Co-chair of the Housing and Safeguarding Adults Alliance The safeguarding aspects of the Care Act 2014 and related statutory guidance – implications for housing and housing support providers Imogen Parry Independent safeguarding adults consultant, researcher and trainer for the housing sector Co-chair of the Housing and Safeguarding Adults Alliance

The limitations of ‘No Secrets’ 2000 Statutory guidance – not legislation Preceded the Mental Capacity Act 2005, much case law arising from the Human Rights Act 1998, DoLS Referred to ‘vulnerable adults’ and ‘adult protection’ not ‘adult at risk’ or ‘safeguarding’ Focus on processes and procedures, contributed to ‘risk aversion’ not personalisation or outcomes Lack of clarity about differences between poor practice, abuse, crime ‘Only’ sheltered and supported housing staff included What are the other limitations of NS? Lengthy consultation review of NS and Law Commission review of social care law

Statements of Government Policy on Adult Safeguarding Issued in May 2011 and May 2013 Set out adult safeguarding principles: Empowerment – presumption of person led decisions and informed consent Prevention – it is better to take action before harm occurs Proportionality – proportionate and least intrusive response appropriate to the risk presented Protection – support and representation for those in greatest need Partnership – local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting abuse Accountability – accountability and transparency in delivering safeguarding

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. 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. Enquiries . SABs to bring together LA, NHS and police to coordinate activity to protect adults from abuse and neglect.. Statutory members are LA, NHS and police but housing is listed in the guidance as a possible additional member if the SAB choose (para 14.117). SARs – requirement on SABs to conduct SARs into cases where someone who is experiencing abuse or neglect dies or there is concern about how authorities acted, to ensure lessons are learned. Previously called SCRs and will be compulsory to do and to publish, unlike SCRs Information sharing provisions should go a long way to address some of the significant problems for front-line housing staff. Plus there is lots in the statutory guidance on the need for information sharing.

Wide scope for what constitutes abuse or neglect The Care Act 2014 – other sections and guidance relevant to safeguarding adults Well-being Co-operation Prevention focus Advocates Wide scope for what constitutes abuse or neglect Self-neglect included in list of types of abuse for the first time Well-being (includes protecting people from abuse and neglect) (S1(3)(g). The definition of well-being now includes ‘suitability of living accommodation’. Cooperation between partners The Act sets out five aims of cooperation including protecting adults with care and support needs who are currently experiencing or at risk of abuse or neglect (para 15.16, Chapter 15). RPs are now explicitly listed in the Act as one of the partners a LA must co-operate with when considering and planning a person’s need for care and support. S6(3)(d). Duty on LAs to promote integration with NHS and other services including housing Prevention focus – (S2 (1). Three levels: primary to stop/prevent care and support needs from developing from those who do not have them – eg through health promotion (WEAAD?) or action to reduce isolation; secondary prevention, (delay) for people at risk of developing needs – eg housing adaptations, telecare, advice, early intervention to prevent escalation; tertiary prevention (reduce) for people with established needs to help improve independence – eg through reablement/rehab. Advocates (S68) introduced for first time for people subject to a safeguarding enquiry or a SAR and who would have substantial difficulty in being involved in contributing to the process and where there is no other appropriate adult to assist (para 14.10). Local authorities should not limit their view of what constitutes abuse or neglect (para 14.17) In response to considerable lobbying on this point, para 14.17 now includes self-neglect

Does the Care Act go far enough to safeguard adults? (1) The Care Act is a major improvement on ‘No Secrets’ But there: are resource concerns is no power of entry or duty to report despite much lobbying and debate may be insufficient ‘teeth’ for SABs to be effective Most commentators argue that putting safeguarding adults on a statutory footing will raise its political and professional profile across all sectors and maybe even with the public and the media. PASAUK: ‘The Act represents a major opportunity to raise the profile of safeguarding adults and put it on a statutory basis that requires multi-agency cooperation and activity and place it on a statutory basis that requires multi-agency cooperation and activity, putting adult safeguarding in a position of near parity with safeguarding children’. (But AEA dissent and argue, via Facebook that the Care Act is a scam as far as safeguarding is concerned). But for housing the Care Act is good news, in particular the focus on ALL housing providers, not just providers of sheltered and supported housing as indicated in No Secrets. My next slides indicate huge changes that will have to be made by housing providers to implement the safeguarding aspects of the Care Act and associated guidance. But there are: inevitable concerns about resources – there’s lots of talk about this for social services but housing providers need to be budgeting for their new obligations now. Currently lots of controversy about eligibility criteria - piece in Inside Housing 26 June ‘Tenants at risk over Care Act’ …. And recent ADASS figures on underfunding. And recent Public Accounts Committee report that stated that central government departments ‘neither understand the scale of the challenges (of new duties on local authorities) nor how much it will cost to implement the changes the Care Act will introduce... It may not be feasible for local authorities to implement all the proposed changes to the intended timetable.... Unprecedented levels of coordinated working between government departments, between central and local government and across local authorities and health bodies. The Departments recognise the complexities and risks but we are not convinced that the responsible bodies will deliver on these ambitions and are concerned they are raising expectations too high. Power of entry , duty to report. Huge pressure from AEA and others on the former issue during the passage of the Bill through parliament. Michael Preston-Shoot, Belinda Schwehr both comment on this

