Monthly Safeguarding Report

Transcription

1 Monthly Safeguarding Report 1

2 Contents Summary Page 3 Overall Trust Safeguarding Statistics Page 4 Audit results Page 6 Average SPOC Case Entry Time Page 11 SCR/DHR/SAR s Page 11 Safeguarding Supervision Page 12 Feedback information Page 12 RFI & CDOP Page 13 Categories of Abuse Page 13 Capacity to Consent Page 15 Incidents Page 15 Frequently Referred Page 16 Audit R results Page 17 Sector Analysis- Detailed referrals and feedback Page 17 2

3 Summary Safeguarding referrals totals are 3643, an annual increase of 2% from February 217, in line with recent trends. Due to the shorter calendar month, the true indication of performance is from Trust referrals per 1, 999 incidents, which increased by 8.6% on the previous month to Notably referrals in Hertfordshire and Suffolk increased on Januarys referral figures. The Audit for February was the 4 th quality assurance audit on SPOC s understanding on the appropriate care pathway for GP Assistance referrals, which continues to evidence competency in this area but highlighted an issue with 12% of GP Assistance referrals being more appropriate for GP Reports, due to the exchange of clinical information. SPOC Case Entry Time remains consistent at just over 9 minutes per referral. 9.4% of SPOC calls were answered within 6 seconds and Operational hours lost in waiting for SPOC to answer in February decreased to its lowest since April 217, at 48hours. The total active amount of Serious Case reviews to date at the end of February is now 32, with 5 new cases received. Compliance for Safeguarding Supervision every 6 months is maintained at 62%. Difficulties are still faced due to operational priorities and cancellation of booked Supervision appointments. 25% of referrals received feedback (or 914 feedback received) which were provided to clinicians across the Trust. This continues to account for approx. 2-25% of administration time in the Safeguarding Office. Requests for information decreased to 83 in February. Cases of Self-Neglect accounted for 59% of all Adult Social Care referrals in February, 28% of these from Essex alone. Compliance on completing Trust Capacity to Consent forms for Safeguarding referrals decreased to 88%. DATIX Safeguarding incidents decreased notably to 64 31% decrease from January. Whilst Patient Experiences logged in February equated to 1, Januarys figures were updated and doubled to 16 an exceptionally high amount, potentially due to more Section 42 enquiries from Social Care following winter pressures. People who have been frequently referred 3 or more times decreased to usual levels at 36 for February. 3

4 Overall Trust Safeguarding Statistics; 3643 Social Care and GP Assistance referrals were made as a Trust in February 218. An annual increase of 2.% and due to the shorter calendar month; a decrease of 6.2% on the previous month Total Monthly Referral Trend Total Monthly Referrals Linear (Total Monthly Referrals ) In June 17 the Trust altered the data which is collated for total 999 calls for the Trust to remove duplicate calls, previous data was altered in line with this. ARP launched mid-october with new reporting software and new data parameters. Safeguarding referrals per 1, 999 calls have not been updated for October due to the ARP occurring mid-month and the old reporting facility had been removed. Referrals per 1, 999 calls in February were , an increase of 8.6% on the previous month Total Monthly Referral Trend per 1, 999 incidents Referrals per 1k 999 calls Linear (Referrals per 1k 999 calls) 4

5 Previous Total Monthly Referral Trend per 1, 999 incidents Referrals per 1k 999 calls Linear (Referrals per 1k 999 calls) Total referrals by Type Trend - Feb Mar Apr May June July Aug Sep Oct Nov Dec Jan- 18 Feb Children Adult Social Care GP Assistance Childr en Adult Social Care GP Assist ance 5

