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Lewisham Safeguarding Adults Board

Partnership Compact and Strategic Business Plan 2022-2023

1. Introduction

This document describes how organisations and their representatives on the Lewisham Safeguarding Adults Board (LSAB) will work together in partnership to safeguard the residents of Lewisham in 2022-23. It is based on the statutory functions of Safeguarding Adults Boards as set out in the Care and Support Statutory Guidance, issued and updated from time to time by the Department of Health and Social Care.

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

1.1 The aims of adult safeguarding:

  • stop abuse or neglect wherever possible;
  • prevent harm and reduce the risk of abuse or neglect to adults with care and support needs;
  • safeguard adults in a way that supports them in making choices and having control about how they want to live;
  • promote an approach that concentrates on improving life for the adults concerned;
  • raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect;
  • provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or well-being of an adult; and
  • then address what has caused the abuse or neglect.

1.2 Six key principles underpin all adult safeguarding work:

  • Empowerment – people being supported and encouraged to make their own decisions and informed consent.
  • Prevention – it is better to take action before harm occurs.
  • Proportionality – the least intrusive response appropriate to the risk presented.
  • Protection – support and representation for those in greatest need.
  • Partnership – local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
  • Accountability – accountability and transparency in delivering safeguarding.

1.3 Safeguarding duty: (this applies to an adult who)

  • has needs for care and support (whether or not the local authority is meeting any of those needs) and;
  • is experiencing, or at risk of, abuse or neglect; and
  • as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.

2. What is abuse and / or neglect?

The criteria set out in section 1.3 above need to be met before the issue is considered as a concern under the statutory safeguarding duty. Exploitation is a common theme in the following list of the types of abuse and neglect.

  • Physical abuse: including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.
  • Domestic abuse: including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence. A new definition is outlined in the Domestic Abuse Act 2021 including a description of ‘personally connected’.
  • Sexual abuse: including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.
  • Sexual exploitation: This is when a sexual act takes place in exchange for things like food, shelter, protection, or to pay bills, and the victim may have been coerced or manipulated into this sexual act.
  • Psychological abuse: including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
  • Financial or material abuse: including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
  • Modern slavery: encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
  • Discriminatory abuse: including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion (including Hate Crimes).
  • Organisational abuse: including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.
  • Neglect and acts of omission: including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.
  • Self-neglect: this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding.

3. The statutory functions of Safeguarding Adults Boards

    As set out in Care and Support Statutory Guidance, issued by the Department of Health and Social Care, each Safeguarding Adults Board should:

    • identify the role, responsibility, authority and accountability with regard to the action each agency and professional group should take to ensure the protection of adults;
    • establish ways of analysing and interrogating data on safeguarding notifications that increase the SAB’s understanding of prevalence of abuse and neglect locally that builds up a picture over time;
    • establish how it will hold partners to account and gain assurance of the effectiveness of its arrangements;
    • determine its arrangements for peer review and self-audit;
    • establish mechanisms for developing policies and strategies for protecting adults which should be formulated, not only in collaboration and consultation with all relevant agencies but also take account of the views of adults who have needs for care and support, their families, advocates and carer representatives;
    • develop preventative strategies that aim to reduce instances of abuse and neglect in its area;
    • identify types of circumstances giving grounds for concern and when they should be considered as a referral to the local authority as an enquiry;
    • formulate guidance about the arrangements for managing adult safeguarding, and dealing with complaints, grievances and professional and administrative malpractice in relation to safeguarding adults (which includes whistleblowing: see 5.4.3 to 5.4.7 of the London Multi-Agency Adult Safeguarding Policy and Procedures);
    • develop strategies to deal with the impact of issues of race, ethnicity, religion, gender and gender orientation, sexual orientation, age, disadvantage and disability on abuse and neglect;
    • balance the requirements of confidentiality with the consideration that, to protect adults, it may be necessary to share information on a ‘need-to-know basis’;
    • identify mechanisms for monitoring and reviewing the implementation and impact of policy and training;
    • carry out Safeguarding Adult Reviews;
    • produce a Strategic Plan and an Annual Report;
    • evidence how SAB members have challenged one another and held other boards to account; and,
    • promote multi-agency training and consider any specialist training that may be required; including considering any scope to jointly commission some training with other partnerships, such as the Lewisham Safeguarding Children’s Partnership Board.

    The Strategic Business Plan for 2022-23 sets out how the LSAB partner agencies will collectively prioritise and deliver these functions over the next 12 months.

