Newcastle Safeguarding Adults Board Annual Report 2023-24

This page includes the content of the NSAB Annual Report 2023-24. You can download the full report below.

Newcastle Safeguarding Adults Board, ensuring Newcastle is a safer City for adults at risk of abuse and neglect.

Introductions from our Chair and Cabinet Member

“Once again, I’d like to take this opportunity to thank everyone who supports and contributes to the work of the Newcastle Safeguarding Adults Board (NSAB).

On an ongoing basis I never fail to be impressed by the passion and commitment of Board members, the wider workforce, and communities to keeping adults at risk safe from abuse and neglect. I would like to acknowledge Dr Clare Abley’s significant contribution to the work of the NSAB over the last 15 years and wish her all the very best in her retirement.

The NSAB has an important statutory function in overseeing and leading on adult safeguarding arrangements across the city. To do this effectively, we need to have robust governance arrangements and multi-agency policy and procedures. Time has been devoted in the last year to reviewing and revising these key documents. Whilst significant changes have not been made, they have been refreshed and brought up to date with changes in practice and any relevant emerging national guidance.

As reported in last year’s annual report work has continued to improve practitioner confidence in applying the Mental Capacity Act (MCA). A key part of this is ensuring those working or volunteering on the front-line have access to good quality training that is relevant to their role. I wrote to all Board members and made the letter publicly available for non-Board member organisations, to request that their MCA training offer was reviewed in line with national competencies. They were also asked to consider making the training mandatory for specific roles. I was pleased to receive positive assurance from all agencies and hope this helps us in achieving one of our key priorities.

Cross-partnership and cross-boundary working is an essential part of safeguarding adults work. The establishment of the Newcastle Partnership Group for Safeguarding and Vulnerability has been a positive step locally, bringing together the NSAB, the Newcastle Safeguarding Children Partnership, the Youth Justice Partnership Board, and the Safe Newcastle Board to discuss priorities and to ensure that the potential in working together is fully realised.

In the past year I have had the pleasure of chairing the Northeast Regional Safeguarding Adults Board Chairs Network, a forum which facilitates the sharing of information from individual SABs and feeding information up to the National SAB Chairs Network, which I also attend. One of the key areas that has been discussed at the Northeast SAB Chairs network has been addressing the Whorlton Hall Safeguarding Adults Review (SAR) recommendations.

Our partnership is one that always strives to learn and improve. We do this is in a variety of ways from holding development sessions, co-ordinating Safeguarding Adults Week activities, through to our role in over-seeing statutory Safeguarding Adult Reviews (SARs). The Board approved a joint SAR-Domestic Homicide Review (DHR) in February 2024; whilst the report cannot yet be published due to ongoing Home Office quality assurance processes, the SAR Committee have continued to make good progress in delivering on the recommendations. This is the first SAR we’ve undertaken jointly as a DHR with the Community Safety Partnership – this was successful, ensuring both statutory processes were fulfilled but avoiding duplication.

hosted a workshop in October in relation to the Multi-Agency Safeguarding Hub (MASH) arrangements, reviewing what more we could collectively do to ensure this was an effective team, able to respond to the increasing demand in safeguarding adults referrals. A series of recommendations were made, many of which have been implemented, including changes to way in which referrals are made and better signposting to other services and support. However, there is still limited partner agency commitment to co-location within the MASH; these issues will continue to be worked through in 2024-25.

As a multi-agency partnership Board, we continue to be ambitious in the priorities we set ourselves for the year ahead, many of which will be taken forward by our conscientious and hard-working sub-committees. Whether it is coordinating SARs, delivering a comprehensive multi-agency training programme, developing new practice guidance, or addressing exploitation, they are an invaluable component of our partnership. You can find out more about their important work below.

Please take the time to read and share this annual report – which clearly demonstrates how the NSAB and our member organisations work diligently, with continued enthusiasm and commitment, to ensure that Newcastle is a safer City for adults at risk of abuse and neglect.”

Vida Morris

NSAB Independent Chair

“I am delighted to be able to offer an introduction to the Newcastle Safeguarding Adults Board’s Annual Report for 2023-24.

The Board plays an important role in ensuring that Newcastle residents fulfil their potential and lead healthy and happy lives. It is great to see the partnership achieving actions against its strategic priorities and being ambitious in its plans for the year ahead.

The Board’s work complements the Council’s Plan 2024-27, which details the outcomes we want for residents and our city, including addressing the root causes and consequences of poverty, ensuring Newcastle is a Longevity City, where people age well, and putting the voice of residents at the heart of everything we do and decisions we make.

Building a brighter future for Newcastle requires us all to work together, and that’s why partnerships and collaboration is so important. As the new Cabinet Member for a Healthy, Caring City I look forward to working with the NSAB to ensure that Newcastle’s multi-agency safeguarding adult arrangements continue to be safe and effective, building on the leadership and support given by my predecessor Councillor Karen Kilgour.”

