RESOLVED that the minutes of the Adult Social Service Review panel's meeting held on 8th October 2012 be signed as a correct record.

None

None

The allocation of items between Part A and Part B of the Agenda was confirmed and that the Homes Causing Serious Concern was to be taken as Part B1.

Head of Professional Standards in Adult Social Services presented the report with a document attached. She explained that "The self neglect, dignity and choice" document sets out guidance and procedure for responding to cases of self neglect. Even in cases where it appears that the risk to the individual may be significant, there may be no clear legal grounds to intervene. However the risks to individuals can be high with some cases of self neglect leading to the person's death and local authorities wondering should more should have been done to intervene.

The officer advised that it was important to have this document following recent cases where people at risk passed from one team to another or one service to another. The document is designed to be both a multi-agency guide to issues of self neglect as well as offering procedural guidance for case workers. She went on to say that there was no one piece of legislation that covered this area and the document offered useful guidance to all practioners.

A question was raised regarding the indicators of self neglect listed on page 4/5 of the document, especially relating to the environment section and hoarding and possible fire risk.

The officer replied that where possible housing officers would work with social work teams to assess the issues and solutions. This can be a long process as people who self neglect may be reluctant to have contact with social services and it is a matter of building trust.

Members welcomed the document and one asked if self neglect and mental health issues were treated in a different way as separate issues. She also asked if the issue of self neglect, especially hoarding, had always existed or is it a new phenomena or was it more common for it to be reported following recent media coverage.

In reply the officer stated that it was sometimes difficult to establish intention and that there was a need to build rapport with the person as they often distanced themselves from help. There was no one route and no ‘quick fix', the Safeguarding board could not investigate under the normal process although instances self neglect fell under the safe guarding realm and there was often multi agency involvement.

Members asked if any research had been undertaken to link autism to self neglect. Was there a strategy to identify people to self harm or spot early signs?

The officer advised that she was not aware of any research but it is quite possible that some people who self neglect may be on the autistic continuum which is very broad. Many adults with autism will not have a formal diagnosis although increasingly children are being diagnosed. The reasons why a person self neglects may be many and various and would form part of trying to work with them to understand their problems and find a solution.

Following further discussion the Panel RESOLVED to note the report and accompanying guidance document.

The Advocacy review seeks to scope the amount and breadth of advocacy, provided by the council via contracts with providers and includes other forms of advocacy provided by NHS Croydon.

The purpose of the review is to (1) Identify what advocacy is and the forms it can take (2) describe the current advocacy arrangements and (3) identify whether there are any significant gaps in current advocacy provision.

The Head of Professional Standards in Adult Social Services presented the report and the review document. The document sets out clearly the different types of advocacy in terms of advocacy that is required in law and that which enables improved equality, choice and control but is not mandatory. It also sets out the differences between advocacy that is instructed and non instructed, family and befriender advocacy, self advocacy, peer advocacy and independent advocacy. The review document also sets out the training needs.

The Executive Director of Adult Services, Health and Housing advised the Panel that the review of advocacy provision had been requested by the Safeguarding Board to see if Croydon were providing sufficient advocacy. The report is for the commissioners of the service across health and adult social care and the push for the review came from the voluntary sector. The Safeguarding Board have seen the report and the voluntary sector organisations were happy with the review and the recommendation contained in the report.

Members asked a number of questions including questions about monitoring the person's needs and the service given and if agencies report to commissioners.

Officers responded to all the questions and in relation to monitoring pointed out that the contract had key performance indicators built in and that the review was being presented to the commissioning board.

The Chair of the Panel thanked officers for the detailed report.

The Panel RESOLVED to note the report and the accompanying Review document.

The Head of Democratic Services and Scrutiny discussed with the Panel the future agenda items. Following a discussion a number of topics were put forward for future meetings subject to further discussion between the Chair and Executive Director as follows;

24 April 2013

• Update on the Carers' Hub
• Update from Croydon Care Solution
• Personalisation report

16 July 2013
 

• Adult Social Care Annual Complaints report
• Implementing Croydon Action Plan following the Winterbourne recommendations
• Dignity and Care update report

The Panel RESOLVED that the report be noted.

The Panel Noted the dates of the next two meetings

• 24th April 2013
• 16th July 2013

Was moved and seconded and RESOLVED: that the Press and public be excluded from the remainder of the meeting on the grounds that it is likely, in view of the nature of the business to be transacted or proceedings to be conducted, that there will be disclosure of confidential or exempt information falling within paragraph 3 of Part 1 of Schedule 12A of the Local Government Act 1972, as amended.

SUMMARY of proceedings of exempt part B proceedings (Section 100C(2) LGA 1972 requires a summary to be provided without disclosing the exempt information where in consequence of exclusion of parts of the minutes which display exempt information the minutes of the meeting would not be intelligible as a record.

The report contained details of two Care Homes causing serious concerns. Each home was discussed in turn identifying why it was causing serious concern and after each discussion the Councils actions on each Home was noted.

The first Home was being monitored following instances of abuse by staff who have subsequently been suspended. The Council has received a robust report from the homes management and a July assessment by the CQC advised the home was compliant. The Council continue to support and monitor the home. The second Home was being monitored following a referral to the safeguarding team. Meetings between Council officers and the homes owner have set the expectations for safeguarding. The Council will continue to monitor the home.