Safeguarding

Welcome 

The year covered by this report, 2020/21 saw the world react to the COVID-19 pandemic. As we all know it has had significant impact on all of us, with many families suffering personal tragedies.

It has also had a massive impact on how services have had to respond to safeguarding the most vulnerable people in our communities. I have witnessed the tremendous effort that many agencies, and individuals, in Barnsley have made to keep their fellow citizens safe often whilst putting themselves at risk. That includes members of the public who have taken an increased interest in the circumstances of the vulnerable in their communities.

Throughout the year, the Barnsley Safeguarding Adults Board has kept its work going and has taken a very keen interest in how services have managed to keep doing their work whilst facing a set of circumstances never experienced before in our lifetimes. The Board, and its sub groups, have continued to meet albeit via video conferencing and have continued to make improvements.

I would particularly draw attention to the fact we have been able to employ a part time multi- agency trainer, a real step forward in our arrangements. It means that we can now offer our own training packages, mapped against national competencies for health and social care staff. Delivered locally, via E learning and video conferences, to staff and volunteers who work with adults at risk

We have, with significant support from Board members reviewed our strategic plan and our priorities. This has strengthened the link between the work of the sub groups and the Board itself and has helped the Board to identify successes and areas for additional work. The priorities agreed are:

• Ambition 1: To ensure that collectively we all work hard to prevent harm and abuse across Barnsley.
• Ambition 2: To develop citizen led approaches to safeguarding
• Ambition 3: To continue to develop safe transition experiences for young people
• Ambition 4: Learning together and continually improving

Self-neglect and hoarding continue to be of concern. Despite considerable effort to improve the working practices and the training of staff, we are still seeing cases of chronic neglect and severe hoarding. I am confident that we have a better understanding of issues that can often lead to a person becoming isolated, self-neglecting and potentially then living in very poor circumstances; for example, the death of someone who has played an important role in their lives. We will continue to work hard at making an impact in those cases that come to the attention of services, but my plea is that members of the public be prepared to contact services to let them know of any individual who may be starting to decline in this way. Early contact is one of the key things that services can do; by acting early it can prevent situations from becoming much worse.

As the Independent Chair, I can say that the Board and its member agencies, continue to display a high level of commitment to keeping the most vulnerable in our community safe and this annual report gives much more information on the work of the Board and safeguarding in Barnsley.

Robert Dyson QPM,DL

Independent Chair, Barnsley Safeguarding Adults Board

Adult safeguarding

What is abuse?

Any action, deliberate or unintentional, or a failure to take action or provide care that results in harm to the adult (this is called neglect). There are many different types of abuse; more details about abuse can be found on the Safeguarding Web site https://www.barnsley.gov.uk/safeguarding

The website tells you how you can tell us if you or someone you know if being harmed or abused.

Who do we help keep safe?

All adults aged 18 and over who:

1. Need care and support, even if they are not getting care or support now
2. They are experiencing, or at risk of, abuse or neglect
3. 3. As a result of their care and support needs is not able to protect themselves from risk of abuse, experience of abuse or neglect.

Adults who are not able to speak up for themselves are particularly vulnerable and we all need to speak up to keep them safe.

Safeguarding data

In 2020/2021, Adult Social Care received 2,023 concerns, up from 1,695 received in 2019– 2020. This is a 20% increase; however, only 29% (591 adults needed safeguarding or social care support. This figure does not include adults who experienced domestic abuse). Barnsley Safeguarding Board encourages people to tell us about adults they feel may be at risk of harm,  they may not need safeguarding, but we can signpost them to other sources of help and support. The Board is committed to supporting all workers and volunteers to share high-quality safeguarding concerns and has developed a range of training and guidance documents to help workers. The annual audit programme includes a review of the quality of safeguarding concerns received by Adult Social Care and an evaluation of the responses sent to the referrers.

Relatives sent in 25% more concerns; this may be due to the impact of COVID-19 and families spending more time together with less contact from workers and professionals. GP referrals increased by 42%, but only 11 GP practices shared concerns. In the coming year, the Board will support an evaluation of GP’s involvement in safeguarding and offer any training required. Barnsley Hospital shared 87% more concerns during 2020 – 2020 than the previous year (216 cases), reflecting the expansion of the safeguarding team at the hospital and their commitment to safeguarding training. Berneslai Homes sent in small numbers; however, they have shared data with the Safeguarding Adults Board of high levels of preventative work with tenants. The Board recognises and celebrates the high level of prevention work by many organisations as part their commitment to prevent harm and abuse.