Councillor Adam Walker

Cabinet Member for Healthy, Caring City

Who we are and what we do

The NSAB is the statutory partnership responsible for ensuring the effectiveness of safeguarding adult arrangements in Newcastle. The Care Act 2014 states that the Board must have three core members: Newcastle City Council, Northumbria Police and North East and North Cumbria Integrated Care Board. The Board has three statutory duties, we must: develop and publish a strategic annual plan, produce an annual report and undertake Safeguarding Adults Reviews when the criteria has been met. The NSAB is supported by a number of sub committees, one of which is jointly overseen by the Newcastle Safeguarding Children Partnership (NSCP). Our NSAB roles and responsibilities page has more information about the Board and it’s work.

2023-24: Our Year in Brief

Home Takeover

A cross-partnership project produced two animations on home takeover. The animations were a joint effort across the Newcastle Safeguarding Adults Board, The Newcastle Safeguarding Children Partnership and the Safe Newcastle Board, as well as input from the University of Northumbria, Newcastle. There are two versions of the animations, one aimed at professionals and one aimed at young people (to be used in schools, Year 7 and above).

Recently published research about exploitation during the Covid pandemic, undertaken by the University of Northumbria, identified a lack of awareness of what home takeover was and what it involved. This was the main catalyst for the production of the animations which it is hoped will be used to increase understanding of the issue and how people can be supported.

The animations were launched during spring 2024, with a series of webinars providing additional information and guidance on how to respond to concerns about home takeover. The professionals version has had 1,223 views since it was launched.

Home takeover is when criminal gangs use violence and abuse to target the homes of vulnerable people to use them as a base for crime, often drug dealing. It is commonly referred to as “cuckooing” (because cuckoos invade the nests of other birds) and it can also be called home invasion. Home takeover is often, but not always, linked to County Lines ​

There are different types of home takeover:​

Using the property to deal, store or take drugs.​ ​
Using the property for sexual exploitation or sex work.​ ​
Taking over the property as a place for them to live.​ ​
Taking over the property to financially abuse the owner or tenant.​​

The animations were funded via the Supplementary Substance Misuse Treatment and Recovery Drug and Alcohol grant, due to the association between substances and vulnerability (and exploitation). ​The NSAB would like to place on record their thanks to the Project Group who worked alongside CC Animation Studios. The Group had representatives from Newcastle City Council (Adult Social Care and Public Health), North East and North Cumbria Integrated Care Board, Northumbria Police, Northumbria University and Your Homes Newcastle.

Plans and priorities

The Board starts each year by agreeing it’s strategic annual plan for the 12 months ahead. The plan is informed by our local data, learning from audits and reviews, consultation activity, agency self-assessments and any changes in national policy, guidance or legislation. Some priorities are carried over from our 2022-23 plan.

Our Strategic Annual Plan 2024-25 includes the following action areas:

Receive assurance on the quality and availability of advocacy to ensure people are appropriately represented in the safeguarding adults process.
Strengthen relationships with the other organisations, including the Department of Work and Pensions and Prisons.
Respond to the increased vulnerability of people who use drugs and/or alcohol.
Review existing practice guidance on: self-neglect, organisational abuse, engagement and pressure ulcers.
Promote key safeguarding adult messages, particularly to members of the public, adults with care and supports needs and smaller community groups.
Ensure there is high quality training available on a single and multi-agency basis.
Evaluate how well learning from previous Safeguarding Adult Reviews is embedded in current practice.
Review the Adult Multi-Agency Safeguarding Hub (MASH) arrangements.

Local data

The table below gives a summary of safeguarding adults activity in 2023-24. In Newcastle, we still monitor the volume of referrals that the Local Authority receive, even though this is not reported via the national, statutory data collection. There was a 2.8% increase in referrals on the previous year. 51% of referrals met the safeguarding adults concern criteria. This conversion rate was a slight improvement on the previous year, hopefully reflecting work done in the past year to improve the quality of safeguarding adult referrals.

53% of safeguarding adult concerns were about women, 46% were about men and 1% recorded as other. The age of adults at risk has remained consistent for the last few years. The majority of referrals are about people aged 18-64 (55%) but data tells us that the prevalence of abuse increases with age, when we compare the number of concerns with overall population totals for each age group. 77% of concerns were about adults of white ethnicity. Ethnicity was not known in 16% of cases, an area of recording that the NSAB would like to see improvements upon.

The Primary Support Reason (PSR) describes the type of service an adult at risk is receiving from the Council. Not all adults at risk will require a service provided or funded by the Council (e.g. they may be a self-funder, or receiving a service from another organisation). Last year, the most common PSR was physical support (27%), followed by mental health (12.5%) support and then learning disability support (9.3%).

The most common location for someone to experience abuse and neglect was their own home (50% of all S42 enquiries). The second most common location was a care home. It is important to note that the location of abuse does not necessarily equate to the source of risk being the service provider.

The table below shows the different types of abuse and neglect that Section 42 enquiries were undertaken about last year. The most common form of abuse was neglect (23%), followed by self-neglect (19%). This is consistent with the picture from last year.

