Welcome to this short podcast on behalf of the West Sussex Safeguarding Adults Board which will give you information about the outcome of our complex case audit which we carried out in 2022 to 2023.
This audit looked at the records of ten people who had been referred to our multi-agency risk management subgroup, also known as MARM. The audit looked to evaluate and reflect on practice, learn from experience, inform multi-agency practice development, and strengthen multi-agency working.
So, firstly, I would like to explain the criteria for the audit.
For our audit, complex cases were defined as cases where adults with care and support needs have a high level of support with many aspects of their daily life, and rely on a range of health and social care services. This may be as a result of a combination of two or more of the following: illness, disability, and broader life circumstances, including multiple disadvantages.
We looked at the records of seven adults who were discussed at MARM and three adults who had been referred but were not appropriate for discussion at MARM. Further details about the adults such as their ages, ethnicities, gender, and support needs, can be found in the learning briefing which accompanies this podcast.
So, now I’ll share with what our audit found in terms of the top three issues and barriers in working with complex cases.
The top three issues were; the adult not engaging, self-neglect, and mental health issues.
The top 3 barriers were; difficulties in establishing and maintaining contact, Mental Capacity Act Assessments and Best Interest Decisions, and multi-agency working and coordination of support.
There were also four other key themes identified where improvement or development is needed.
- The first was a need to improve Mental Capacity Act assessments.
- The second was that if the person lacked capacity for a decision or decisions, there was a need for support from a representative or advocate.
- The third was effective multi-agency working being evidenced.
- And, the fourth was addressing issues impacting on the ability to manage risk.
So, what else did we look at alongside this audit?
In addition to the audit, we also carried out a survey with staff to understand the issues, barriers and positive factors in supporting complex cases, and the support offered by MARM subgroup. The findings from this survey can be found in the learning briefing accompanying this podcast.
In addition to the survey, we also considered themes from Safeguarding Adults Reviews relating to complex cases. The most common themes were; making safeguarding personal and improvements required to Mental Capacity Act Assessments, risk management, multi-agency working and communication, and recognising and responding to safeguarding and quality concerns. You can read more about our SARs on the Statutory Publications page on our website.
So, what can we together, do next?
To make the findings of this audit matter and improve the experience for adults with complex needs, we have several resources to support your knowledge and practice to be current.
Firstly, please see our Policy and Protocols on our website which should be underpinning your practice in safeguarding complex cases. These include:
- The Sussex Safeguarding Adults Policy and Procedures which represent the standards for good practice in adult safeguarding in Sussex.
- The Safeguarding Thresholds Guidance which provides professionals with examples of the different categories of abuse and neglect and the best course of action to take.
- The Multi-Agency Self-Neglect Procedures which contains detailed guidance on supporting those who self-neglect including information on the Mental Capacity Act.
- Multi-Agency Risk Management Protocol which gives advice on referring to MARM for cases where an adult is putting themselves or others at significant risk by refusing services, and all options have been explored and the level of risk is still high.
- The Sussex Information Sharing Protocol which sets out how information between partner agencies should be shared. And last but not least,
- The Sussex Safeguarding Escalation and Resolution Protocol which supports consistent and timely decision-making where there may be disagreements or issues between professionals.
In addition to these policies and protocols, on our Learning and Podcasts page of our website we also have a range of other learning resources which can support your practice with safeguarding complex cases. These include learning briefings and podcasts on the following:
- Self-neglect
- Multi-agency working and communication
- Risk assessment
- Making Safeguarding Personal
- Person-centred approaches
- Professional curiosity
- What is Safeguarding?
- Domestic abuse
- Shared learning from reviews
- Learning from other SAB audits
This brings us to end of our podcast. Thank you very much for your time to listen to it and, we appreciate your support to make a real difference to adults with complex needs, including those experiencing self-neglect.