this is comparable with the
previous year where this group accounted for 84.6% of the alerts. The
most significant percentage increase in alerts between 2008/09 and
2009/10 is from the Black/ Black British Caribbean population with 32 in
2009/10 compared to 12 in 2008/09 however this compares more closely
with the percentage of alerts raised for Black/ Black British Caribbean in
2007/08.
4.9 The figures in the table below compare closely with the ethnic background
of East Sussex. According to the mid 2007 estimates, 95% of the
population of East Sussex are from a White background and 5% are from
Black or Minority Ethnic backgrounds. In comparison, 4.6% of alerts came
from Black or Minority Ethnic backgrounds suggesting that alleged victims
from minority ethnic backgrounds have the same level of access to
safeguarding services as other East Sussex residents.
Table 2: Ethnicity of alleged victims
2007/08 2008/09 2009/10
Alerts Percentage Alerts Percentage Alerts Percentage
Total alerts
% of alerts
that went on to
that became
become
referrals
referrals
White British 965 87.4% 1337 84.6% 1813 85.6% 1282 85.8%
White Irish 5 0.5% 6 0.4% 11 0.5% 10 0.7%
Any other White
Background
21 1.9% 28 1.8% 40 1.9% 23 1.5%
Traveller of Irish
Heritage
1 0.1% _ _ 2 0.1% 2 0.1%
Gypsy / Roma 1 0.1% 4 0.3% 2 0.1% 2 0.1%
Mixed (Black
Caribbean & 4 0.4% _ _ 1 0.0% 1 0.1%
White)
Mixed (White &
Black African)
_ _ _ _ _ _ _ _
Mixed (White &
Asian)
3 0.3% 1 0.1% 2 0.1% 2 0.1%
Mixed (Any other
background)
6 0.5% 10 0.6% 10 0.5% 5 0.3%
Asian/Asian
British - Indian
3 0.3% 3 0.2% 4 0.2% 3 0.2%
Asian/Asian
British - Pakistani
_ _ 2 0.1% _ _ _ _
Asian/Asian
British -
2 0.2% 2 0.1% 9 0.4% 6 0.4%
Bangladeshi
Any other Asian
background
3 0.3% 1 0.1% 1 0.0% 1 0.1%
Black/Black
British –
17 1.5% 12 0.8% 32 1.5% 22 1.5%
26

Caribbean
Appendix 1
Black/Black
British - African
1 0.1% 1 0.1% 6 0.3% 6 0.4%
Any other Black
background
1 0.1% 6 0.4% 14 0.7% 12 0.8%
Chinese 1 0.1% 2 0.1% 3 0.1% 0 0.0%
Any other ethnic
group
9 0.8% 12 0.8% 12 0.6% 5 0.3%
Refused 35 3.2% 76 4.8% 90 4.3% 66 4.4%
Information not
yet obtained
26 2.4% 78 4.9% 65 3.1% 46 3.1%
Totals 1104 100% 1581 100% 2117 100% 1494 100.0%
Gender of alleged victims
4.10 There were more alerts for females than males in 2009/10, with 1,262
female alleged victims, and 855 male alleged victims. This is comparable
with 2008/09 where there were 960 alerts for female alleged victims and
621 alerts for male alleged victims.
4.11 In 2008/09 the proportion of alerts that result in a referral were consistent
across the genders however in 2009/10 there has been a significant
increase in alerts leading to a referral for female alleged victims with 74%
compared with 65% for male alleged victims.
Table 3: Gender of alleged victims
2008/09 2009/10
Males Females Males Females
Alerts
Alerts that
led to a
referral
% of
Alerts to
Referrals
Alerts
Alerts
that led
to a
referral
% of
Alerts to
Referrals
Alerts
Alerts
that led
to a
referral
% of
Alerts to
Referrals
Alerts
Alerts
that led
to a
referral
% of
Alerts to
Referrals
Older 242 223 92.1% 484 450 93.0% 247 200 81.0% 613 529 86.3%
People
(65+)
Physical 54 47 87.0% 67 57 85.1% 101 69 68.3% 107 79 73.8%
Disability
Learning 264 200 75.8% 284 203 71.5% 399 210 52.6% 338 166 49.1%
Disability
Mental 48 37 77.1% 95 73 76.8% 63 54 85.7% 149 123 82.6%
Health
Other 13 9 69.2% 30 24 80.0% 45 25 55.6% 55 39 70.9%
Vulnerable
Person
Total 621 516 83.1% 960 807 84.1% 855 558 65.3% 1262 936 74.2%
Incident by type
4.12 There are six types of abuse, Sexual, Financial, Discriminatory, Physical,
Psychological and Neglect. Table 4 shows the number of investigations for
each type of abuse.
27

Appendix 1
4.13 Investigations into cases of multiple abuse are also monitored however
due to the current recording systems, we have been unable to breakdown
the components of the cases of multiple abuse. A new recording system
has been put in place from May 2010, and this data will be available for
next year.
4.14 There were also a number of cases referred for investigation that have
been classed as Institutional abuse (a new category for 2009/10).
Institutional abuse is abuse that arises from an unsatisfactory regime. It
occurs when the routines, systems and norms of an organisation override
the needs of those it is there to support.
4.15 Prior to 2009/10, institutional abuse was investigated however improved
recording mechanisms have allowed further analysis of these cases to
improve service provision.
Table 4: Types of abuse that were referred for investigation
2007/08 2008/09 2009/10
Total
Referrals
started
% of Total
Referrals
Total
Referrals
started
% of Total
Referrals
Total
Referrals
started
% of Total
Referrals
Sexual 81 7.5% 84 5.7% 82 5.2%
Financial 158 14.6% 239 16.3% 206 13.0%
Discriminatory 2 0.2% 11 0.7% 11 0.7%
Physical 572 52.9% 528 36.0% 456 28.9%
Psychological 75 6.9% 73 5.0% 133 8.4%
Neglect 120 11.1% 274 18.7% 340 21.5%
Multiple 73 6.8% 259 17.6% 184 11.7%
Institutional _ _ _ _ 8 0.5%
Other classifications _ _ _ _ 159 10.1%
Totals 1081 100% 1468 100% 1579 100%
4.16 The most common type of abuse is Physical abuse, with 28.9% of referrals
for investigation; this is the trend since 2007. However, they have
decreased as a proportion of the total number of referrals.
4.17 Incidents of neglect have increased from 18.7% (274) in 2008/09 to 21.5%
(340) in 2009/10, and incidents of financial abuse have decreased from
16.3% (239) in 2008/09 to 13% (206) in 2009/10.
4.18 Further breakdown of the types of abuse being referred for investigation by
gender shows that the proportions of discriminatory and physical abuse are
similar for both males and females however sexual abuse, psychological
abuse and neglect seem to be considerably more common for females
than for males. The table below provides a further breakdown.
Table 5: Types of abuse referred for investigation in 2009/10 by gender
Female
% of
referrals
started Male
% of
referrals
started Total
Sexual 66 80.5% 15 18.3% 81
Financial 122 59.2% 84 40.8% 206
Discriminatory 6 54.5% 5 45.5% 11
Physical 251 55.0% 205 45.0% 456
psychological 88 66.2% 45 33.8% 133
Neglect 228 67.1% 112 32.9% 340
Multiple 108 58.7% 76 41.3% 184
28

