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Leicester Safeguarding Adults Board Annual Report 2019-2020

This report covers a year that ended in an unprecedented way. The Covid-19 pandemic put adult safeguarding into a position of more central importance than ever before.

This report covers a year that ended in an unprecedented way. The Covid-19 Pandemic put adult safeguarding into a position of more central importance than ever before. Although the outbreak began in earnest at the very end of the year this report covers, that relatively short period will have the greatest implications for the work of the Safeguarding Board in 2020 to 2021, and beyond. I would like to send condolences on behalf of the Board to those who have lost loved ones or been affected by the pandemic. I would also like to thank all those professionals who have worked tirelessly to keep adults at risk safe in very uncertain times.

Looking back to the earlier part of the year that is under review in this report, there were important cultural developments in the way that professionals work in adult safeguarding. The board members try to stay curious about what our data is telling us and the first part of the report sets out the context of referrals and volumes that sits behind cultural change in the way that safeguarding is done.

Learning underpins the work of the board and I would like to thank those who organise the three principle strands of this – multi agency training; audit; and reviews. I was privileged to attend two well attended conferences organised under the auspices of this Board and the equivalent partnership for Leicestershire and Rutland. The range of speakers, and the thought given to content, was inspiring. As was the contribution by professionals which was a powerful reminder of the always-complex task of adult safeguarding.

Partnership around the board remains strong. It has been helpful for me as a new chair of the Board to spend time in organisations, being shown around by our Board members. As important is partnership between different important strategic groups in Leicester, where coordination and leadership on community safety, child safeguarding, vulnerability more generally, and population health and wellbeing are dealt with. I have invited some new members to our Board to try and strengthen links and accountability and been made welcome at these other partnerships to discuss how we can coordinate our efforts across families and for adults with care and support needs who live with multiple risks. I hope that more than ever, because we are moving into a new and challenging context, this coordination can proceed at pace in the coming year.

Thank you for your interest in reading this report and thank you to Board colleagues and the Business Unit that supports the work of the Board.

Fran Pearson, LSAB Independent Chair

The main objective of a Safeguarding Adults Board is to assure itself that local safeguarding arrangements and partners act to help and protect adults in its area who meet the following criteria:  

  • Adult has needs for care and support (whether or not the Local Authority is meeting those needs)
  • Adult is experiencing, or at risk of experiencing, abuse or neglect
  • As a result of their care and support needs, adult is unable to protect themselves

Leicester Safeguarding Adults Board must seek to achieve this objective by coordinating and ensuring the effectiveness of each of its members in relation to adult safeguarding. We have a strategic role that is greater than the sum of the operational duties of our partners; we oversee and lead adult safeguarding across Leicester and are interested in a range of matters that contribute to the prevention of abuse and neglect.

Leicester Safeguarding Adults Board Membership

Criminal justice National Probation Service, Leicestershire
  Derbyshire, Leicestershire, Nottinghamshire and Rutland Community Rehabilitation Company
  HMP Leicester
Emergency services Leicestershire Police
  East Midlands 
  Leicestershire Fire and Rescue Service
Health Leicester City Clinical Commissioning Group
  Leicestershire Partnership NHS Trust
  University Hospitals Leicester NHS Trust
  NHS England
Local authority Adult Social Care
  Children's Social Care
  Housing
  Community Safety
  Trading Standards
  Lead Member
Inspectorates Care Quality Commission
Consumer champions Healthwatch
Care home associations East Midlands Care Association

As a partnership, Leicester Safeguarding Adults Board appoints an Independent Chair to oversee the work of the Board, provide leadership, offer constructive challenge, and ensure independence. To support consistency, alignment where appropriate, and a shared understanding of effectiveness across the two partnerships, our Independent Chair is shared with Leicestershire and Rutland Safeguarding Adults Board, as are a number of our sub-groups. The day to day work of Leicester Safeguarding Adults Board is undertaken by the sub-groups. The board office supports the operational running of these arrangements and manages the Board on behalf of the multi-agency partnership.

With a population of more than 330,000 Leicester is the 10th largest city in the UK. The mean age of Leicester’s population is significantly lower at 34.8, than that of the East Midlands at 40 and England at 39.3 and it boasts the largest proportion of people aged 19 and under in the East Midlands. Information from the 2011 census celebrates Leicester as one of the most ethnically diverse cities in the UK with the population being made up of people from the following ethnic groups: White (50.5%), Asian, Asian British (37%), Black/African/Caribbean/Black British (6%), Mixed/Multiple Ethnic Groups (3.5%), Other Ethnic Groups (3%). The population of Leicester is made up of 49.4% males and 50.6% females.

