Northumberland review

To review submission of Adult Concern Notifications in relation to issues of self-neglect related to alcohol use, mental health and housing issues, in order to ensure that vulnerability is being correctly identified and alerted.

To review training received by Officers in relation to domestic violence and abuse and ensure that it includes explicit consideration of female perpetrators and male victims and the dynamics within this, included those who present as both a victim and perpetrator.

To ensure that officers undertaking welfare checks in cases where there are concerns around Safeguarding and/or Domestic Abuse are aware of the need to see victims alone and to make direct enquiries regarding potential abuse.

To review practice in DV cases where there is serious injury, to ensure that policy is being adhered to and that consultation with CPS is occurring.

To incorporate into the recommended alert system a prompt for Safeguarding referrals, where necessary, in relation to frequent attenders.

To ensure that NHCFT’s Safeguarding awareness raising and training includes and highlights issues around self-neglect related to alcohol use, mental health concerns, and housing issues; as well as the need, in cases where concerns around domestic abuse or violence have been identified, to try and see patients alone at subsequent attendances.

To ensure that NHCFT’s Safeguarding training and documentation includes issues around self-neglect related to alcohol use, mental health concerns, and housing issues.

To review training in relation to domestic violence and abuse and ensure that it includes explicit consideration of female perpetrators and male victims and the dynamics within this; as well as the need, in cases where concerns around domestic abuse or violence have been identified, to try and see patients alone at subsequent attendances.

To consider use of an ‘alert’ system, as recommended in NHCFT’s IMR, to identify patients with complex needs who are frequent attenders to A&E. This is in order to facilitate access to specialist support services and prompt, where necessary, Safeguarding referrals.

action be taken to ensure staff recognise and consider the different types and patterns of abuse and neglect, especially self-neglect.

‘police disclosure forms’ should be submitted, when information is received from other agencies or self-disclosed regarding violence, aggression or criminal activity, to then contribute to the risk assessment

information regarding domestic abuse, and actions taken should be shared with the GP / primary care.

To ensure concerns of third parties are appropriately followed up on and that this information is not shared directly with those considered to pose the risk, unless this has been explicitly considered and discussed with the third party referrer.

To ensure that historic risk information is explicitly considered and documented in relation to any current concerns and the decision making and actions that follow.

To review procedures for risk assessment to ensure they include the need to identify and request information from all appropriate sources when completing/updating risk assessments. To sample completed assessments to clarify that this is taking place.

When patients undergo a transfer of care, teams should ensure they follow the Trust Care Co-ordination policy. All Service Managers should ensure that their Community Clinical Managers discuss this in their team meetings and send copies of meeting minutes confirming this to Incident and Claims.

The Trust should ensure that administrative staff have agreed protocols in place regarding pathway management, which should be agreed at the Safe group.

for the Addictions Governance Manager to clarify action taken by addictions following advice from Safeguarding and feedback to Incident and Claims

for the Clinical Risk Manager to clarify with the Safeguarding team lead what would happen now and how risk information would be shared.

the CCG recirculate to practices the exemplar policy and to promote its adoption

remind practices of the importance of exploring carer issues and the role of carer assessments.

To encourage practices to implement systems whereby when a partner or family member is requesting access to information, GPs cross reference with the individual’s records where possible to ensure there are no concerns in relation to domestic abuse.

improved documentation should be developed to support decision making, particularly in relation to case closure where risks are potentially high and the person’s capacity to make decisions is unclear.

the supervision and training framework for adult social care staff should include clear guidance in relation to management of complex cases, domestic violence and case closure.

To ensure that the guidance recommended also stresses the need to identify and collate relevant information from a broad range of sources to inform risk assessments of both victims and potential perpetrators.

A protocol should be developed by Adult Social Care for joint visits to be undertaken with Police in cases where an adult is or may be at risk of abuse and/or neglect and Adult Social Care staff have been unable to gain entry.