Appendix 1
Institutional 7 87.5% 1 12.5% 8
Other Classifications 110 69.2% 48 30.2% 158
Totals 986 62.4% 591 37.4% 1577
(There were also 2 cases investigated that had no gender recorded)
Levels of Investigation
4.19 Safeguarding alerts come from a variety of sources and involve a range of
situations. Such variations require different levels of response, depending
on the nature and seriousness of the allegation being made. To ensure a
proportionate response to the investigation, the levels of Investigation are
broken down into four levels:
• Level 1 Investigation- A 'one off', isolated incident that has taken
place in a provider service setting, or involving a provider service,
and has not seriously adversely affected the physical, psychological
or emotional well-being of the vulnerable adult. The Manager of the
relevant provider service is always asked to Investigate the
allegation for Level 1 Investigations
• Level 2 Investigation- The physical, psychological or emotional wellbeing
of the vulnerable adult may be being adversely affected. A
practitioner with relevant skills for example a social worker will
always be asked to investigate concerns for Level 2 Investigations.
• Level 3 Investigation- The physical, psychological or emotional wellbeing
of the vulnerable adult has been adversely affected by the
alleged incident and/or an offence may have been committed
• Level 4 Investigation- A number of vulnerable adults may be or have
been adversely affected and / or Institutional abuse may be
indicated
4.20 The levels of investigation that were undertaken in 2009/10 are shown in
Table 6.
Table 6: Total investigations at each safeguarding level
2007/08 2008/09 2009/10
Total % of Total Total % of Total Total % of Total
Referrals Referrals Referrals Referrals Referrals Referrals
started
Level 1 345 31.9% 343 23.4% 352 22.7%
Level 2 321 29.7% 412 28.1% 454 29.3%
Level 3 289 26.7% 421 28.7% 507 32.8%
Level 4 126 11.7% 292 19.9% 235 15.2%
Total 1081 1468 1548
There were an additional 31 referrals that had no level recorded or were inappropriately classified.
29

Appendix 1
2007/08 Levels of investigation
2008/09 Levels of investigation
Level 3
27%
Level 4
12%
Level 1
31%
Level 2
30%
Level 4
20%
Level 3
29%
Level 1
23%
Level 2
28%
2009/10 Levels of investigation
Level 4
15%
Level 3
33%
Level 1
23%
Level 2
29%
4.21 The proportions of levels are consistent across the whole in 2009/10 and
2008/09.
4.22 There has been a slight increase in level 3 referrals with 507 in 2009/10
compared with 421 in 2008/09 and a slight decrease in level 4 referrals
with 235 in 2009/10 and 292 in 2008/09.
Incidents by location
4.23 The types of location where incidents of abuse took place are presented in
table 8.
4.24 The most common location of alleged abuse in 2009/10 is residential care
homes, with 446 (28.2%) and a person’s own home with 341 (21.6%).
There are also a considerable number of cases (429) where the location is
not known 429. This accounts for 27.2% of the referrals that were started
in 2009/10. This is the same trend as the previous year however
improvements in the recording of information has resulted in a 24.2%
reduction in the number of investigations with a location recorded as ‘not
known’.
4.25 Consideration has been given to the number of cases where the location is
still recorded as ‘not known’, and it is not thought to be a recording issue,
as at the point of referral it can often not been known where the location of
the abuse took place. It is often identified as part of the investigation.
30

Appendix 1
Table 8: Incidents by location
2007/08 2008/09 2009/10
Total
Total
Total
% of Total
% of Total
% of Total
Referrals
Referrals
Referrals
Referrals
Referrals
Referrals
Started
Started
Started
Own Home 168 15.5% 252 17.2% 341 21.6%
Residential Care
Home
293 27.1% 328 22.3% 446 28.2%
Nursing Care Home 35 3.2% 167 11.4% 129 8.2%
Independent
Healthcare provider _ _
5 0.3% 9 0.6%
Acute Hospital 7 0.6% 21 1.4% 23 1.5%
Community
Hospital
11 1.0% 6 0.4% 12 0.8%
Other Health
Setting
13 1.2% 5 0.3% 24 1.5%
Supported
Accommodation
21 1.9% 25 1.7% 31 2.0%
Day Centre /
Service
81 7.5% 36 2.4% 50 3.2%
Public Place 40 3.7% 47 3.2% 56 3.5%
Education /
Training /
Workplace
4 0.3% 2 0.1%
Establishment _ _
Other _ _ 7 0.5% 23 1.5%
Not known 412 38.1% 566 38.6% 429 27.2%
Extra Care
Sheltered scheme _ _
1 0.1% 4 0.3%
Totals 1081 1468 1579
31

Appendix 1
Source of Referrals
4.26 The source of referrals is presented in Table 9. There has been a
significant increase (77%) in referrals from the Care Quality Commission
and a 54% decrease in the number of referrals from police, bringing the
number back in line with those received in 2007/08.
Table 9: Source of referrals that have been started
2007/08 2008/09 2009/10
Total
Referrals
% of
Total
Total
Referrals
% of
Total
Total
Referrals
% of
Total
Started Referrals Started Referrals Started Referrals
Self referral 31 2.9% 45 3.1% 60 3.8%
Family member 41 3.8% 50 3.4% 80 5.1%
Friend / Neighbour 31 2.9% 65 4.4% 33 2.1%
Residential Care staff 347 32.1% 400 27.2% 398 25.2%
Social Worker / Care
Manager
201 18.6% 221 15.1% 219 13.9%
Primary / Community/Health
staff
41 3.8% 60 4.1% 77 4.9%
Secondary Health staff
(including SPT staff)
127 11.7% _ _ 194 12.3%
Mental Health Staff _ _ 169 11.5% _ _
Care Quality Commission _ _ 39 2.7% 69 4.4%
Housing 29 2.7% 27 1.8% 47 3.0%
Education/Training/Workplace
Establishment
3 0.3% 5 0.3% 3 0.2%
Police 40 3.7% 142 9.7% 65 4.1%
ASC Domiciliary Staff _ _ _ _ 5 0.3%
ASC Day Care Staff _ _ _ _ 17 1.1%
Other Service user _ _ _ _ 4 0.3%
Other 113 10.5% 197 13.4% 243 15.4%
Unknown 77 7.1% 48 3.3% 65 4.1%
Totals 1081 1468 1579
32

Appendix 1
The relationships of the alleged perpetrators of abuse to their victims
4.27 In 2009/10 we revised our reporting codes to enable us to capture data
more accurately. This has resulted in us now being able to show more
detail around the relationship of the alleged perpetrators of abuse to their
victims.
4.28 The table below shows the relationship of alleged perpetrators to their
victims.
Table 10: Relationship of alleged perpetrator to their victim in 2009/10
Relationship to Victim
Total Referrals
Started
% of Total
Referrals
Day Care Staff 5 0.3%
Domiciliary Staff 9 0.6%
Friend 60 3.8%
Health Care Worker 8 0.5%
Main Family Carer 65 4.1%
Neighbour 16 1.0%
Other Family Member 140 8.9%
Other Professional 32 2.0%
Other Service User 247 15.6%
Paid Carer 148 9.4%
Partner 22 1.4%
Perpetrator not known 110 7.0%
Power of Attorney 7 0.4%
Residential Care Staff 177 11.2%
Rogue Trader 7 0.4%
Stranger 15 0.9%
Volunteer/Befriender 7 0.4%
Not recorded/ other 504 31.9%
Total: 1579 100.0%
4.29 Of those that have a relationship recorded, the highest proportion relates to
another service user (247 referrals). The following chart shows the client
group that these service users are allocated under.
33

Appendix 1
1.6%
1.2%
14.6%
61.9%
20.7%
Not Recorded
Other Vulnerable Adult
Physical/ Sensory/ Frailty
Mental Health
Learning Disabilities
4.30 The most common client group where the perpetrator is another service
user is learning disabilities. This is also often the case with clients with
mental ill health and is due largely to two main factors:
• People with learning disabilities who receive support from adult social
care tend to live and/or spend much of their time in shared living
arrangements within group homes or supported accommodation, or within
day services with shared facilities and activity space. These unavoidable
environmental factors may have an impact on the behaviours of some
service users, leading to anxiety and tension and incidents between
service users.
• Behaviours of some service users that appear to have little connection
to the environment but are part of that person’s innate behaviour.
4.31 To minimise the risk of harm from service users, providers of care and
support would be aware of potential triggers and manage peoples’
individual care needs accordingly. The response to these incidents is risk
managed proportionately. Most of these ‘user to user’ incidents are lowlevel,
one-off incidents where no significant harm has occurred and there is
a correlation between the highest frequency being in Learning Disability
Services and the SVA investigations being Level 1 investigations.
The Social Work team managing the case
4.32 The Social work teams that manage the cases are presented in table 11.
The Assessment and Care management team, the Learning Disability
Team and mental health teams manage the majority of cases together,
totalling 1,387 cases. There has been a significant decrease in the number
of cases being managed by Learning Disability, from 33.8% (497) in
2008/09 to 27.9% (440) in 2009/10. There has however been a
considerable increase in the number of referrals that have come from the
Forensic team, increasing from 8 referrals in 2008/09 to 38 in 2009/10,
highlighting an increased awareness in the reporting of possible cases of
abuse in this setting.
Table 11: Social Work team managing the case
2007/08 2008/09 2009/10
34