6 Audit Results The Safeguarding Team will conduct themed audits throughout the financial year. It is the intention to run some of the audits twice throughout this period. The first audit will set a benchmark. Recommendations/changes will be made; the improvement can then be measured in the second audit of the theme. The completion of recommendations will determine the frequency of the audit. In August 216 the SPOC Supervisory Team were fully trained to check all GP Assistance referrals, to ensure that they are dispatched to the most appropriate destination. The facility for SPOC Health Advisors to dispatch GP Assistance referrals was removed and from September 216, SPOC Supervisors undertook the function to Quality Check all GP Assistance referrals for the Trust. For quality assurance purposes, the Safeguarding Team continue to audit GP Assistance referrals on a 6 monthly basis and check a random sample daily. GP Assistance referrals have previously been audited in September 216, March and July 217. The purpose of this audit is to quality check the SPOC Supervisors understanding of the referral process and appropriate pathway selection GP Assistance referrals were made in January % or 465 referrals were randomly selected and audited by the Safeguarding team to establish; 1. How many referrals the SPOC Supervisors identified as more appropriate for Adult Social Care. 2. How many of these Supervisor identified re-directs, would have been redirected by the Safeguarding Team. 3. How many other GP Assistance referrals, if any, the Safeguarding Team would have felt appropriate for Adult Social Care. 4. How many other associated referrals should have been made and were not. 5. On review of the GP Assistance referrals how many referrals would have been more appropriate as a GP Report. The first two audits in September 216 and March 217 checked 1% of GP Assistance referrals, and reviewed accurate category of abuse selection, however due to the results of the first two audits and a separate audit solely on categories of abuse, these were not audited in the third or this audit. 1. How many referrals the SPOC Supervisors identified as more appropriate for Adult Social Care. Of the 1638 GP Assistance referrals in January, SPOC Supervisors identified 27 or 1.64% as inappropriate GP Assistance referrals and re-directed as an Adult Social Care referral. Compared with previous audits, completed in September 16, March 17 and July 17, where this figure was 6%, 3% and 1.54% respectively. 6

7 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Re-direct Trend on Audits 7% 6% 5% 4% 3% 2% 1% % 6% 3% 1.54% 1.64% Re-directs Accuracy of GP Assistance pathway choice by SPOC Health Advisor 27 Correct GP pathway Incorrect GP pathway How many of these Supervisor identified re-directs, would have been redirected by the Safeguarding Team. Of the 27 GP Assistance referrals identified by SPOC Supervisors as appropriate for Adult Social Care, 25 or 93% the Safeguarding team would also have re-directed. Re-direct Trend on Audits 12% 1% 8% 6% 4% 2% % 78% 1% 1% 93% Re-directs 7

8 Correct Identification by SPOC Supervisors 7% Correct Identification Incorrect Identification 93% 3. How many other GP Assistance referrals, if any, the Safeguarding Team would have felt appropriate for Adult Social Care. Of the 465 or 28% of GP Assistance referrals randomly selected for audit, the safeguarding team identified a further 7 GP Assistance referrals or 1.5% as appropriate as an Adult Social Care referral. Previous audits completed in March 17 and July 17, the figure was.72% and.3% respectively. 2.% 1.5% Re-direct Trend on Audits 1.5% 1.%.5%.%.72%.3% Re-directs 4. On review of the GP Assistance referrals, how many other associated referrals should have been made and were not. On review of the 465 GP Assistance referrals which were audited in January, 3 or.6% of other referrals were requested to be made by the Safeguarding Team which had not been made by the SPOC Health Advisor, where there were other associated persons connected to the initial incident, which should have been referred and were not. Compared to the last audits in September 16, March 17 and July 17 where this was respectively 13 or 1.7%, 8 or.8% and 2 or.6%. 8

9 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 2.% 1.7% Missed Referrals 1.5% 1.%.5%.8%.6%.6% Missed referrals.% 5. On review of the GP Assistance referrals how many referrals would have been more appropriate as a GP Report referral. The Trust has a GP report pathway which is for the transmission of clinical data only to GP s and does not require a care package or medication review. As part of the audit we reviewed how many of the randomly selected GP Assistance referrals would have been more appropriate as a GP report referral, due to them just containing clinical data. On review of the 465 GP Assistance referrals audited in January, 54 or 12% were deemed to be more appropriate as a GP Report. Referrals more appropriate as a GP Report 12% GP Assistance Referral GP Report Referral 88% Re-direct information is gathered from case cancelled data. If a case is not cancelled when it is re-directed, it will not show up in the re-direct information. This has a serious impact in the quality of recorded data in how many referrals the SPOC Supervisors are re-directing. It was noted from this month s audit data, that on 2 occasions a re-direct had been requested by the Safeguarding Team, however the original case had not been cancelled therefore reducing the reported figure. This could potentially explain why the over the last 6 months the re-direct figures have not been consistent. 9

