Newcastle Safeguarding Adults Board Annual Report 2020-21

This page includes the content of the NSAB Annual Report 2020-21. You can download the full report below.

Introductions from our Chair and Cabinet Member

“It goes without saying that this has been a challenging year – for adults with care and support needs, their families, and those who work or volunteer to keep adults at risk safe. I pay tribute to the dedication, resilience and understanding of so many people who have worked alongside the Newcastle Safeguarding Adults Board (NSAB).

From the start of the Covid-19 pandemic, partner agencies were clear that safeguarding adults duties remained a priority. Organisations adapted quickly to work in different ways, whether that was the Multi-Agency Safeguarding Hub (MASH) working remotely or agencies participating in safeguarding adults meetings virtually via Microsoft Teams.

The NSAB continued to meet as normal, albeit virtually. Extraordinary Board meetings were held in May and July 2020 to ensure there was regular dialogue between agencies and oversight of any risks to multi-agency safeguarding adult arrangements. An Operational Leads group was established to monitor any particular issues or trends coming through in safeguarding adults concerns.

The Annual Report details some of the indirect impacts of Covid-19 on safeguarding adults work – increased vulnerabilities and reduced professional face-to-face contact with those at risk – and our response to these.

Safeguarding adults activity has increased in Newcastle throughout the year. There have been particular areas where we have seen increased risk: domestic abuse, self-neglect, poverty and concerns for people’s mental health. The report shines a spotlight on these areas.

The Board continues to work alongside other multi-agency partnerships, particularly around criminal exploitation and serious violence. The Newcastle Partnerships Group (formed in 2020-21) aims to create a forum where issues of common interest can be discussed and addressed.

The pandemic has tested us all, but it has forced us to do things differently. In some cases this has improved our safeguarding adults response. In 2021-22 we will build on these opportunities and ensure that any changes are fully embedded within our systems, policies and procedures.

I would like to end by reiterating my thanks to everyone who has risen to the challenges of 2020-21.”

Vida Morris, Newcastle Safeguarding Adults Board Chair

“The Covid-19 pandemic has been the central feature of the last year and brought significant challenges to us all.

The annual report details the increasing volume of safeguarding concerns and safeguarding adults enquiries which have placed additional demands on our services.

The response to Covid-19 has required committed and innovative partnership working in a number of areas, including ensuring that the person at risk of abuse (or their representative) remains at the centre of the safeguarding process, working alongside City LifeLine to provide training and awareness-raising to new volunteers and community groups, identifying people on the shielding list who might have been at increased risk of abuse or neglect and continuing to deliver a multi-agency training programme, albeit virtually.

Poverty, increased burdens on informal carers, household tension, substance misuse and increased mental health need can all be factors that increase the risk of abuse and neglect for adults with care and support needs and have been an indirect impact of the pandemic and associated lockdowns. These areas will continue to be an important feature of the Board’s work in 2021-22.

I would like to offer my sincere thanks and appreciation to all those who have worked tirelessly, with resilience and dedication, to keep so many of our residents safe from abuse and neglect.”

Councillor Karen Kilgour, Deputy Leader of Newcastle City Council and Cabinet Member for Health and Social Care

Who we are and what we do

The Newcastle Safeguarding Adults Board (NSAB) is a statutory multi-agency partnership responsible for safeguarding adults from abuse and neglect. There are a number of agencies represented on the Board, including the Council, Health Services and the Police. Our NSAB roles and responsibilities page has more information about the Board and it’s work.

Our year in brief

April 2020: Covid-response focusses on ensuring safeguarding arrangements are maintained, monitoring safeguarding adults activity levels and ensuring key messages are getting to the public, professionals and volunteers.

May 2020: Extraordinary NSAB meeting and Operational Leads Group established. Risk areas identified and NSAB Strategic Annual Plan revised to reflect these. Briefing produced on Covid-19 vulnerable groups to increase practitioner awareness of increased risk areas. Four Safeguarding Adults Review (SAR) referrals received. NSAB Twitter account, @newcastle_sab, launched.

June 2020: Toolkit produced highlighting the services and support that might prevent abuse or neglect happening during Covid-19.

August 2020: Guidance issued on ensuring Making Safeguarding Personal principles are followed when safeguarding adults enquiries and/or meetings are being held virtually.

September 2020: NSAB discussions focus on recovery in anticipation of a longer-term lifting of restrictions.

November 2020: Learning Event held in relation to a case not meeting the criteria for a Safeguarding Adults Review. Co-ordinated communications activity to coincide with National Safeguarding Adults Week. Launch of Missing Adult Protocol.

December 2020: All multi-agency training previously offered face-to-face now available via Teams.

January 2021: NSAB Self-Assessment Session with Board members to ascertain areas of good practice and areas of challenge. Used to help inform the NSAB’s Strategic Annual Plan for 2021-22. New website, www.newcastlesafeguarding.org.uk, jointly covering safeguarding adults and children, goes live.

February 2021: Safeguarding Adults Best Practice Week – over 200 practitioners attend eight short webinars covering topics related to safeguarding adults.

Strategic Annual Plan

The Care Act 2014 requires all Safeguarding Adults Board’s to produce an annual plan that details how we will meet our objectives and how our member and partner agencies will contribute.

Our plan for 2020-21 had to be adjusted to reflect the impacts of the Covid-19 pandemic – our work and achievements are summarised on page 6 and detailed throughout this report.

Looking forward to our 2021-22 plan, we have used a variety of information sources to ensure our priorities reflect the needs related to safeguarding adults at risk. This has included using our local data, learning from cases and audit, results of agency self-assessments, consultation with both the public and professionals and responding to national policy, guidance or legislation.

Feedback from the public particularly focussed on the need to raise awareness of what safeguarding adults is and where people can go if they have a concern about abuse or neglect.

Our Strategic Annual Plan 2021-22 includes the following action areas:

Targeting support and awareness raising with referrers about the importance of seeking views of the adult at risk or their representative.
Seeking feedback from adults at risk/their representatives on their involvement in virtual safeguarding adults enquiries.
Responding to national guidance on safeguarding and homelessness.
Continue to implement the NSAB Communications Strategy, specifically ensuring that key messages are not limited to online/digital platforms.
Maintaining an overview of the implementation of Liberty Protection Safeguards (LPS).
Consider and agree proposals for our e-learning offer beyond our existing contract.
Address recommendations from work done in 2020-21 around poverty and safeguarding adults.
Production of guidance on preventing, identifying and responding to financial abuse.
The review and update of multi-agency NSAB policy and procedures.
Addressing learning from Safeguarding Adults Reviews and any other relevant review processes e.g. Domestic Homicide Reviews.