Total
Referrals
started
% of
Total
Referrals
Total
Referrals
started
% of
Total
Referrals
Appendix 1
Total
Referrals
started
% of
Total
Referrals
Assessment and Care
Management
277 25.6% 564 38.3% 590 37.4%
Hospital Team 91 8.4% 142 9.7% 137 8.7%
Older People’s Mental Health 73 6.8% 93 6.3% 142 9.0%
Working Age - including
Assertive Outreach Team
(AOT) , Crisis Resolution
7 0.6% 14 1.0% 13 0.8%
Home Team (CRHT), Mental
Health Primary Care
Other Mental Health Team 107 9.9% 144 9.7% 202 12.8%
Learning Disability Team 519 48.0% 497 33.8% 440 27.9%
Sensory Team 3 0.3% 6 0.4% 5 0.3%
Substance Misuse 1 0.1% 4 0.3% 5 0.3%
Forensic team 3 0.3% 8 0.5% 38 2.4%
Unknown _ _ _ _ 7 0.4%
Totals 1081 100% 1468 100% 1579 100%
Strategy meetings/ discussions held by service area.
4.33 Depending on the level of the investigation, strategy meetings/ discussions
have a number of objectives including the sharing of information between
agencies, agreeing tasks and timescales of each stage of the investigation
and if necessary, identifying and implementing emergency protection plans
to safeguard a vulnerable adult pending the outcome of the investigation.
4.34 The Strategy meetings/ discussions held by service area are shown in
table 12.
4.35 There has been a significant increase in the number of investigations that
have involved a completed strategy meeting/ discussion. 90.9% of
investigations have a strategy meeting recording. Adult Social Care has set
a target of 100% for 2010/11.
Assessment
& Care
Management
Hospital
Team
Older
Peoples
Mental
Health
Teams
Community
Mental
Health
Teams
Table 12: Ended referrals with Strategy Meetings/ discussions by
Service area
2007/08 2008/09 2009/10
Count of
Ended
Referrals
Referrals
with
complete
strategy
meetings/
discussions
% of
referrals
with a
completed
strategy
meeting/
discussion
Count of
Ended
Referrals
Referrals
with
complete
strategy
meetings/
discussions
% of
referrals
with a
completed
strategy
meeting/
discussion
Count of
Ended
Referrals
Referrals
with
complete
strategy
meetings/
discussions
% of
referrals
with a
completed
strategy
meeting/
discussion
303 125 41.3% 414 348 84.1% 585 580 99.1%
87 17 19.5% 151 121 80.1% 134 134 100.0%
58 41 70.7% 108 95 88.0% 129 106 82.2%
106 19 17.9% 127 51 40.2% 126 114 90.5%
35

Other Mental
Health Team
Learning
Disability
Team
Sensory
Team
Unknown
Totals
Count of
Ended
Referrals
Appendix 1
2007/08 2008/09 2009/10
Referrals
with
complete
strategy
meetings/
discussions
% of
referrals
with a
completed
strategy
meeting/
discussion
Count of
Ended
Referrals
Referrals
with
complete
strategy
meetings/
discussions
% of
referrals
with a
completed
strategy
meeting/
discussion
Count of
Ended
Referrals
Referrals
with
complete
strategy
meetings/
discussions
% of
referrals
with a
completed
strategy
meeting/
discussion
_ _ _ 2 0 0.0% 89 54 60.7%
520 394 75.8% 470 313 66.6% 430 368 85.6%
4 2 50.0% 5 4 80.0% 5 5 100.0%
_ _ _ _ _ _ 4 4 100.0%
1079 598 55.4% 1277 932 73.0% 1502 1365 90.9%
The outcomes of Investigations
4.36 Upon completion of the investigation, an outcome is assigned identifying
whether the allegation was substantiated, unsubstantiated, partially
substantiated or inconclusive. A breakdown of these outcomes is shown in
table 13.
Table 13: Outcome of investigations
2007/08 2008/09 2009/10
Total
Total
Total
% of Total
% of Total
% of Total
Referrals
Referrals
Referrals
Referrals
Referrals
Referrals
started
started
started
Substantiated 263 49.2% 656 44.7% 651 41.2%
Unsubstantiated 66 12.3% 320 21.8% 390 24.7%
Not Determined /
Inconclusive
107 20.0% 256 17.4% 309 19.6%
Partially
Substantiated _ _ _ _
15 0.9%
Unknown
(Blanks)
99 18.5% 66 4.5% 3 0.2%
Others _ _ _ _ 41 2.6%
Not yet
completed _ _
170 11.6% 170 10.8%
Totals 535 1468 1579
4.37 As shown, in 41.2% of cases, the allegation was substantiated. This is a
slight reduction on the 44.7% that were substantiated in 2008/09 however
36

Appendix 1
the number of allegations that were substantiated remain the same. The
increased number of alerts alongside the lower percentage of
substantiated allegations suggests that people are more prepared to report
cases of suspected abuse, including those cases that might not have
previously have been considered serious enough to warrant reporting.
The outcomes for the victims
4.38 It is important that the outcomes for victims are monitored closely as this
can be used in the future to inform models of best practice around how
certain types of abuse are dealt with. The table below provides details
about the outcomes of investigations for the victims:
Table 14: Outcomes for the alleged victims
2007/08 2008/09 2009/10
Total % of Total % of Total
Referrals Total Referrals Total Referrals
started Referrals started Referrals started
Outcomes for Alleged
Victim
Increased Monitoring
Vulnerable Adult
removed from property
or service
Community Care
Assessment and
Services
Referral to advocacy
scheme
Referral to Counselling /
Training
Management to access
to finances
No further action
% of Total
Referrals
215 40.2% 261 17.8% 358 22.7%
24 4.5% 79 5.4% 31 2.0%
5 0.9% 19 1.3% 14 0.9%
1 0.2% 3 0.2% 2 0.1%
6 1.1% 17 1.2% 47 3.0%
4 0.7% 23 1.6% 34 2.2%
58 10.8% 551 37.5% 550 34.8%
37

Outcomes for Alleged
Victim
Guardianship / Use of
Mental Health Act
Restriction /
management of access
to alleged perpetrator
Other
Perpetrator Removed
Provider guidelines/
Risk assessment
revised
Service quality issues
addresses
Refused Intervention
Not yet completed
Total
Total
Referrals
started
Appendix 1
2007/08 2008/09 2009/10
% of Total % of Total
Total Referrals Total Referrals
Referrals started Referrals started
% of Total
Referrals
2 0.4% 1 0.1% 1 0.1%
1 0.2% 27 1.8% 26 1.6%
85 15.9% 95 6.5% 106 6.7%
34 6.4% 73 5.0% 76 4.8%
59 11.0% 67 4.6% 55 3.5%
23 4.3% 51 3.5% 92 5.8%
18 3.4% 31 2.1% 17 1.1%
_ 170 11.6% 170 10.8%
535 1468 1579
4.39 The highest percentage of outcomes has been classified as ‘No further
action’ with 34.8% of all referrals being classified as such. This outcome
occurs when the initial safeguarding plan and investigation has addressed
the issues identified so no further action is considered necessary.
4.40 A further 22.7% of referrals had an outcome of increased monitoring which
includes any investigations that require ongoing monitoring of the
safeguarding plan.
4.41 The results have also shown a reduction every year in the number of
referrals that have resulted in intervention being refused, suggesting that
the outcomes of the referrals are becoming more closely tailored to an
individuals circumstances.
4.42 The following table provides a further breakdown of the most significant
increases and decreases in the outcomes of referrals for the victim.
Table 15: Top 5 increase and decrease in outcomes for alleged victims
%
% increase
decrease
from
from
2008/09 to referrals in
2008/09 to
2009/10 2009/10
2009/10
Outcome - top 5
increases
Referral to Counselling/
Training
Service Quality Issues
Addressed
Management of Access
to Finances
+176% 47
Outcome - top 5
decreases
Vulnerable Adult
Removed from Property
referrals in
2009/10
-61% 31
+80% 92 Refused Intervention -45% 17
+48% 34
Increased Monitoring +37% 358
Other +12% 106
Referral to Advocacy
Scheme
Community Care
Assessment
Provider Guidelines/
Risk Assessment
Revised
-33% 2
-26% 14
-18% 55
38

