ANNUAL COMMUNICATIONS

& ENGAGEMENT REPORT 2015-16

Ensuring our safeguarding arrangements act to help and protect adults

Summary

FEBRUARY 2016

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The Board’s Communication and Engagement Strategy was published in November 2015 with a stated Aim to: Actively engage people in raising awareness of adult abuse and neglect, inspiring people to take action to prevent this.

The Communications and Engagement (CE) strategy also included the following objectives:

1.1 Take into account the views of key stakeholders1.2 Measure and evaluate what adults experiencing the safeguarding process say1.3 Better promote and connect existing preventative strategies 4.2 Evaluate how well each member agency is co-operating and collaborating.

The last six to nine months have largely involved researching, consulting on and creating a framework and set of methodologies to deliver the Board’s CE Aim. Linked to this the key achievements and outcomes include:

1. The Board’s branding guidelines being developed and published2. The CE Strategy being published3. Two periods of formal consultation including Annual Surveys:

a. February to May 2015b. October 2015 to February 2016

4. The website being commissioned and launched in December 2016 (formally in January 2016)a. Focus on connecting preventative services and information (objective 1.3) b. Includes a Training Portal (end of February 2016)c. Includes an Audit Portal (April 2016)

5. The web based E-Bulletin being launched in December 2015 6. Promotional materials being created (due to be finalised March 2016) 7. A Social Media presence being created 8. The first set of public events being delivered.

Monitoring, Reviewing and Evaluation

The following sections include the milestones outlined in the CE Strategy Operational Work Plan:

EventsTo date the Board has delivered three days of bespoke events: Two days of Board specific Care Act training on 18 & 19 January 2016 (in conjunction with ADASS) and the Self-Neglect conference on 29 January 2016.

A total of 276 people attended these events and although the evaluations are still being collated; in general terms these events were well received and helped to support the Aim of the CE Strategy (objectives 1.1 & 4.2).

The attendance at the conference was a little disappointing as more than 20 people dropped out on the day without any prior warning, which was compounded by turning away people prior to the event as this was fully booked.

The Learning, Training & Development (LTD) Sub-Group has discussed the potential for a second Mental Capacity Act conference later in the year (possibly November). Otherwise the LTD group have deferred other awareness raising events back to the CE Sub-Group. This could include support of the region-wide ‘See it, Report it’ campaign in the summer (dates to be agreed) and activities in support of the Mental Health Awareness/Dementia Week in May; World Elder Awareness Day in June; and bespoke footfall events to support the Board’s consultation work in October-November 2016 (objective 1.1).

E-Bulletins

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Edition One was published in October 2015 but at that stage it wasn’t web-based (as the website didn’t exist then) so it is unknown how many people read this. Edition Two was web-based and was published in December 2015; to date this has been read by 252 people. Nobody has contacted the Business Unit to date to suggest articles to be included, although there has been lots of feedback on each draft edition.

Linked to the themes outlined in the summary it is hoped the Board can increase read figures into the low thousands by the time Edition Six is published. This can only be achieved with a significant improvement in partnership working.

Focus GroupsTo date the Board has not delivered any bespoke consultation events, although two informal footfall events are planned for October/November 2016 as stated earlier. However over the last 12 months the Business Unit have attended over 30 consultation events and linked into the work of over 50 organisations (objectives 1.1 & 1.2).

There has been recent discussion regarding ‘user voice’ and how to best to capture this and improve the methods the Board use to support this. One direct quote from recent engagement work summarises some of the key aspects to be considered when developing the approach to this:

“I feel that adults who have suffered from abuse should be informing bodies such as the safeguarding board on their plans; however this needs to be done carefully and by engaging people on their terms, and in ways/settings which make people feel more comfortable. This can take time and will need relationships to be developed”.

The Board initially decided not to have a specific sub or working group set up to take this activity forward; therefore it may now be useful to develop the relationships which have already been created with other organisations, and formalise this engagement work so that safeguarding can be explored in a more consistent and planned way. For example working more closely with Healthwatch, Carers and community organisations working with minority and more marginalised (harder to reach) groups of people. The membership of the CE Sub-Group could also be expanded to include links to the organisations which work closely in support of these groups of people.