In 79.63% of section 42 enquiries, the adult at risk or their representative was asked their desired outcomes; this is a 5% improvement on the previous year.
In 79.2% of section 42 enquiries, where the individual was identified as lacking in mental capacity, the adult at risk was supported by an appropriate representative, a 4% improvement on the previous year.
In 88% of section 42 enquiries, risk was either removed or reduced. Previous audits have identified that risk remains in situations where capacitated adults are taking decisions to accept a level of risk.

Improving Practice Committee

The Improving Practice Committee continues to be an important link between front-line practice and strategic developments in safeguarding adults.

As well as the usual Safeguarding Adults Week activities, the Committee have overseen the move to the acceptance of online-only safeguarding adult referrals, monitored attendance at safeguarding adult meetings and finalised the work on the NSAB’s multi-agency policy and procedures, including a new eople in a Position of Trust (PiPoT) framework and revision of the Falls Protocol. The Committee’s membership represents a wide range of sectors and organisations, whose contributions are valued and meaningful.

The largest piece of work by the Committee was the review and update to the NSAB’s multi-agency policy and procedures which was completed in March 2024. The review was informed by changes in legislation, learning from statutory reviews, audits and changes in local operational practice. A summary flowchart and summary table of the procedures was produced to assist in communicating the key points.

As part of work to try and improve the quality of safeguarding adult referrals, the NSAB wanted referrers to use the online referral form (rather than other versions/formats). The Committee considered the implications of this and provided a forum where concerns could be raised and worked through. The referral form itself was also changed, so that questions related to Making Safeguarding Personal came at the start. This was in response to findings from multi-agency audits. The move to accepting online referrals only went live successfully on 1 April 2024.

The PiPoT framework was a new addition to the multi-agency policy and procedures, launched in September 2023. The framework outlines the expectations when there is a concern related to someone who works or volunteers with adults with care and support needs. The framework reflects a fair and transparent approach and seeks to build on organisation’s internal allegations management processes.

A review of the NSAB’s Falls Protocol was prompted by some case examples. There appeared to be a lack of awareness of the protocol and a misunderstanding of when a safeguarding adults concern should be raised following an adult falling. The guidance was reviewed, with further clarity being provided when a fall was unwitnessed and/or a significant injury had resulted from the fall. The protocol was re-promoted and was featured in one of the Safeguarding Adults Week webinars.

The IPC is a place where anyone can raise a practice issue for discussion. This was highlighted when Safeguarding Adults Manager’s raised the issue of poor attendance at safeguarding adults meetings. A process was put in place to track attendance, apologies and provision of information to meetings; this was then reported back to the Committee.

In Autumn 2023, data showed that only 15% of meetings were attended by all those who were invited. The pressures on agencies and services was highlighted and the need to have to juggle many different priorities. A briefing was produced that can be sent to those invited to meetings to highlight their importance, to arrange a deputy to attend wherever possible, or submit a written report. The Committee will continue to monitor attendance in 2024-25.

The annual activities during Safeguarding Adults Week are becoming a highlight of the NSAB’s calendar. During the week of 20-24 November 2023, there were 8 webinars hosted, as well as a presence at the Carers Conference. The Improving Practice Committee are pivotal in coordinating the week’s activities – identifying the topics and themes to be covered, holding events within their own organisations and disseminating information. A full round-up of the week was published on the NSAB website.

Safeguarding Adults Week stats

389 people attending webinars or events.
3,970 post impressions on “X”
1,230 hits on our website, with 224 first time visitors.

IPC Priorities for 2024-25:

Support the SAR Committee in demonstrating learning from SARs is embedded in practice by co-ordinating multi-agency audits and facilitating case presentations.
Review and update local practice guidance. We’ve got an ambitious programme for the coming year, including the Safeguarding Transition Protocol, Self-Neglect Practice Guidance, Engagement Guidance and contribution to regional guidance on Organisational Abuse Enquiries.
Continue to host a programme of activity during Safeguarding Adults Week, including an in-person event.
Continue monitoring of attendance at safeguarding adults meetings.
Review guides to the safeguarding adults process for adults at risk, their families and carers and members of the public.

Learning and Development Sub-Committee

As one annual cycle of planning and delivery of training concludes, and another commences the opportunity is provided to reflect upon developments throughout the year. The agenda for the Learning & Development Committee (L&DC) has remained as busy and dynamic as ever, constantly responding to the need for new areas of staff training to protect and support individuals at risk of abuse or neglect in our local community.

The Committee continues to coordinate an extensive range of training at different levels to meet the wide-ranging needs of agencies and staff who undertake a spectrum of roles and responsibilities within our local community. We continue to draw on various sources of information to update the Safeguarding Adults and Mental Capacity training.

One key area of work has been a greater degree of collaborative working between the L&DC and the Newcastle Safeguarding Children Partnership Learning & Improvement Group. This closer working relationship has facilitated the sharing of ideas, continuity of approach in appropriate areas and promoted access for staff to training provided by both adults & children. This can be seen with

Updating of the Joint Training Evaluation Framework that provides a structured approach to evaluating training. Our training evaluates well, as you can see from the quotes below:

Structure and content of the course was extremely good. Course leader superb in encouraging everyone and valuing there, contribution.