Self-neglect and safeguarding adults

The NSAB quickly identified that during the Covid-19 pandemic there were increased risks of self-neglect with people being less likely to seek help and support.

This might be because people did not want to be a burden or were worried about asking for help or medical attention as they were fearful of getting Covid-19. It was identified that those already vulnerable to self-neglect were likely to be at more acute risk with less professional contact from all services.

Self-neglect is a complex area of safeguarding adults work. It can result in serious harm if appropriate support or monitoring is not in place. The most serious cases require a co-ordinated, multi-agency response and safeguarding adults arrangements are well-placed to facilitate this.

Professionals are encouraged to follow local self-neglect practice guidance. This highlights a preventative approach, aiming to negate the need for a safeguarding adults enquiry.

The NSAB will continue to work on self-neglect in 2021-22. This will include: plans to raise awareness with the public about self-neglect and what can be done; a re-launch of self-neglect and hoarding training; and an update to self-neglect guidance to reflect the impact of Covid-19 and learning from reviews.

Mr K is an insulin dependent diabetic, he lives at home with family visiting him and supporting where possible. Mr K’s home environment provides a concern for visiting professionals, with environmental hazards that are increasing and extreme. Mr K has admissions throughout the year. There are a number of Safeguarding referrals from acute and community staff, there is consideration of mental capacity and in particular, examination of Mr K’s mental capacity around his health needs. There are concerns about his understanding of risks and specialist teams, social workers, carers and district nurses are all pulling together to support Mr K’s safety at home. The environmental hazards are a grave concern and pose a risk to professionals. Teams continue to encourage Mr K to address hazards and through small steps, these were reduced. Adult Social Care played a significant role in working to incrementally introduce to Mr K possible ways to improve his environment. Using the principles of the self-neglect practice guidance of persistence and creativity things improved. The longevity of this case and risk meant the Trust consulted with legal services. Mr K’s voice was evident throughout, he wished to return home and was assessed as having mental capacity to make this decision. Although a very difficult decision for all involved and one that generated waves of discomfort – balancing Human Rights, risk, proportionality and accountability is never easy. The challenges of safeguarding remain and Mr K reminds us of the importance of collaboration, debate and tenacity.

CASE STUDY, NEWCASTLE UPON TYNE NHS HOSPITALS FOUNDATION TRUST

What our local data tells us

2020-21 saw a 42% increase in the number of safeguarding concerns and a 33% increase in Section 42 Enquiries. There were 10,774 safeguarding adults concerns (reports to the local authority of suspected abuse or neglect in relation to an adult) reported and 6,762 Section 42 Enquiries (statutory enquiries made by the local authority when it is confirmed that the “concern” meets the criteria under the Care Act, 2014).

Partner agencies worked hard at the start of the year to remind people that safeguarding adults duties still applied and that services were still available to protect adults from abuse and neglect. The success of this communication activity, as well as the strength of the multi-agency safeguarding system in responding to concerns is reflected in this data.

The Local Government Association Safeguarding Insights Project reported that Local Authorities from across the country had seen rises in the volume of safeguarding concerns over the course of 2020-2021.

The Covid-19 pandemic and accompanying lockdowns had an unprecedented and extraordinary impact on safeguarding. Rates of safeguarding concerns during 2020 were overall higher than 2019.

SAFEGUARDING INSIGHTS PROJECT, LOCAL GOVERNMENT ASSOCIATION, APRIL 2021

Since the implementation of the Care Act 2014, there has been a continued increase in the proportion of concerns that are about adults aged 18-64. In 2020-21, 60% of all Section 42 Enquiries related to working-age adults in Newcastle. In the last year, this increase has been seen more steeply. This trend was also reflected nationally. However, the prevalence of abuse or neglect (when compared to overall population totals for age groups) continues to increase the older a person gets.

60% of Section 42 Enquiries related to abuse or neglect perpetrated in a person’s home reflecting the reality that people have been spending more time at home. This was a 12% increase on the previous year.

2020-21 saw a significant increase in the percentage of concerns where the Primary Support Reason of the person was not known (38%). This measure will be subject to further audit but may reflect national data collection guidance which states a primary support reason should only be recorded following assessment from Adult Social Care. A safeguarding concern will not always require an Adult Social Care assessment and a person does not have to be eligible for, or receiving, social care services to be considered under safeguarding adults procedures.

20% of all Section 42 Enquiries were about an individual lacking in mental capacity. 50% of safeguarding adults concerns related to women, 47% to men and in 3% of cases, gender was unknown.

74% of safeguarding adults concerns related to people who were White British. 21% of concerns related to people whose ethnicity was unknown or undeclared.

The most common form of abuse reported was emotional abuse. Significant rises were seen in relation to emotional, financial, domestic abuse and self-neglect. These risks reflect the themes reported in Newcastle for safeguarding concerns linked to Covid-19.

In 86% of Section 42 Enquiries, risk is either removed or reduced. Safeguarding enquiries must be proportionate and reflect the wishes of the adult who is at risk therefore it is not always possible to take action.

In 71% of safeguarding adults enquiries, the adult at risk or their representative was asked their desired outcomes. This was a decrease on the previous two years. An audit was undertaken which identified a decreasing ability for organisations at the front-line of the pandemic response to identify the views of the person before raising a concern.

Poverty and safeguarding adults

Are people who experience poverty more likely to experience abuse and neglect? If so, what can agencies working in Newcastle do to reduce the likelihood that a person will be affected by poverty? And what more can we do to support people who are at risk of abuse?

These questions were considered as part of the Newcastle Safeguarding Adults Board (NSAB) Strategic Annual Plan for 2020-2021. In response there was close collaboration between those working in the Active Inclusion Newcastle partnership and those working in safeguarding adults roles.

A basic analysis of ward-level data relating to the the Indices of Multiple Deprivation (IMD) and safeguarding adults activity revealed that the wards experiencing the highest levels of deprivation also had the highest levels of safeguarding adults concerns and safeguarding adults enquiries.