Appendix 1
4.43 It is encouraging to see a 61% reduction in the number of cases that have
resulted in the vulnerable adult being removed from the property as this
would further increase the level of distress felt by the victim and despite the
action being required to ensure the victims safety, could also have
detrimental effects in the individuals wellbeing.
4.44 There are some cases where a care home is closed down as a result of an
SVA investigation. In these circumstances, the removal of the vulnerable
adult from the property is unavoidable.
The outcomes for the alleged perpetrator
4.45 In 2008/09, one of the main priorities identified was to improve the level of
recording in relation to the outcomes for alleged perpetrators as the results
for that year showed that 61.3% of the referrals (900) had been recorded
as ‘Not known’. Although the numbers of referral outcomes that are
recorded as unknown are still high, it is encouraging to see from the results
below that the proportion has reduced to 53.2% in 2009/10. It is anticipated
that these figures will improve further with the introduction of a new
recording system in 2010/11.
Table 16: Outcomes for alleged perpetrator
For Alleged
Perpetrator /
Organisation / Service
Criminal Prosecution /
Formal Caution
Total
Referrals
started
2007/08 2008/09 2009/10
% of Total % of Total
Total Referrals Total Referrals
Referrals started Referrals started
% of
Total
Referrals
4 0.7% 12 0.8% 5 0.3%
Management Action 13 2.4% 17 1.2% 25 1.6%
Action by
Commissioning
Authority
12 2.2% 6 0.4% _ _
39

For Alleged
Perpetrator /
Organisation / Service
Appendix 1
2007/08 2008/09 2009/10
Total % of Total % of Total % of
Referrals Total Referrals Total Referrals Total
started Referrals started Referrals started Referrals
Police Action 6 1.1% 17 1.2% 16 1.0%
Community Care
Assessment
8 1.4% 26 1.8% 15 0.9%
Removal from
Property or Service
13 2.4% 16 1.1% 27 1.7%
Management of
access to the
1 0.2% 17 1.2% 47 3.0%
Vulnerable Adult
Referred to PoVA List
/ ISA
1 0.2% 8 0.5% 19 1.2%
Disciplinary Action 3 0.5% 33 2.2% 22 1.4%
Counselling / Training
/ Treatment
15 2.7% 10 0.7% 20 1.3%
Action under Mental
Health Act
_ _ 2 0.1% 4 0.3%
Continued monitoring _ _ _ _ 131 8.3%
Exoneration _ _ _ _ 1 0.1%
No Further Action 99 17.9% 215 14.6% 187 11.8%
Not Known 370 66.9% 900 61.3% 840 53.2%
Other 8 1.4% 19 1.3% 50 3.2%
Not yet completed _ _ 170 11.6% 170 10.8%
Total 553 1468 1579
Table 17: Top 5 increase and decrease in outcomes for alleged
perpetrator
Outcome - top 5
increases
Management of access
to the Vulnerable Adult
% increase
from
2008/09 to
2009/10
referrals in
2009/10
+176% 47
Other +163% 50
Outcome - top 5
decreases
Criminal Prosecution/
Formal Caution
Community Care
Assessment
%
decrease
from
2008/09 to
2009/10
referrals in
2009/10
-58% 5
-42% 15
Referred to POVA List +138% 19 Disciplinary Action -33% 22
Counselling/ Training +100% 20 No Further Action -13% 187
Action under Mental
Health Act
+100% 4 Not Known -7% 840
40

Appendix 1
4.46 The results show that the most significant increase in outcomes for alleged
perpetrators is in the management of access to the victim.
Use of the Independent Mental Capacity Advocate Service (IMCA)
4.47 There were 6 Deprivation Of Liberty Safeguards (DOLS) referrals where
the IMCA was involved to speak up for the person or person’s
representative.
4.48 There were 228 other referrals where the IMCA spoke up for the person in
health and social care decisions where the person was befriended.
Deprivation of Liberty Safeguards
4.49 Deprivation of Liberty Safeguards (DOLS) is a lawful means of authorising
the deprivation of liberty for those without capacity in order to carry out
safe care in a person's best interests where no other proportionate way
exists. East Sussex encourages registered managers in care homes and
hospitals to request DOLS for a person in their care whenever necessary.
4.50 Up until the end of March 2010, 158 DOLS referrals were received.
4.51 Most of those needing DOLS continue to be older people in the active
stages of dementia living in care homes and hospitals (95%). A very much
smaller number have been those of working age with Learning Disability,
acquired brain injury or other specialist condition. The DOLS service
continues to be delivered from a small specialist team on behalf of both
Adult Social Care and the Primary Care Trusts across the county, and as
needed for our residents beyond. This work is supplemented by the work
of our IMCA providers POhWER, a national advocacy organisation of high
reputation.
4.52 To date DOLS in the form of unauthorised deprivation of liberty has
resulted in further wider safeguarding investigation on 3 occasions where
the deprivation of liberty was assessed as not in the person's best interests
and therefore unlawful.
Complaints Information relating to Safeguarding
4.53 This year the Complaints Unit recorded 7 complaints about the
safeguarding process, this was a 22% reduction from last year, when we
received 9 complaints. The complainants were all relatives of the service
user/victim.
1 (14%) of these complaints was upheld
2 (29%) of these complaints were partly upheld
4 (57%) of these complaints were not upheld
4.54 There were no clear themes, although shortfalls in communication with the
complainant ran through most complaints. For example:
• 2 complainants felt that the case conference was overwhelming and
their views were not heard.
41

Appendix 1
• 1 of the complaints was because the complainants felt that the SVA
process should not have been undertaken. An off line investigation by a
Community Mental Health Team manager concluded that the Safeguarding
process was necessary given the original allegations made by family
members and that the Deprivation Of Liberty Safeguards action had been
appropriate and taken following legal advice. The recommendations were:
- That the Community Mental Health Team review their communication
process to ensure a lead person is identified to communicate with family
members in complex situations;
- Action plans need to clearly identify who will be responsible for
implementing different aspects; and
- When complaints are made against staff, managers need to give serious
consideration to changing the worker to maintain trust in the service.
• A granddaughter felt that the SVA investigation into the financial
arrangements for her grandmother was inadequate. This included
dissatisfaction that the GP was not approached as part of the SVA
investigation. Again, the matter was complex because of the relationship of
family members. This complaint was not upheld because the person had
capacity and had adequate arrangements in place for the management of
her finances.
4.55 At the request of the Local Government Ombudsman, one complaint went
to an external investigation. The investigation involved a range of complex
issues and the complainant was the alleged perpetrator in the SVA
investigation. The complainant was unhappy about the SVA process
because they felt it was groundless, took too long, meant they were unable
to look after their mother's affairs and East Sussex County Council did not
make available a personal allowance to their mother. The investigation
concluded that there were justifiable grounds for both initiating the SVA
and upholding the allegations.
4.56 This year the Complaints Unit received 31 complaints that were passed
through to Social Care Direct as safeguarding alerts. Issues included:
• 38% possible financial abuse;
• 29% (8% anonymous) poor care and neglect within residential and nursing
home settings;
• 13% concern about staff conduct;
• 8% missed service by home care agencies; and
• 12% other
Summary
4.57 The basis of using activity information to inform what key areas the
partnership needs to focus on will continue.
4.58 Significant improvements have been highlighted from 2008/9 to 2009/10
both in terms of recording and operational practice. There has been a
significant increase in the number of Safeguarding Vulnerable Adults cases
managed by the department.
42