Location of abuse

The percentage of safeguarding concerns about adults living in care homes dropped from 44% to 37% this year. The decrease is linked to a reduced number of adults in care homes, decreased visits by family and professionals; however, the Board acknowledges that most care homes provided high-quality care despite the challenges to staffing resulting from COVID-19. The percentage of concerns about abuse in adults' homes increased by 11% (from 40% in 2019/20 to 51% in 2020/21). This brings Barnsley in line with national data and suggests that training to support workers and volunteers to recognise and report financial abuse has been successful. Sadly many adults were victims of scams or abuse by family and friends, who were trusted with money and bank cards, as result of having to “Shield” due to health vulnerabilities. The Board worked with communication colleagues to advertise these scams as soon as they were identified and to support adults to protect themselves. The positive action taken to identify vulnerable adults in the community at the start of the first lock down helped identify adults at risk of harm and highlighted a number of adults who were self-neglecting and/or hoarding.

Types of abuse

The percentage of self-neglect and/or hoarding cases managed within safeguarding increased by 3% on the previous year. We are pleased that the new policy and training has raised awareness of the issue and supported a strong multi-agency response to the risks. Specialist hoarding training was agreed to support workers to respond, in line with research and best practice. The percentage of financial abuse cases fell from the previous year, however the number received in the year increased, reflecting the increase in the total number of concerns received. Safeguarding has enabled many adults to regain control of their money and set up alternative arrangements to help them during the pandemic. The communications plan for 2021- 2022 will include a strong focus on providing information to adults about safeguarding and giving them the knowledge to take action that will prevent or stop it.

The percentage of organisational abuse cases investigated in care settings rose in 2020/21, after a fall in the previous year. The Board acknowledges that care services (care homes and care at home services) have worked in very challenging circumstances during the year managing the impact of COVID-19 and the majority have delivered high quality care and support. The Board will work closely with partners and the Quality in Care Improvement Forum to support excellence in all care settings in the coming year.

Safeguarding adults – S42 enquiries. What adults want help with to make them safe.

A section 42 enquiry begins when an adult meets the three-stage test (see page 4) and they agree, they want help to stop the harm/reduce the risks or are unable to make the decision due to dementia etc. It is then agreed that they need safeguarding using the Mental Capacity Act (2005) Best Interest decision-making process.

• An assessment or review of care by Adult Social Care
• Signposting information to specialist services
• No further action as the adult declined any help at this time

The adults we supported to stop harm and abuse via a S42 enquiry

The increase in reporting of abuse involving men is positive (up from 30% to 43%) as they are often under-represented in the data as they are more likely to decline support.  The rise in the number of adults aged 65+ (up from 70% in the previous year to 80% this year) is in line with national data and reflects the increased reliance on services or family support. The proportion of black and minority ethnic adults referred for safeguarding support (4%) is in line with our demographic data.

Concerns, S42 and making safeguarding personal – Quarter 3 and 4 - 2019/20

Concern only	Proceeded to S42 enquiry	Met Stage 3
666	256	30

The 30 cases that met the three-stage test were offered services to make sure the adults were safe outside of safeguarding, in line with the Care Act and Making Safeguarding Personal.

Did adults feel that we removed their risks by working with them in safeguarding?

Remains	Reduced	Removed
4%	48%	48%

The data above relates to the 256 (S42) cases. It shows a positive result with 96% of adults saying that safeguarding removed or reduced the risk of further harm, making them feel safer. The Making Safeguarding Personal principles that respects adults rights to make choices may result in adults remaining in relationships or situations where risk still remains. The adult is offered the option to come back for help at any time if they wish to address the risks. We will still take safeguarding action against the adult's wishes, if other adults are at risk or we believe the adult is under duress. The People in Positions of Trust policy provides workers with a framework to respond to allegations involving workers or volunteers.

Adults who are supported by social care services who tell us they feel safe

The proportion of people who use services who feel safe:

Year	Barnsley	Yorkshire and Humber	National
2016/17	76.0	69.1	70.1
2017/18	73.4	69.6	69.9
2018/19	75.1	71.2	70.0

Adults in Barnsley report feeling safer than adults in all areas of the country, despite a small drop in 2017/18. Barnsley continues to exceed both national and Yorkshire and Humber figures.*

The proportion of people who use services who say that those services have made them feel safe and secure:

Year	Barnsley	Yorkshire and Humber	National
2016/17	95.0	86.6	86.4
2017/18	94.8	88.3	86.3
2018/19	97.1	88.2	86.9

Adults in Barnsley continue to report that services provided made them feel safe, and the rates of satisfaction reported is higher than all other areas of the country.*

(* Data for 2020/21 is not available until October 2021)

Case studies

Mr Smith

Mr Smith video transcript

Mr Smith is 66, he lived alone in a Berneslai Homes upper floor flat and no contact with family. He has several physical and mental health issues, which stopped him from taking his rubbish out of the flat.