Partner WebsitesTo date five of the Board’s partner organisations have directly linked their public facing websites to the Board’s website:Hartlepool Borough CouncilMiddlesbrough Borough CouncilStockton-on-Tees Borough CouncilHartlepool and Stockton-on-Tees CCGSouth Tees CCG (although the page this is on is out of date and pre-Care Act)

Work to establish the correct and appropriate contacts within the partner organisations for social media, websites, intranets and in-house magazines has been slow, as in some instances organisations have not responded to repeated requests for this information (objective 4.2). To date there is evidence that Stockton-on-Tees Borough Council has referenced the Board’s work via their staff intranet and three organisations have included the Board’s work on their in-house bulletin:Stockton-on-Tees Borough CouncilThe Department for Work and Pensions (CE Sub-Group member)Catalyst (Stockton-on-Tees LEG member) Presentations/Training/WebinarsThe Board’s Training Strategy was published in November 2015 and the Training Plan is still being developed. However the Board’s Training Portal is due to be publically launched in the last week of February 2016, which will have a significant effect on promoting the work of the Board and more broadly improving the awareness of adult safeguarding. Otherwise it is too early to evaluate outcomes linked to this area of work.Press & Radio

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To date the Board have issued one press release, which was written in support of the Self-Neglect Conference and formal launch of the Board’s website in the last week of January 2016. In response to this one smaller radio station in Redcar requested an interview and Middlesbrough Borough Council included the press release on their website. Otherwise there was no other evidence of interest from press and media.

This highlights that more work is required in developing relationships with key individuals in the press and media, combined with improving the awareness of the work of the Board so that future press releases get more attention, resulting in a more positive outcome.

Public AdvertisingAs yet there has been no activity in this area which is due in part that the Board’s promotional materials have only started to be developed in recent weeks. This was inter-linked to the development of the Board’s website and the images/key messages which were created for that. This has led to two initial posters being developed and a draft safeguarding adults’ leaflet.

When these materials are finalised a programme of activity can be created, which could include ‘focusing’ on key locations (links to the mapping of safeguarding data) to display posters and distribute leaflets such as care homes and GP’s surgeries; considering other public advertising such as buses and town centre bill boards; radio adverts as well as links to social media as described below. A cost/benefit analysis should be conducted to consider the rate level of listeners/readers/footfall before any of these activities are taken any further forward.

Public MeetingsAnn Baxter (TSAB Independent Chair) has attended six formal and public meetings since September 2015 to promote the Board’s strategic Plan and Annual Report, which includes Overview and Scrutiny Committees/Board in each of the four Boroughs, and the Tees Valley Chief Executive forum.

Social Media The Board’s Twitter account was created in November 2015 and Facebook launched in January 2016. The Twitter account is now following over 150 organisations with 65 followers which includes’ all of the Board’s partner agencies (except Hartlepool & Stockton-on-Tees CCG). To date over 140 Tweets have been published, some of which have been ‘Re-Tweeted’ and ‘Liked’ by other organisations. In the current early stage, Facebook has only had a smaller number of Posts, although one Post (which was boosted) ‘Reached’ nearly 1,000 people. This highlights the potential of promoting the work of the Board via Facebook. There is a plan to use ‘Adverts’ on Facebook to further test the potential of this type of publicity.

SurveysIt appears to be too soon to fully evaluate Making Safeguarding Personal activities/surveys are there has only been a limited response to date making it hard to formulate any firm conclusions or the % return rate: 11 responses from Hartlepool Borough Council 4 responses from Middlesbrough Borough Council 5 responses from Redcar & Cleveland Borough Council 4 responses from Stockton-on-Tees Borough Council Although 81% of respondents stated they felt safer as a result of safeguarding enquiries/outcomes.

There have been over 800 responses to the Board’s Annual surveys over the last 12 months, which included a combined version in June 2015, and two separate surveys which have just been analysed below.

Three generic questions were asked across the two recent surveys: one for Professionals and one for the General Public (which included service users & Carers):

Question Professionals (213 responses) Public (130 responses)

I feel fully informed about the ten forms of abuse and neglect? 80% 33%

(Carers 16%)

I know how/the general public know how to report abuse and neglect to the Local Authority?

