Tuesday, 11 June 2019

Brent Scrutiny to examine progress since the 'Adult B' Safeguarding Adult Review

The Community and Wellbeing Scrutiny Committee will tonight (6pm Brent Civic Centre) receive an update and progress report LINK resulting from the Safeguarding Adult Review (SAR) of Adult 'B' whose case was covered on Wembley Matters and in some of the national press. The Review was triggered because there was evidence that Adult B had experienced abuse and/or neglect and that there was concern about how agencies had worked together to safeguard and promote her well being.

The report to Scrutiny by Michael Preston-Shoot, Independent Chair of the Brent Safeguarding Adults Board, sets out in details what has been done locally as a result of the Review as well as the national context.

His final remarks summarise the current position:
The purpose and terms of reference for the Adult B SAR are detailed in the review itself, which is an appendix to this report LINK. Put succinctly, the SAR’s purpose was to identify good practice and shortcomings in Adult B’s care and support provision and to learn lessons about the care and support provided to a person with learning disabilities, protection planning and the use of the Mental Capacity Act 2005.

It is clearly laid out in the SAR that what had been provided to Adult B over a considerable number of years had been very limited. She had been provided with accommodation and her basic needs had been met. However, with reference to the components of wellbeing in section 1 (Care Act 2014), provision had been limited. The SAR therefore challenges all those involved with arrangements for the care and support of learning disabled people with respect to what the vision and ambition is for service provision.

 If residential care is to be provided to people with learning disabilities, then this needs to be accompanied by other forms of service provision in order to deliver on all aspects of wellbeing. It is questioning whether, in all cases where care and support is being provided, relying just on annual reviews is sufficient to ensure that people’s needs continue to be met and their wellbeing enhanced.

Concerns about provision for learning disabled people are not unique to Brent. There have been other SARs that have highlighted shortcomings, of which Winterbourne View (South Gloucestershire SAB) and Mendip House (Somerset SAB) are particularly noteworthy.

In relation to the recommendations, detailed advice was taken by Adult Social Care in relation to the other residents in the care home and that advice has been acted on, with plans implemented to ensure their health and wellbeing. The first recommendation has, therefore, been completed although work obviously is on-going with respect to monitoring the quality of the new arrangements.

Adult B now has an allocated social worker. Adult B and her mother were provided with considerable support in the run-up to her move and this support has continued. Adult B is safe and well, and is making good progress in her new placement. The second recommendation has, therefore, also been completed but work is on-going with respect to monitoring the quality and outcomes of the new arrangements.

The third and fourth recommendations relate to the development of services generally for learning disabled people and the SAB’s role in seeking reassurance that the lessons from the Adult B SAR have been embedded. The SAB will receive regular updates from Adult Social Care and the CCG regarding the development of services for learning disabled people, the management of provider concerns, and the provision of primary care healthcare checks. The SAB also receives regular updates of the outcomes locally of reviews of deaths of learning disabled people (the Learning Disability Mortality Review Programme), which means that the case of Adult B is not seen in isolation.

The responsibility for overseeing the outcome of the recommendations rests with the SAB and ultimately myself as Independent Chair. I have facilitated dissemination events and will continue to do so in order to ensure that the lessons from the Adult B SAR, and from other SARs nationally involving learning disabled people, are known and the findings reflected in good practice locally. 

The last SAB annual conference deliberately included a keynote presentation on SAR findings and another on good practice with learning disabled people. The SABs strategic plan, a statutory requirement from the Care Act 2014, is being updated for 2019/2021 and there will be a strategic priority that focuses on learning disabled people to ensure a focus on service improvement in this field of practice.

Adult B and her mother will continue to receive support from a social worker and GP to ensure that her health and social care needs are met. Adult B’s mother was consulted during the SAR process, so that her views were incorporated fully. She was also fully involved in discussions about publication of the SAR and was supportive of publication to ensure that lessons are learned both locally and nationally.

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