Practitioner input was provided via a survey and workshop in September which sought to further understand the relationship between poverty and abuse and neglect. Conversations demonstrated that the relationship was complex but poverty can create circumstances under which abusive or neglectful behaviours are more likely to transpire. Those involved in the workshop highlighted the impact that poverty can have on the probability that someone will experience self-neglect.

Following the workshop, an audit of 29 resident’s cases who had been to subject to safeguarding adults procedures were reviewed to understand their financial and housing circumstances and to identify potential opportunities to provide future advice and support to prevent or reduce crisis

The findings from the survey, workshop and audit resulted in the following recommendations:

Safeguarding Adults Plans for people at risk of self-neglect need to address the risk of poverty
Self – Neglect practice guidance should include the risk of poverty
Professionals from all agencies should be aware of the support available to informal carers
The NSAB should consider how routine conversations about finances and money can be built into the safeguarding adults process.
All agencies should promote the Active Inclusion training programme
Agencies working in Newcastle should ensure that staff are aware of sources of advice, support and information about both financial inclusion and safeguarding adults.
Take a more coordinated approach to those with mental health problems

These have been incorporated into the Strategic Annual Plan for 2021-22.

Safeguarding Adults Review Committee

The Safeguarding Adults Review (SAR) Committee received four referrals in 2020-21 for consideration for a SAR. A SAR is the statutory review process when an adult with care and support needs has died or suffered serious harm as a result of abuse and neglect and there is reasonable cause for concern about how agencies have worked together (Section 44, Care Act 2014). It was agreed that three of these cases met the criteria.

This was an unusually high number of referrals for the Committee to receive. This experience is something that has not been unique to Newcastle and there is some sense that Covid-19 has been a factor in the increase. The three cases all involved aspects of self-neglect, domestic abuse and substance misuse.

The SAR Committee, in conjunction with the NSAB, needed to decide the best way of conducting the SARs within the resources available, appreciating the significant pressures agencies were under due to Covid-19 and a desire to be able to learn from these cases as quickly as possible. It was agreed that the SARs would be undertaken concurrently, with a case linked to Covid-19 being prioritised first.

The SAR processes are ongoing and it is hoped the first SAR will be published in winter 2021. The key findings and actions taken will be published in next year’s annual report.

A Learning Event was held for the case which did not meet the criteria for a SAR in November 2020. This was another case which involved self-neglect but that was quite hidden to services and professionals. A seven-minute briefing will be produced highlighting the key learning from this case.

In November 2020, a national Analysis of Safeguarding Adults Reviews was published. In 2020-21 the Committee began benchmarking the Newcastle position in relation to the recommendations. Any areas for improvement will be the basis of a SAR Committee workplan in 2021-22.

Chris Piercy, Executive Director of Nursing and Patient Safety at Newcastle Gateshead CCG, and Chair of the SAR Committee, retired in March 2021. The Committee is grateful for Chris’s leadership and commitment to safeguarding adults in Newcastle.

Domestic abuse and safeguarding adults

In 2020-21, the NSAB saw a significant increase in reported safeguarding adults concerns related to domestic abuse. In addition, the Safeguarding Adults Review (SAR) Committee received three SAR referrals which all included aspects of domestic abuse. NSAB partner agencies were also involved in two Domestic Homicide Reviews (DHRs) co-ordinated by Safe Newcastle.

Safeguarding adults procedures should be used to respond to domestic abuse when the person at risk is an adult with care and support needs and as a result of those needs they are unable to protect themselves from the harm or risk of it.

During the past year, the link between lockdowns and increased domestic abuse risks has been well reported. For adults with care and support needs specifically, there have been increased risks related to informal carer stress or tension and a widening of power imbalances. Abusers may have experienced additional anxiety about, for example, supplies of food, alcohol, medication and illicit drugs. The consequences of this could be escalated abuse of those around them.

The NSAB have promoted many of the new initiatives that have been established throughout 2020-21. This has included Safe Spaces at pharmacies and the Ask for ANI codeword scheme.

The NSAB will continue use their platform and voice to highlight the domestic abuse risks faced by adults with care and support needs. In particular, highlighting that domestic abuse is experienced by older and disabled people and ensuring that people do not perceive domestic abuse as something that is only perpetrated by family members who are or have been intimate partners – it might be sons, daughters, grandchildren for example.

Once published, the NSAB will respond to the findings and recommendations that arise from the SARs and DHRs.

The Safeguarding Partnership Team received a safeguarding alert, after one of our customers contacted their Housing Officer stating that they had to flee their home address, due to fear of violence. The perpetrator of the alleged abuse was the customers adult son. She disclosed that the abuse and violent behaviour had been going on for a few years and that it had become worse. It centred around her son asking for money from her and using threats of violence until the demands were met. The customer was in receipt of benefits and had recently seen a reduction in her income. She took the opportunity to leave her home while her son was out. She informed YHN that her son had earlier demanded £20 from her so she could use her own bathroom facilities. She had given her son some money and later left home, leaving her medication, which she had been prescribed for her mental health. Based on the information shared with the Housing Officer a Safeguarding Initial Enquiry Form was submitted to Adult Social Care and emergency accommodation was sought. The following day a housing application was submitted. YHN contacted the customer and completed a MARAC referral (for high risk domestic abuse), as well as a referral for an Independent Domestic Violence Advisor (IDVA). The case was discussed the following week at the MARAC Panel meeting. As a result of the abuse she had suffered she was hospitalised under section 2 of the Mental Health Act, as her mental health had severely deteriorated and she wouldn’t come out of her room and she had stopped eating. As part of the Safeguarding Adults Enquiry, a strategy meeting was convened and she was assigned a Social Worker. The Social Worker liaised with YHN throughout her time in hospital and all agencies were to be advised of her discharge date. A safeguarding adults plan was agreed for post-discharge, Once she was discharged YHN made her housing application active and a priority banding awarded. She was offered a new property and YHN prioritised the void repair work due to her significant risk of harm and her insecure housing situation. She continues to be open to YHN’s Support and Progression services. As a result of working in partnership, all agencies were able to share information regarding the health and wellbeing of both the victim and perpetrator. Whilst she was not prepared to support a Police prosecution, her son has been allocated a Mental Health support worker and a Care Act Assessment is being carried out of his care and support needs due to drug and alcohol misuse. Work is also being carried to address the violence towards his mother.