Neighbours complained about fruit flies.  When visiting, it was clear that Mr Smith was hoarding and, as a result, had mice and fleas. The level of hoarding meant that Mr Smith was unable to use his bedroom and was sleeping on his sofa and was at risk of fire due to his heavy smoking.

Mr Smith welcomed the support of Berneslai Homes, South Yorkshire Fire and Rescue, his GP, Adults Social Care, and a private cleaning company all worked with him to address the risks of fire and falling. Between September and November 2020, Mr Smith’s health needs were reassessed. His medication changed. The cleaning company helped him de—cutter, and Berneslai Homes prioritised his move to a ground floor flat to support his independence.

He is now delighted with the outcome and the support he received, which has resulted in him contacting family as he is no longer ashamed of his home. The private cleaning company offer him ongoing support to keep the property clean and to manage his laundry.

Organisations involved with Mr Smith worked to the self-neglect and hoarding policy principles and report that a high level of cooperation to work with Mr Smith was in place.

(Please note these are not the real names of the individuals involved.)

Mr Jones

Mr Jones video transcript

Mr Jones is 49 with a diagnosis of Cerebellum; his condition means that he has a physical disability and needs to use a Zimmer frame, and his speech is affected and sounds slurred, alongside uncontrolled diabetes. Previously he was active and went out regularly on his scooter.  

Mr Jones had drug issues, both prescribed and non-prescribed and problems with alcohol. He was targeted by drug users who used his property, often without his consent.

In 2020 he broke his hip and needed surgery; this meant he was reliant on friends for money, food and substances. Sadly, this resulted in him being financially abused and people moving into his property and refusing to leave this is called cuckooing. Neighbours reported that Mr Jones home was being used as a 'drug den', but they were too scared to make a formal statement to the Police. The Multi-Agency Panel (MAP) discussed the issue, and joint working plans were made to improve the safety and wellbeing of Mr Smith. Adult Social Care and the Community Matron visited weekly and supported him to attend health appointments. The Police gathered information that showed that he was a victim of financial abuse, cuckooing and threats of violence. Adult Social Care put a care package in place, and Berneslai Homes offered him an alternative property, which he accepted.  Mr Jones is receiving support from tenancy support officers to manage his money/debts. The community matron supports the management of his diabetes, and his social worker and mental health worker have helped reduce his anxiety, allowing him to reduce his alcohol intake/drug use significantly. Mr Jones said he feels much safer; he is taking pride in his new home and is positive about his future.

The MAP was established to work with all relevant organisations with adults at high risk of harm that would either not consent to or would not be eligible for a safeguarding
response.

(Please note these are not the real names of the individuals involved.)

Key achievements in 2020–2021

Despite the challenges of COVID-19, the board and its subgroups met throughout the year using digital platforms.

The Safeguarding Adults Forum by Experience (SAFE) is a customer group whose members include adults who access support and help to live independently or support relatives or friends who access support. They were unable to meet digitally as many of its members did not feel confident with digital meetings. However, they did contribute via post and emails to the design of new leaflets and the communications strategy.

Achievement	Impact
A multi-agency trainer was appointed and commenced work in January 2021	The Board now has a dedicated (part-time) trainer who will coordinate and lead the design and delivery of high-quality training and learning opportunities for staff, volunteers and community groups in Barnsley.
South Yorkshire Safeguarding Awareness Week took place in November 2020, moved from July to maximise the opportunities to hold public facing events	Large numbers of staff and volunteers had access to training and development opportunities. An effective communications campaign delivered safeguarding messages to Barnsley residents in the absence of planned public events (cancelled due to COVID-19 restrictions)
The Board held a development event to review its strategic plan and confirm its commitment to tackling issues that have been “difficult to solve”	A new strategic plan was developed, the linked workplans and “traffic light” ratings will enable the board to evaluate progress against all its priorities
Agreed to produce and circulate a bi-monthly newsletter	Available on BSAB webpage and on partners webpages. It provides a summary of the work of the board.
Completed an audit into the deaths of four homeless adults	Resulted in production of an action plan jointly owned by the Adult Safeguarding, Health and Wellbeing Boards and the Barnsley Safer Partnership Board. This will mean that adults who are insecurely housed will have improved access to support and help.
Designed a delivered a “Welcome to the Board” event for new members	Supported the new members to become active in the group by providing them with information about the work of the board.
Signed of several new policies and guidance, including a new organisational abuse policy	Staff and volunteers are supported by the creation of policies and guidance to safeguard adults effectively.
Agreed a new communications plan	Regular safeguarding messages will be delivered to the public and evaluated to improve messages and their impact.
Approved the launch of three new E learning packages on safeguarding and self-neglect and hoarding	All workers and volunteers can freely access high quality E learning packages to increase their knowledge of safeguarding. The board would like to thank the Barnsley Council workforce development service for their support in designing and launching these new resources.

