Engaging the Housing sector Designated Nurse Adult Safeguarding in Adult Safeguarding Sallyann Baxter Designated Nurse Adult Safeguarding South Kent Coast CCG 1

‘The role of housing in preventing and addressing adult abuse is neglected in legislation, policy, practice and research’ Report of the joint committee on the draft Care and Support Bill, England March 2013, para. 163. 2

“Housing staff have a key safeguarding role to play, alongside their colleagues in social care, health and the police, in keeping people safe. They are well placed to identify people with care and support needs, share information and work in partnership to coordinate responses” SCIE Guide 53 - ‘Adult safeguarding for housing staff’ (2014) 3

Problems and complexities of partnership working Disincentives and barriers for all social housing providers to be involved in adult safeguarding Until now there have been weak regulatory and legislative responsibilities on general needs housing providers, contributing to:  lack of a safeguarding culture  insufficiently trained staff  under-reporting of abuse  limited data on vulnerabilities of tenants Problems and complexities of partnership working 4

New drivers and incentives for housing providers’ engagement in adult safeguarding (1)  Increasing public, political and media awareness of abuse  Reputational risk for all providers of services for adults at risk  Increasing numbers of adults at risk living in social housing  Safeguarding links to other agendas that housing is (or should be) engaged in: anti-social behaviour; crime reduction; domestic abuse; disability hate crime; health and well-being 5

New drivers and incentives for housing providers’ engagement in adult safeguarding (2)  Evidence through SCRs of failures of housing providers to prevent murder, abuse and neglect of adults at risk, including those living in general needs housing  SCIE guidance on ‘Adult safeguarding for housing staff ’  Housing and Safeguarding Adults Alliance  Care Act 2014 and statutory guidance 6

Aim to improve the engagement of all social housing providers in safeguarding adults and build greater understanding by the statutory partners of the key role housing can play 7

The Care Act 2014 - safeguarding sections 42-45 New duty for local authority to carry out enquiries (or cause others to) where it suspects an adult is at risk of abuse or neglect (S42). Requirement for all areas to establish a Safeguarding Adults Board (SAB) SABs to carry out safeguarding adults reviews (SARs) New ability for SABs to require information sharing from other partners to support SARs or other functions. 8

The Care Act statutory guidance for adult safeguarding – housing implications (1) All housing providers and housing support providers should have clear operational policies and procedures in adult safeguarding All housing staff must be: • familiar with the six principles underpinning adult safeguarding • trained in recognising the symptoms of abuse • vigilant and able to respond to adult safeguarding concerns 9

Findings of 21 SCR (2010-2013) 30% of all publically available adult SCRs concerned vulnerable individuals living in social housing Half lived in specialist housing and half lived in general needs housing Thematic analysis identified six themes or lessons 10

Summary of housing related lessons Internal: Housing providers should improve: data bases of all tenants ensuring that vulnerabilities are identified support and contract monitoring involving vulnerable tenants awareness of safeguarding by all staff and ensure effective reporting of abuse External: Housing providers are inhibited in their effectiveness in adult safeguarding due to: barriers to information sharing, often caused by negative attitudes towards housing staff high referral thresholds by adult social care failures of risk and capacity assessment and diagnosis by adult social care 11

Overcoming information sharing problems – tips for housing staff Know about and use all relevant multi-agency information sharing protocols Set up multi-agency meetings to improve these protocols and address problems Increase awareness and understanding of role of housing staff Ensure that decisions are being taken at the right level within your organisation and within Adult Social Care 12

Tips to housing staff re thresholds If told that the alert or referral cannot be accepted (as it doesn’t meet their referral threshold or their definitions of abuse or vulnerable adult/adult at risk), consider: checking what their policy says on referral criteria and definitions. Is their interpretation open for discussion? reconsidering the facts of your referral – have you left something out or underestimated/downplayed the risks? ask if they have a mechanism for gathering information on apparently low level cases, especially where there is an emerging pattern of referrals, eg MASH (quote Pilkington, Hayter) asking for advice on how to handle the situation yourself or via other agencies if the case is not accepted and investigated ,refer again if circumstances and risks change Ensure that decisions are being taken at the right level within your organisation and within Adult Social Care 13

Tips to housing staff encountering problems re assessment, diagnosis, choice If you are told ‘it is the person’s choice’(e.g. to refuse services/intervention/proceed with prosecution) or that ‘they have capacity and the right to make unwise decisions’ consider: Was the person coerced? Is anyone else at risk? Has there been a proper and recent capacity assessment on this issue? Could there be an over-riding duty of care? Has the person been accurately and recently diagnosed (e.g. learning disability or mental health issues) and risk assessed? Particular attention should be paid if:   their circumstances have deteriorated and/or   their needs have increased or are very complex and/or   there is a sudden change in behaviour i.e. ‘an escalating problem’ 14

Summary of action needed by housing providers to improve adult safeguarding Ensure effective housing representation on SAB, MAPPA, MARAC, MASH, CSP, VARM etc. Housing providers should introduce an organisational culture change incorporating a ‘culture of curiosity’, a clear transformation process and:   Ensure leadership in this change from the very top of the organisation   Improve recording of vulnerability on data bases and IT systems to flag up repeats, patterns and warning signs   Employ internal safeguarding leads   Ensure robust adult safeguarding policies, procedures, guidance and supervision   Train ALL staff, regularly, in adult safeguarding and MCA   Seek inclusion in current revisions to local multi-agency safeguarding policies, procedures and processes in the light of the Care Act and MSP   Instill staff confidence to challenge other agencies   Improve customer awareness of safeguarding   Self-assess against the Housing and Safeguarding Adults Alliance objectives and Care Act checklist 15

Thank you