Does the Care Act go far enough to safeguard adults? (2) is a lack of clarity about thresholds and sometimes an absence of systems for low level concerns are insufficient references to the need to make links with other issues such as domestic abuse, hate crime and ASB is a lack of clarity about consent issues Although the guidance states that the level of need is irrelevant it is hard to see how councils will function without some kind of threshold to progress an alert to a referral. There is an absence of MASH (or VARM) systems for low level concerns in many areas of the country (encouraged in para 14.29). Also see Belinda Schwehr on entitlement/assessment CC 3.3.14 and 21.7.14. Insufficient references to overlaps between safeguarding and other issues such as DA and ASB The issue of refusal of consent (paras 14.79, 14.93, 14.157, 14.158, 14.169, 14.184) is still contradictory. The recent SCIE guide refers to this issue states that a person’s choice should be respected unless one or more of the following applies: very high risk to the individual, coercion is involved, other people are at risk, the alleged abuse has care and support needs and may also be at risk, the victim lacks the mental capacity to make a decision about their safety, a serious crime has been committed, staff are implicated in the crime. (http://www.scie.org.uk/publications/guides/guide53/frontline-housing/sharing-information.asp) SCIE cite Parry.I. (2013) Adult safeguarding and the role of housing, Journal of Adult Protection Vol.15 No. 1 2013.

The Care Act draft statutory guidance for adult safeguarding – housing implications (1) 14 references to housing providers, housing support providers Agencies should identify a senior manager to take a lead role in organisational and inter-agency safeguarding arrangements Although not a statutory member of SABs, housing providers and housing support providers may be invited Housing support workers may be asked to ‘make enquiries’ The Care Act final statutory guidance was published in October 2014 following consultation on the draft in the summer. Chapter 14 provides guidance on Sections 42 -47 and 68 of the Care Act and includes: 14 references to housing providers and housing support providers States that a senior manager should take a lead role (para 14.187) or ‘consider the benefits of having a lead for adult safeguarding’ (para 14.109). ‘Regular face-to-face supervision from skilled managers is essential to enable staff to work confidently and competently with difficult and sensitive situations’ (para 14.46). Managers have a central role in ensuring high standards of practice and that practitioners are properly equipped and supported (para 14.172). Anyone in contact with the adult must... have access to practical and legal guidance, advice and support... including local inter-agency policies and procedures (para 14.40). ‘SABs may wish to invite additional partners to some meetings depending on the specific focus or to participate in its work more generally. Examples include representatives of housing providers, housing support providers’ (para 14.117) The Act (S42(2)) and guidance (para 14.84) make it clear that an enquiry could be undertaken by people other than the local authority (the lead agency) including ‘a housing support worker’ . Para 14.59 states that ‘all those carrying out such enquiries should have received appropriate training’.

The Care Act draft statutory guidance for adult safeguarding – housing implications (2) 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 Policies and procedures (eg para 14.41 + lots more, see checklist). Specific to housing, the guidance states that ‘all service providers, including housing and housing support providers, should have clear operational policies and procedures that reflect the framework set by the SABs in consultation with them (para 14.196). See the Housing and Safeguarding Adults Alliance webpage for examples of good practice policies and procedures by Together Housing Group (Sue Lewis) All housing staff must be: familiar with the 6 principles which are: empowerment, prevention, proportionality, protection, partnership, accountability. The six principles that underpin adult safeguarding apply to all sectors and setting including housing providers (para 14.13) Trained including via multi-agency training set by the SAB (para 14.122). Staff must know: signs and types of abuse who to report to (14.86), how to support adults to think and weigh risks and benefits of different options (para 14.30).. vigilant and able to respond to adult safeguarding concerns, including housing (para 14.29, 14.30). Do your own organisation’s current adult safeguarding policies, procedures and guidance include all these points? Recommend that you self assess against the Housing and Safeguarding Adults Alliance checklist against the safeguarding aspects of the Care Act statutory guidance