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Statement on Safeguarding Adults Review on support given to homeless man with complex needs

Cornwall Council accepts the findings of a summary report published today (November 27by the Cornwall and Isles of Scilly Safeguarding Adults Board (CIOSB) on the support given to a homeless man with complex health and welfare needs.

The Board commissioned the review so partner agencies in Cornwall and Devon could learn from the experiences of the man, who is identified only as ‘Jack’ in the executive summary report to protect his anonymity.

Jack is now safe and well and lives in a nursing home.

The review examined Jack’s experiences with health and social care agencies over a three-year period from 2016 to identify if there were areas in his support that could be improved.

His case was one of the first to be referred to the High Risk Panel set up in 2018 and made up of Cornwall Council’s adult social care services, NHS Kernow Clinical Commissioning Group, Royal Cornwall Hospitals Trust, Devon and Cornwall Police and other agencies.

The panel enables professionals to discuss detailed support for individuals who are causing high levels of concern and need a focussed and co-ordinated approach across several agencies in order to protect and support them.

This initiative has continued since Jack’s case and has been extremely successful in supporting many more individuals in Cornwall.

Cornwall Council portfolio holder for adults, Cllr Rob Rotchell said: “Jack was one of the first people we supported through our High Risk Panel and his positive outcome being settled in a new home demonstrates that the Panel is working effectively to make timely referrals of complex cases and manage multi-agency planning.

“Jack’s story highlights how difficult it is for individual practitioners and agencies to balance respecting a person’s autonomy and right to choose with the duty of care to prevent significant harm or to protect an individual from abuse and neglect.

“As a health and care system we are always striving to improve our services to residents and continually learning from experiences and research in this difficult and complex area which is developing all the time.

“The executive report clearly identifies the issues raised by Jack’s review and an action plan is now in place to monitor how local services in our health and care system are changing in the light of the recommendations in the review.”

The report says Jack spent several years living a transient lifestyle mainly across the South West. He was homeless and there were increasing concerns about his health and welfare.

He had multiple contacts with housing personnel, mental health practitioners, police officers, emergency hospital departments and social workers.

In November 2018 Jack came under the supervision of the Court of Protection that now oversees his care placement and a Deprivation of Liberty order.

The scope of the Safeguarding Adults Review looked at a number of issues as they related to Jack, including support for adults who self-neglect, those with multiple complex needs and who are homeless.

It also looked at practices surrounding assessment of an individual’s mental capacity, hospital discharge, liaison between different local authorities and partnership and collaborative learning.

The review says practitioners and some agencies and services worked diligently to try to meet Jack’s accommodation, care and support needs and that there is evidence of some information-sharing between agencies, including across local authority boundaries.

The report adds Jack’s behaviour and lifestyle proved challenging for individual practitioners and service providers when trying to meet his needs and keep him safe.

It identifies issues in Jack’s care and makes recommendations which have been agreed by all partner organisations of the Safeguarding Adults Board.

A key recommendation in the review is that formalised, multi-agency systems should be used to bring together practitioners and managers to share information, risks and mental capacity assessments so an agreed plan can be put in place to support an individual.

It says policies and procedures for homelessness and self-neglect should complement each other, be up to date and monitored regularly for effectiveness and joint working.

It also calls for legal advice and training for frontline staff and managers to support their work in dealing with complex care and mental capacity and information sharing.

An action plan has started to monitor how services for highly complex cases such as this could be continually improved, including overseeing the effective working of the High Risk Panel which manages complex referrals.

The Cornwall and Isles of Scilly Safeguarding Adults Board’s executive summary review into Jack’s story can be viewed here. 


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Story posted November 27, 2020