Appendix 1
4.59 Over the last year, improvements to recording have included recording
institutional abuse, a break down of multiple abuse and the recording of the
offer and acceptance of a safeguarding plan. This data will be available for
the coming year.
4.60 To continue these improvements in the future, a number of priorities have
been identified that will ensure not only that any actions undertaken are
recorded and reported accurately, but also that high standards of
operational practice are maintained. These priorities include:
• The implementation of Care Assess, a new recording tool within Adult
Social Care;
• Ensuring cases are recorded as outcomed when the investigation is
closed;
• Aligning the CareFirst recording training and operational training to provide
a comprehensive SVA training package for staff; and
• Monitoring any areas of concern more frequently to ensure that all issues
are addressed promptly.
6 Updates from Partner Organisations
Specialist Investigations Branch
Serving Sussex
43

6.1 Sussex Police (Specialist Investigation Branch)
Adult Safeguarding 2009 – East Sussex
Safeguarding Vulnerable Adults 2010 – East Sussex
Appendix 1
Sussex Police Specialist Investigation Branch (SIB) oversees the policing of
Adult Safeguarding across the whole of Sussex. The Branch representatives
attend the Adult Safeguarding Board and Performance, Quality and Audit
Group. SIB reps. now chair a Pan-Sussex Adult Safeguarding Group which
encourages consistency across the whole of Sussex. Reps. also attend the
Pan Sussex Investigative Training Group to develop expertise in
investigations. Adult Safeguarding investigations continue to be an important
part of the role of the Anti-Victimisation Units (AVU) in East Sussex. The
specialist detectives are now located in Eastbourne and Hastings police
stations managed by one dedicated detective inspector.
In April 2009 the DASH (domestic abuse stalking harassment and honour
based violence) risk tool was introduced in East Sussex and all officers have
had the opportunity to attend briefing sessions. Abuse by family members is
recorded as domestic abuse and DASH has increased the opportunity to
identify vulnerable of victims. Risk management training is now being rolled
out to all officers for a better understanding of DASH and vulnerable adults.
Newly promoted supervisors are trained to identify vulnerability and
safeguarding concerns.
During 2009 police investigators in East Sussex video interviewed 179
vulnerable adult witnesses in the course of investigations, 13 (7%) of these
were recorded as having been joint interviews with a police interviewer and a
trained social worker. A joint ABE refresher/update training event was held at
Slaugham Manor in October 2009 for police officers and social workers to
encourage more use of joint interviewing. The ABE interview process will be
changing to a digital format and an audit process will be developed by SIB to
ensure more accurate data is collected about each interview undertaken.
National data is now being collected on the use of intermediaries; used 9
times in Sussex in the last 6 months of the year. Work is now being done to
increase awareness of this service and encourage more extensive use to
support vulnerable witnesses at court.
The Sussex Police Vulnerable Adult at Risk form is now in use by police
officers and recently became an auditable electronic form. More vulnerable
adults in need are now being routinely flagged to social services by police
officers. Changes to the form have already been implemented based on
feedback from adult services teams and future plans include a secure email
link directly between police and social services to aid communication.
The service at the Saturn Centre (sexual assault referral centre for Sussex)
has continued to develop over the last year. This has included the opening of
a second medical room to avoid delays at busy times. During 2009 a total of
23 vulnerable people from East Sussex used the service and a further 13
vulnerable people self referred.
44

Appendix 1
2010 will see a new Safeguarding Vulnerable Adults Policy for Sussex Police
to incorporate elements of the forthcoming Sussex Policy and Procedures.
This will include a more standardised response to adult safeguarding serious
case reviews which are placing an increasing demand on statutory agency
resources. The introduction of the Domestic Homicide Review process in
2010 will present further challenges but will hopefully improve services across
the board through learning the lessons in every serious case.
From April 2010 we welcome a new head of branch, Detective Superintendent
Jane Rhodes
6.2 South Coast Ambulance Service (SECAmb) Annual
Report Update
Safeguarding the most vulnerable groups within any society is core business
for all health Trusts which includes Ambulance Trusts. The safeguarding
agenda has become increasingly high profile over the last twelve months,
through a variety of consultations and also the publication ‘Death by
Indifference’ and the subsequent Parliamentary and Health Service
Ombudsman response which gives guidance on the provision of public
45

Appendix 1
services to people with learning disabilities. The Department of Health’s work
on tackling inequality, reducing discrimination and celebrating diversity is
closely linked to the safeguarding agenda.
Through the Safeguarding Lead, the Trust has developed links with all adult
safeguarding boards across the Trust geographical area; this includes
engaging with Serious Case Reviews (SCR) with 3 adult reviews involving
SECAmb having been completed during the year 09/10.
The Trust has approved policy and procedures regarding both Child and Adult
Safeguarding. These documents are the foundation for all referrals made by
staff and complement local procedures which differ slightly across the
geographical area covered by the Trust.
Every referral is followed up and feedback regarding the outcome is given to
the reporting staff regarding the outcome. This work is currently undertaken by
temporary staff and is reliant on appropriate staff being available. There have
been periods during this financial year where no support was available; this
has a negative impact on feedback being made to staff due to capacity.
The Trust is also closely monitoring incidents where crews are called to care
settings and a spreadsheet to log all incidents has been developed. This will
enable identification of frequent issues being raised at particular
establishments and closer working with adult social care around safeguarding
all residents of these settings. This work is linked with an action plan
formulated following a serious case review within East Sussex.
The total number of referrals has risen steadily over the past 12 months. The
total number for both children and adult referrals made during 2009-2010 is
1,432. This shows an increase of 174% on the previous year. In East Sussex,
the number of adult referrals has more than doubled over the same period,
going from 31 in 2008-2009 to 73 in 2009-2010. At present it is not possible to
separate social care concerns from those which became safeguarding
investigations, however a review of the database requirements for
safeguarding is being undertaken which should enable this differentiation to
be available in the future.
A national safeguarding forum across the eleven ambulance Trusts in
England has now been developed. This group is specifically targeting the
national agenda where increased value can be achieved through collaborative
working.
46

Appendix 1
Currently work is being focused on the development of national training
requirements including appropriate levels for each skills group and
competency level. Standards for adult safeguarding are being looked into and
will be based on current guidance and best practice.
47

Appendix 1
6.3 This section refers to data reported by Sussex Partnership Foundation
Trust
Safeguarding Vulnerable Adults East Sussex
Annual Report
April 2009 – March 2010
This report records the Safeguarding Vulnerable Adults monitoring statistics
for the four reporting quarters: April - June, July - September, October -
December 2009 and January - March 2010. It also includes all alerts received
retrospective of their quarterly reports (see Appendix 1).
The statistics are collated each quarter following the return of the
Safeguarding Vulnerable Adults Monitoring Forms (Appendix 1) from the
Team Managers from Working Age Adults Mental Health Services, Older
Peoples Mental Health Service, Secure & Forensic Service and SMS*.
Mental Health in Primary Care statistics were collected separately from WAA
in 2009/10.
In 2009/10 there were 358 Safeguarding Vulnerable Adults new alerts
recorded: this compares with 261 reported cases for 2008/09 as indicated
below:
Working Age Adults
Older
Peoples MH
Services
Secure &
Forensic
Service
Totals
05/06 68 63 1 132
06/07 69 44 1 114
07/08 90 61 1 155
08/09 142 3 * 111 5 261
09/10 WAA SMS MHiPC
165 24 11 145 13 358
The year’s quarterly figures are summarised in Appendix 1 of this report.
There has been an ongoing improvement in the rate and efficiency of returns
of the Safeguarding Vulnerable Adults Monitoring Forms from Team
Managers in 2009/10 compared to 2005/06, when its recording began. This is
reflected in the increase in numbers of recorded alerts year on year from each
Care Group. A reminder to all Team Managers is sent in advance of the
quarter end and a further reminder is sent to those who delay in submitting
their return.
The origins of the referrals, the types of abuse recorded, the actions, together
with the Investigations and outcomes of the reported cases, are all
comparable in content to those of 2008/09 and in previous years.
48