Leicester City 2019/20 Safeguarding Adults Data

The Care Act 2014 sets out our statutory duties and responsibilities for safeguarding, including the requirement to undertake Enquiries under section 42 of the Act to safeguard people. Below is a summary of safeguarding activity recorded during 2019/20 for both safeguarding Concerns raised, and Enquiries undertaken.  A total of 2049 concerns were raised, a total of 1468 individuals were involved in a concern during the year.

During 2019/20, 462 individuals were involved in a Section 42 Safeguarding Enquiry. At the conclusion of a Section 42 Enquiry, where a risk was identified during the Enquiry, an outcome concerning the status of this risk is recorded. In 2019/20, 536 Enquiries were concluded, and a risk was identified in 454. Of those with a risk identified, the risk to the individual was reduced in 59% of cases, and removed entirely for a further 34%, in 7% of cases the risk remained.

Making Safeguarding Personal is an important aim of our safeguarding adults process. Where possible we aim to achieve during the enquiry process the outcomes the individual involved has identified for themselves. During 2019/20 we recorded these outcomes for 286 of enquiries undertaken. Where these outcomes were identified, they were fully achieved in 57% of cases and achieved in part in a further 39%.

Leicester City 2019/20 Safeguarding Adults Data Continued

Section 42 safeguarding enquiries completed during the year 2019/20

Concluded enquiries by the type of abuse

  • Physical abuse: 18.2% (131)
  • Sexual Abuse: 4.0% (29)
  • Psychological abuse: 17.3% (125)
  • Financial or Material Abuse: 15.3% (110)
  • Organisational Abuse: 6.8% (49)
  • Neglect or Omission: 31.9% (230)
  • Forced Marriage: 17.3% (125)
  • Modern Slavery: -
  • Self Neglect: 0.3% (2)

Outcome at the conclusion of a safeguarding enquiry where a risk was identified

  • Risk reduced: 58.6% (266)
  • Risk Remains 7.0% (32)
  • Risk Removed 34.4% (156)

Basically you’re pulling out the key figures from the charts and putting them into bullets.

MSP Outcomes for concluded enquires

  • Fully Achieved 55.6% (164)
  • Not Achieved 5.4% (16)
  • Partially Achieved 39% (115)

Safeguarding Concerns raised during the year 2019/20

Individuals involved in a concern by gender

  • Male 42.5% (620)
  • Female 57.6% (843)

Individuals involved in safeguarding concerns by age band

  • 18 to 64 36.3% (530)
  • 65 to 74 12.3% (179)
  • 75 to 85 22.6% (330)
  • 85 to 94 24.0% (350)
  • 95 and over 4.9% (72)

Individuals involved in a concern by ethnicity

  • White 73.4% (1079)
  • Asian / Asian British 15.7% (231)
  • Black / black British 3.3% (48)

Individuals involved in a concern by support reason (where known)

  • Physical support 53.5% (472)
  • Sensory support 1.5% (13)
  • Support with memory and cognition 7.4% (65)
  • Mental health support 17.5% (154)
  • Social support 4.0% (35)

Section 42 Safeguarding Enquires commenced during the year 2019/20

Individuals involved in an enquiry by gender

  • Male 43.5% (192)
  • Female 56.5 (249)

Individuals involved in an enquiry by age band

  • 18 to 64 41.4% (183)
  • 65 to 74 14.7% (65)
  • 75 to 85 22.4% (99)
  • 85 to 94 18.1% (80)
  • 95 and over 3.4% (15)

Individuals involved in an enquiry by ethnicity

  • White 77.0% (339)
  • Mixed / Multiple 1.6% (7)
  • Asian / Asian British 12.5% (55)
  • Black / Black British 3.6% (16)

Individuals involved in an enquiry by support reason (where known)

  • Physical support 43.1% (88)
  • Sensory support 3.4% (7)
  • Support with memory and cognition 8.8% (18)
  • Mental health support 19.6% (40)
  • Social support 3.4% (7)

For more information about adult safeguarding, please visit our website www.leicester.gov.uk/lsab where you will find our introductory guide and our guide to the process of keeping adults safe from abuse and neglect in Leicester. Alternatively, call 0116 454 6270 to request a copy of these guides.

