Birmingham Safeguarding Adults Board

Strategic Plan 2019-2021

Contents

1. Safeguarding Statutory Duties 3

2. National Context of Adult Safeguarding 4

3. The Work of BSAB for the people of 5 Birmingham in 2019-2021

4. Ambitions 6

5. Role of the Board 7

6. Achieving Through Partnerships 8

7. Our Safeguarding Duties 9

8. Six Adult Safeguarding Principles 10

9. Making Safeguarding Personal (MSP) 11

10. Risk Enablement 12

11. Mental Capacity Act 2005 13

12. Assurance, Governance & Scrutiny 14

13. Safeguarding Adults Review (SAR) 15

14. The BSAB’s Role in Learning & Development 16

15. Communications and Engagement 17

16. BSAB Assurance & Governance Structure 18

About our Strategic Plan

The Birmingham Safeguarding Adults Board (BSAB) will ensure that, wherever possible, safeguarding responsibilities across the city are delivered in a way that empowers individuals, that supports defensible decision making and that risk enablement has ‘Making Safeguarding Personal’ (MSP) at its heart. Our ambitions and priorities in both the Strategy and in the supporting Action Plan have been developed by our citizens and our partner organisations,

with a key focus on effective preventative interventions that minimize the risk of abuse and neglect. We have achieved many improvements to safeguarding adults over the last two years and I am grateful to all of our partners for their leadership, energy and dedication to make this happen. The Board will continue to work hard to make certain the culture change we have initiated in Birmingham continues at pace, to determine that safeguarding is ‘everyone’s business’. A city free from harm and neglect of our most vulnerable citizens will always be an ultimate aim and I look forward to joining forces with all of our partners towards meeting this challenge.

Cherry Dale Independent Chair Birmingham Safeguarding Adults Board

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1 Safeguarding Statutory Duties

The Care Act 2014 states that the statutory duties for all Safeguarding Adult Boards (SABs) are: 1. To publish a strategic plan developed in association with the local

Health Watch organisation. The strategic plan sets out how objectives will be achieved by the Board and by each of its constituent members. This document addresses that duty for the people of Birmingham.

2. To publish an annual report detailing what the Birmingham

Safeguarding Adults Board (BSAB) has done during the year, including work associated with Safeguarding Adults Review (SAR) and the contribution that each board member has made for the people of Birmingham.

3. To decide when a SAR is necessary, to conduct the SARs and to

either implement the recommendations from a SAR or to provide a reason for not implementing recommendations.

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Birmingham Safeguarding Adults Board (BSAB) is one of 117 safeguarding adults boards in England which have been organised into a network. National priorities of the ADASS Adult Safeguarding Policy Network are. 1. Serious Adult Reviews (SARS) - how to embed learning and key themes identified from SARs; develop local champions;

promote consistent SAR standards, methodologies and guidance to involve families.

2. Safeguarding thresholds - benchmarking and consistent approaches to Section 42 decision making, enquiries and conversion rates; coercive control, hate crime, self-neglect, adults who were abused as children, people with complex needs, modern slavery, human trafficking, financial scamming and doorstep crime, transition and risk of exploitation, homelessness and safeguarding, suicide and safeguarding, forced marriage, female genital mutilation (FGM) and honour-based abuse.

3. Quality Assurance - use of market intelligence, making the best use of local information sharing panels and surveys, developing common audit and assurance tools/sets of principles.

4. Out-of-area issues/cross boundary flows.

5. Institutional/organisational abuse or neglect.

6. Making Safeguarding Personal (MSP) - service user/carer participation and hearing the voice of citizens. Ensuring consistent use of available tools/resources and working with front-line practitioners (all professionals).

7. Prevention and safeguarding - tackling social isolation and strength-based approaches to communities.

8. Mental Capacity (Amendment) Act 2019 and the Liberty Protection Safeguards.

9. Learning and development - training frameworks, shared learning from peer reviews, guidance and top tips for Boards/Councillors/practitioners and informing areas for improvement.