Safeguarding Adults Reviews (SAR) - learning lessons

The SAR completed in 2019-20 exploring the death of Clive, as a result of self-neglect, generated an action plan which was completed by all organisations. These action plans are monitored by the SAR sub-group and reported to the Board.

A review of Valerie and Ian was completed. Valerie and Ian were a very private couple who were very reluctant to accept support, including from family members. Following Ian’s death, Valerie’s self-neglect increased, and she was admitted to the hospital in a neglected state and died.  Our local experience and national research show that there is an increased risk of self-neglect and hoarding following a bereavement or loss.  The report’s author was asked to examine the learning from previous reviews and suggest alternative approaches to reduce the risk of further deaths. Read the report regarding Valerie and Ian or read the seven-minute briefing.

The Board approved the action plan in March 2021 and will be monitored by the SAR subgroup and reported to the board to improve early identification of adults at risk of hoarding and/or self-neglect to offer support and help.

The Board approved a review of Lola, a young woman with learning disabilities (not formally diagnosed), who was admitted to intensive care in January from her family home. This will be completed by September 2021.

Progress on action included in the 2019-20 strategic plan

News

The board is sad to report the death of Pat Durie, a longstanding member of SAFE and many other community groups in Barnsley. A donation to the planting of an orchard has been made in her memory. We are pleased to welcome five new members to the SAFE group.

The board continues to work with the Safeguarding Boards on issues affecting the region and is actively involved in coordinating regional training events. We welcome your views about how we can deliver our ambition to prevent harm and abuse to adults at risk in Barnsley. Please contact robertdyson@barnsley.gov.uk (Independent Chair) or catherine@barnsley.gov.uk (Board Manager)

Activities

• Three self-neglect and hoarding events were delivered sharing the learning from Clive and the early learning from Valerie and Ian
• Learning from Safeguarding Adults Reviews session was held to support the development of practice, based on reviews completed in other areas
• Barnsley Council’s Area Team Managers were trained to identify safeguarding at the start of the lock down
• Specialist training was delivered to adult social care staff and care staff in line with the agreed training competencies.
• South Yorkshire Police received training in the identification and reporting of potential Safeguarding Adults Review cases.
• Specialist training was purchased to help staff respond positively and effectively to adults whose hoarding is negatively impacts their lives.

Guidance and policies

Several new guidance and policy documents have been approved. These are included in the newsletters with links to them. Some are highlighted below:

• Summary guidance on the People in Positions of Trust and the Self-Neglect and Hoarding Policy has been issued with links to the full documents on the professionals and volunteers page.
• Understanding Wilful Neglect guidance was approved
• Recognising and responding to factitious illnesses

Structure of the board

• Independent Chair
• Barnsley Safeguarding Adults Board
  • Performance Management and Quality Assurance Subgroup
    Chair: Adult Social Care
  • Learning and Development Subgroup
    Chair: Barnsley Council
  • Safeguarding Adults Forum by Experience
    Chair: Member of SAFE
  • SAR and DHR Sub Committee
    Chair: Independent Chair of BSAB
  • Pathways and Partnership Subgroup
    Chair: Voluntary Sector, replaced by Adult Social Care

Board budget 2020–2021

Financial Position of Adult Safeguarding Board 2020/21

Type	Income	Expenditure
Employee costs	-	£58,244
Public transport	-	£102
Supplies and services	-	£24,503
Business support	-	£25,000
NHS Barnsley CCG	£25,000	-
Miscellaneous contributions	£10,000	-
Police and crime commissioner	£20,429	-
BMBC	£16,670	-
Underspend carried forward	£35,750	-
Total	£107,849	£107,849

Barnsley Safeguarding Adult Board partners

Thank you to all our partners who have worked with us to demonstrate what they are doing to prevent harm and abuse every day.

• Barnsley Carers Service
• Barnsley College
• Barnsley Hospital
• Barnsley Safeguarding Children's Partnership
• Berneslai Homes
• Care Quality Commission
• Centre point
• Healthwatch Barnsley
• Humankind
• IDAS
• NHS England
• NHS South West Yorkshire Partnership
• NHS Barnsley Clinical commissioning group
• Northern College
• Recovery Steps
• South Yorkshire Fire and Rescue
• South Yorkshire Police
• South Yorkshire Police and crime commissioner
• National Probation Service
• Umbrella