As a partnership, Leicester Safeguarding Adults Board outlined its strategic priorities in its three-year strategic plan published in 2017. Throughout this time, core priorities have been ensuring statutory compliance and enhancing everyday business. Developmental priorities have been strengthening user and carer engagement, raising awareness within our diverse communities, understanding how well we work together, and improving safeguarding transitions for young people.

CORE PRIORITY 1: Ensuring statutory compliance – Leicester safeguarding adults reviews 2019/20

Safeguarding Adults Boards have a statutory duty under S.44 of the Care Act 2014 to undertake safeguarding adults reviews in cases which meet the criteria. The purpose of a review is to identify lessons to be learnt and to apply those lessons for the future. During 2019/20 Leicester Safeguarding Adults Board concluded one Safeguarding Adults Review (SAR) and commissioned four. For the purposes of transparency, a table of SAR referrals, decisions, and outcomes during 2019/20 is provided:

SAR referrals and outcomes (2019-2020)

Referral date: January 2019
Date case first heard: February 2019
Decision made: The partnership concluded that it was now known or suspected that the individuals death resulted from abuse or neglect. There were complexities in ascertaining whether or not the individual was likely to have had care and support needs, but after detailed exploration, the SAB determined (July 2020) that a SAR would be carried out under S.44(4) of the Care Act 2014 (non mandatory).
Outcome: SAR S.44(4)


Referral date:
August 2019
Date case first heard: September 2019
Decision made: The partnership concluded that in this case an individual with care and support needs died as a result of abuse or neglect. However, there was not reasonable cause for concern about how partners had worked together to safeguard the person, therefore a SAR was not mandatory. A decision was made to commission a non mandatory SAR under S.44(4) of the Care Act 2014.
Outcome: SAR S.44(4)


Referral date: November 2019
Date case first heard: December 2019
Decision made: The partnership concluded that the individual who died was unlikely to have had needs for care and support, there was no evidence that the death resulted from abuse or neglect, and there were no concerns about how agencies worked together. The criteria for a SAR was not met and no SAR was commissioned.
Outcome: No SAR


Referral date: January 2020
Date case first heard: February 2020
Decision made: In this case, a person with care and support needs is alive and the SAB knows or suspects that they have experienced serious abuse. There was cause for concern about how organisations worked together to safeguard the individual. A mandatory SAR under s.44 (1a) of the Care Act 2014 was commissioned.
Outcome: SAR S.44(1a)


Referral date: February 2020
Date case first heard: February 2020
Decision made: A decision was made that a non mandatory SAR should be carried out, based on the circumstances known. The partnership was unable to conclude that the criteria for a mandatory SAR were met, however there were concerns over how agencies worked together, from which could learn.
Outcome: SAR S.44(4)


Referral date: March 2020
Date case first heard: March 2020
Decision made: Although the individual who died had needs for care and support, there was no evidence to suggest that the death was a result of abuse or neglect, and there were no concerns about how agencies worked together. The partnership concluded that a SAR would not be commissioned.
Outcome: No SAR

 

It is anticipated that all four of our reviews commissioned during the 2019/20 business year, will be concluded during 2020/21, and the findings reported on in our 2020/21 annual report. We publish our SARs throughout the business year and they can be found on the LSAB page dedicated to SARs on the Leicester City Council website.

‘Mary and Graham’ SAR

Concluded during 2019/20, our ‘Mary and Graham’ SAR is published in full on the LSAB web pages of the Leicester City Council website. A summary of learning has also been provided in the April 2020 publication of Safeguarding Matters, along with a link to a reflective practice case study for use in learning and development activities, training, team meetings, and supervision. The Board would like to offer condolences to the family and thank them for their contribution to this review as well as their support with its publication.

In response to the recommendations in the review, the Safeguarding Adults Board has:

  • Published the review in full
  • Shared the learning via learning briefings and reflective practice case studies
  • Sought assurance that learning has been shared and embedded within partner agencies
  • Facilitated a conference with a focus on domestic abuse in older people
  • Promoted the use of professional and appropriate challenge across the safeguarding adults partnership

The work of the Performance Sub Group, Joint Audit Group, Training Sub Group and Joint Policy and Procedures Sub Group. A local Safeguarding Adults Board must seek to achieve its objective is by ‘co-ordinating and ensuring the effectiveness of what each of its members does’ (Care Act 2014). Leicester Safeguarding Adults Board works with Leicestershire and Rutland Safeguarding Adults Board to maintain up to date inter-agency adult safeguarding policies and procedures across Leicester, Leicestershire and Rutland. These policies and procedures are hosted on our dedicated policy and procedures website called the MAPP (Multi Agency Policies and Procedures). Throughout 2019/20 these policies and procedures continued to be reviewed and updated in line with learning from reviews, audits, and best practice.

