Lincolnshire Safeguarding Adults Board Annual Report

Strategic priorities and key updates

Our overarching priority from 2022 to 2025 is prevention and early intervention.

The areas of work we intend to focus on over the coming years can be defined into three areas:

  • making safeguarding personal
  • learning and shaping future practice
  • safeguarding effectiveness

Find out more about adult safeguarding on our website.

Key updates

Throughout 2022-2023, the board enjoyed the full support from all partner agencies, those that are statutory:

  • local authority
  • integrated care board
  • police

and those that we welcome as partners, such as:

  • all seven district councils
  • agencies from the voluntary sector
  • all emergency services
  • care provider representation

The collaborative work undertaken by all partners is far greater than the sum of its parts.  It creates:

  • a very positive culture of challenge
  • some new and innovative service models
  • very strong safeguarding teams

Some key pieces of work undertaken during 2022-2023 include:

Prevention and early intervention

A focus on keeping people safe by mitigating safeguarding risks before they escalate. Priority areas for focus will include:

  • further improvement in the quality and safety of residential and nursing care
  • preventing and or limiting the impact of pressure sores (across NHS and independent sector providers)
  • tackling the domestic abuse of older adults - including joint working with the other three statutory boards
  • preventing financial abuse (includes an opportunity for joint working with the other three strategic boards)
  • safeguarding adults with complex needs by piloting phase two of the team around the adult (TAA) approach

Work undertaken in 2022 and 2023 on prevention and early intervention includes:

  • Prevention strategy: we have updated our previous prevention strategy and developed a strategy for 2023-2026. Key areas of focus include:
    • further improvement in the quality and safety of residential and nursing care
    • preventing the impact of pressure sores
    • tackling domestic abuse of older adults
    • preventing financial abuse
    • safeguarding adults with complex needs by piloting phase two of team around the adult
  • We are working closely with the newly formed Lincolnshire domestic abuse partnership to combat elder abuse.  A current key focus is on domestic abuse in older adults.

Learning and shaping future practice

We will ensure that the learning from all our reviews and assurance activities is shared and embedded within partner agencies.  The aim is to reduce the risk of repeat incidents or causes of harm. Key areas of focus will include:

  • trailing innovative approaches to safeguarding adult reviews (SARs)
  • completing assurance activities to inform the continuous improvement of safeguarding practice across all partners
  • identifying themes and trends to drive training and awareness input locally and nationally, for example, professional curiosity and mental capacity
  • build on our ability to evaluate that system-wide change has taken place as a result of the learning
  • supporting all stakeholders to improve the quality and impact of their safeguarding activity to improve the outcomes for adults who are abused
  • establish a constant cycle of learning and improvement at a local and national level

Safeguarding effectiveness

The board must work effectively.  To do this, we ensure the effective operation and continuous improvement of the governance, scrutiny and business.

Key areas of focus will include:

  • To develop a flexible and effective communications and engagement strategy.  This will include a review of the LSAB information and advice offered.
  • Ensuring our quality assurance process is robust.  We will:
    • identify any challenges, share best practices and hear the voice of the service user
    • incorporate the completion of the local assurance framework by LSAB partners
  • Ensuring an effective risk and issues management process and the board’s policy and procedures, including a review of the LSAB’s risk register.
  • Data collection and analysis to ensure our work is always based on evidence. This will include developing an enhanced assurance dashboard for the LSAB executive.
  • Develop a service user and community engagement plan to help us embed our co-production ambitions further.
  • Lincolnshire Assurance and Assessment Framework (LAAF) is a self-assessment audit. 15 LSAB organisations took part, rating their effectiveness in a number of adult safeguarding areas. This LAAF saw a tailored assessment for care home and domiciliary providers and a peer moderation element. Overall, most responses to the safeguarding standards were rated as effective.
  • Quality assurance programme: LSAB plans to replace the LAAF with a quality assurance approach of peer-to-peer site visits in 2024.

Making safeguarding personal (MSP)

Ensuring all LSAB partners can consistently evidence an MSP approach to safeguarding practice. In particular:

  • partners can evidence that they have spoken to the person at risk before raising a safeguarding adult concern
  • that all partners will encourage the person at risk (or their advocate) to confirm what outcomes they wish to be achieved
  • that we will seek to achieve the outcomes expressed in a personalised way
  • that partners will work together to keep people safe and prevent safeguarding risks from escalating
  • implementation of the LSAB MSP action plan

Trauma-informed practice

As a result of the learning from TAA phase 2, we have begun a working group with:

  • Lincolnshire Domestic Abuse Partnership (LDAP)
  • Lincolnshire Safeguarding Children Partnership (LSCP)

The aim is to deliver a consistent approach to trauma-informed practice across the partnerships.

Transitional safeguarding

We are collaborating with LSCP to develop a joint protocol on this area of safeguarding.

Policies and guidance

During the reporting period, we published our:

  • reviewed policy and procedures
  • first person in a position of trust protocol
  • professional curiosity resource pack

We continue to work on our quality incident form to support care homes and domiciliary providers.

Self-neglect and hoarding

We are currently:

  • reviewing our self-neglect protocol
  • working closely with colleagues from public health on the hoarding protocol

Team around the adult (TAA) – Phase 2

We have set up a task and finish group with the Mental Health, Learning Disability and Autism Group (MHLDA).  The group was established in April 2022 to progress a second phase of the TAA initiative.  It operates under the oversight of the LSAB prevention strategy.

The existing TAA remains unchanged and runs alongside Phase 2. To support the task and finish group in developing recommendations for improvement, we established a multi-agency audit group (MAAG).  The MAAG comprises representatives from:

  • police
  • adult care (LPFT and LCC)
  • housing (district councils or framework housing)
  • LPFT
  • LCHS
  • VCSE sector

Since July 2022, the group have been auditing the activity of 40 individuals who presented most often to each of the four agencies.  Ten each from the:

  • police
  • LPFT crisis team
  • district councils
  • LCC emergency duty team

There has been a great commitment to these meetings.  Information is shared and attendees actively participate.  This fosters open discussions, professional curiosity, and constructive challenges.

The MAAG work together with the task and finish group. Each has a specific role:

  • MAAG focus on what the person’s situation is and how they were being supported
  • the task and finish group considers these findings to help determine priorities for change, improvement, and implementation

The audit will establish if the individual’s needs have been met.  If they haven’t, the TAA will support the coordination and development of a multi-agency support plan.  The aim is to empower the person to maintain their safety and wellbeing in the long term.

From the audits to date, the task and finish group have identified a need for coordinated and multi-agency access.  This access is required for multi-agency trauma informed practice training and resources.  We have agreed to develop this in Lincolnshire alongside the other statutory boards.

Feedback and learning have been shared as part of the self-neglect protocol review.  This includes the emerging findings associated with a frequent perception of ‘non-engagement’ and ‘individuals not being ready for support’.

The final MAAG is scheduled for Tuesday 31 October 2023.  By then, activity relating to 35 individuals will have been audited. The task and finish group will review the findings in their entirety.  They will then consider and agree on the next steps and further recommendations for improvement.

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