Overall, effective training delivery for an adult safeguarding course involves relevant and engaging content, skilled instructors, flexibility, assessment and feedback mechanisms, resources, and support participants. Thank you

In- person training with the facilitator was engaging very inclusive it allowed learning and participation to be easy to follow.

I found the reassurance that there is no such thing as an incorrect alert the most valuable thing and will use that to ensure that if I have any concerns that I will raise them without any doubts.

We will continue to explore joint working with Newcastle Safeguarding Children’s Partnership, Public Health, and Safe Newcastle. We have also worked closely with Tyne & Wear Fire and Rescue Service (TWFRS) and Your Homes Newcastle (YHN) to deliver our successful Self-Neglect thematic workshops, reflecting their knowledge and expertise in this area. We have also worked closely with Safe Newcastle and the Safeguarding Children’s Partnership to deliver sessions to all Newcastle City Council elected members.

We have had an array of guest speakers to Committee meetings, most recently from Newcastle City Council’s Active Inclusion team. Their aim is to make it everyone’s business to prevent homelessness & financial exclusion by coordinating support for residents to have the foundations for a stable life. We consider whether we can enhance safeguarding adults training with any of the information shared by our guest speakers, as well as promoting their specialist training via our networks.

In response to a recommendation from a Domestic Homicide Review, the L&DC is engaging in a joint venture with Cumbria, Northumbria, Tyne & Wear NHS Foundation Trust (CNTW) and the Sexual Assault Referral Centre to offer workshops on Responding to Disclosures of Abuse.

“Any professional who may encounter disclosures of sexual abuse should be briefed on how victims may be signposted to practitioners and organisations who are trained to offer direct, confidential, specialist support in these circumstances. Trauma informed practice is crucial if victims of sexual abuse are to be supported.”

The Committee has successfully offered a blended approach to training, offering virtual and in-person delivery of training. We successfully recommissioned our online offer of e-learning until December 2024. This e-learning platform has six courses MCA, Deprivation of Liberty Safeguarding and Safeguarding Adults Level 1, Safeguarding Children Level 1 Basic Awareness courses and Safeguarding Children Level 2, Exploitation Basic Awareness. The Committee has also ensured that high quality training and information is available to staff with the delivery of the multi-agency training plan as well as seeking assurances from partner agencies on any single agency safeguarding adults training they deliver.

3,652 participants on multi-agency training.
1,279 people accessing Level 1 basic awareness e-learning.
95% of participants rate NSAB training good or excellent
92% of participants felt training would influence their practice.

L&D Committee priorities for 2024-25

The focus on delivering Safeguarding awareness workshops to community groups and the wider public.
Provision of training regarding Responding to Disclosures of Abuse, and Malignant Alienation – in partnership with Cumbria, Northumberland, Tyne & Wear Trust, and the Sexual Assault Referral Centre.
Joint working with Newcastle Safeguarding Partnership, Public Health & Safe Newcastle, and other organisations to develop and deliver training from new and emerging issues.

Safeguarding Adults Review Committee

The Safeguarding Adults Review (SAR) Committee finalised a joint SAR/Domestic Homicide Review (now known as a Domestic Abuse Related Death Review); this was approved by the NSAB and Safe Newcastle Board in February 2024. Prior to publication, the report is required to go through a Home Office Quality Assurance process. It is anticipated that the report will be published in Autumn/Winter 2024 and will therefore be reported fully in next year’s annual report. Agencies have commenced implementation of the recommendations whilst the assurance process is ongoing.

The Committee have continued to implement recommendations from the previously concluded reviews: the Adult L and N SARs and the Self-Neglect Thematic Review. Some of the progress in 2023-24 include:

Continued delivery of specialist training on a multi-agency basis, including MCA and Vulnerable Dependent Drinker (Adult L & N) and Domestic Abuse and Older People (Adult L).
Improved relationships with pharmacies and the development of guidance aimed to strengthen their involvement in safeguarding adult enquiries (Adult N).
Consideration of other area’s approaches to responding to self-neglect, including specialist operational teams and practitioner groups (Self-Neglect Thematic Review).

An assurance exercise was undertaken in summer 2023 which asked NSAB agencies to provide confirmation they had addressed recommendations coming from the three recent reviews. This included: confirmation that Safeguarding Adult and MCA Leads existed and were visible within their organisations; communication of escalation pathways; supporting staff to be legally literate; and how agencies ensure front-line staff have a focus on smoking cessation and fire safety with people who are substance dependent.

The ability to deliver upon recommendations has been bolstered by Newcastle City Council’s appointment of a Safeguarding Adults Project Manager who is coordinating the delivery of actions linked to drugs and alcohol. The post-holder commenced in March 2024.

The SAR Committee held a Development Session in September 2023 which had been very helpful for members. There was a focus on good quality SAR referrals (referencing the SAR Quality Markers) and the interface between SARs and other review processes. Presentations were received on the LeDeR (Learning Disability mortality reviews); fire fatality reviews; Coroner processes; and drug and alcohol related deaths.