CASE STUDY, YOUR HOMES NEWCASTLE

Learning and Development Sub-Committee

The Learning & Development Committee (L&DC) has taken the opportunity to reflect upon the challenges of planning and delivering training in 2020 – 2021 following the extraordinary events of the year. Unfortunately, once the COVID – 19 pandemic emerged and the country went into lock down in mid-March 2020, all face to face training was suspended. This remains the case to date.

However, it has given the L&DC the opportunity to look at new and innovative ways of developing and delivering training. This has enhanced our Training Programme for 2020 – 2021. The Committee continues to coordinate an extensive range of training at different levels to meet the needs of agencies and staff who have a wide spectrum of roles and responsibilities.

The Committee worked very hard in response to the COVID -19 pandemic and the fact that it was not possible to deliver face-to-face training. We have successfully developed and launched high quality virtual training courses (including webinars) at the end of 2020 with uptake proving very popular as they were rolled out.

We have successfully promoted our training via our NSAB Twitter account, the new Newcastle Safeguarding website and with links in the community and voluntary sector (via Connected Voice). Newcastle City Council’s Commissioning Team have also promoted training via their weekly bulletin to social care providers.

2053 participants on safeguarding adults training courses.
1607 e-learning courses completed.
842 completions of safeguarding adults basic awareness, our most popular e-learning course.

E-learning proved to be vital in the early stages of the pandemic and was very popular with the independent and voluntary sector organisations within Newcastle. It meant that safeguarding training was still accessible in the interim period when Teams training was being developed. We’ve also relied upon our Level 1 Workbooks and uptake has been positive since a re-promotion of it during the summer of 2020.

Looking ahead to 2021-22

Our attention will focus on a blended approach to delivering training as the digital age is clearly here to stay. We look to continue our highly successful virtual training to compliment some face-to-face training, in accordance to government guidelines. It is hoped that some face-to-face training will resume at some point in 2021 -22. We are exploring different methods and platforms such as films or radio interviews which we could turn into podcasts and short information drops.
There will be new training developed in line with new Code of Practice for Liberty Protection Safeguards (once published) which will be replacing Deprivation of Liberty Safeguards.
The current contract with our e-learning provider comes to an end in August 2021. The Committee are considering various options including the possibility that e-learning may be commissioned on a regional basis.
Our Self- Neglect & Hoarding training has been reviewed and the Committee are working in partnership with Your Homes Newcastle to relaunch this.
The Learning and Development Committee members will continue to work jointly with the Newcastle Safeguarding Children’s Partnership’s Learning & Improving Group (LIG). This will include Train the Trainer sessions in 2021-22, aimed at supporting trainers who deliver safeguarding training in their organisations, by sharing our training resources and giving them the opportunity to form support networks. It will also ensure that training meets the NSAB and NSCP Capability Framework which outlines the minimum standards for safeguarding training in the City. There will also be work done to develop a joint online evaluation framework for training.
We will continue to utilise the joint website, both as a platform to promote training and where people can book training. We will also to add other resources which will support people’s development.
The Committee is looking forward to the opportunities and challenges of the year ahead. It will continue to work tirelessly to offer an extensive range of training on different platforms and arenas, to the organisations who safeguard adults with care and support needs.

Improving Practice Sub-Committee

Much has been achieved this year despite the added complexity and challenges posed by the Covid-19 pandemic. The commitment of Improving Practice Committee (IPC) members has been outstanding, with good attendance at meetings. Just one meeting was cancelled in April 2020 at the start of the pandemic. All other meetings have been held successfully on-line using Microsoft Teams.

New members bring diversity and renewed enthusiasm to our work. This year we have welcomed new representatives from Cumbria Northumberland Tyne and Wear NHS Foundation Trust (CNTW), Northumbria Police, Newcastle Gateshead CCG, Your Homes Newcastle and Your Voice Counts. All are contributing actively to the work of the IPC and their input is very much appreciated.

One of the highlights has been our Safeguarding Adults Best Practice week. Due to Covid-19 restrictions we ran the event online. Eight webinars were held over 5 days from 8th-12th February 2021, with over 200 people joining sessions remotely. Topics included Prevent, safeguarding carers, advocacy, social prescribing and Information NOW, coercive control, cultural competency, poverty and financial inclusion and working through challenges of adversity. The event was a huge success and we plan to deliver a similar programme in 2021/22.

Making Safeguarding Personal (MSP) continues to be a priority. Local guidance on involving people virtually in safeguarding adults enquiries was shared with the IPC in August in order to gain approval. The MSP Scorecard was updated and there was agreement to focus on two important priorities: ensuring desired outcomes of the adult at risk are sought and support/ representation for the adult at risk.

Following on from the work in 2019/20 on the Herbert Protocol, in August this year we discussed and contributed to work on the regional protocol for ‘missing adults’. This was then launched during Adult Safeguarding week in November 2020. We have also provided input to the Strategy on Criminal Exploitation and Serious Violence which was also discussed at our August meeting.

Much of the face to face work around safeguarding adults has been on-line in 2020/21. When it became clear that this situation would continue, a survey of virtual meetings took place (opened in February 2021) to obtain feedback from those involved. Whilst there were limited responses to the survey, respondents painted a favourable impression of virtual meetings. Not having to worry about travelling to a meeting or parking were raised as positives as well as the ability to research systems for information during the meeting. The Committee would like to further understand adult at risk (or representative) experience of participation in virtual meetings.

A number of IPC members are part of a subgroup that audits safeguarding referrals related to different themes, with the overall aim of improving practice. The important work of this audit group has continued. In October an audit of 10 cases that were referred to safeguarding but that did not progress to a section 42 enquiry took place. A number of recommendations were made including attempting to get mental health service representation within the Multi-Agency Safeguarding Hub (MASH).

The issue of social isolation remains high on our list of priorities. Although we have been unable to hear from public health about their data, we have heard from Information NOW and members continue to raise awareness of this resource amongst their colleagues.

Improving Practice Committee priorities for 2021-22

Making Safeguarding Personal will remain a priority for the Committee. We will focus on two important elements: increasing the proportion of enquiries where a person is asked their desired outcomes and increasing representation for those people who would have a substantial difficulty in participating in the safeguarding adults process.

We will continue to focus on implementing new policy and legislation, focussing on what this will mean for front-line practitioners. Updating of local policy, procedures and guidance will continue in 2020-21. We anticipate doing work to update the transition protocol, guidance on service user on service user abuse and guidance on self-neglect.