35% 61%

I know how/the general public know how 25% 50%

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to get appropriate support/help in relation to abuse and neglect?

The % rating is for those respondents who answered ‘Agree/Strongly Agree’When you compare these responses the professionals obviously have a more pessimistic perception on public awareness, than the public themselves, although the true reality is likely to be somewhere in between. This means that on average approximately half of the public Teeswide know how to report abuse to the Local Authority and just over a third know how to access appropriate support and help.

Question Public (130 responses) Carers (18 responses)

In my current situation I feel safe from abuse and neglect? 72% 50%

I know how to protect myself from all forms of abuse and neglect? 50% 28%

The % rating is for those respondents who answered ‘Agree/Strongly Agree’ (General Public survey only)

When you combine the answers across all questions individually for Carers this provides a more negative outlook than for the wider stakeholder groups in that survey. Although there are some limitations with the data due to the size of the sample group, this could indicate that more specific work is required to further assess Carer issues in relation to safeguarding.

There was one specific question on the Professionals’ survey in relation to the work of the Board:

Question Strongly Agree

Agree Neither Agree or Disagree

Disagree Strongly Disagree

Don’t Know

I think the TSAB is making a difference to help prevent abuse and neglect?

10% 47% 31% 0% 0% 11%

The response to this question is positive in the sense that 0% of the 213 respondents were negative about the work of the Board, and only 11% didn’t know about the Board. Although only 10% strongly agreed, which understandably reflects the transitional period the Board has just been through and provides a benchmark for future reference.

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Increase the awareness of newer forms of abuse like Modern Slavery & Self-Neglect

Have more of a focus on preventing radicalisation

Work to Highlight the sexual exploitation of people who may lack the capacty to understand and assert their 'right to say no'

Challenge organisations Teeswide to work more closely to prevent abuse and neglect

Ensure adults who have suffered from abuse and neglect further inform us on our plans

Challenge one another and hold other Boards/Public Bodies to account

Further prioritise the work on disability 'Hate' and 'Mate' crimes

Train more staff and volunteers to help protect adults at risk of abuse and neglect

Improve the general awareness of safeguarding & how people can better protect themselves

0 50 100 150 200 250 300

Fig 1:What should our priorities be for 2016-17

Figure 1 is the combined set of responses from both surveys as there wasn’t much variation between the two separate sets of data. This provides a clear perspective for the Board in developing strategic objectives for 2016-17.

Individual comments/feedbackSee Annex One:

Website To date the Board’s website has had 2166 hits which equates to an average of 275 hits per week since the formal launch and includes the specific details:Homepage: 561 hitsProfessional’s page: 111 hits Find Support in Your Area page: 77 hits (linked to objective 1.3) Alert Form page: 54 hitsPosters & Leaflets page: 47 hits

Across the four Boroughs the following number of ‘sessions’ is registered by location:Hartlepool: 14Middlesbrough: 93Redcar: 40Stockton: 224

In total there is a 60:40 split in the % of people who are New Visitors:Returning Visitors to the website.

I can understand how carers can become

overwhelmed by their caring responsibilities,

which could lead to neglect. More should be done to promote how to

prevent this

There should be more joint working between children's

and adults safeguarding

services

Make it a mandatory requirement that

prior to approval of PHB, and before

PA's are employed, they must undertake

training on safeguarding and

MCA

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The overall success of the website is tied into and overlaps with the promotion of the Board’s work via social media, partners’ websites, intranets and other public advertising. It has only been 6-7 weeks since the website was launched but it is realistic to work towards doubling the current level of activity up to 500 hits per week over the next 6-12 months.

Conclusions

The CE strategy and in particular the stakeholder analysis may now need to be reviewed by the CE Sub-Group to reflect the need to build relationships with the press and media, review the involvement of carers groups, and develop the link to other stakeholders as suggested previously.