An area of improvement that was identified at the Development Session was understanding how well learning from SARs has been embedded in current practice. The Committee will take this forward in 2024-25, in close conjunction with the Improving Practice Committee.

Missing, Slavery, Exploited, Trafficked (M-SET) Sub-Committee

Strategic M-SET is a joint sub-committee of the NSAB and the Newcastle Safeguarding Children Partnership (NSCP). It’s focus is around missing, slavery, exploitation and trafficking.

Detective Chief Inspector Kevin Ashurst, Northumbria Police, took on chairing Strategic MSET in late 2023. Here are his thoughts on the work of the Committee and the year ahead:

“MSET came about as a result of the learning taken from Operation Sanctuary a decade ago and this MSET system is now well established and has been for a number of years. I am proud to chair this group with a number of our close partners across the City, the main aim of the MSET process is to safeguard the most vulnerable persons within our community when all other processes have been implemented and not quite worked. There are several layers of this multi-agency meeting, and in this process we make effective decisions as a partnership about how we can safeguard our Newcastle residents most at risk of all forms of exploitation. Over the next twelve months we will see several initiatives come to life:

Right Care Right Person has been embedded now for a number of months and will go from strength to strength in helping us to be able to get the right care for every person who comes into contact with Emergency Services.
We are bringing in a new protocol which will give us a better chance of safeguarding missing persons who have been in the armed services, the Forcer Protocol will be rolled out over the Summer, this will help us find our armed forces veterans quicker who go missing.
Northumbria Police now have a dedicated missing team, this started in February 2024 and focuses on reducing the harm that our missing children and adults face, this in conjunction with Right Care Person has seen the numbers of missing persons in Newcastle reduce, adults have reduced by 27% and children have reduced by 13%.”

There has been more robust sharing of intelligence and trends; Northumbria Police continuing to share data around missing, exploitation markers and National Referral Mechanism referrals, whilst other partners share intelligence and emerging trends. This key information sharing informs priorities for strategic MSET and prompts strategic action.

One of the key emerging trends the Committee heard about in 2023-24 was the sale of illegal vapes and the links to exploitation, with significant partnership activity being undertaken to identify and address this issue.

Missing, slavery, exploitation and trafficking span a number of different strategic forums and organisations and one of the key challenges is ensuring that there is joined up working across these. The Committee took a keen interest in developments around the Serious Violence Duty and provided input to the local strategic needs assessment and delivery plan for this.

Membership of the Committee was also reviewed to ensure that there was key representatives from the Violence Reduction Unit and Community Safety.

As reported in last year’s annual report a key focus of the Committee’s work was to improve the coordination of training around exploitation. A multi-agency Task and Finish Group was established which has developed an Exploitation Competency Framework. The aim of the competency framework is to provide clarity on what key groups (adults at risk, the public and professionals alike) need to know and understand and ensure that there is consistency in the messages that are being delivered. The Task and Finish Group also looked at where the biggest gaps were in training provision. It was identified that there was a very limited training offer for people who might be in a position to identify exploitation but who were not in specialist safeguarding roles. This led to the development of a package of Exploitation Awareness Training which is being delivered as part of the NSAB and NSCP’s multi-agency training programme in 2024-25 and is also being offered to individual agencies to use to train their own staff or volunteers. In the coming year, the Committee will evaluate the implementation of the competency framework and address any training gaps or opportunities. Members of the Committee were involved in the production of the Home Takeover animation.

Towards the end of the year, the Committee reviewed it’s delivery plan. The plan has eight key objectives:

A greater understanding of the local intelligence picture in relation to missing, slavery, exploitation, trafficking.
Practitioners are confident in recognising and responding to missing, slavery and exploitation concerns.
Communities have an awareness of missing, slavery, exploitation and trafficking issues and know what to do if they have concerns about themselves or someone else.
The work of MSET and its priorities are informed by children, young people and adults with care and support needs.
The multi-agency response to exploitation works effectively to prevent exploitation and protect the most vulnerable people.
Recommendations and learning from new policy, legislation, research, guidance and statutory reviews.
Develop and maintain links with other relevant partnerships tackling associated issues.
A greater understanding of the role electronic communication has in enabling exploitation, slavery and trafficking.

There is good partner agency commitment to delivering on the Committee’s priorities and these priorities will drive the work of Strategic MSET in 2024-25.

Online referral form

One of the key priorities for the NSAB in 2023-24 was to improve the quality of safeguarding adults referrals that were made. A decision was made that professionals should only refer using the online referral form, rather than using other formats. This would allow the mandating of questions so key information was not omitted from referrals.

Making Safeguarding Personal questions were moved to the beginning of the form. This means that questions about the views of the adult and whether the adult might need support to be engaged in the safeguarding action are now front and centre of the referral form.

We began to communicate the changes and the plans to move to online-only referrals in November 2023, with a deadline of 1 April 2024 to stop accepting other referral forms.

The functionality of the online referral form was improved, additional guidance was provided on how to respond to certain questions and referrers would now receive an emailed copy of their completed referral.