The Performance Sub Group is responsible for ensuring that Leicester Safeguarding Adults Board has a clear quality assurance framework. It delivers a range of business as usual matters, including management of the performance data and intelligence, a programme of assurance activity, and the production of an annual assurance statement (which includes the results of the annual local Safeguarding Adults Assurance Framework). Throughout 2019/20 the Performance Sub Group also led on the development of a new 5-year Strategic Plan on behalf of the partnership.

Our Joint Audit Sub Group undertakes multi-agency safeguarding adults audits across Leicester, Leicestershire and Rutland. The process brings together practitioners to give a multi-agency view on practice in safeguarding cases to identify areas of good practice and areas for learning and improvement. During 2019/20 separate audits focused on ‘Mental Capacity Act and Safeguarding’ as well as ‘Financial Abuse’. Audit findings directly influenced changes to local policies and procedures, with the aim of improving practice across the partnerships.

Section 14.139 of the Care Act Statutory Guidance notes ‘Each SAB should… promote multi-agency training and consider any specialist training that may be required. Consider any scope to jointly commission some training with other partnerships…’. The LSAB Training Sub Group leads this work on behalf of the partnership, in line with our Training Strategy.

In June 2019 the Training Sub Group arranged for Barrister Alex Ruck Keene to brief the partnership on what we can expect from Liberty Protection Safeguards. It was a useful introduction which enabled board members to develop a joint understanding of potential implementation and transition arrangements. 

November 2019 saw Leicester Safeguarding Adults Board, in partnership with Leicester Safeguarding Children Partnership Board, Leicestershire and Rutland Safeguarding Adults Board, and Leicestershire and Rutland Safeguarding Children Partnership, facilitate a one day conference at Leicester City Hall. Local and national speakers provided information on a range of topics which spanned the priorities of both children and adults safeguarding, including Mental Capacity Act for 16+, Modern Slavery, Prevent, Forced Marriage, Exploitation, Cuckooing and County Lines. The event concluded with an update on learning from local reviews and audits. 

In January 2020, the Training Sub Group arranged, for strategic leads across the partnership, a briefing from Former NCA Head of Drugs, Threat and Intelligence, Tony Saggers on ‘cuckooing’. The focused and informative sessions were well attended and will support the partnership to consider the local response to Cuckooing and Adult Safeguarding throughout 2020/21 (see also developmental priorities 3 and 4).  

Leicester Safeguarding Adults Board, in partnership with Leicestershire and Rutland Safeguarding Adults Board, also facilitated a multi-agency safeguarding adults conference at City Hall in February 2019. Representatives from across the partnership attended. National speakers included Office of the Public Guardian with a focus on financial abuse, an overview of the Court of Protection and Inherent Jurisdiction (Eliza Sharron, Barrister – Kings Chambers), and Dr Hannah Bows, Assistant Professor in Criminal Durham Law School, on Domestic Abuse and Older People. The purpose of the day was to increase awareness of the complex areas of Financial and Domestic Abuse and reflect on defensible decision making that underpins an assessment of risk. Group exercises, with multi-agency colleagues, allowed the opportunity for reflection on defensible decision making.

The Training Sub Group also oversaw a training programme which included regular ‘Mental Capacity Act Forums’ for for care providers in the city, as well as Leicestershire Fire and Rescue Service’s ‘Fire Safety in the Homes of Vulnerable Adults’ multi-agency training. Leicester Safeguarding Adults Board worked closely with Leicestershire and Rutland Safeguarding Adults Board to facilitate a Trainers Network across Leicester, Leicestershire and Rutland, and contributed to the established newsletter Safeguarding Matters newsletter, which is read widely across the partnerships.

DEVELOPMENTAL PRIORITY 1: Strengthening User and Carer engagement

During 2019/20 the Engagement Sub Group, having consulted with national user group ‘Shaping Our Lives’, developed and promoted the role of Ambassadors Network Coordinator. This was a paid role for someone who had experienced adult safeguarding (or potentially a parent/carer of someone that had experienced adult safeguarding services). The vision was that the individual would Chair the Engagement Sub Group and take a position as board member for the Leicester Safeguarding Adults Board. The Ambassadors Network Coordinator, once in post, would be supported by the LSAB Engagement Officer to develop a network of safeguarding ambassadors across Leicester. The post was created and subsequently advertised widely, both locally and nationally, but we were unable to recruit. Having to take an alternative course of action, our Principal Social Worker agreed to chair the Engagement Sub Group, and work began to consider alternative ways of strengthening user and carer engagement. 

