Multi Agency Safeguarding Hub MASH National Adult Support & Protection Conference 2nd October 2019 – Dovecot Studios, Edinburgh Caroline Ronaldson – Team Manager – Social Work Elaine Wylie – ASP Adviser – NHS Dumfries & Galloway

Demographics Region wide remit over four localities At 30 June 2017, the population of Dumfries & Galloway was 149,200 - the 13th highest population in 2017 out of all 32 council areas in Scotland Population by age: 15.7% of the population aged between 0 and 15 59.2% aged between 16 and 64 25% aged 65 and over Largest town is Dumfries with a population around 40,000 in Nithsdale area. The next largest town is Stranraer at >10,000. Length across D&G by road approx 100 miles. Although 13th highest in population, it is the 3rd largest geographical area behind Highlands and Argyle and Bute.

Refer onwards/ signposting Life Before MASH Locality Team Screen Referral Manage under ASP Refer onwards/ signposting

Dumfries & Galloway Statistics and Trends 2011 - 2015   2011/12 2012/13 2013/14 2014/15 Average 2011/15 Number of Adult Referrals 6474 6808 7809 7637 7182 How many went to Inquiry 1380 1676 1666 1279 1500 How many went to investigation 49 63 43 57 53 How many went to AP Conference 16 17 12

Why was MASH created? To improve our overall multi-agency approach to protecting and safeguarding adults at risk of harm by bringing together all essential partners i.e. Police, Health and Social Work. Considering key messages and recommendations from: Report of a joint inspection of adult health and social care services, Services for older people in Dumfries and Galloway (Care Inspectorate, 2016); Report of a joint inspection, Services for children and young people in Dumfries and Galloway (Care Inspectorate, 2014); National and Local Significant Case Reviews in relation to vulnerable adults and children.

Remit / Core Functions Protect and safeguard individuals who may be at risk of harm Provide a single point of entry for screening referrals Identify and assess risk Facilitate Initial Referral Discussions (IRDs) Assess and share information timeously and securely Implement interim safety plans Provide joint performance reporting to evidence outcomes and support Quality Assurance

Consultation / Challenges Practitioner / Strategic consultation – pre and post inspections Chief Officers Group Adult and Child Protection Committees Resource, finance, location (vetting within Police HQ) Agreement of remit / functions and hours Escalation processes

Implementation September 2016: Soft launch of Adult MASH Co-located within Crichton Hall (NHS property) Remit for only the East of the region February 2017: Full implementation of both Adult and Child MASH Co-located within Police Headquarters, Cornwall Mount

Structure / Key Partners Social Work: Adult – Senior Social Worker x 2; Care-Coordinator; Council Officer, Admin. Police Scotland: Detective Inspector; Detective Sergeants x 2; Detective and Police Constables; Admin. NHS: Health Advisor Nurse Consultant for Clinical Risk – 2-3 mornings per week. Direct links to other partner professionals within Social Work, Police and NHS.

Referral Process / Triage Triaged by Access Team Referral received by Contact Centre MASH Locality SW Team

Adult Initial Referral Discussion An Adult Initial Referral Discussion (aIRD) is a formal face to face tripartite meeting between Social Work, Health and Police to: Consider the concerns raised Source and share single agency information (including information from relevant partner agencies) Analyse information to support identification of risk factors and protective factors (using the Risk Matrix Tool) Inform decision making as to whether or not action needs to be taken to protect an adult from harm Agree actions

IRD Outcomes Potential outcomes from an IRD: Adult Support & Protection Investigation Planning Meeting (exceptional) Self Directed Support planning Signposting / referring on to other agencies No further action

Governance The Adult MASH has, since implementation, been subject to regular multi-agency scrutiny – performance and governance is monitored to improve / acknowledge good practice. Also, ensuring policies and procedures are adhered to: Quarterly and annual reporting – data collated within MASH MASH Steering Group / IRD Review Group Public Protection Committee

What works well? Shared understanding of risk Faster and more effective joint decision making Information sharing Earlier and more effective co-ordinated intervention Collaborative commitment to continuous improvement More effective use of public resources Links with MARAC / MATAC / DSDAS A shared understanding of thresholds Simple structure: 1 x NHS Board and 1 x Local Authority

Challenges Information sharing IT Systems Thresholds Multi-agency management decision making Workload within MASH

What are we continuing to explore? Enhanced knowledge and skills Additional input from partner agencies / professionals Multi-Agency training both within MASH and from MASH to partner agencies / professionals Feedback to referrers for all ASP concerns Chronologies Ideas for change

Questions?