    4. Lewisham Safeguarding Adults Board (LSAB) Terms of Reference

    The LSAB works to prevent harm or neglect and to help those harmed by leading on and facilitating the following safeguarding adult activities for the borough:

    • Strategic planning: activities such as consultation, setting goals and objectives, action planning and prioritisation, securing resources, tracking and review of implementation and goal achievement for safeguarding strategy. In addition the LSAB will influence and link to strategic planning and commissioning across the partnership to advise and scrutinise in relation to safeguarding adults.
    • Setting standards and guidance: activities such as setting standards to be achieved, developing policies and procedural guidance to guide practice towards those standards. Monitoring and auditing the implementation of these policies and procedures.
    • Quality assurance: lead and ensure activities such as monitoring, audit and review of practice, review of serious cases, incorporation of research and national guidance are undertaken as required. Conducting audits to ensure the effectiveness of what is done by agencies individually and collectively to safeguard and promote the welfare of adults at risk. Commissioning Safeguarding Adult Reviews and / or other reviews of incidents or organisations when an adult dies or is seriously harmed and abuse or neglect is suspected or proven.
    • Promoting participation: by people who use services and carers in safeguarding practice. Promoting awareness and action in the wider community.
    • Awareness raising & publicity: activities such as public awareness campaigns, targeted publicity and educational strategies, raising awareness within services.
    • Capacity building and training: activities such as training and workforce development.
    • Relationship management: activities such as the negotiation and clarification of interagency roles and contributions, member agency compliance, troubleshooting and resolution of difficulties, liaison with wider partnerships and related areas of practice. In addition, undertake work as appropriate with the Lewisham Safeguarding Children’s Partnership Board, Safer Lewisham Partnership and Lewisham Health and Wellbeing Board to ensure that policy and procedures, training and all other activities are co-ordinated and coherent.

    4.1 Care and Support Statutory Guidance

    Members of a SAB are expected to consider what assistance they can provide in supporting the Board in its work. This might be through payment to the local authority or to a joint fund established by the local authority to provide, for example, secretariat functions for the Board. Members might also support the work of the SAB by providing administrative help, premises for meetings or holding training sessions. It is in all core partners’ interests to have an effective SAB that is resourced adequately to carry out its functions.

    Members who attend in a professional and managerial capacity should be:

    • able to present issues clearly in writing and in person;
    • experienced in the work of their organisation;
    • knowledgeable about the local area and population;
    • have a thorough understanding of abuse and neglect and its impact;
    • understand the pressures facing front line practitioners;
    • able to explain their organisation’s priorities;
    • able to promote the aims of the SAB; and,
    • able to commit their organisation to agreed actions*.

    * While board members representing their organisations are expected to have the authority to commit their organisation to agreed actions, those board members representing Sub-Groups or non-service provider organisations may not have the relevant authority. In their case their role is to liaise between the Board and the Sub-Group and take back to their own organisations any proposals or recommendations for action.

    Each member of SAB must co-operate and contribute to the carrying out of a Safeguarding Adults Review (SAR) with a view to:

    1. identifying lessons to be learnt from the adult’s case, and
    2. applying those lessons to future cases.

    4.2 The responsibilities of members of the LSAB

    The Lewisham Safeguarding Adults Board has an Independent Chair and Deputy Chair from one of the Board’s partner agencies.

    The LSAB expects board members to:

    • develop and maintain effective working arrangements based on trust and mutual understanding;
    • be an active partner in safeguarding and promoting the welfare of adults at risk of harm or neglect;
    • contribute to the LSAB financially or by providing staff for particular tasks;
    • collate and provide management information as required by the LSAB and contribute to quality assurance arrangements;
    • share information to safeguard adults in line with agreed information sharing arrangements;
    • commit to the work of the Board by undertaking allocated tasks or sourcing the appropriate support from within their agency to undertake the work and contributing to discussions;
    • identify and support staff to participate in the interagency activities of the LSAB through their active membership of the Sub-Groups and / or Task & Finish Groups, and to progress of the work of the Board between meetings;
    • ensure that the policies, procedures, guidance, tools and resources in the Lewisham Adult Safeguarding Pathway are disseminated and acted upon in an effective way within their own organisations;
    • ensure that communications are cascaded through organisations, services and to front-line staff as appropriate;
    • represent the LSAB and its activities within their own organisation and within any groups they represent on the Board;
    • report difficulties with own organisation and between organisations to the LSAB and work with partners to find effective solutions.

    4.3 Organisations represented on the LSAB

    1. Age UK Lewisham and Southwark
    2. Bromley, Lewisham and Greenwich MIND
    3. Department for Work and Pensions – South London District
    4. Healthwatch Lewisham
    5. Lewisham & Greenwich NHS Trust
    6. Lewisham Adult Social Care
    7. Lewisham Children & Young People’s services
    8. Lewisham Refugee and Migrant Network
    9. Lewisham Safeguarding Children Partnership (LSCP)
    10. Lewisham Homes
    11. Lewisham Joint Commissioning Group
    12. Lewisham Public Health
    13. Lewisham Public Protection and Safety
    14. Lewisham Strategic Housing Services
    15. London Ambulance Service
    16. London Fire Brigade
    17. Metropolitan Police, Lewisham (South East BCU)
    18. National Probation Service, Lewisham and Bromley
    19. NHS South East London Clinical Commissioning Group
    20. South London & Maudsley NHS Foundation trust

    There will also be representatives from partner agencies on Sub-Groups.

