Agenda item

To be presented by Richard Kelvey (Avon and Somerset Police), Vice-Chair of the Board and Becky Lewis, Bristol Safeguarding Boards Joint Unit Business Manager.

The Board considered the annual report and presentation from Bristol Safeguarding Adults Board.  The Independent Chair, Louise Lawton had extended her apologies and Richard Kelvey presented the report on her behalf.

The Board were asked to note the following from the report:

·         This is the second report from the BSAB since the establishment of the Board as directed by the Care Act 2014.

·         All of the last five SCRs/SARs involved adults with mental health needs living in the community (3 published in 2016, 2 underway).

·         The question - ‘is the current service provision sufficient for meeting the needs of adults with complex needs, including mental health, in the community?’

·         The question of who leads on the issue.

·         Some professionals have limited skills to support the needs of those with poor mental health.  The police have powers of arrest but this is not the  solution when addressing issues arising from the behaviour of a person with poor mental health.  Many police officers working in the field now have access to a specialist advisor to give guidance.  This problem is one encountered by other professions, for instance care workers and housing officers working in the community.

·         The other theme is one of vulnerable adults causing harm to one another, giving rise to the question of how best to assess the complex needs of a vulnerable adult living and sharing accommodation with others. 

·         Emerging theme – is the oversight of risk management arrangements for adults with mental health needs placed in supported accommodation in Bristol by other local authorities sufficient?

·         The challenge for all partners is to consider this question: ‘are we practiced in considering these issues and questioning the requirements of service users?’

·         Also acknowledged is the difficulty in keeping track of vulnerable adults.  Unlike the obligation to know the whereabouts of children in care, adults are able to move from region to region at will.  

·         The challenge amongst health professionals is who takes the lead to support the complex needs in this area.  Working professionals who come into contact with vulnerable adults with poor mental health require training / knowledge to support the needs of this group in society.

·         The learning from the SCRs will be shared between regional authorities and partners.

The following was noted from the discussion:

a.      The reporting of safeguarding concerns arising from care provided in hospitals and care homes appeared to have grown.  It was explained that the mechanism for reporting and recording has improved, therefore allowing for more informed data.  In turn, the data can be used to properly inform learning and training for the workforce.

b.      There continues to be a strong link between the incidents relating to vulnerable adults and poor mental health reflected in the SCRs.  The issue of vulnerable people obtaining access to the right care and receiving advice from professionals working in the community remains a challenge.  The CCG is strategically reviewing the issue of overall integration of services.

c.       Housing officers, when faced with the actions of tenants, for example who hoard items, would be looking to make the home decent and a fit environment for them to continue to live in.  Actions would be taken to move the tenant to alternative accommodation to allow cleaning of the property; they are not skilled in identifying and diagnosing whether such behaviour is ‘eccentric’ or resulting from poor mental health.

d.      Concern that the wider issue of financial constraints being faced by all partners impacts on the provision of the mental health triage service.

e.      The challenge of accessing support for those vulnerable adults identified as needing support from the mental health services but who fail to engage or who suffer relapses and then refuse to re-engage.

f.        Acknowledged the need for support to those professionals in housing who place vulnerable clients in places that may cause challenge.  A form of capability assessment is required to aid the process.

g.      BSAB is seeking support and endorsement from partners to release staff to participate in audit work assessment.

h.      It was suggested that training of professionals should be locality based rather than via a citywide event.

Action:

·         Letter from the Chair of the H&W Board to the BSAB to confirm support.

·         Becky Pollard to lead on the issue of delayed transfer of care from hospitals to community and integrated work.

·         Contact and sharing with local neighbourhood partnership groups to share issues of poor mental health.