10 Total Monthly Re-directs Re-directs Total Linear (Redirects Total) Summary; The amount of referrals that the SPOC Supervisors are identifying to be re-directed from GP Assistance to Adult Social Care referrals remains consistent and continues to evidence competency of SPOC Supervisors understanding of the pathway. The majority of cases that SPOC Supervisors re-directed, would have been re-directed by the Safeguarding team (25 of 27). The total GP Assistance referrals which were identified by the Safeguarding Team as requiring re-directing, which were not identified by SPOC Supervisors, whilst increasing significantly from.3% to 1.5% still only represents 7 of 465 referrals. All 7 identified referrals were around Self neglect. Associated referrals which had not been made remains consistently low at.6% and also continues to evidence understanding of multiple referrals by SPOC Health Advisors. 12% of GP Assistance referral would have been more appropriate as a GP report. Recommendations; Contact SPOC Manager to advise of the issues with redirected cases without the case being cancelled and the potential influence on the reported figures to disseminate through SPOC teams. Contact SPOC Manager to receive a progress check on Safeguarding training/refresher training of SPOC Health Advisors, to consider if refresher training is required prior to the next audit. Refresher training last provided in SPOC Dec 17 but may not have captured all new starters. The Safeguarding Team continue to check 1% of GP Assistance referrals on a daily basis and will continue to re-audit GP Assistance referrals for Quality Assurance purposes on a 6 monthly basis. Highlight the similarities of GP Report and GP Assistance referral pathway to the Regional Clinical Co-ordinator & Safeguarding Lead. 1

11 Average SPOC Case Entry Time The SPOC Call Centre monitor call statistical information for all the services they provide. The Safeguarding Team requested the average call length of each Safeguarding referral call made by clinicians into the call centre. SPOC have been able to provide the average time taken to log each referral from the start to finish time recorded on Adastra as a representation of the average time taken to complete each referral Av Safeguarding SPOC Case Entry time, in mins Av Input time Linear (Av Input time) SCR/DHR/SAR s The below represents the current amount of active Serious Case Reviews (SCR)/Domestic Homicide Reviews (DHR) and Serious Adults Reviews (SAR), either at stage of scoping or submitted Chronology, draft or submitted Independent Management Review or outstanding recommendations for completion, up to the end of this month. Work was undertaken in December to confirm closure of a number or outstanding reviews. 5 new Case Review notifications were received in February, with 1 case being closed. 11

12 Active SCR/DHR/SAR Total cases Safeguarding Supervision The below represents the % of nominated Safeguarding Lead s, Trust Board, Managers and Area Clinical Leads who have had documented Safeguarding Supervision within the last 6 months. In line with the new Supervision Policy, 24 identified personnel require Supervision by the Safeguarding Lead, Named Professional or Named Doctor for Safeguarding. Safeguarding Supervision 7% 6% 5% 4% 3% 2% 1% % 52% 48% 45% 35% 39% 48% 5% 58% 66% 58% 66% 62% 62% Compl iance Overall Trust Feedback for all Safeguarding Referrals In, 25% or 914 of the 3643 Trust referrals received feedback which was sent out by the Safeguarding Team. It is expected that the Safeguarding team may not have the capacity to process all feedback as thoroughly in the forthcoming months. 12

13 Axis Title Total Feedback sent to staff Feedback Received Linear (Feedback Received) RFI s and CDOP Requests The below represents the amount of information which was requested from the Safeguarding team from external organisations, excluding Serious Case/Adult or Domestic Homicide reviews. Due to the main office telephone number recently being changed (effective 3 th November) this has had an impact on received RFI s at the end of 217, whilst the new number was being disseminated CDOP & RFI request's RFI's 5 Categories of Abuse The below details the total categories of abuse for all Safeguarding Adult & Child referrals, to show the reasoning for the Trust s Safeguarding concerns, followed by a breakdown per locality for last month. Following a recommendations from the infrequently used categories of abuse, it was decided that from January 218, Toxic Trio would be removed as a category of abuse reported. 13

14 What is the suspected type of abuse? October 17 November 17 December 17 January 18 February 18 Child Adult Child Adult Child Adult Child Adult Child Adult Concealed pregnancy 1 1 Domestic Abuse/Violence Emotional Fabricated or Induced Illness 2 2 FGM 1 Financial or Material Hate Crime 1 Human Trafficking Institutional Neglect Physical Self Neglect/Environmental Sexual Toxic Trio Violent Extremism Adult and Child Referrals by Sector Feb 18 Beds Herts Cambs Essex Norfolk Suffolk Abuse Category Adult Child Adult Child Adult Child Adult Child Adult Child Adult Child Concealed pregnancy Domestic Abuse/Violence Emotional Fabricated or Induced Illness 1 1 FGM Financial or Material Hate Crime Human Trafficking/ 1 1 Institutional