At the MASH Workshop held in October, it was identified that referrers were unsure about other referral pathways where they were concerned about an adult but their concern would not meet safeguarding adults criteria. Additional signposting was added to the referral form about concerns related to care and support needs; mental health; drug or alcohol use; housing; poverty or financial inclusion; domestic abuse and environmental health.

In 2023-23 a one hour webinar was developed, delivered and recorded which covered how to make a good safeguarding adults referral. This complimented existing guidance covering the same topic.

It is hoped all of these measures will increase referrer confidence and ensure referrals are being made to the right services and support.

Adults at risk, family, friends and members of the public can still use different methods of referring concerns, including by telephone.

Partner agency perspectives

Newcastle City Council

In Newcastle City Council we refreshed our corporate safeguarding policy and guidance under our Keeping Everyone Safe approach. Keeping Everyone Safe (KES) is the collective term used to bring together key messages in relation to safeguarding children, safeguarding adults, Prevent (counter terrorism), and domestic abuse. The approach reinforces safeguarding as everyone’s responsibility and everyone’s business.

KES aims to ensure all people working for, or representing, the Council are:

Familiar with the different types of abuse/neglect that can occur.
Aware of statutory and non-statutory multi-agency processes, procedures, and referral points responsible for keeping people safe.
Able to report any concerns they have either witnessed or been told about.

The core offer of Safeguarding Level 1, 2, and 3 continues to yield high engagement from staff, supported through the embedding of programmes on iLearn (our learning management system), which enrols and notifies users of their mandatory requirements. The current uptake of each course are:

Level 1 64%
Level 2 92%
Level 3 64%

Our level 3 offer has been revamped this year, with a half-day refresher session developed for internal social work teams. This offer has been well received, with upcoming dates close to fully booked. This session is developed with a focus on reflection in mind, reminding staff on key themes whilst allowing the practical application of knowledge of coordinating enquiries.

Another part of our core offer available to colleagues available on iLearn is ‘Mental Capacity Act and Vulnerable Dependent Drinkers’ which responds to the direct needs of the people we support in Newcastle. Completion rate for this course is at 91%.

Following the positive feedback received last year and reflecting ongoing themes arising from safeguarding adults reviews and case audits, this year has seen the implementation of a varied and bespoke programme of training delivered by Edge on the topic of assessing capacity. This suite of sessions expands on the highly reviewed ‘Assessing Capacity and Best Interests’ training and delves into specific themes such as: Self-Neglect and MCA; Executive Functioning and MCA; Substance Misuse and MCA; Assessing Capacity & Best Interest and High-risk Cases. This reflects the richness of the MCA offer and will guide future commissioning of this training moving forward so we can continue to support specific areas of need with application of the Mental Capacity Act.

Newcastle City Council’s expertise around adult exploitation continues to attract attention at a national level. In 2023-24 Adult Social Care staff delivered two webinars to 150 people from across the UK about their experiences of supporting victims of adult exploitation.

I just wanted to say thank you for the invite today. We all thought that it was an outstanding and inspirational workshop, one of the best that we have seen on exploitation delivered with passion and commitment. Newcastle are lucky to have you.

Public Health have funded a Project Manager post, sitting within the Safeguarding Adults Unit, who is coordinating and taking forward actions from Safeguarding Adult Reviews and Domestic Abuse Related Deaths where there is a link to drugs and/or alcohol. The two-year post commenced in March 2024, with the post-holder bringing significant expertise from drug and alcohol treatment services.

Preparation for the Care Quality Commission (CQC) assessment of local authorities has continued over the last year. Work undertaken on action plans as a result of our peer review annual conversation has all been completed and we have pulled together and are maintaining the collection of documents and data for submission as part of the CQC Information Return. A monthly assurance dashboard has been developed and is being used to assure ourselves on different aspects of work and data, including the volume of safeguarding activity and adherence to timescales.

Safeguarding Newcastle Against Poverty (SNAP) leads on from the success of Partnerships for People and Place (PfPP). Both projects sought to better understand and break the links between poverty and safeguarding risks. Whilst PfPP initially focused on Elswick, Benwell and Scotswood, SNAP has been extended to provide equitable support for residents whilst continuing to focus on the early identification of problems to prevent issues from reaching crisis point and safeguarding risk. The project continues to work closely with Newcastle Foodbank and Newcastle Community Pantry. SNAP impact in 2024:

13 contacts for information/advice only.
136 formal contacts
60 safeguarding adults referrals
37 Section 42 Enquiries
13 Adult Social Care referrals
5 Safeguarding Children referrals
7 Children’s Social Care/Early Help referrals
66 referrals into other services

Northumbria Police

The Newcastle Gateshead Clinical Commissioning Group (CCG) transitioned to the North East and North Cumbria Integrated Care Board (ICB) on 1 July 2023, with the structure and governance arrangements being formalised at Executive Board Level. Richard Scott was appointed as Director of Nursing for the North Integrated Care Partnership (ICP) in December 2022. There is now a Safeguarding Executive meeting chaired by the Chief Executive Nurse which facilitates escalation of safeguarding issues to the ICP.