10. Policies and procedures – multi-agency and region-wide.

11. Dashboards, performance monitoring and data – core sets of metrics including in relation to MSP.

2 National Context of Adult Safeguarding

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The citizens of Birmingham have a right to live their lives free from harm or abuse. Where abuse occurs, it must be reported and responded to promptly in a way that is proportionate to the issue(s) raised. Through Making Safeguarding Personal (MSP) the people of Birmingham who experience harm or abuse have a right to have their voice heard throughout any process we operate in response. This is a key provision of the Care Act 2014 through the delivery of more personalised care and wellbeing support. Hearing the voice of the citizens of Birmingham with regard to adult safeguarding is also a cornerstone of the strategy of the Birmingham Safeguarding Adults Board (BSAB). The Care Act 2014 and its statutory guidance provides for the BSAB to be the local strategy lead for safeguarding Birmingham’s citizens and promoting the wellbeing of both adults at risk and carers within the city. Through its work, BSAB provides oversight of the impact and effectiveness of safeguarding of its members and partner agencies. BSAB also provides advice, training and assistance for its members and partner agencies for the benefit of the people of Birmingham. This strategy provides an overview of what the BSAB will achieve in the next two years; the accompanying Action Plan provides detail of how the board will achieve and report on the impact of its strategic goals. Each sub-committee of the Board will develop its own action plan to deliver the strategic objectives; these action plans will also identify how the priority areas within this strategic document will be delivered.

3 The Work of BSAB for the people of Birmingham in 2019-2021

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Birmingham Safeguarding Adults Board (BSAB) is committed to three overarching ambitions: 1. Making safeguarding everyone’s business; ensuring

everyone understands what it is and what to do. 2. Making Safeguarding Personal (MSP) - we champion

person-centred approaches. Our ambition for MSP includes all relationships people have inside and outside of their family or care setting known as contextual safeguarding.

3. Risk Enablement - supporting people to maintain as

much control and choice over their own lives as possible.

To support the achievement of these ambitions we have developed four key priorities for action:

• Communication and Engagement

• Prevention and Early Intervention

• Empowerment and Enablement

• Learning through development and assurance

We recognise that to meet our ambitions it is crucially important to continue to build a safeguarding partnership of trust and respect across the many excellent organisations across the city.

4 Ambitions

The Care Act 2014 sets the legal framework for the delivery of care and support services in England and the way of working for Adults Safeguarding Boards that we have used to our best advantage to create an innovative, dynamic and collaborative adult safeguarding culture. We have reduced bureaucracy and empowered many organisations and citizens to make safeguarding personal and everybody’s responsibility.

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5 Role of the Board

The Care Act 2014 introduced the ‘Wellbeing Principle’ and placed the promotion of wellbeing at the core of Birmingham Local Authority’s care and support functions. Wellbeing relates to a range of factors including social wellbeing, contribution to society (self-worth/value), and personal and family relationships. Given what we know about the functioning of the human mind and emotional needs, there are clear links between loneliness and poor wellbeing. We also know through national and international research that there are emerging links between social isolation and the propensity for abuse and neglect, therefore it is also deemed to be the responsibility of Birmingham Safeguarding Adults Board (BSAB). The Executive Safeguarding Adults Board meets five times a year, details of the membership of the Executive Board and the impact of each board member are shown in the Annual Report. The Safeguarding Adults Partnership Board also meets five times a year, details of the membership of this board and its impact is also shown in the Annual Report.

This is a version of a diagram presented by Braye, S; Orr, D; Preston-Shoot, M, (2011); The governance of adult safeguarding: findings from research into safeguarding adults boards, SCIE

BIRMINGHAM COMMUNITY ENGAGEMENT

1 RAISE AWARNESS IN

BIRMINGHAM

2 WORK TO REDUCE HARM IN

BIRMINGHAM

3 HELP BIRMINGHAM ADULTS USING CARE

SERVICES TO IDENTIFY AND MANAGE RISKS

4 INVESTIGATE AND PROTECT BIRMINGHAM

WITH CARE AND SUPPORT NEEDS

BIRMINGHAM ADULT SERVICE USER AND CARER INVOLVEMENT AND ENGAGEMENT

PR

EV

EN

TIO

N

RE

SP

ON

SE

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6 Achieving Through Partnerships

Our board is committed to ensuring there is a broad partnership of agencies engaged in championing safeguarding principles and ways of working across the city. We will work towards full engagement with third sector, carer and user groups in the city. We are committed to being inclusive, whilst recognising the vital contribution non-statutory bodies have to offer in delivering effective safeguarding in Birmingham. It is our ambition in 2019-2021 to reach even further and encourage organisations of all sizes and shapes to work with us to roll out our social movement. We feel we are stronger together and have a much greater opportunity to create real change within the city if we work in partnership. We will develop and champion peer-to-peer support in 2019-2021 that will add quality through inclusivity and partnership working. We will continue to rise to the challenge of leading the safeguarding culture change in Birmingham and to make sure that our collective vision, values and culture translate into front-line practice that benefits the citizens of Birmingham. We encourage all partner agencies to sign a Memorandum of Understanding and join the work of the Birmingham Safeguarding Adult Board (BSAB) and partners.