DEVELOPMENTAL PRIORITY 2: Raising awareness within our diverse communities

Recognising that our safeguarding alerts and subsequent safeguarding activity are not representative of the population of Leicester, the Engagement Sub Group worked to update and promote our awareness raising material including a revamp of our website to make it more accessible to local communities. Resources available under our ‘What Is Adult Abuse and How To Report Concerns’ website page include:

  • Introductory guide to keeping adults safe from abuse and neglect in Leicester
  • Guide to the process of keeping adults safe from abuse and neglect in Leicester
  • Report abuse or neglect in Leicester postcard
  • Safeguarding training resource (developed by the LSAB Training Sub Group)

Our LSAB Engagement Officer began to promote these materials with local communities across Leicester and also consulted with communities on the new Strategic Plan, developed by the Performance Sub Group. Whilst the impact has not been as significant as we would have hoped, there has been some measured improvement in increasing safeguarding alerts across communities, which is positive. This work will continue into 2020/21.

Impact from 2018 to 2020:   

  • Safeguarding alerts from Asian/Asian British ethnic group has risen by 1.3% from 14.4% to 15.7%
  • Safeguarding alerts from Mixed/Multiple ethnic group has risen by 0.3% from 1.3% to 1.6%
  • Safeguarding alerts from ‘Other’ ethnic group has risen by 0.2% from 0.9% to 1.1%
  • Safeguarding alerts from people with mental ill health has risen 1% from 16.3% to 17.3%
  • The overall conversion rate from alert to enquiry has risen by 3.6% from 22.4% to 26%

DEVELOPMENTAL PRIORITIY 3: Understanding How Well We Work Together

DEVELOPMENTAL PRIORITY 4: Improving Safeguarding Transitions for Young People

Throughout 2019/20 Leicester Safeguarding Adults Board worked collaboratively with Leicester Safeguarding Children Partnership Board, Leicestershire and Rutland Safeguarding Adults Board, and Leicestershire and Rutland Safeguarding Children Partnership to undertake a Safeguarding Transitions Task and Finish Group. The group’s focus was on victims of child exploitation (for example CSE, gangs, county lines, cuckooing, domestic abuse, extremism, modern slavery and trafficking) who are transitioning or have transitioned between child and adult safeguarding. The group outlined the current position in light of safeguarding transitions work across Leicester, Leicestershire and Rutland and identified a gap in information-sharing, provision, and services for vulnerable young adults who do not have needs for care and support. The report has been shared with the Child Criminal Exploitation (CCE) Operations Group, which sits under the Leicester, Leicestershire & Rutland Vulnerability Executive, who will be taking forward additional work during 2020/21.   

At the start of 2020, the Covid-19 global pandemic meant significant changes to ways of working throughout the partnership. Leicester SAB worked jointly with Leicestershire and Rutland SAB to regularly review the work of the Boards. A number of sub-group meetings were put ‘on hold’ for a short time, and ways of working were restructured to ensure that the essential and statutory work of the Boards continued. The partnership built relationships with the Local Resiliance Forum, who led on the immediate response to the pandemic.

Looking to 2020/21, our new strategic plan will be published in 2020, it will be joint with Leicestershire and Rutland SAB and will cover the period 2020-2025. The business plan for 2020/21 is currently being developed in light of Covid-19 and will be published alongside our strategic plan, on the ‘plans, reports, and strategies’ page of our web pages. 

Leicester safeguarding adults board

Performance subgroup

  • Chair: Ruth Lake, Director Adult Social Care and Safeguarding, Leicester City Council

Review subgroup

  • Chair: D/Supt Matt Ditcher, Leicestershire Police

Training sub group

  • Chair: Rachel Garton Designated Nurse, Clinical Commissioning Group

Engagement sub group

  • Chair: Jo Dyke, principal social worker, Leicester city council

LLR Audit Sub Group

  • Chair: Laura Sanderson, lead practitioner, Leicestershire County Council

LLR Policy and procedures Group

  • Chair: Barney Thorne, partnerships manager, Leicestershire Police