The creation of the prevention department has seen the introduction of a missing from home investigation team to work alongside the missing from home coordinators. They also own the MSET portfolio and have introduced a dedicated Inspector for this area of business. There has been no formal evaluation as yet but early signs have shown real positive impact on the reduction of missing persons with Newcastle seeing a 25% reduction in the last 12 month period. We have also introduced an Inspector for mental health and problem solving to oversee the street triage team and continue to drive right care right person.

Training for Primary Care staff has continued with sessions being provided online and available as a resource on the GP Team net, this includes sharing of learning from Case Reviews and promoting good practice from recommendations. A number of requests are now being received from individual GP practices for face-to-face sessions which is being reviewed in line with resource availability.

We have utilised the expertise of Safelives to deliver Domestic Abuse Matters training to over 1,500 of our front line practitioners to ensure a greater awareness and focus on domestic abuse. Particularly on recognising the signs of coercive and controlling behaviour and emotional abuse.

We have now introduced the City Safe project into Newcastle City Centre. This is a multi-agency project seeking to reduce crime, anti-social behaviour and vulnerability across the City and improve perceptions of safety amongst the public whilst improving business confidence.

A cohort of individuals have been identified, some with complex vulnerabilities and addictions and they are being provided with increased access to services (drug, alcohol, mental health, housing etc) to problem solve their issues.

A hub with a range of services working closely together to seek long term solutions to issues will reduce harm and vulnerability within the city.

North East Ambulance Service Case Study: multi-agency working

The North East Ambulance Service’s (NEAS’) Safeguarding Team were notified of a 45 year old man who had been repeatedly contacting the service for varying and nonspecific medical and mental health complaints. The majority of his calls were made whilst he was intoxicated and there were some concerns about self-neglect to himself and his property.

An overarching safeguarding adults referral was made and the man was allocated a Social Worker. A comprehensive history was given to Adult Social Care and weekly updates of contacts and general themes.

Tyne and Wear Fire and Rescue Service were also reporting increasing contact with the patient. There were reports of food waste, animal faeces, rubbish and concerns of increased fire risks with rubbish piling up within his oven. The man’s GP was notified of the situation and a multi-agency meeting was convened.

In the initial period, NEAS continued to be contact by the man and a decision was taken to continue to attend the address as it was apparent NEAS were sometimes the only service or person he was in contact with. The man was then admitted to hospital following a fall.

During his hospital stay it allowed his family to gain access to clean and tidy his property and for the Social Worker to put measures in place to support this gentleman on discharge. It was agreed that this gentleman required support around his care upon discharge – he was receptive to this.

Since discharge from hospital, the gentleman is doing well, residing in supported accommodation and having all of his care and support needs met. This gentleman has been absent from alcohol and has been rebuilding relationships with his family who are positively supporting the patient. The social worker remains involved to aid with the transition of moving into his new property and ensuring that the patient has all the relevant support agencies required.

It was decided that the safeguarding adults enquiry could end as great progress had been made and risks were being managed. There have been no calls to the ambulance service since discharge from hospital.

Tyne and Wear Fire and Rescue Service

In response to a regional spike in fire deaths in the previous year, 2023/24 saw Tyne and Wear Fire and Rescue Service (TWFRS) undertake a number of activities, training and initiatives to address this increase, and gain partner support to improve our engagement with individuals and families at high risk of fire. This included:

April 2023 Partners conference at TWFRS in Washington
Distribution of ‘When to Refer’ cards to make referrals easier, and remove barriers to referring
Publishing and distribution of our Preventing Fire Deaths 7-Minute Briefing
Presentations to partner groups and subgroups
Presentation of ‘I Didn’t Know the Fire Service Did That’ in Safeguarding Adults week 2023.

The result of this work has been a 45% increase partner referrals to TWFRS for a Safe and Well visit in Newcastle, from 359 to 521. Of those 521 partner referrals, 326 were High Risk of Fire, and 196 were Very High Risk of Fire, so we are seeing the correct referrals from Newcastle partners.

North East and North Cumbria ICB

North East and North Cumbria Integrated Care Board (NENC ICB) completed its restructure ICB 2.0 during 2023- 2024. This was finalised in April 2024. Newcastle Gateshead is managed as one delivery team under the umbrella of the larger organisation.

Trina Holcroft was appointed the Deputy Director of Nursing with responsibility for Safeguarding for the North and Louise Mason Lodge was appointed as part- time Director of Safeguarding to the Executive Board. The Designated Nurses are working together to establish standardised and consistent processes across the region to support the work of the Local Authorities, Safeguarding Boards and multi – agency partnerships. Delivery Teams report to the Safeguarding Executive meeting chaired by the Executive Chief Nurse, facilitating an assurance and escalation process for safeguarding issues across the ICB.

The ICB remain committed to training and education in the safeguarding arena and the promotion of shared learning across the Integrated Care System (ICS) Participation continues from the Designated nurse and safeguarding team to the Safeguarding Adult Reviews (SAR’s) and Domestic Homicide Reviews (DHR’s) with contribution to the process, sharing of learning and seeking assurance from commissioned agencies to support recommendations and actions from the reviews.