Kenny Bell

Commander, West Midlands Police

Simon Fenton Chief Executive, Forward Carers

Supporting BSAB to achieve its aims has been both challenging and rewarding. Knowing that we are a community that care for one another, and that we are

taking steps to improve the wellbeing of local people by reducing and preventing abuse is very satisfying. Forward Carers look forward to continuing the work of keeping the people of Birmingham free

from harm.

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Sitting alongside my peers who are

equally passionate about helping the most vulnerable has been exciting and powerful. There is an incredible amount

of knowledge and experience on the board, which is harnessed towards

delivering the best for whom we have the privilege of safeguarding.

Professional duties, public partnerships,

early help, preventable work with vulnerable

people

7 Our Safeguarding Duties

Statutory Safeguarding Adults (S.42) Enquiries led by

the Birmingham Local Authority

Wider Safeguarding

Agenda

Safeguarding duties apply to any adult who:

• has need for care and support (whether or not the local authority is meeting any of those needs);

• is experiencing, or at risk of abuse or neglect; and

• as a result of those care and support needs, is unable to protect themselves from either the risk of, or the experience of abuse or neglect.

‘Care and Support’ means the mixture of practical, financial and emotional support for adults who need extra help to manage their lives and be independent - including older people, people with a disability or long-term illness, people with mental health problems and carers. It can include an assessment of a person’s needs, the provision of services and the allocation of funds to enable a person to purchase their own care and support. It could include care homes, personal assistants, day services, or the provision of aids and adaptations.

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8 Six Adult Safeguarding Principles

“I am asked what I want as the outcomes from the safeguarding

process and these directly inform what happens.”

EMPOWERMENT People being supported and encouraged to make their own decisions and informed consent.

PREVENTION It is better to take action before harm occurs.

“I receive clear and simple information about what abuse is, how to

recognise the signs and what I can do to seek help.”

“I am sure that the professionals will work in my interest, as I see

them, and they will only get involved as much as needed.”

PROPORTIONALITY The least intrusive response appropriate to the risk presented.

PROTECTION Support and representation for those in greatest need.

“I get help and support to report abuse and neglect. I get help so that I

am able to take part in the safeguarding to the extent to which I want.”

“I know that staff will treat any personal information in confidence,

only sharing what is helpful and necessary. I am confident that

professionals will work together and with me to get the best result for

me.”

PARTNERSHIP Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.

ACCOUNTABILITY Accountability and transparency in delivering safeguarding.

“I understand the role of everyone involved in my life and so do they.”

Birmingham Safeguarding Adults Board (BSAB) fully embraces the six adult safeguarding principles that should guide and inform the approach to delivery of safeguarding responsibilities by all partner agencies across the city. These principles are:

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9 Making Safeguarding Personal (MSP)

The Board encourages you to have conversations with the people that you support to ensure that they have as much choice and control over their lives as possible whilst maintaining their safeguarding. Citizens are the experts in their own lives and we must always work alongside them to make sure that their quality of life, wellbeing, and safety is optimal, but on their terms with their input and influence. We do not believe in safeguarding people to the point that we just make them unhappy; we will always consider the six principles of safeguarding, adopt them in our practices and seek them in our assurances. The standards are ‘We’ statements under the following themes:

Birmingham Safeguarding Adults Board (BSAB) supports and promotes MSP principles; we agree that:

“A shift in focus from process to people involves fundamental cultural and organisational change. It is not simply a question of changing individual practice, but the context in which that practice takes place and can flourish.”

MSP is about having the conversation with the individual first.

MSP continues to be a shift in culture and practice in response to what we now know makes safeguarding more-or-less effective from the perspective of the person being safeguarded. It is having conversations with people about how we might respond in safeguarding situations in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety. It is about seeing people as experts in their own lives and working alongside them. It is about collecting information about the extent to which this shift has a positive impact on people’s lives. It is a shift from a process supported by conversations to a series of conversations supported by a process (Local Government Association (LGA) Making Safeguarding Personal Guide 2014).