During 2020-21 the Committee have scoped the work for a task and finish group on financial abuse which is due to start in June 2021. We have been in touch with a number of relevant stakeholders, including Northumberland Tyne and Wear DWP, Trading Standards, Moneywise Credit Union and our colleagues within the Safeguarding Adults Partnership and look forward to working with them to develop guidance on identifying preventing and responding to financial abuse.

We will build on the success of the on-line best practice event held in February 2021, by holding a similar programme of webinars during 2021/22.

Mental health and safeguarding adults

The last 12 months have seen increased reports through safeguarding adults procedures about concerns for people’s mental health.

Covid-19 and associated lockdown measures have a significant impact on people’s mental health. Things such as anxiety, loneliness and isolation can create or increase mental health need. With this, comes the potential for increased vulnerability to abuse or neglect.

An audit co-ordinated by the Improving Practice Committee Audit Group highlighted that there were a significant proportion of concerns being reported through safeguarding adults procedures which were purely about a person’s mental health with no abuse or neglect (or risk of it) being associated with it. This was taking up resource within the Adult Multi-Agency Safeguarding Hub (MASH) and it was felt that it would be beneficial to have further representation within the MASH from mental health services. It was hoped that this would assist in the effective response to individuals and ensure that the MASH was able to dedicate more of their capacity towards concerns related to abuse and neglect. The resource to be able to make this happen is currently being explored by NSAB member agencies.

As part of the preventative work of the NSAB, opportunities have been used to promote the services and support available to support people’s mental health during this time:

Stop Suicide North East and CNTW produced a wellbeing and mental health during Covid-19 booklet which was sent to every address in region.
Skills for People started up a Keeping People Connected group to keep people with a learning disability and/or autism in touch during the lockdowns.
The NHS website Every Mind Matters has information on looking after mental health and where to get further help and support if you need it.
Suicide Text Safe – Northumbria Police have collaborated with the Missing People Charity to take advantage of a service which offers missing adults in mental crisis with early contact and support from the Samaritans. Early analysis of this service shows that 80% of missing adults who are offered an intervention take up the offer of contact and support from the Samaritans. This is in keeping with our multi-agency focus on preventing the harms suffered by missing adults

Missing, Slavery, Exploited, Trafficked (M-SET) Sub-Committee

Like all sub-committees of the the NSAB (and NSCP), the work of the strategic M-SET committee has been indirectly influenced by Covid-19. Intelligence shared at M-SET has highlighted some changes to how children and adults might be abused or exploited and the location where it might happen.

Reports from Changing Lives (Net Reach and Nowhere to Turn) have been helpful in highlighting some of the increased risks and vulnerability at this time (see page 25). The Committee have received regular reports about immigration abuse and harmful practices (e.g. Female Genital Mutilation). Immigration abuse was of particular concern as the UK transitions post-Brexit.

The launch of the Missing Adults Protocol ,on a regional basis, will help achieve consistent responses to adults who go missing and return home interviews should help better understand some of the reasons why adults go missing.

Members of the Committee have contributed to the National County Lines Coordination Centre’s Strategic Assessment, highlighting the risks to adults as a result of County Lines.

Looking ahead to 2021-22, the Committee will review their delivery plan, in light of the challenges and changes brought about by Covid-19 and to align work more closely to the Criminal Exploitation and Serious Violence Strategy.

Northumbria Police’s Missing From Home Coordinators have played an active role in multi-agency safeguarding over the past 12 months in respect of young adults missing through Criminal Exploitation and County Lines.

The addition of adult social care representatives into Newcastle’s Operational MSET meetings has been a positive step in assisting to safeguard our young people as they transition into adulthood.

Northumbria Police alongside adult social care partners and Edge NE have effectively safeguarded young adults involved in County Lines across the UK by working closely together, communicating quickly and working with partners in housing and third sector to support vulnerable young adults.

A consistent chair from Northumbria Police chairs the M-SET sub-Committees in the Northumbria force-area. There is a focus on all age exploitation, learning from practice and improving collaboration across partnerships.

Partner agency perspectives

NHS Newcastle Gateshead CCG

The CCG has supported the development of a programme of training for clinical staff to undertake forensic examination of non-accidental injuries for adults. Initial training was provided in January 2021 and work is underway to develop a service specification for a planned potential regional/national pilot. The CCG has also led and established a Multi-Agency group to support implementation of the Liberty Protection Safeguards (LPS).

The CCG Safeguarding Team have supported the NSAB priorities for 20-2021 in the following areas:

Attending safeguarding meetings and managing information sharing on behalf of GPs to ensure that adults at risk are appropriately supported and represented.
Developed quality assurance and incident management systems which support identification of key themes and issues at a service level to support earlier intervention.
Worked in partnership with the Local Authority and care providers to manage and support improvement when issues have been identified.
Led an Appreciative Inquiry working in partnership with agencies from across the City.
Used social media to promote safeguarding issues during the pandemic and displayed safeguarding information and posters at Covid testing and vaccination hubs.
Delivered Safeguarding Training via remote learning (MS Teams) to ensure health staff maintain knowledge and competencies for safeguarding adults.

Newcastle City Council

Over the course of the past year staff within Adult Social Care and Integrated Services have been at the centre of efforts to keep the people of Newcastle safe. This included responding to a 42% increase in the volume of safeguarding concerns, co-ordinating Section 42 Enquiries and working creatively to support adults who have been at increased risk of abuse and neglect.

Staff have played a pivotal role in co-ordinating the city-wide response to the pandemic. Staff working in Newcastle City Council commissioning teams maintained daily contact with providers of social care support to ensure issues such as system pressures, concerns and supply of vital PPE equipment could be raised and responded to appropriately. Social work staff have assisted with the wrap-around support for care homes, as well as undertaking face-to-face visits where the risk or circumstance required it.

The Safeguarding Adults Unit established a fortnightly Safeguarding Adults Leads Operational catch up meeting which provided an additional platform for safeguarding leads from across partner agencies to share emerging themes, and work collaboratively to ensure the effectiveness of the multi-agency system during an extremely challenging time.

From the on-set of the pandemic, a daily performance dashboard was established which allowed workers to identify themes across safeguarding concerns which were linked to the impact of the pandemic. Safeguarding performance information was reported to the Adult Social Care and Integrated Services Directorate Management Team on a fortnightly basis providing an oversight of the safeguarding system including the sharp rise in the volume of safeguarding concerns. These additional performance measures and reporting ensured that early themes of domestic abuse, self-neglect and mental health were identified and practice guidance was quickly developed and shared with staff.