    4.4 Governance and accountability

    • The LSAB is responsible for ensuring organisations are meeting their safeguarding obligations effectively, and will hold them to account if they are not.
    • As individuals, Board members are accountable to their own agencies but the Board as a whole will be accountable to the Department of Health and Social Care, and provides reports locally to the Health and Wellbeing Board and the Healthier Communities Select Committee. Its work may be scrutinised periodically by the Overview and Scrutiny Committee and is liable to be inspected at any time by the Care Quality Commission (CQC).
    • The Board, through the independent chair, is accountable to the Chief Executive of the Local Authority, the Chief Executive of the CCG and the Borough Commander of Police.
    • These Executive Group of agencies may periodically meet to discuss the strategic direction of the Board, and additionally invite the London Fire Brigade Borough Commander, Chief Executive of Lewisham & Greenwich NHS Trust, and Chief Executive of the South London & Maudsley NHS Foundation Trust to join this group.

    4.5 Equality and fairness

    • The LSAB operates on the basis of principles which actively value the benefits of diversity and which ensure fair treatment in service delivery. This will include both equal access to and outcomes from local service delivery.
    • The LSAB will seek, so far as it is practicable, to ensure equality of representation and participation in the local democratic process of which it is a part.
    • The LSAB will, through its composition and ways of working, seek to inform, support, involve and give a voice to all sections of the local communities it serves, with particular emphasis on the inclusion of black, Asian and minority ethnic groups, faith communities and those living with a disability. It will seek to ensure an appropriate gender balance in its membership, so far as this is practicable.

    4.6 Dispute resolution between LSAB Members – escalation policy

    In order for practitioners and agencies to work together effectively to safeguard adults at risk, ‘professional challenge’ should be seen as part of a healthy working relationship.

    Successful partnership working is reliant upon resolving professional disagreements in a timely manner in order to avoid any potential risks to the adult(s) in question.

    • As far as possible any inter-agency disputes should be resolved by negotiation and discussion between the practitioners directly involved.
    • If this does not bring the matter to a satisfactory conclusion this should be escalated through the hierarchies of the agencies up to senior management level if needed.
    • If this still does not lead to a constructive and positive outcome the issue should be referred to the Executive Group in writing via the Chair of the LSAB. The group will consider whether it is necessary to establish a panel consisting of no less than three members from constituent organisations, who have no direct involvement in the matter. Appropriate representation from LSAB member(s) of the agencies involved in the dispute will then be invited to attend a resolution meeting. A formal agreement to resolve the dispute will be recorded and sent to the organisations involved for reference.

    4.7 Conflicts of interest

    Whenever a representative has a conflict of interest in a matter to be decided upon, the representative concerned shall declare such interest at or before discussions begin on the matter. The Chair shall record the interest in the minutes of the meeting and that representative shall take no part in the decision making process.

    5. The operational structure of the Lewisham Safeguarding Adults Board

    5.1 The frequency of LSAB meetings

    The Board meets four times a year. Board meeting dates will be set as far in advance as possible to ensure availability of all board members.

    5.2 LSAB Sub-Groups

    LSAB work activities are designed to achieve results in the most effective and efficient ways. This may include formal Sub-Groups meeting on a planned regular basis or through smaller specific Task and Finish Groups, workshops or other consultative events. This may include electronic consultation methods.

    Each Sub-Group have their own Terms of Reference and are responsible for delivering specific LSAB Strategic Objectives, and may commission Task and Finish Groups to deliver specific pieces of work linked to these objectives. Members of these groups must understand the remit of the LSAB; that they are assisting the LSAB to meet its objectives; and have the capacity to undertake work for the Board.

    Membership of these groups will reflect a range of agencies across Lewisham. They may also include individuals with specialist knowledge or the ability to add value to achieving and implementing planned objectives.

    Members are expected to attend meetings; contribute to discussions and activities of the Sub-Group. They may be required to undertake agreed specific tasks, delivering these in a timely way, alerting the Sub-Group Chair or other identified lead officer in advance of any deadlines being missed.

    Strategic Learning will be shared along with the Lewisham Safeguarding Children Partnership (LSCP) and Safer Lewisham Partnership (SLP) to share the learning from Safeguarding Adults Reviews, Child Safeguarding Practice Reviews and Domestic Homicide Reviews, enabling higher level strategic objectives to be developed and shared.  

    5.3 Attendance

    Individuals identified as Board, Sub-Group and / or Task and Finish Group members are expected to regularly attend meetings. Where there is unavoidable absence, all organisations should ensure that there is a suitable substitute representative from their agency.

    5.4 Administrative arrangements for the LSAB

    The draft agenda will be sent to Board Members for approval/late item requests 15 working days before the meeting. Board members will have five working days to respond. Requests to alter the agenda after this deadline will not be accepted.

    The agenda and associated papers for each Board meeting are issued no later than five working days before the meeting by the LSAB Administrator.

    Papers for the next meeting must be submitted to the LSAB Administrator at least 10 working days before the meeting. Only papers submitted before this deadline will be dealt with by the LSAB Administrator and included in the documents circulated with the agenda. Any documents missing the deadline must be circulated by the author/organisation and printed copies brought to the Board Meeting.

    Minutes of LSAB Board meetings are taken by the LSAB Administrator and circulated within 15 working days of the meeting.

    6. Review

    These terms of reference will be reviewed as required in response to significant change in guidance, legislation or member organisations.

    Appendix 1: Strategic Business Plan 2022-23

     

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