15 Neglect Physical Self-Neglect /Environmental Sexual Violent Extremism 1 Capacity to Consent For more accurate reporting of Capacity Assessments, Capacity questions are now only asked of those patients who are seen face to face and who do not agree to transport, as the requirement for the Capacity Assesment question being prompted Adult GP Assistance referrals were made in. 294 of these patients were not seen face to face or were not the patient. 215 of these remaining 1147 referrals recorded that the patient did not agree to treatment or transportation. Out of these 215 patients who had refused treatment or transportation, 19 Capacity assessments were then completed by the Trust clinician; 88% compliance. 95% 9% 85% 8% 75% Capacity Forms completed where the patient has no capacity 91% 88% 88% 86% 84% 91% 91% 93% 92% 91% 91% 88% 84% Capacity Forms completed Incidents 64 Safeguarding related DATIX incidents were logged. Previous month s figures have also been updated. 15

16 Number of DATIX Safeguarding incidents logged DATIX Safeguarding incidents logged Linear (DATIX Safeguarding incidents logged) 1 Patient Experience had been logged where Safeguarding was highlighted as a concern. Previous month s figures have also been updated. Number of Safeguarding related Patient Experiences PALS/C omplai nts Linear (PALS/ Compl aints) Frequently Referred The Safeguarding Team obtain a monthly report on how many patients are referred 3 or more times in a month, from the Adastra system Total persons with 3 or more referrals in a month Total persons with 3 or more referrals in a month 16

17 Total persons referred 3 or more times, per area B&H Essex N,S,C Audit R Audit R has been superseded by Audit Online. There is currently no Safeguarding Report available on Audit Online. Sector Information Total referrals by Sector B&H Essex N,S & C 17

18 % of Trust referrals by Sector B&H Essex N,S & C Linear (B&H) Linear (Essex) Linear (N,S & C) The below table is a breakdown of referrals by Sector by Children & Adult, for information only. Month/Area Totals Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan 18 Beds Herts Cambs Norfolk Suffolk Essex Feb 18

19 Beds Referrals Child Adult GP Herts Referrals Child Adult GP Norfolk Referrals Child Adult GP 19

20 Suffolk Referrals Child Adult GP Cambs Referrals Child Adult GP Essex Referrals Child Adult GP The Safeguarding team collate information on Private Ambulance Services, from the Base Station location provided on the referral. The accuracy of the information is subject to human error, due to inaccuracies with reporting referrer s base location. 2

21 Total referrals, where the base location is recorded as PAS PAS Feedback Total Trust feedback received/obtained was 25% for and represents the true value of the amount of feedback the Trust received from our partner agencies. The below represents the amount of feedback received/obtained in Sector area from both GP and LA s. 5% % Total Beds Feedback received 4% 3% 2% 1% % 41% 4% 35% 35% 34% 36% 24% 26% 28% 29% 29% 26% 22% Beds Linear (Beds) 7% 6% 5% 4% 3% 2% 1% % 42% % Total Herts Feedback received 59% 6% 59% 5% 52% 45% 47% 5% 44% 38% 38% 56% Herts Linear (Herts) 21

22 5% 44% % Total Norfolk Feedback received 4% 3% 2% 1% 7% 14% 13% 9% 1% 8% 5% 9% 5% 7% 8% 8% Norfolk % 34% 25% 21% 38% 36% 4% % Total Suffolk Feedback received 35% 3% 25% 2% 15% 1% 5% % 29% 29% 3% 19% 29% 28% 29% 15% Suffolk Linear (Suffolk) 35% 3% 25% 2% 15% 1% 5% % 11% 11% % Total Cambs & Peterborough Feedback received 32% 6% 6% 4% 5% 5% 5% 5% 5% 3% 3% Cambs & P'b 22

23 5% 4% 3% 2% 32% 44% % Total Essex Feedback received 37% 32% 28% 29% 31% 3% 34% 37% 33% 28% 25% Essex 1% % Linear (Essex) 5% 4% 3% 2% 1% % Feedback sent to PAS Providers as % of referrals by PAS 43% 23% 23% 19% 2% 25% 24% 17% 17% 12% 13% 5% 7% 1% PAS Linear (PAS) Author: Denise Kendall Auditor: Rebecca Bavington 6 th March