As part of the wider Newcastle City Council pandemic response staff from across the council came together to support residents as part of the Covid-19 response plan. This included the approach to support self-isolation and city-wide preparedness to mitigate or minimise associated social and health inequalities.

Citylife Line Welfare and Wellbeing Team (WWT) is a core component of COVID Control for Newcastle. The service underpins the self-isolation support to ensure residents receive timely aid and protection from across voluntary and community sector and statutory services, including through the safeguarding adults pathway where required. WWT work closely with staff in Adult Social Care and act as a single point of contact for any resident to raise an issue that they experience because of Coronavirus by providing Welfare Checks. This agile style of working has enabled the provision of a clear front door into the Council when residents have a range of concerns.

In October 2020 the “Keeping Everyone Safe” training programme was launched. This mandatory training programme for all Newcastle City Council staff brings together key messages of safeguarding adults, safeguarding children, domestic abuse, Prevent and other community safety themes under one training course with one core message.

Connected Voice Advocacy

Connected Voice Advocacy provide a range of advocacy services in Newcastle and Gateshead. We ensured that practices during the pandemic remained person centred and complaint with the Mental Capacity Act. Advocates have played an important scrutiny role in local institutions and service providers to make sure the vulnerable were reached despite lock downs. This has included rights-based calls to care homes and hospitals to ensure people’s rights were upheld, decisions were being made lawfully and that there was least restrictive practice over lockdowns. Where needed, face-to-face advocacy visits have been undertaken to ensure privacy and to facilitate the disclosures.

The service has delivered awareness raising sessions for the community and voluntary sector around the role of advocacy in safeguarding. During the last year, this has included local level campaigns to remove myths during the pandemic, for example that advocacy was no longer applicable due to the Coronavirus Act or local authority easements.

The organisation has taken on a campaigning role nationally for improvements to the Mental Health Act and Mental Capacity Act to improve the quality of life and access to support services.

Connected Voice Advocacy received additional funding from the Police and Crime Commission for Safeguarding people during the pandemic due to the rise in advocacy referrals for victims of Hate Crime. It was acknowledged that people were turning to their support service which requires them to be safeguarded from abuse such as financial, physical, psychological, sexual abuse or neglect.

Connected Voice provide a range of support to the voluntary and community sector (VCS) around their safeguarding responsibilities. This includes a specific safeguarding section within the monthly “On the Hoof” bulletin and safeguarding training. Connected Voice have played an integral role in supporting the VCS during the pandemic, including administering Covid recovery grants to support vulnerable people. The service have also been helping community groups to adapt to online services.

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW)

For the period of reporting, all agencies have been delivering services under Covid restrictions and increasingly using remote technologies. Throughout this CNTW has protected frontline care and treatment services and ensured face to face contacts have continued to be offered.

CNTW has continued to engage with all serious case reviews, learning events, safeguarding conferences and Domestic Homicide reviews. Staff have also attended all extraordinary meetings to ensure good and effective feedback and assurance to our partner agencies.

CNTW has continued to provide advice support and supervision to clinical services trustwide to ensure that safeguarding and public protection referrals have be made where required and service users and staff are supported.

This case relates to a mother and son. Both individuals have very complex needs, and each had multi agency teams involved. The CNTW Safeguarding Team, were initially alerted to the case, by the completion of a web-based report. After triaging the case, we were then able to formally engage in with a multi-agency response. Concerns related to domestic violence incidents due to frustration in the household. The agencies involved shifted to a “think family” approach, considered the needs of those involved as a part of a whole-system, and how to respond to this. There was an escalation in incidents. All professionals were fully aware of the risks, due to both having very complex needs and contacts with associates of the son. There was excellent communication between all agencies and a fully coordinated approach was taking by all professionals. Both individuals were subsequently detained under Section 2 of The Mental Health Act to ensure that their mental health needs were fully assessed and to ensure they were both safe. The mother has now been discharged and current risks have been addressed. The son is due for discharge soon. Whilst there are still concerns, both individuals have ongoing support, care plans and professionals involved in their care. Everyone is clear that safeguarding adults procedures can be re-opened should things change or escalate.

CASE STUDY, CUMBRIA, NORTHUMBERLAND, TYNE AND WEAR NHS FOUNDATION TRUST

Newcastle upon Tyne Hospitals NHS Foundation Trust

Covid-19 has continued to present many challenges to the NHS, not least to safeguarding practice and training, with social distancing changing previous methods of multi-agency working and training. During this extraordinary year, safeguarding has remained a priority for the Trust and this is demonstrated by a 17% increase in referrals to the local authority. Cases continue to demonstrate a sense of intensity in the abuse and risk. Our involvement is not limited to the Newcastle Area and referrals/safeguarding activity supports individuals who live in across the North East.

Key achievements through this year are a system of establishing outcomes from safeguarding activity to review risk and consider if there is a need for further action. From recent Safeguarding Adult Reviews there is an emerging theme around escalation and the review of cases to prevent further harm and risk occurring wherever possible. A challenge for the team is identifying which cases may indicate greatest risk particularly within increased activity.

We have expanded work to include participation in the MASH triage process and we have continued to participate in multi-agency safeguarding meetings.

Electronic medical records has increased the opportunities to provide a “safeguarding footprint” for staff on the front line to understand individual circumstances and risks. We continue to work with our IT colleagues to grow safeguarding visibility.

We have continued to consider “Think Family” and have strengthened working relationships. We have introduced a role that works across children’s and adult safeguarding, with a particular focus on the overlap with midwifery and women’ services.

We have maintained a range of training and increased the number of staff who have achieved Level 3 Adult Safeguarding and offered a number of bespoke learning via Teams. This has include learning from Safeguarding Adult Reviews, Prevent and the impact of Covid-19 on domestic abuse.

By far the greatest area of concern continues to remain self-neglect, which can often include complex young individuals who may be street homeless or living in temporary accommodation, who use substances and consequently are vulnerable to exploitation from others.

Understanding mental capacity and Making Safeguarding Personal where there is self-neglect is an essential element of support. During the pandemic, it has become clearer that these concerns can be acute and there can be exacerbation from isolation.

The importance of ensuring consistent use of the Mental Capacity Act continues. As we transition to Liberty Protection Safeguards, ensuring we have a strong and consistent understanding of the Mental Capacity Act is critical. This work has continued through the development of e learning and examination of challenges through action research.