Appendix 1
The recording form was reviewed and amended twice in the past year, once
at the beginning of October 2009, with a further amendment made in
November 2009. It now includes the date the alert was received by the Team
together with the client’s Pims number to enable cross-checking of reporting
from the in-patient teams into the Community Mental Health Teams. It should
also ensure non-duplication of recordings, and for audit identification. The
November amendment was an inclusion regarding perpetrators.
The Monitoring Recording form includes reportage of the Level of
Investigation plus whether usage was made of the IMCA service. Three
referrals were made to the IMCA service in 2009/10 2 from Working Age
Adults, one from OPMHS: in all other cases the IMCA service were not used.
Last year approximately 20% of returned forms had this information omitted
but in 2009/10 improvement is such that it has fallen to around 5 - 8%.
Ongoing staff training in safeguarding issues continued in 2009/10 with the
one day Investigating Officer and one Day Investigating Managers courses, as
well as Safeguarding Basic Awareness training and the one week ABE
course. Staff from all Care Groups have made good use of the on-line SVA e-
learning package available through the intranet and the uptake of this has
steadily increased since its inception in May 2009. Staff feedback on this
learning is that it is extremely useful, user-friendly and assists in their
understanding of SVA issues in their day-to-day work.
49

Appendix 1
Summary of Safeguarding Vulnerable Adults Quarterly Statistics
1 April 2009 – 31 March 2010
Alerts by Care Group
April –
June 09
July –
September
09
October –
December
09
January –
March 10
Total (No)
= WAA + OPMHS + SMS +
Secure + Forensic & MHiPC
Working Age Adults 42 47 49 27 165
Older Peoples Mental Health
Services
46 41 30 28 145
Mental Health in Primary Care 1 4 - 6 11
Secure & Forensic Service 3 1 4 5 13
Substance Misuse Service 0 3 6 15 24
Total Cases 92 96 89 81 358
50

Appendix 1
6.4 East Sussex Downs & Weald and Hastings & Rother
PCTs and NHS East Sussex Community Health
Services
General overview of the year
The year has been eventful within the PCTs and for its community provider
organisation, NHS East Sussex Community Health Services (ESCHS) which
is now functioning as an ‘arms length’ organisation, in preparation for
complete separation from the PCTs by April 2011. This has required both
parts of the organisations to review their governance arrangements for
Safeguarding for both adults and children, and for these to be clear to all staff
providing care.
Although relationship has been in place for a longer time period with the acute
unit, it has been identified that for both ESHT and ESCHS there is a gap,
which is to have in place monitoring and reporting arrangements of Adult
Safeguarding events to the PCT. This includes the need for the PCTs to have
a clear method of challenging and holding both organisations to account. As a
result of this we are including ‘Safeguarding’ as an agenda item at the
quarterly Clinical Quality Review Group meetings with ESHT and ESCHS.
The PCTs are working closely with South East Coast hub to devise and have
in place a standard contract for nursing home providers. This contract will
measure and monitor the quality of the Safeguarding processes which are in
place in order to achieve the ‘referred Provider’ status. This includes having
reporting systems for Safeguarding events in place both to CQC and to the
PCTs thereby ensuring compliance with Sussex Multi-Agency Policy, that
there is robust medicines management processes in place, that there is
appropriate annual training for Safeguarding Vulnerable Adults for staff. In
addition homes will be asked to provide monthly reports which will include
measures identifying SVA events, and these will be monitored and questioned
by the PCTs.
What’s worked/ing well / challenges
Worked well:
A strong intention exists between the PCT and its partner organisations to
work together to develop processes which will help protect patients. This
includes clear guidelines for staff about dealing with Safeguarding events, and
reporting pathways to the Board.
Challenges:
Ensuring there are no gaps in the governance arrangements within the PCT
and that robust reporting arrangements are in place with our provider
organisations.
Developments, achievements & work undertaken
The community provider has developed a process for adult safeguarding
which will operationalise the multi-agency safeguarding policy at a local level.
A recent Serious Case Review has identified gaps in skills and knowledge
51

Appendix 1
within the clinical and management staff of the commissioning arm of the
PCT; an action plan is in place to address these.
Work undertaken (including any relevant data re activity):
As above, a Serious Case Review has identified a number of gaps in
managing Safeguarding issues. This has included training needs for PCT
nursing staff; the need to raise awareness with independent contractors such
as GPs, and reporting and the development of a robust governance process
for the PCT.
Future plans / priority areas for 2010/11 &/or beyond:
The SCR identified training needs within the PCTs.
Further work for the PCT in the development of robust governance processes.
Any other information / areas / issues
Training is being planned for relevant staff within the PCT and this will include
ensuring they understand how to identify and report on safeguarding events.
East Sussex Community Health Services (ESCHS)
We have always enjoyed a good working relationship with both the East
Sussex Primary Care Trusts and we continue to work together in order to
protect vulnerable adults within our services. We have strengthened our
reporting guidelines in line with recently published recommendations from the
Department of Health (Clinical Governance & Adult Safeguarding- An
Integrated Process, Feb. 2010) while maintaining our focus on raising staff
awareness in identifying and reporting SVA concerns. ‘Safeguard’ our
‘incident reporting system’ now contains a mechanism where we can identify
and report on SVA incidents which occur within our services. This will enable
us to better record the number of incidents which occur and to monitor the
outcomes.
We continue to work very closely with our fellow providers of care i.e. Adult
Social Care (ASC) & East Sussex Hospitals Trust (ESHT) through the SVA
Board and it’s ‘working groups’ in order to develop and maintain a cohesive
approach across all our services in order to protect vulnerable adults. Through
our dedicated SVA Lead post we are able to contribute nursing advice to the
investigation of allegations of adult abuse. This is greatly enhancing our joint
working approach.
Our contractual arrangement with Adult Social Care to provide a ‘Deprivation
of Liberty Safeguards (DOLS) Assessment service continues to operate very
well. We also continue to provide a Best Interest Assessor (BIA) through our
SVA lead to support this service and to carry out assessments which would
represent a conflict of interest for our colleagues in ASC. We continue to
carry out our role as a ‘Supervisory Body’ in signing off DOLS orders in
relation to ESHT and all other hospitals within our area. We have seen a
steady rise in the number of authorisations we are being asked to sign,
We continue to work hard to develop our joint training capability with our
partner organisations ASC & ESCHS. We are fully committed to playing our
part in the planned introduction of a pilot scheme starting this September to
52

Appendix 1
introduce a joint SVA training session across all of our organisations. This a
very exciting development which we hope will be well received and promote
even better working relationships across all our organisations.
We also to continue to play our part in the Sussex wide NHS Leads Network
as well as becoming fully involved in the emerging NHS South East Coast
Adult Safeguarding Network.
53

6.5 East Sussex Hospital Trust Safeguarding Adults
Appendix 1
General overview of the year
• Robust training on level 1 & 2 with multi disciplinary input on Level 2.
• Heightened awareness of SVA with an increase in referrals from Trust
staff.
• Increased training sessions.
• Provision of e-learning jointly purchased by Adult Social Care and
Primary Care Trust.
• Progressing work on electronic register for safeguarding referrals.
• Continuing work within the East Sussex Hospital Trust Safeguarding
Group
What’s worked well/challenges
• Obtaining professional help with the electronic register.
• Joint work on delivering training in a multi agency training programme.
• Inter agency collaborative working.
• Developing and making the East Sussex Hospital Trust Safeguarding
Group more robust and functional.
Developments, achievements & work undertaken
• Plan for a deputy to the Safeguarding Lead, which will support and
assist with Safeguarding Vulnerable Adults within East Sussex Hospital
Trust.
• Continuing to have Learning & Development input and support from the
Trust’s Learning & Development Department.
Work undertaken
• Obtaining professional help with making the Safeguarding Vulnerable
Adults database more robust so as to deliver reports and information to
relevant groups and source areas for further training.
• Working with the NHS Safeguarding Vulnerable Adults South Coast
forum in a bid to ensure consistent practice amongst our NHS
organisations.
• Developing the ‘outcomes’ of the Safeguarding Vulnerable Adults
process to ‘close the loop’ in the procedure.
54

