Safeguarding Adult Boards

Section 43 of the Care Act requires every Local Authority to establish a Safeguarding Adults Board (SAB) for its area. The SAB operates at a strategic level, helping and protecting adults in its area who are at risk of, or experiencing abuse and neglect. It does so through co-ordinating and reviewing a multi-agency approach across all member organisations. The approach that the SAB takes directly influences how frontline safeguarding operations are undertaken in each member organisation.

Although the Local Authority is responsible for establishing and maintaining a SAB, the SAB is concerned with much more than the safeguarding activity of the Local Authority. It oversees and leads on all adult safeguarding across the entire locality area. To do this effectively it must concern itself with a whole range of matters that contribute to the prevention of abuse and neglect, including but not limited to:

1. The safety of patients in its local health services (commissioned and non-commissioned);
2. The quality of local Care and Support services (commissioned and non-commissioned);
3. The effectiveness of prisons in safeguarding vulnerable offenders;
4. How effectively further education services safeguard adults;

To gather intelligence about the whole range of matters the SAB must concerns itself with it must have representation from each area. Collaboration and co-operation are key to the effectiveness of the SAB.

Under the Care Act certain organisations have to be part of an SAB. These are:

1. The Local Authority/Authorities which set it up;
2. The Integrated Care Boards in the Local Authority area(s); and
3. The Chief Officer of Police in the Local Authority area(s).

The Local Authority/Authorities may also include such other members in the SAB as it considers appropriate but must consult the core partners in the ICB and Police before doing so.

The Local Authority/Authorities must be satisfied that all members of the SAB have the requisite skills and experience for the SAB to be effective.

The Statutory Guidance suggests that consideration should be given to appointing an independent chair of the SAB. This is not a requirement but can provide a measure of reassurance that the SAB has some independence from the Local Authority/Authorities and other partners.

Depending on local intelligence and need, the SAB may wish to invite additional organisations to attend some meetings or to participate in its work more generally.

Examples include:

1. Ambulance and fire services;
2. Representatives of providers of health and social care services, including independent providers;
3. Department for Work and Pensions;
4. Representatives of housing providers, housing support providers, probation and prison services;
5. General practitioners;
6. Representatives of further education colleges;
7. Members of user, advocacy and carer groups;
8. Local healthwatch;
9. Care Quality Commission;
10. Representatives of children's safeguarding boards; and
11. Trading standards.

The main objective of the SAB

The main objective of the SAB is to assure itself that local safeguarding arrangements and partners act to help and protect adults in its area who:

1. Have needs for care and support (whether or not the local authority is meeting any of those needs);
2. Are experiencing, or at risk of, abuse or neglect; and
3. As a result of their care and support needs are unable to protect themselves from either the risk of, or the experience of abuse or neglect.

The duties of the SAB

A SAB has 3 core duties:

1. It must publish an evidence based strategic plan for each financial year that sets out how it will meet the above objective and what each member will do to achieve this;
2. It must publish an annual report detailing what the SAB and each member has done during the year to achieve the above objective and implement the strategic plan, and detail the findings of any Safeguarding Adults Reviews that have taken place;
3. It must conduct any Safeguarding Adults Reviews under Section 44 of the Act. See Safeguarding Adults Review for further details about what a review is and when a review must take place.

The functions carried out by the SAB to fulfil its duty and meet its objective

One of the primary functions of the SAB is to develop strategies for the prevention of abuse and neglect.

Examples include:

1. Commissioners and the regulator (normally CQC) working with providers to address poor quality care;
2. The police and housing working to address hate crime or anti-social behaviour in a particular neighbourhood; and
3. The Local Authority working with people who have Care and Support needs to produce accessible information and advice about reducing the risk of abuse or neglect.

Other functions of the SAB include;

1. To identify the role, responsibility, authority and accountability of each agency or professional group in relation to safeguarding adults;
2. Analysing and interrogating data on safeguarding notifications to increase the SAB's understanding of prevalence of abuse and neglect in a way that builds up over time;
3. Holding partners to account and challenging member organisations to maintain the effectiveness of its operation;
4. Arranging for peer review and self-audit;
5. Developing policies and strategies for protecting adults in collaboration with relevant agencies that take account of the views of adults with Care and Support needs, carers and advocates;
6. Consider a range of circumstances and provide clarity on whether an enquiry and referral to the Local Authority would be required;
7. Formulate guidance around adult safeguarding arrangements and processes, including complaints, grievances and response to professional malpractice in relation to safeguarding adults;
8. Develop strategies to deal with the impact of issues of race, ethnicity, religion, gender, sexual orientation, age and disability on abuse and neglect;
9. Share information appropriately for the purpose of protecting adults, including determining what information from a safeguarding adult review should be published;
10. Monitor and review the implementation and impact of policy and training;
11. Promote multi-agency training and specialist training;
12. Evidence how SAB members have challenged one another and held other boards to account;
13. Provide information and advice to other partnership organisations such as the Community Safety Partnership or the Domestic Abuse Board; and
14. Any other function the SAB considers appropriate to meet its main objective.

In the following circumstances, all requests for information made by the Safeguarding Adults Board must be complied with:

1. The request is made for the purposes of enabling the SAB to exercise its function; and
2. The request is made to the person who is likely to have the information.

The SAB can only use the information obtained from making such a request for the purpose of carrying out its functions.

All agencies involved in the SAB should draw up a common agreement relating to confidentiality and information sharing. The agreement should be consistent with the Caldicott Principles:

1. Information will only be shared on a 'need to know' basis when it is in the interests of the adult;
2. Confidentiality must not be confused with secrecy;
3. Informed consent should be obtained but, if this is not possible and other adults are at risk of abuse or neglect, it may be necessary to override the requirement; and
4. It is inappropriate for agencies to give assurances of absolute confidentiality in cases where there are concerns about abuse, particularly in those situations when other adults may be at risk.

The SAR should seek to determine what the relevant agencies and individuals involved in the case might have done differently that could have prevented the harm.

The SAB should weigh up what type of review process will best promote effective learning and improvement action to prevent future deaths or serious harm occurring again.

The process should be determined locally but the approach should always be proportionate to the scale of the abuse or neglect that has occurred, the impact on the person and the level of complexity in the issues to be examined during the review. Reviews of serious cases should be led by a person who is independent of the case being reviewed.

The person and/or their family or representative should be consulted at an early stage when deciding how to complete the SAR, so that they can be as involved as possible and the 6 key principles of safeguarding apply. See the Aims and Principles of all Adult Safeguarding.

The SAB should aim for completion of a SAR within a reasonable period of time and in any event within 6 months of initiating it, unless there are good reasons for a longer period being required.

A report should usually be written as part of the SAR, setting out how the review was carried out, the conclusions it reached, identifying any lessons learned and action to be taken by the SAB. The findings from the SAR should be included in the SAB’s annual report.

The recommendations and action plans from a SAR need to be followed through by the SAB. Action to rectify errors should be taken before the final action plan is written whenever possible and appropriate.

The SAB should also consider what information from the SAR should be published.