Changing Lives

Changing Lives produced a Net-Reach report to highlight our concerns that a worrying number of women are advertising to sell or exchange sex, across specialist paid platforms as well as mainstream community selling pages, as a direct result of the financial hardship created by Covid-19. We’re calling for action to support women with existing vulnerabilities such as homelessness, addiction and poverty, who consistently slip through the net.

There has been a sharp increase in sexual violence among women selling sex and/ or experiencing sexual exploitation since the beginning of the pandemic. During the first four months of lockdown, there was a 179% increase in the number of women disclosing that they have experienced sexual violence in some of Changing Lives’ services. This is highlighted in our Nowhere to Turn report.

Changing Lives have a dedicated worker attending the MASH meetings who coordinates all internal referrals, this has proved to be successful and should be sustained, especially to help support our Housing and Homelessness Services in Newcastle.

Changing Lives continue to be part of the Northumbria Exploitation Safeguarding Hub, operationally and strategically.

Changing Lives have campaigned nationally for women survivors of sexual exploitation to get equal access to Justice. During February 2021 Changing Lives produced an influencing paper, drawing on learning and exploration within the STAGE project about how women who have survived sexual exploitation access and experience justice. Justice is understood in broad terms by the project partners, including accessing the criminal justice system, receiving protection and equitable treatment within this, to recovering from trauma. We continue to promote our recommendations locally within safeguarding.

For this year’s Safeguarding Adults week Changing Lives delivered a range of Safeguarding Adults Lunch and Learn sessions for all staff, a huge amount of knowledge and experience was shared. The sessions covered the following topics:

Person-led safeguarding
Using the right language
Learning from Serious Case Reviews
Safeguarding and Exploitation
Transition between Children’s and Adults Services
Safeguarding and Advocacy

The session on person-led safeguarding involved Fulfilling Lives Experts by Experience Group to explore what it meant to be person-led in safeguarding. There were some powerful statements, including:

“Prepare people for meetings and what to expect, create a safe environment and use the word “we”, help people have a voice”
“Listening is so important, understanding what people want from the safeguarding process”

Northumbria Police

As part of our commitment to protecting the vulnerable, the force are currently launching their Early Intervention Strategy and delivery plan. The plan has four pillars: Working Together; Preventative Intervention; Community Resilience and Our People. Our ultimate aim is to achieve a safe environment for people, their families and the wider communities to thrive without fear of harm and to ensure perpetrators are identified and targeted, and that the opportunity for them to cause further harm is removed or minimised.

Northumbria Police have recently created a new Strategic Innovation Partnership Team (SIP). This ensures that the same member of the Safeguarding Senior Management Team at DCI level attends all 6 six of the Local Authority’s Safeguarding Adult’s boards. Within the new SIP team, there is now a learning and improvement function, overseen by a Detective Inspector who will attend all learning and improvement/ quality improvement sub groups, to work with partners to drive and share internal and external learning and improvement. The SIP team will help support the NSAB priorities and provides a consistent and innovative approach to Safeguarding and the development of safeguarding procedures.

Northumbria Police have also led on the review of the multi-agency Exploitation Hub and the commitment of all six Local Authorities and Clinical Commissioning Groups to work together to provide a multi-agency response to those at risk of sexual, criminal exploitation and all aspects of Modern Slavery.

Within the past 12 months Northumbria Police have worked with regional Safeguarding Adults Boards to develop a Missing Adult Protocol. The protocol contains guidance for partners about police responses to Missing persons and Safeguarding guidance for all agencies. The protocol also contains a return interview template and introduces the Winnie Protocol for agencies to record information in respect of adults at risk of going missing. Since the launch of the protocol in November 2020 the protocol has attracted positive comment from the National Safeguarding Adults network and the NHS England Head of Safeguarding.

Northumbria Police have enhanced their support to the return home interview process by introducing a pilot which sees our Street Triage Service attend and conduct return home interviews with those adults who have been missing due to a mental health crisis. It is hoped that by providing early intervention by a mental health specialist we can provide effective signposting and support to prevent future missing episodes and serious harm linked to suicide/self harm.

In response to the rise in online fraud and cyber scams throughout the Covid Pandemic which impact on our vulnerable adults, Northumbria Police have led several campaigns to highlight awareness of frauds including local radio interviews and publications both online and in local newspapers. This demonstrates Northumbria Police preventative approach, providing the vulnerable with the knowledge required to keep themselves safe.

National Probation Service

Our activities in the past year, in common with every organisation, have been dominated by the Covid pandemic and much of the work that we have done in the National Probation Service (NPS) has been involved with organising and delivering our response.

Our main priority has been to ensure that we continue to supervise our service users safely and efficiently while also ensuring the safety of our staff. Although our focus has been on mitigating the effects of the pandemic, we have not lost sight of key areas of work which of course includes safeguarding vulnerable adults. In addition to our “business as usual” approach to and work with service users and partners around safeguarding, we have had a particular focus on domestic abuse working with perpetrators to safeguard vulnerable victims.

We continue to participate in a number of local forums – e.g. MARAC, MATAC – and through MAPPA we ensure that the most complex and high risk offenders are successfully managed via a well-established multi agency approach for the benefit of vulnerable victims and their families. We have also this year successfully rolled out a toolkit for Offender Managers – the Skills for Relationships Toolkit (SRT) – working with perpetrators not suitable for groupwork interventions.

We are also involved in the delivery of a national pilot of polygraph for high risk domestic abuse perpetrators, provision that formed part of the Domestic Abuse Act passed in April 2021. This is an innovative piece of work that will represent a significant addition to our ability to successfully manage perpetrators. Domestic abuse has not been our only focus. We continue to work effectively with perpetrators of sexual offences who have offended against both children and adults and we have undertaken a significant amount of education and training around Contemporary Slavery and other forms of exploitation.

The National Probation Service has a long-standing commitment to working with its service users to empower them to manage their own risk by providing practical help and support within the statutory frameworks within which we work. Safeguarding is at the heart of what we do and our policies and procedures as well as the training and support that we provide for staff working in our organisation are evidence of that commitment. As an organisation we recognise that we cannot achieve what we want to achieve by working in isolation and our commitment to working in partnership – either on a day to day basis in case management or in more specialist activities such as MAPPA, MARAC and counter-terrorism functions – is well established and evidenced throughout all of the work that we do to help reduce re-offending and protect the public.

