Page 17 - 251420_TSAB ANNUAL REPORT A4 WEB

Safeguarding Adults Review

Safeguarding Adults Review What has the Board done?
(SAR) Definition Locally:

• The arrangements for End of Life care have been reviewed
The Care Act 2014 says that Safeguarding Adults Boards must and strengthened following a single agency review.
arrange a SAR when an adult dies or is seriously harmed as
a result of suspected or known abuse or neglect and there • Improvements have been made to procedures relating to
is reasonable cause for concern about how partners worked health care professionals who visit care homes to improve
together to safeguard the adult. Agencies who worked with communication between staff.
the adult come together to establish if they could have done
things differently and reduced the risk of harm or death from • The TSAB Decision Support Guidance has been updated
happening. A SAR is not about blame, its purpose is to learn to include more detail when considering Domestic Abuse
from what happened and to see if anything can be changed cases and to ensure a proportionate response to SAR
so that harm is less likely to happen in the same way to other notifications.
people in the future.
• The thematic review on the TSAB’s RASC procedures
SAR Sub-Group activity identified the following five key areas for learning:
leadership and management; staff behaviour, attitude and
competency; safeguarding teams; partnership working;
The SAR Sub-Group consists of Senior Managers from our and commissioning and contract compliance. It was
key partners and they are responsible for considering new SAR identified that emphasis needs to be placed on managing
notifications, overseeing any ongoing SARs or other reviews, risk and to support services at an earlier stage, which may
ensuring any learning from reviews (locally, regionally, nationally) prevent the service from declining and being placed into
are considered by TSAB partners and taken forward in their serious concerns.
own organisations and for overseeing the implementation of
action plans arising from SAR activity across Tees.
Regionally and Nationally:
• The SAR Sub-Group considered 6 SAR notifications this
year (compared to 3 in the previous year) and decided that • Newcastle City Council presented the learning from
one case met the criteria for a SAR: this review started in their Joint Serious Case Review (historical sexual
March. There were three notifications indicating poor care exploitation affecting girls and young women) which was
practice within care homes, which had been or were about a good opportunity for the SAR Sub-Group to explore
to be subject to the TSAB Responding to and Addressing similar issues across Tees. As a result of this the Board
Serious Concerns (RASC) procedures. Although none of developed a Protecting Adults from Sexual Abuse and
these cases met the criteria for a SAR, the Sub-Group Exploitation leaflet and also included Sexual Exploitation
agreed to carry out a review of the lessons learned from within the Safeguarding Champions event. The Board has
implementing the RASC to identify any common learning. strengthened reporting mechanisms and 37 safeguarding
The remaining 2 cases did not meet the criteria for a SAR concerns were raised in 2018-19 relating to sexual
exploitation. Plans have started to deliver a conference in
• The SAR Sub-Group monitored the action plan in relation 2019 which will focus on exploitation. The Board will also
to the SAR Carol case which was published in 2017 and be strengthening links with professionals working with
good progress was made by our partners to ensure the children at risk of exploitation in 2019-20.
learning from this case was taken forward within their own
organisations. The group also continued to oversee the • The Board’s web page on organisational abuse has been
actions and learning from 4 single agency reviews. updated in response to the Nightingale Homes thematic
review to highlight ‘What a good organisation looks like’.
• The SAR Sub-Group considered learning from 8 SARs and
2 thematic reviews, regionally and nationally; summaries
of these reports are available at www.tsab.org.uk and are
shared with TSAB partners following each SAR Sub-Group
meeting.

| 17