Appendix 1
• Developing the Serious Untoward Incidents as part of the Safeguarding
Vulnerable Adults process.
Future plans / priority areas for 2010/11 &/or beyond
• Review the multi agency joint training programme pilot with a view to
making this a permanent venture.
• Submitting reports and information to the relevant Trust Boards and
Safeguarding Adults Board generated from the developing electronic
database.
• Reviewing East Sussex Hospital Trust Safeguarding Vulnerable Adults
Policy and including Serious Untoward Incidents with pathways for
reporting both to the SHA and to Adult Social Care under
Safeguarding.
• Appointing a deputy to the Safeguarding Lead so as to support and
ensure consistency in the working of the two hospitals.
55

Appendix 1
6.6 Registered Care Homes Association (RCHA)
The Registered Care Homes Association is represented on the Safeguarding
Vulnerable Adults Board by its Chairman, and members of its Executive
Committee continue to attend Safeguarding meetings where this is
appropriate to support service providers when requested to do so.
The RCHA is committed to working with providers and other agencies to
ensure that adults are protected from abuse and makes its website
CAREFINDER available to Adult Social Care to inform all care providers of
their responsibility in Safeguarding matters
It will rigorously report any incidents of abuse that comes to its notice.
The RCHA also provides on its website, Policies and Procedures in respect of
Safeguarding which it expects its members to adhere to
The Association works with Adult Social Care to ensure a response to
Safeguarding interventions where member service providers are involved.
56

6.7 Trading Standards
Appendix 1
Dealing with and protecting vulnerable consumers is now very much a part of
the ‘day job’ for the officers of East Sussex Trading Standards Service.
Although the core work is, advice, education and intervention, below are three
areas of work that have been catching the public’s attention:
Buy With Confidence
The Buy With Confidence Scheme continued to grow. 83 businesses have
joined the scheme since April 2009 with a further 53 applications in progress
bringing the total number of businesses in the scheme to 362.
No Cold Calling Zones
Trading Standards has worked in partnership with Neighbourhood Watch,
District and Borough councils, community groups and Sussex Police to launch
a further 5 zones this year.
Scamnesty
During February 2010 an advertising campaign was launched to raise the
profile ‘Scamnesty’ across East Sussex. Posters were put up in participating
libraries who took part by taking in scam mail from consumers. Commercials
were run on Heart fm, Sovereign fm and Arrow fm throughout February giving
a reach of over 220,000 people. Advertisements were placed in the local
newspapers promoting Scams Awareness giving a reach of around 250,000
people.
In addition to this we also issued regular press releases throughout the month
of February which were covered in a range of Sussex newspapers and also
sent by email to 1855 Neighbourhood Watch Contacts.
In total, over 7000 scam mailings were received and of these 5650 were
recorded and entered onto a spreadsheet for intelligence purposes.
As part of this project we have also made 39 interventions, designed to break
the cycle of victimisation. One of the interventions involved collecting over
3,500 letters from a sixty year-old gentleman in Hastings who has been
sending approximately £400 per calendar month for at least the last ten years.
Another successful intervention was made when a post office worker
successfully stopped an elderly gentleman from transferring £2600 via
Moneygram.
Most of the mailings come in from abroad making taking effective enforcement
action difficult, however in November 2009, based on intelligence gathered
from a previous “scamnesty” East Sussex County Council took Court action
against a UK registered company and individual Directors, who had sent out
136,000 misleading mailings, generating hundreds of complaints. The case
received prominent coverage in the Daily Mirror.
57

Local Life Show 2011
Appendix 1
We are planning to run the Local Life Show for its fourth year on the 19 th
March 2011. The event will be sponsored by Moira House Girls School and
Waitrose as well as by our media partner Sovereign FM. Once again we will
have The Community Chef and East Dean Farmers Market alongside talks
from Make it and mend it, an organisation that aim to empower people to ‘use
more and throw away less’. There are also plans for a children’s area
featuring Mr and Mrs Doak’s bumper bookshop for boys and girls who will be
running story time throughout the day, there will also be a face painter for all
the little ones to enjoy.
Trading Standards Advertiser column
Trading Standards are fortunate enough to now have a weekly column in the
Eastbourne and District Advertiser that will feature stories on current and
relevant Trading Standards issues, Information on consumer advice and other
schemes run by the department such as Buy With Confidence our approved
trader scheme and Support With Confidence our scheme to approve local
providers of care and support services.
Trading Standards Newsletter
Although only in the early stages Trading Standards plan to release a monthly
newsletter to feature articles from the Advertiser column, information on
consumer rights, practical guidance to protect yourself from criminal and
unfair trading, information on the latest scam warnings, information about
businesses that you can trust through our approved trader scheme – Buy With
Confidence and the opportunity for residents of East Sussex to get involved
by telling us which areas are most important to them.
With the help of the County Communications team every opportunity is taken
to publicise the above schemes. Promotion of schemes and campaigns both
to the public, our partner agencies and other stakeholders will hopefully give
further benefit to all our residents.
58

7 Self-Directed Support in East Sussex
Appendix 1
As part of the implementation of Self-Directed Support (SDS) we have
developed a choice and risk framework to support risk taking and promote
safety.
East Sussex has systems in place to enable CRB checks for individuals who
use Direct Payments and Individual Budgets.
Information leaflets have been produced to promote uptake as well as
information about abuse and the selection of personal assistants.
Adult Social Care and Trading Standards have worked together to introduce a
new scheme to approve local providers of care and support services.
This means more flexibility and responsiveness for those that need help. They
could use different businesses and services in their local area to help them
live as independently as possible for longer in their own homes.
To make the most of this opportunity people need more information and
advice to be able to make good choices about their care and support. People
who are buying their own care, whether funded by social care or privately,
need to make informed choices to help them live independently in their own
homes.
The Support With Confidence scheme will include providers of care and
support services who are currently unregulated by formal inspection regimes.
Demand and competition to provide these services in this emerging market is
increasing.
The scheme will help service users to select providers and Personal
Assistants they will feel happy with, on grounds of quality and safety.
How does it work?
We make checks on each provider's background, their qualifications and
experience, customer service and compliance with legal standards.
Approved scheme members are vetted and trained before they join. They
agree to:
• ensure that they and their staff are properly trained for their work
• respond promptly and appropriately to customer complaints
• an Enhanced Criminal Records Bureau clearance
• provide references as part of their application
• undertake any appropriate training.
Trading Standards and Adult Social Care will monitor scheme members once
approved.
What will it look like?
Once up and running, the public will be able to find service providers through
a database much like the existing Buy with Confidence scheme for
everyday goods and services:
59

Appendix 1
Who can apply?
We are inviting applications from businesses, providers and individuals which
provide any of the following services:
• Personal Assistants (where people use their social care funding or their
own money to engage people to support them)
• cleaning and housework
• shopping services
• meal preparation or cooking in the home
• meal services
• daytime opportunities, such as leisure and recreational activities
• community and mobility equipment and adaptation services
• home repair and maintenance
• gardening
• taxi or transport services
• pet services.
60

