This area relates to Section 42 safeguarding enquiries, reviews, safe systems, and continuity of care.

Strengths

• Bexley has a strong and well functioning safeguarding adult board.
• The volume and length of time people are waiting across this system is supported through the Bexley operating model.

Considerations

• The Council delegates or commissions a considerable proportion of its Care Act functions but retains safeguarding. This fosters positive partnerships however these remain Council duties and the Council may wish to strengthen the narrative on how these elements are being managed safely
• There are opportunities to improve pathways into adulthood from children services by earlier and more open sharing of information

Quality Statement Six: Safe systems, Pathways, and Transitions

Safeguarding Adults Board

Bexley has a proactive and functioning Safeguarding Adults Board that is cohesive and focused on improving outcomes. There is a strong partnership between social care, health, and the police. The Board are using lessons learned from safeguarding adult reviews (SARS), and other intelligence to make strategic changes including ensuring that vulnerable adults who are missing are subject to the same protocols and priorities as missing children. The Board appears to have a good balance of internal and external focus in terms of the areas of focus and are working in partnership across several police forces on specific issues. There was a good understanding on some of the areas of development within the system including Making Safeguarding Personal. The board are involving people with lived experience as quality checkers.

Waiting lists

Whilst Bexley does have waiting lists these are relatively low and managed by the joint operating model with OneBexley. There are however over 280 people waiting for assessment and this includes people with the most complex needs. The Council needs to assure itself that it understands the risk and is managing it appropriately.

Deprivation of Liberty Safeguarding (DOLS) functions are managed both internally and using agency staff. This is helping to manage the numbers with only 12 people unallocated at the time of the review with 79% of people allocated on time.

Operational arrangements

Bexley has a proactive and strengths-based transitions team which works closely with the shared lives service and leads the way on Individual Service Funds and personalised support planning. There are some frustrations around the relationships between children and adult services particularly around proactive planning for young people with less complex needs and limited access for transitions workers to the children’s case management system. The Council has recently had a CQC SEND visit (outcome not yet published) which identified some areas for improvement.

The complex care team appears to be significantly over stretched as a result there are reports from other parts of the internal and external parts of the system that they are holding and managing risks which they are not always confident doing and that the front door teams are unable to pass on complex work. There are some potential risks around information governance arrangements for external partners accessing the adult social care case management system liquid logic. The Council may want to ensure providers are clear on their responsibilities when accessing and recording information and that people with care and support are aware of the access of external providers.

It was reported in some of the focus groups that there was an opportunity to improve the information, advice and guidance offer for self-funders.

Hospital discharge

Bexley does not have any acute hospitals within its footprint consequently Bexley residents access acute care in bordering authorities. Bexley currently operates a discharge to assess model and benchmarks well in offering reablement to people leaving hospital with 4.4% of people over the age of 65 being offered reablement compared to a London average of 4.3% and an England average of 2.9%. The peer team heard reports regarding decisions taken at ICB level that potentially put the discharge to assess offer at risk.

Quality Statement Seven: Safeguarding

As is common in other areas there has been an increase in safeguarding demands within Bexley. Initial safeguarding enquiries are allocated promptly, with teams reporting 98% of initial enquiries being allocated within 48 hours and 100% allocated within five days. The peer team heard that improvement has been delivered by a redirection of resources from other parts of the system. Completion and closure of safeguarding enquires appears to be a more challenged position and teams reported significant capacity challenges. At the time of the review there were 115 open enquires.

The peer team did not get a sense that making safeguarding personal (MSP) was embedded within practice and case audits suggest that recording of MSP outcomes were not discussed with people. This has also been identified by the Safeguarding Adults Board. Similarly, there did not appear to be a robust feedback mechanism for people who has been through a safeguarding process. There are a number of quality assurance functions and resources in place which are clearly impacting on waiting times, but the Council may want to consider how the processes are supporting improved outcomes for people.