Adult safeguarding currently has a low profile across Tees in relation to public facing communication channels: social media; press and media; websites and other public advertising methods. This includes the website activity of most of the Board’s partners, many of which don’t have any safeguarding adults’ information; and the Board’s E-Bulletin, which although at an early stage of development, has currently reached less than 0.25% of the combined workforce of the Board’s partner agencies (realistic target 5-10%).

It has been a busy and productive year for the CE Sub-Group in making a start to “actively engage people in raising awareness of adult abuse and neglect”. A platform has been created to enable this profile to be significantly improved, but further support is required by all of the Board’s partner agencies to enable this to happen.

Martin CrowProject OfficerBusiness UnitTeeswide Safeguarding Adults Board Annex One

Teeswide Safeguarding Adults Board Survey(s) October 2015 – February 2016

The following are the most pertinent comments which were received from both the General Public and Professionals version of the Board’s surveys.

General

1. Having read your website I answered agree to many of the questions as I now feel fairly informed. Prior to reading your website I would have answered disagree to most as I had no awareness at all on the support services available to me.

2. Link in with key retailers and use their visibility to promote your message.3. There is a need for more Pro-active work to be carried out within Care Homes. Greater presence within

Care Homes.4. Assertive outreach with the general public and media reference the importance of protecting vulnerable

adults.5. There should be a focus given to raising awareness in schools about adult abuse and neglect.6. In depth training on the new definitions of abuse would be hugely beneficial to professionals and the

general public.7. There should be more joint working between children's and adults safeguarding services.8. Campaigns which target vulnerable groups and use social media to highlight issues. Also myth bust so

people aren't afraid to report abuse.9. More literature and education for the general public on how to report abuse who/how to contact First

Contact for example. Professionals are aware of this but when I have spoken with the general public they are usually unsure of the process/contact information.

10. Have information on awareness of abuse to the general public to enable people to identify what abuse is and how to access support. Needs to be widely available in the community - media campaigns and posters in community and health / DWP settings.

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11. Increased public awareness of safeguarding issues not just the usual physical / neglect abuse (headline grabbers) but issues around modern slavery / family abuse including financial / FGM etc.

Asylum Seekers and Refugees

1. I think a lot of refugees are victims of abuse and neglect without even knowing it. What they thought may have been acceptable in their 'old' culture won't be here and in that way they can become a target for abuse.

2. I work and volunteer with Asylum Seekers and refugees. I see a lot of mental health problems with this group of people who don't have the confidence to seek help, and who often remain very isolated. I think this group of people will fall into the category of self-neglect and the scale of the problem maybe underestimated or unseen by statutory bodies. I feel that adults who have suffered from abuse should be informing bodies such as the safeguarding board on their plans; however this needs to be done carefully and by engaging people on their terms, and in ways/ settings which make people feel more comfortable. This can take time and will need relationships to be developed.

3. I think a lot of people will lack the confidence or knowledge to seek help, particularly men who can sometimes bottle things up more than women might. I think there is a lot of potential for modern slavery, which might be underestimated by people. I think a lot of people are being exploited in this way.

4. English is not my first language and I don't understand anything really about this subject. All I know is if somebody was to hurt me I would tell the Police.

Carers

1. Carers are often not confident in identifying abuse and the process to follow if they have concerns. They are also afraid of the repercussions on them and or the person cared for, especially if an incident occurs between them.

2. I can understand how carers can become overwhelmed by their caring responsibilities, which could lead to neglect. More should be done to promote how to prevent this.

3. I haven't had a carers assessment under the Care Act; but even if I do so what can the Local Authority do? I have real concerns about putting my son into respite care due to the lack of quality care available.

4. Having had a bad experience with Sunderland Council I am now pretty confident in Hartlepool Council where I live, in approaching them for support. I know they will listen to me. I think more needs to be done for people with Learning Disabilities; there is a clear link between physical health and mental health but physical health is often overlooked. The adult I care for experienced this, and although I knew he was physically unwell Doctors initially ignored this and put this down to his mental health status. He eventually was admitted to Hospital and nearly died due to low Sodium levels. The concept of independent living is the right one, however this can mean extremely intensive support is required, which can mean people are either neglected or too much pressure is put upon carers.