All of our activity has taken place against a backdrop that not just includes Covid but the most significant restructure of our service since Transforming Rehabilitation in 2014. Those changes, which bring back together both public and private sector providers of Probation services into one single, unified organisation were implemented in June 2021 and represent a significant organisational challenge for all of us. While the process of transition is still ongoing, and while we continue with the process of recovery from Covid, our focus will however remain on the critically important business of safeguarding vulnerable adults.

In the last year, we have worked hard to ensure that we have not let standards drop and we have employed creative and innovative ways to ensure continuity of services and relationships with partners while also ensuring that we continue to support, engage and hold the people that we work with to account.

Your Homes Newcastle (YHN)

During 2020-21, the Safeguarding Partnership Team have recruited additional resources, to enhance our response to Safeguarding. We are an integral part of the Adult Multi Agency Safeguarding Hub. We have changed our ways of working to ensure the service continued throughout the lockdowns.

The team are a Single Point of Contact for all safeguarding, domestic abuse and public protection matters, within the business.

We have an Internal employee Safeguarding & Domestic Abuse Forum which includes all our safeguarding trainers in order to:

To continually raise the profile of children and adults’ safeguarding across YHN.
Monitor and analyse safeguarding performance and identify areas of the business that may require additional support
Monitor and evaluate training needs to help ensure training content and materials are ‘fit for purpose’.
Provide peer support.
Consider feedback and learning from Safeguarding Adult Reviews

During the Sumer of 2020 an internal Review was undertaken to consider the working practices and arrangements within the YHN Safe Living Team. The Safe Living team has been restructured and a new Safe Living Plan is in place.

A further positive outcome of this internal Review has been the Safeguarding Partnership Team transitioning into the Support Services Department. This has enabled us to build upon and enhance our internal support for all vulnerable customers and further make safeguarding personal.

Within the Support Services Department we have staff that support victims of abuse. These staff work closely with our safeguarding partners by risk assessing victims and offering emotional and practical support to customers to improve their situation.

Through the work of the internal Safeguarding & Domestic Abuse Forum we have motivated staff who act as Safeguarding Champions across all directorates, with YHN.
During 2020-21, 97% of YHN staff completed the “Keeping Everyone Safe” online training.

Tyne and Wear Fire and Rescue Service (TWFRS)

Quarterly Safeguarding Meetings with our Deputy Chief Fire Officer (strategic lead on safeguarding) have been increased to monthly meetings to ensure changes, developments, updates and trends are communicated and actioned as soon as practicable.

We have developed our reporting systems, in collaboration with local Safeguarding Adult Boards, to improve the quality and quantity of referrals. This has included the addition of questions related to Making Safeguarding Personal, in particular asking the adult what they would like to happen next.

We have delivered training to fire stations on the importance of referring all adults that present distressed at bridges, regardless of the number of agencies that attend incidents.

We have helped to form a Northern Fire and Rescue Service Safeguarding hub to share best practice and keep updated of developments regionally. This includes fire and rescue services from Lancashire, Merseyside, Cheshire, Manchester, Cumbria, Durham & Darlington, Northumberland, Cleveland and Northern Ireland.

Safeguarding data is now included in our Performance Action Group (PAG) to ensure the quantity and quality of our safeguarding adults referrals are improving.

Following two fire fatalities in December 2019 within the Asian community, TWFRS have undertaken a number of actions with the aim of preventing future similar incidents:

Prevention and Education (P&E) Teams engaged with women within the communities who would most likely be affected, as well as staff and volunteers of support groups and organisations. Messages were conveyed in alternative languages.
Internal TWFRS training for Operational and P&E Teams updated to include loose clothing risks.
Community Safety (CS) advocates made information videos in more than one language, which could be released via all social media platforms and released prior to and during specifically relevant events such as Diwali, Eid, Ramadan etc.
CS advocates compiled an illustrated booklet targeted at anyone who may find it difficult to understand the written word. This was in consideration of many groups of people including those where English is not their first language.
Both electronic and hard copies of the leaflet have been widely distributed to Mosques, Temples and Gurdwaras throughout the service area.

Northumbria Community Rehabilitation Company (CRC)

As a result of HM Government’s decision to re-unify probation providers into a new national Probation Service, the CRC have known for the last 18 – 24 months that the Ministry of Justice would not renew the contract with Northumbria Community Rehabilitation Company.

We have used this period to review and consolidate our training provision in collaboration with partners, to ensure that all our practitioners are up to speed with policy, practice and on-line referral systems and are ready to fully discharge their safeguarding duties as they take up posts in the Probation Service from 28 June 2021.

Amongst our many tasks in transition, we have worked ever more closely with our National Probation Service (NPS) colleagues, to familiarise CRC staff with the current NPS safeguarding policies which are likely to form the basis of Probation Service practice, at least for the first two years post-transition.

In line with Making Safeguarding Personal principles, Northumbria CRC’s Reviewing and Quality Assurance Manager’s has led the development of practitioner responses to the safeguarding needs of our service users. The role involved ensuring that all relevant learning from local and national review work was shared with front line staff, so that they were kept abreast of current trends and might better discharge their duty to work with service users with a focus on person-led decisions and informed consent.

Search

Search has remained committed to the wellbeing and welfare of older people throughout the Covid-19 pandemic. Search has a history of bringing people together in the community for over 41 years, to address social isolation and loneliness.

Search changed its message in the pandemic to “stay safe, stay at home” and it quickly adapted it service delivery models to ensure this was possible. Signing up to help with City Lifeline was part of ensuring this was possible, along with delivering shopping, hot meals, medication and activities to peoples doorsteps. Telephone and online delivery of activity also ensured that Search remained in contact with vulnerable older people. Throughout all of this safeguarding was at the forefront of the work, ensuring that the wave of new volunteers that joined had the correct training and awareness of safeguarding to raise an alert was important.

Our Chief Officer continued in his role as voluntary and community sector representative on the Newcastle Safeguarding Adults Board and was able to feedback on some of the real issues that the pandemic posed to older people.

In 2020-21, the NSAB was chaired by Vida Morris. The NSAB would like to offer thanks to Jacqui Jobson, Chris Piercy and Peter Iveson for their contributions to safeguarding adults in Newcastle over the years and who all stepped down as NSAB members this year.