8 Deprivation of Liberty Safeguards
Appendix 1
Key terms and abbreviations:
MCA: Mental Capacity Act 2005
DOLS: Deprivation of Liberty Safeguards 2007, protects people’s freedom/
best interests
CQC: Care Quality Commission
Authoriser: Manager delegated to agree a deprivation of liberty in a
person’s best interests
BIA: Best Interest Assessor
ASC: Adult Social Care
PCT: Primary Care Trust
S12 doctor: A mental health doctor trained in DOLS
IMCA: Indpendent mental capacity advocate for ‘unbefriended’
Unbefriended: A person without friend or family member who can speak up
for them
POhWER: Advocacy organisation
SCIE: Social Care Institute for Excellence
ADASS: Association of Directors of Adult Social Services
Ordinary Residence: Term to determine who funds a person in care
LIN: Local Implementation network
1. General overview of 2009-10:
1.1 Over the first year of development of the new law, a comprehensive
Deprivation of Liberty Safegaurds (DOLS) and Mental Capacity Act (MCA)
training strategy of the several hundred care home managers, CQC staff,
hospital and social care staff has taken place across the county. This direct
training has been supported by information, guidance and production of a
DVD ‘Knowing You Matter’ for the public and staff and e learning for staff
and carers which links DOLS with the MCA and safeguarding. Best Interest
Assessor (BIA) university based training is established on an annual basis
with 10 trained BIA qualified staff in ASC and 1 in PCT currently. Interface
and refresher training runs for BIAs and doctors. The joint ASC PCT BIA
panel provides quality assurance and approval of best practice. Peer
reflection sessions act as a learning forum for the BIAs drawn from social
work, occupational therapy and nursing.
1.2 95% of the 158 DOLS referrals made were for older people with dementia.
Care homes have been the main referrers to date and this is expected to
continue to be the case, although compliancy in MCA and DOLS into CQC
criteria for registration for hospitals in April 2010 is anticipated to increase
hospital referrals. (16 in 2009-10) DOL can be prevented and often made
unnecessary by sound care planning and regular review by homes and
wards. The DOLS primarily safeguard best interests by advice and
enforceable conditions. The increasing awareness of DOLS is reflected in
the higher number of granted authorisations as managing authorities
become confident of the positives of seeking DOLS for the protection of the
relevant person and of their organisation.
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Appendix 1
1.3 Authorisation of DOLS, ensuring BIA, S12 doctors and IMCA standards and
action on unauthorised deprivation of liberty is undertaken by the current
DOLS implementation lead. Authorisation gives the person detained and
their representative automatic and free right of challenge to the courts. To
year end March 2010 no East Sussex authorisation had been challenged in
court. This is not to say there have been no tensions between those
assessing and representing the person’s best interests, care homes, wards
and the supervisory bodies in carrying out DOLS duties. Rather it is seen as
a reflection of the high quality of the assessment and authorisation work in
seeking local resolution, agreement and understanding in this complex area
of work. The quality of local work is well regarded nationally, with East
Sussex MCA and DOLS audit and learning tools selected for national show
casing on the SCIE website.
2. MCA DOLS service development 2009-10
• DOLS Best Interest Assessor team set up with dedicated, pool and PCT/
out of county BIAs coordinated by a lead senior and administrator.
• Pan Sussex IMCA and s12 doctors arrangements with POWhER and the
PCT established and running well.
• Authorisation sign off system (DOLS implementation lead and heads of
service in ASC and equivalent in PCT)
• Shared ASC/ PCT DOLS arrangements on joint funding and support of
the DOLS team
• Reciprocal pan Sussex arrangements for ‘in house’ DOLS
• East Sussex contribution to National ADASS protocols on interagency
DOLS arrangements.
• East Sussex contribution to National ADASS protocol on Ordinary
Residence
• East Sussex contribution to SCIE web based tools on MCA and DOLS
• Inter agency BIA quality assurance panel and action learning sessions
• Continuing strong performance on DOLS in the emerging national picture.
• Quarterly Local Implementation Network strengthened by Ambulance
Trust attendance
• ‘Buy with Confidence’ Scheme expanded to include will writers and
solicitors offering assistance with Power of attorney and advanced
decisions.
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3. Future plans for 2010/11 and beyond
Appendix 1
Emerging case law, media attention and the political take on the state and rights
of the individual are the current key drivers which may expand, or shrink, the
scope of DOLS. If, as the current White paper suggests, PCTs cease in 2012,
their responsibilities on DOLS may realign to the local authority along with other
areas of public health accountability.
The implementation work is set to continue via the Local Implementation Network
throughout 2010-11. Trialling of a rota of BIAs ready to respond to the requests
for DOLS made by care homes and hospitals will start in July 2010.
Continued Department of Health implementation funding of the MCA and DOLS
is highly uncertain for both the local authority and the primary care trusts beyond
April 2011. This statutory responsibility for safeguarding those in care homes and
hospitals creates additional pressure at a time of severe constraint at national
and local levels.
Consideration will be given in 2010-11 to where DOLS should sit in operational
terms in ASC and the PCTs 2011 and beyond and how it is best funded as a part
of the core statutory safeguarding responsibility of both organisations. Meantime,
it continues to develop and safeguard the freedom and protect the best interests
of people with a mental health disorder and lacking capacity.
63

9 Quality Monitoring Team
Appendix 1
General overview of the year
The Quality Monitoring Team have made a positive difference to the outcomes of
safeguarding investigations where there have involved regulated procedures.
What’s worked well/challenges
Working well:
The Quality Monitoring Team has noted an increase in referrals involving care
providers.
The Quality Monitoring Team are providing background reports on providers for
safeguarding investigations and some improvement in working with providers is
noted.
As the volume of safeguarding work is increasing, this has implications for the
capacity of the Quality Monitoring Team to respond. Adapting to different
practices, in operational teams across the county has also been a challenge.
Developments, achievements & work undertaken
The Quality Monitoring Team were more involved in Learning Disability work
involving care homes during the year and some follow-up audits of providers
three months after close of investigation were successfully and usefully achieved.
A program of supporting care homes where rated 0* or 1* has selectively
improved care standards, and hopefully in turn reduced the recurrence of
safeguarding concerns in these homes, and generally acted in a positive
preventive way.
During the year the Quality Monitoring Team has established a positive presence
in the safeguarding arena involving independent providers.
Work undertaken
Maintaining a database of provider complaints and safeguarding concerns to
support investigations, through background reports; advice and guidance on
provider business practice issues; and some joint investigations where Level 4
investigations involved.
Future plans/priority areas for 2010/11 &/or beyond
• The level of notification to the Quality Monitoring Team is increasing since
the changes to the IT reporting system, CareAssess, instituting a ‘prompt’
to notify the Quality Monitoring Team.
• Providing background reports to Level 3/4 investigations will be sustained.
• Joint work with the PCT will be developed on monitoring care homes
where continuing health care funding is involved; and probably heighten
focus on health care issues: pressure sores, infection control and
medication
64

Looking back from 2009/2010
Appendix 1
The East Sussex Safeguarding Adults Board (SAB) has had a busy year
ensuring there is effective and consistent multi-agency working across all the
relevant agencies and organisations.
The key areas of development during 2009/2010 were:
• A high profile campaign to raise stakeholders and public awareness of
Safeguarding Adults at Risk
• Developing a Provider Protocol to ensure agencies that provide support to
vulnerable adults are aware of their roles and responsibilities and the
appropriate action to take
• Developing Multi-Agency training for raising awareness of Safeguarding
Adults at Risk
• The introduction of the East Sussex SVA Trainer Forum and Training
Approval Scheme
• Developing representative robust data for monitoring, reporting and
evaluation. This has highlighted the following:
o A reduction in numbers of investigations that have been informed as
inconclusive suggesting a more thorough and detailed investigations.
In addition, areas for development have been identified from the Serious Case
Review and a multi-agency action plan is being developed for the SAB.
Planning Ahead
The SAB has agreed a set of priorities for the coming years to 2012 which will be
kept under review.
• Support should be in place to prevent abuse occurring
• All partner agencies and organisations and partners across the community
of East Sussex will actively work together
• Ensure access to information is available about how to gain safety from
abuse and violence
• Ensure people involved in supporting adults at risk have the appropriate
knowledge and skills to undertake their responsibilities
• Implement the improvement plan arising from the Serious Case Reviews
• Continued development of data driven analysis and quality assurance
processes, to ensure information that is captured reflects the work that has
been undertaken and we have robust reporting mechanisms.
65

Contributor organisations to East Sussex Safeguarding
Vulnerable Adults Annual Report
Appendix 1
Sussex Police
South East Coast Ambulance Trust
Trading Standards
East Sussex Hospitals Trust
East Sussex Downs and Weald and Hastings and
Rother Primary Care Trusts
Sussex Partnership NHS Foundation Trust
Registered Care Home Association
Adult Social Care
66