Safety and contingency planning

Safety management

Safe systems

The Multi Agency Risk Management (MARM) subgroup of the West Sussex Safeguarding Adults Board (WSSAB) includes representation from partners and the VCSE. It considers and advises on cases where individuals are not engaging with agencies, or are putting themselves or others at significant risk by refusing services. This is a monthly forum, and it enables agencies to seek advice and support when managing the highest risk and most complex and challenging cases through robust communication and information sharing.

WSSAB has a collaborative agreement with the Health & Wellbeing Board, Community Safety Partnership (CSP) and the Children's Partnership. This enables clear sight and consideration of priorities and collaboration regarding learning, any system changes, as well as scrutiny and accountability in relation to outcomes and objectives.

We are engaged with partners, agencies, and organisations across the system to ensure the safety of residents in West Sussex, which is a corporate priority. This can be demonstrated through our membership of the West Sussex Channel Panel Prevent, Multi-Agency Risk Assessment Conference (MARAC), Multi-Agency Tasking and Co-ordination (MATAC) related to disrupting offending behaviours in domestic abuse, Partnership Police Tactical Tasking Co-ordination Group (TTCG) with focus on the Strategic Intelligence Assessment, locality and district and borough liaison groups and the Domestic Homicide Review Panel, as well as activities in Public Health regarding prevention and health inequalities.

We work with the council's Communities and Partnerships Directorate to deliver the Domestic Abuse Strategy and have awarded a contract for additional accommodation provision for victims fleeing domestic abuse. Whilst only a small number of properties are available at the moment, hopefully this will increase. We have also recruited Housing Independent Domestic Violence Advisors (IDVAs) to bridge the gap with specialist support between domestic abuse and other services with housing providers and district and borough councils.

We have secured BCF funding for hospital-based IDVAs. They have been in place for around a year and have identified significant numbers of domestic abuse victims in hospital settings resulting in additional adult safeguarding referrals. They have also increased the amount of training in hospitals, which has also resulted in higher numbers of safeguarding referrals. We are currently reviewing the Domestic Abuse Safe Accommodation and Support Needs Assessment and strategy, due for completion in December.

Adults' Services and the Communities and Partnerships Directorate closely collaborate on the Domestic Abuse Related Death Panel (DARDR). We consider training opportunities and Communities and Partnerships have a place on the WSSAB and various of its subgroups.  Adults' Services is also a member of the West Sussex Domestic and Sexual Violence and Abuse Steering Group.

In addition, the council is fully aware of its designation as a First Responder Organisation under the National Referral Mechanism and our statutory obligation to identify potential victims and refer cases to the Single Competent Authority. We therefore train our staff to the highest possible level to ensure they are able to identify potential victims and refer accordingly. Our contracts and commissioning teams are fully engaged in working with our provider market in relation to modern slavery and Adults' Services is a member of the Modern Slavery Operational Group.

Safety during transitions

Our transition arrangements for young people form part of our Improvement Programme, with a steering group co-chaired by the Director of Adults and Health and Director of Children, Young People and Learning.  Our staff have fed back that the transition process needs more clarity and a continuing focus on ensuring a seamless and joined-up experience for people who use the services and their families. This will help them understand the different eligibility criteria for Children’s and Adults’ Services, and manage their expectations.

To address this, we have designed and implemented two new joint protocols and ways of working to identify young people with lifelong conditions or disabilities who are likely to have eligible social care needs at age 18 years, using automated prompts and dashboards. We have also introduced age 15+ specialist workers within the Children with Disabilities Service who will prepare a young person for adulthood, working alongside our adult social care teams.

We lead a multi-agency transitions panel, designed to improve the transition to adulthood for young people aged 17.5 years who are presenting with high levels of risk and vulnerability and have complex and sometimes challenging needs. This includes autistic children, children with mental health needs, children in need, children looked after, and care leavers. Any young person who is eligible for s117 Mental Health Act aftercare is referred to the panel to ensure their legal rights continue to be recognised when they become an adult. The panel provides a forum for partners to share information, preventing young people falling through the gaps, to ensure that informed decisions can be made about risks and needs, and how best to assess and mitigate these.

We believe this is an example of good partnership working between colleagues in children’s social care, education, safeguarding, health, and mental health services. The panel is highly regarded by referrers and its members due to the contribution it makes to ensuring young people are safely guided through this phase in their life, as highlighted in the quote below:

In addition, the WSSAB Seventeen and a Half Plus Safeguarding Protocol has been developed for cases where there is safeguarding concern for a young person who is approaching their eighteenth birthday. It sets out the arrangements for young people aged 17.5 - 25 years, whose circumstances may mean that Safeguarding Adults’ procedures would apply when they are 18 years old. A holistic approach is adopted to understand the circumstances of the young person and the vulnerabilities and risks they may have, including the impact of previous abuse. Referrals and contacts are made to the Safeguarding Adults Hub (SAH) where a transition pathway has been developed to avoid any internal system barriers and to ensure the criteria is applied consistently.