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Hearing the person

Respecting the person’s choices

Understanding the person

Being honest with the person

10 Risk Enablement

Birmingham Safeguarding Adults Board (BSAB) believes that at the heart of adult safeguarding lies a tension between the duty to protect an adult from the risk of harm with the duty to support them to maintain as much control and choice over their life as possible. All practitioners involved in safeguarding an adult at risk have a duty to understand this tension and to work with the adult (and others involved with them) to ensure that an appropriate balance is struck between managing risk and protection from harm with promoting their autonomy and wellbeing in any action they take. We call this “Risk Enablement”.

The Practice Guidance developed with partners over 2017-2018, aims to support practitioners to achieve the balance between protection and autonomy that is right for the adult in each case. This can be found here:

http://www.bsab.org/media/Risk-enablement-WEB.pdf BSAB has an expectation that all its partner organisations support their front-line staff in adopting the principles of its Risk Enablement Guidance as part of meeting their adult safeguarding duties. Partners must ensure the values and culture of their organisations explicitly supports front-line staff in working in this way.

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11 Mental Capacity Act 2005

The Mental Capacity Act 2005 must always be considered in practice to support the positive wellbeing of the citizen. Making Safeguarding Personal (MSP) and applying the risk enablement approach cannot be done properly without applying the principles of the Mental Capacity Act.

“…is a legal framework for acting and making decisions on behalf of individuals who lack

the mental health to make particular decisions for themselves… Mental Capacity

Act 2005

…is intended to assist and support people who may lack capacity and to discourage anyone

who is involved…from being restrictive or controlling… Mental Capacity

Act 2005

…aims to balance an individual’s right to make decisions for themselves with their right to be

protected from harm if they lack capacity to make decisions to protect themselves.” Mental Capacity

Act 2005

“…The fact is that all life involves risk, and the young, the elderly and the vulnerable, are exposed to additional risks and to risks they are less well equipped than others to cope with. But just as wise parents resist the temptation to keep their children metaphorically wrapped up in cotton wool, so too we must avoid the temptation always to put the physical health and safety of the elderly and the vulnerable before everything else. Often it will be appropriate to do so, but not always. Physical health and safety can sometimes be bought at too high a price in happiness and emotional welfare. The emphasis must be on sensible risk appraisal, not striving to avoid all risk, whatever the price, but instead seeking a proper balance and being willing to tolerate manageable or acceptable risks as the price appropriately to be paid in order to achieve some other good – in particular to achieve the vital good of the elderly or vulnerable person’s happiness. What good is it making someone safer if it merely makes them miserable?”

Justice Mumby, Court of Protection (2007)

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12 Assurance, Governance & Scrutiny

Birmingham Adults Safeguarding Board (BSAB) will actively seek assurance at a strategic and operational level across all types of service types within the city; including where the services provided are commissioned and offer care and support for vulnerable citizens of Birmingham. BSAB will challenge commissioners to include safeguarding principles and assurance in all service specifications and monitoring of contracts. Working in this way to gain robust assurance, from both commissioned services and the third sector partners, a structured reporting mechanism will generate intelligence and knowledge of local adult safeguarding matters and concerns. BSAB will use this and other data to facilitate and inform a timely view on the impact of the safeguarding partnership. The Executive Board receives assurance summaries from the Scrutiny and Governance Committee which forms a representative body to consider the statements of assurance from our partner agencies in relation to adult safeguarding practice and safeguarding frameworks. annual assurance statements scrutinise strengths, weaknesses and risks, any learning and development needs for partners and how well the services are meeting the principles of Making Safeguarding Personal (MSP), Risk Enablement and Care Act expectations. Each year, each partner organisation is asked to share with us a statement of their work, good practice, citizen voice and any concerns or themes they have around adult safeguarding.

The Priorities for Assurance, Governance and Scrutiny for 2019-2021: 1. Peer-to-peer audit arrangements to be developed and rolled across partnerships. 2. To embed citizen involvement in the overall assurance process. 3. Provide informed challenge and scrutiny with recommendations as appropriate from reports received, and

follow up all recommendations with impact progress reports.

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13 Safeguarding Adults Review (SAR) A Safeguarding Adults Review (SAR) may be held when an adult with care and support needs dies (or has experienced serious abuse or neglect) and there is concern that partner agencies could have worked together more effectively to support and protect the person who suffered harm. These reviews are to identify whether any lessons can be learned about the way organisations worked together and to consider how the learning can be used to improve practice in the future.

A SAR is not an enquiry into the cause of an individual’s death or injury. It does not look for someone to blame and it is completely separate from any investigation being undertaken by the police or a coroner. SARs concentrate instead on whether professionals can learn anything from what happened.