5. Carers are often not confident in identifying abuse and the process to follow if they have concerns. They are also afraid of the repercussions on them and or the person cared for, especially if an incident occurs between them.

6. There is a need for more Pro-active work to be carried out within Care Homes. Greater presence within Care Homes

Health and Social Care Practitioners

1. Organisations are still working independently of each other with a distinct lack of co-ordination and co-operation. Adult safeguarding has a very low profile and there is huge amount still to be done in increasing awareness, improving reporting and creating a preventative culture.

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2. Continue to work collaboratively with all partners to ensure a cohesive approach to safeguarding issues. Continue to develop training that is bespoke for residential care to ensure there is a rolling programme of appropriate training for the care workforce.

3. Make it a mandatory requirement that prior to approval of PHB that PA's employed must undertake the training on safeguarding and MCA.

4. The Emergency Duty Team do not always follow the correct Teeswide safeguarding procedures and are not using the correct alert forms. This can create complications for other local authority first contact teams who sometimes have to follow up or chase down some of the details and conduct enquiry work that should have already been completed. They need to be working more closely with daytime first contact teams across Tees.

5. Reporting from professionals can be very poor and in particular from Cleveland Police, NEAS and some care provider staff. They are not following Teeswide safeguarding procedures correctly and are not using the correct Alert forms in some instances. This creates problems and can mean that the initial enquiry stage takes longer than it should because we have to chase up details and correct them in some instances. This can increase risks and feels as if sometimes professionals are passing the buck to local authority safeguarding teams. Carers also need more support and training about safeguarding and how their lack of knowledge can lead to alerts being raised. For example carers can report something but not take the appropriate initial actions to protect an adult, and as such leave them at further risk. These issues would summarise the key prevention outcomes: the quality of reporting from professionals needs to be better, and both carers and professionals can carry out very simple actions to prevent further abuse or neglect, rather than submitting a safeguarding alert and dropping all of the risk/work onto the local authority.

6. Safeguarding teams assessing safeguarding issues with Care Homes need to make sure Care Homes have a clear FALLS management and action plan. Referring to the FALLS team should not be the only action, but maybe 'one' of the actions. CGG's and LA's have funded Care Homes with sensors to prevents falls for people with dementia but the equipment is sometimes not used/not appropriately used/misused/stolen/damaged.

7. Members of the public constantly tell me that their GP has told them that getting a diagnosis of Dementia is not that important. This is very poor practice/advice on lots of different levels and is a barrier for people accessing support and protecting themselves and family members from abuse. How are GP's trained in safeguarding?

8. Once a SG referral has been made Social Services need to attend and not do phone calls; visit more than once to gain as much information verbal and non-verbal, observe the adult in their own environment before deciding on what the appropriate action should be.

9. Involve care staff in the safeguarding processes, not just management, this will increase staff understanding of the impact to SU's/families and instill a greater sense of individual and peer accountability (obviously not where they are directly involved in incidents).

10. Professionals sometimes don't have the ability or the time to talk to people properly and complete assessments correctly, preventing further risks or the need for repeat referrals or safeguarding alerts.

11. Analyse key vulnerable groups or locations with high numbers of vulnerable adults and prioritise engagement and community support initiatives in these areas. Ensure a focus on vulnerability generally rather than the specific focus on those that meet the social care threshold for care.

12. The Board needs to develop a more visible and outward facing communication strategy in order to help adults protect themselves as well as informing the public about signs of abuse and where to go for information, advice and reporting.

Voluntary Sector

1. Professionals working in the voluntary sector are sometimes not taken as seriously as they should by social workers. This can mean that safeguarding alerts and referrals are repeated as they are sometimes excused or pushed to one side more than if a statutory agency reports something. I have professional

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qualifications and have had a lot of training, and as such have good insight with the clients I work with which should not be ignored

2. I have witnessed social workers taking families word that they were 'ok' and closing the case without doing anything to further check this. This has meant re-referrals have happened and people have then had to wait longer for further assessments, as it became obvious the family were not in fact 'ok'. The quality of social workers is very variable.

3. The Public Sector need to better recognise the value of the voluntary sector and the reach that VCS agencies have in front line work with more vulnerable adults.

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