We have been working hard with colleagues from the all-age Continuing Care teams to develop shared policies and working protocols to ensure continuity of care for people moving between Adults’ Services and NHS Continuing Care Funding. We have developed a shared Disputes Policy and we are developing guidance to ensure a standard approach is adopted towards agreeing transfers of case and funding responsibility.

Our hospital discharge services, for both mental health and general hospitals, have robust methods of managing discharge planning to ensure continuity of care for people and rates of failed discharges across the county are low. The introduction of the Transfer of Care Hub and dashboard provides visibility of people who no longer meet the criteria to stay in hospital and allows all partners to see what plans are in place to support a safe discharge. Whilst the discharge processes are safe, we do recognise there are system improvements required to address demand pressure in this area.

We have recently undertaken a project to improve continuity of care for people who have been paying for their residential care (self-funders) and whose capital has depleted. There are a high number of self-funders in the West Sussex care market. This project has focused on bringing down backlogs in this area and on improving, practice, processes and visibility of the customer journey through improved data capture.

When people transfer between our services our teams communicate to discuss the changes that have initiated the transfer and meant that the criteria for another service has been met. Risk assessment is considered throughout the process and the person remains at the centre of all decision making.

Following a recent review of out-of-county placements we have prioritised all out-of-county customers (including transition customers), for reviews within our individual team plans to ensure the placement and their care and support remains the most appropriate for their needs and wishes,  and to safeguard them.  These reviews support the wider market development commissioning programme that is focused on increasing local provision, promoting independence such as Extra Care and Supported Living.

It is anticipated that data will continue to show a trend towards an increase in less restrictive models of support because of our strategic approach. For those placements that have not had an annual review we work with the host authorities when home closures or safeguarding enquiries are raised with us. Families and providers also notify us if there are changes in needs that require a review or reassessment to be prioritised. 

Contingency planning

We have contingency plans in place to ensure preparedness for possible interruptions in the provision of care and support.   A detailed business continuity plan sets out a business impact analysis of key identified activities, including statutory obligations, levels of reputational, operational and financial impact and risk, and resourcing requirements. The plan is reviewed annually as part of the business planning process.

Out of hours

The West Sussex Out Of Hours service operates outside of usual working hours and provides an emergency response for adult social care issues. The service is run by daytime staff, who work on a rota to cover shifts, with a duty manager taking calls directly from the public and other professionals. The service runs every day of the year and will respond to social care emergencies, provider failures and wider welfare emergencies, for example responding to requests from the council's Resilience and Emergencies Team to support partner agencies.

The WSCC AMHP Service operates 24 hours a day, 7 days a week, 52 weeks of the year.  During weekends and bank holidays, the rolling rota Hub staff provide the basic service and additional shift cover is provided by Out of Hours AMHPs. These additional staff are AMHPs who may be drawn from the Hub, Spoke, Casual Bank or Sussex Partnership Foundation Trust (SPFT). An AMHP Duty Manager is available over a 24-hour period to support the AMHP Service. During Out of Hours an Emergency Duty Manager (EDM) is available out of hours between 5pm and 9am Monday-Friday and, all day weekends and bank holidays, to take calls should there be a customer emergency or staffing issue.

Provider monitoring

When quality issues are identified by contracts through their monitoring of services a referral is made to the Quality Assurance and Market Support Team to provide reactive support to that service to address quality issues and drive improvement in a targeted, constructive, and risk-based way.

Quality issues are identified through various mechanisms such as concerns raised internally by operational staff, within the parameters of memorandums of understanding and information sharing agreements, through information sharing and risk escalation mechanisms such as the Quality Assurance and Safeguarding Information Group (QASIG) which is attended by our commissioning, safeguarding and operations teams and by system partners, such as the ICB and the CQC. The Quality Assurance and Market Support Team, where appropriate, are engaged when an adult social care service enters the provider concerns process.

The contract management approach details our response to provider failure and the actions taken to hold providers to account such as the suspension policy and contractual action plans. We communicate our expectations for standards and quality to the market through our market position statements, commissioning strategy and at a service level in specifications and contractual arrangements. In addition, the Commissioning Team are developing a revised Provider Quality Assurance Framework to ensure it reflects the proactive and reactive work of the Quality Assurance and Market Support Team. Once completed, the framework will demonstrate how the council achieves oversight of care quality and supports the market to maintain and improve the quality of adult social care services in the county. It will also make transparent how we work collaboratively with other local authorities where services are commissioned outside of the county to keep people safe and to address quality issues.

Information about quality of services helps us identify commissioning needs and determine how we can support care providers. Following recommendations from a Safeguarding Adults Review (SAR), we are piloting use of an online resource to enable care providers, and professionals external to the Council to report issues with the quality of a service which do not meet safeguarding thresholds.