Any individual (including members of the public) may put forward a case for consideration for a SAR review using the portal via the BSAB website at https://www.bsab.org/professionals/safeguarding-adults-reviews/ A staff member in a partner agency who believes a SAR is warranted should discuss their concerns in relation to the case in question within their organisation before submitting a request. Birmingham’s Safeguarding Adults Board (BSAB) has a Safeguarding Adult Review Group comprised of board members and other partners to fulfil this statutory duty. This can be found within the document entitled ‘BSAB Operating Agreement 2018’, which can be found using the portal via the BSAB website at https://www.bsab.org/publications/all-publications/ The Birmingham Safeguarding Adult Review group seeks to hear the voice of those citizens affected by the SAR process and to respect their thoughts and feelings within the review process by ensuring we learn from their experiences. Their stories will inform our partnership working practices, will influence prevention and early help strategies, and will reduce harm and neglect.

The Priorities for the SAR Group for 2019-2021: 1. Foster a learning culture by improving the dissemination of learning from local, regional and national SARs. 2. Develop safeguarding adult review champions. 3. Develop the skills and knowledge of partner organisations enabling positive contribution to SARs.

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14 The BSAB’s Role in Learning & Development

Birmingham Safeguarding Adults Board (BSAB) recognises that safeguarding responsibilities in the city must be delivered flexibly, in a wide-range of ways and by a large variety of partners. Safeguarding is genuinely everybody’s business, and as part of the fundamental culture shift we are seeking to deliver in Birmingham, our approach is collaborative rather than prescriptive. BSAB recognises that partners have individual training needs. Partners are individually and separately responsible for assessing the learning and development needs of their own staff or volunteers; and we recognise and respect that this is likely to look different from organisation to organisation.

The role of BSAB is to promote a learning culture and seek assurance that the system as a whole works, rather than focusing on the arrangements within partner organisations. We do however expect that the approach to learning and development within all partner organisations should continue to reinforce the basic cultural shift we are trying to deliver together in Birmingham, as below:

• A commitment to embed risk enablement in a way that has impact for those receiving services.

• A culture of defensible decision-making.

• A focus on prevention and early intervention.

• A commitment to working in partnership/collaboration to improve outcomes for Birmingham citizens.

• A commitment to Making Safeguarding Personal (MSP).

Priorities for the Learning & Development Group for 2019-2021 will be: 1. A planned approach to learning and development following a ‘self-

assessment’ against national guidance (see Action Plan). 2. To ensure all learning activity is underpinned by knowledge from ‘experts by

experience’, local organisations and best practice. 3. To jointly develop and promote the competency framework to support the

consistent upskilling of all people working with our most vulnerable citizens.

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Priorities for communications and engagement for 2019-2021 will be: Our communication intentions do not change, we are still committed to communicating with all stakeholders in the most effective way to ensure all partners remain aware and are committed to safeguarding adults in Birmingham, therefore our priorities are: 1. To work with employers and third sector organisations to help us raise awareness of safeguarding with their

employees and the users of their services. 2. To review the current website and procure a new website for BSAB involving citizens and other

professionals in all aspects of its design. 3. To increase citizen co-production in the work of the adult safeguarding board for all areas of its business

where it is appropriate to do so, to ensure the voice of the citizen is heard and acted upon.

15 Communications & Engagement Birmingham Safeguarding Adults Board (BSAB) is committed to communicating effectively and efficiently with all stakeholders using a variety of communication channels.

Our communication aims are to ensure that:

• People with care and support needs, vulnerable adults, carers, partners and the wider community know what adult abuse is and what to do should it happen to them or someone they know.

• People with care and support needs, vulnerable adults, carers, partners and the wider community understand the work of the Board and are able to access safeguarding information and resources to prevent adult abuse.

• People’s experiences of safeguarding are heard to inform safeguarding arrangements in Birmingham.

• We listen - citizens are involved in all areas of safeguarding activity in Birmingham.

• Partners will understand their respective roles and responsibilities, leading to improvements in multi-agency working, and outcomes for the adults that are in receipt of safeguarding support.

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16 BSAB Assurance & Governance Structure

OVERVIEW & SCRUTINY

COMMITTEE (OSC)

HEALTH & WELLBEING BOARD (H&WB)

BSAB Executive Board

BSAB Business Meeting

Birmingham Safeguarding Adults

Partnership

Learning & Development Group

(L&D)

Scrutiny & Governance Committee

(S&GC)

Safeguarding Adults Reviews (SARs)

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