Page 7 - TSAB Board Minutes - 25 October 2019

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 The Blue Light Project is an initiative to develop alternative approaches and care pathways for
drinkers who are not in contact with treatment services, but who have complex needs. It challenges
the belief that only drinkers who show clear motivation to change can be helped, and sets out
positive strategies that can be used with this client group.
 The Blue Light approach has now been adopted by a large number of Local Authorities across
England and Wales. A Blue Light Manual has been developed which sets out the key principles
and contains a range of advice and tools for working with clients who are not in contact with
services. The Manual has won a number of awards.
 MW provided a case study of an individual who presented with a number of health issues and a
high level of alcohol consumption. The individual had previously been identified as a high volume
service user and there had been an escalation in his behaviour in conjunction with high levels of
alcohol consumption. Diagnosis of the individual was complex as he was deemed to have capacity
and had a complicating factor of an alcohol related brain injury. Following a multi-agency approach
and input from the Blue Light working group a coordinated approach was developed and a
significant improvement was observed with this individual with cost savings to services being
significant.
 A report titled Learning from Tragedies – An Analysis of Alcohol–Related Safeguarding Adult
Reviews published in 2017 was published by Alcohol Change UK in June 2019. 41 Reviews were
found in total, 15 of which mention alcohol. In 11 cases alcohol is relevant to the main incident.
Most individuals had multiple complex needs in addition to alcohol misuse which presented
problems with support services coping with that level of complexity. The report also found that
there is too little guidance on applying the Care Act or the equally relevant Mental Capacity Act to
this group of people. Chronic alcohol misuse is an important issue in adult safeguarding and self-
neglect.
 A number of recommendations have been suggested by Alcohol Change UK on publication of the
report which include the Mental Capacity Act 2005 should be amended to include specific
guidance for working with individuals with alcohol misuse or dependence, especially then they are
likely to have complex needs. It was noted that the SAR Sub-Group have considered the
recommendations from this report in respect of the learning for the Board.
 MW highlighted that alcohol can have a complex impact on individuals and cause a number of
physical conditions. Foetal Alcohol Syndrome is one such condition.
 SAR 3 - Carol highlights the Blue Light project as a model of best practice with this client group.
 MW explained that assertive outreach services work and are the best evidenced intervention. This
multi-agency approach has been evidenced as successful in several parts of the country.
 MW highlighted the importance in the commissioning of alcohol services and that it should be
carried out in a way that minimises levels of staff turnover and recognises the importance of
continuity in supporting people with complex needs. More investment is also needed within these
services.
 Alcohol Change recommend that when carrying out a review the SAR team should always have
access to independent expertise in alcohol misuse in order to properly assess the role of alcohol
in the incident, and to ensure that lessons are effectively learned.

Ann Workman (AW) thanked MW for his presentation and advised that she would share it with Public
Health colleagues for discussion.

Patrick Rice (PR) commented that within Redcar and Cleveland Borough Council (RCBC) an existing
multi agency group is established where client groups have access to assertive outreach workers whose
specialism is Alcohol. Mike Milen (MM) highlighted that there is an assertive outreach service established
in Redcar which has been in operation for 12 years and unfortunately due to it not being commissioned
has struggled with funding.

JG advised that through the Crisis Concordant work there was funding available and a house
commissioned however it is clear that this not enough. MW advised that Alcohol Change have now
completed draft guidance on what is assertive outreach and is more than happy to send to members for
comments.

Minutes Approved – 11.12.19 7