The Safeguarding Professionals Network continues to provide a forum for safeguarding health staff from both commissioning and providers to develop safeguarding practice and share learning across the ICS.

The ICB Safeguarding Team support the Named GPs with training for Primary Care staff both online and at Face-to-Face sessions to promote good practice from case review recommendations, share learning and develop resources which are also easily accessible on GP team net (an online platform). Further support for individual practices is provided on a case-by-case basis where there are complex needs or multi – agency working where there is a requirement.

The forensic training project which was commenced in 2022 and resulted in an online Conference and resource support for health professionals has also been continued in the GP training programme with the addition of non-fatal strangulation, improving awareness of domestic abuse.

The Designated Nurse for Safeguarding Adults chairs the NSAB’s Safeguarding Adults Review Committee, and the team also support areas of multi-agency work including supporting asylum seekers, hate crime prevention, Prevent, Community Safety Partnerships and the Local Domestic Abuse Partnership Board.

There has also been participation in task and finish groups for Mental Capacity Assessment, which, following conclusion of the initial sessions it was agreed to continue the ongoing work to promote improved quality of assessments and support of staff training in this area.

Participation in a multi-agency project funded through Substance Misuse Treatment and Recovery Drug and Alcohol Grant also saw the development of animations raising practitioner awareness of Home Takeover which is very prevalent in the area with young people /adults and highlighted the collaborative working within the ICB and partner agencies. Safeguarding Adults Week was promoted across the ICB highlighting themes and raising awareness.

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

A second Named Nurse is now a permanent post in CNTW’s Safeguarding and Public Protection Team (SAPP). The post has increased the Trust’s senior safeguarding resource and supported improved partnership working.

Safeguarding Level 3 training has remained compliant with 85% or above throughout 2023-24.

Learning from local cases continues to be disseminated to Trust staff via Trust Bulletin.

The SAPP team have worked closely with locality care groups attending weekly safety meetings to support the management of safeguarding issues.

The Trust has commenced the Safeguarding Adults Audit 2024 in Q4. This will be monitored via the Trust Clinical Effectiveness Committee and SAPP group.

An assurance exercise has been completed in response to Norfolk SAR Joanna, Jon and Ben. Further work is planned for 2024-2025 to overlay learning from Durham SAR from Whorlton Hall.

A part of the NHS Patient Safety Incident Response Framework (PSRIF), CNTW have set up the Patient Safety Learning and Improvement Panel (PSLIP). This panel will join up outcomes from Statutory Safeguarding Reviews with outcomes from internal patient safety reviews to help embed all learning Trustwide.

The Trust is involved in Northumbria Police pilot focussed on Hate Crime. New incident classifications have been added to the Trust reporting system and incidents are reviewed by SAPP team when identified as a safeguarding issue.

CNTW Academy arranged for a session to be delivered by Daphne Franks on Predatory Marriage in October. This was held via Teams with positive feedback.

Case study: working with the NENC ICB Exploitation Nurse

Newcastle upon Tyne Hospitals NHS Foundation Trust

The Newcastle Hospitals front line workforce continue to be fundamental in identifying and responding to increasing and complex safeguarding activity in both acute and community settings. To ensure the delivery of high quality safeguarding practice, we have developed a series of master class sessions to enhance learning, aligned to the NSAB priorities.

We are working to embed this learning through specialist services outreach to wards and clinical areas to support staff translating safeguarding policy and guidance into practice. Our focus for the master class sessions included older people affected by domestic abuse, responding to domestic abuse within the emergency department and self-neglect (focusing on legal options). We have also offered opportunities for acute care staff to work directly within the safeguarding team as secondees, which helps expand confidence and demystifies the process of safeguarding.

As a Trust we are continuing to see a substantial increase in the use of the Mental Capacity Act (MCA). This is evident through case discussions and audit. Added to that there are increasing numbers of Deprivation of Liberty Safeguards and continued involvement of legal services. We continue to strengthen the application of the Mental Capacity Act with the development of legal literacy sessions and supervision and support to staff. The Trust has mandated MCA training for all front line and patient facing staff with a current compliance of over 92% will be launching mandated enhanced MCA and Deprivation of Liberty Safeguards training for specific workforce groups in the year ahead.

We continued with learning and development sessions focusing on the emerging themes from safeguarding adult reviews. We have further embedding learning from practice with a supervision session and training for key staff in responding to Vulnerable Dependant Drinkers which highlights the link with the MCA.

Mental Capacity has remained a key focus for the Trust with the support of colleagues from Digital Health, Training and Risk Management. The Trust ensures that evidenced Mental Capacity application is demonstrated through audit. Mental Capacity training and awareness emphasises the involvement of the individual and their voice in decision making with the Making Safeguarding a Personal Agenda remaining a central message throughout all training, support, and supervision. We have also held sessions for community colleagues on home take over and the growing concerns around exploitation.

Case study: domestic abuse

Domestic abuse remains an ever-present concern within safeguarding. In the Trust we continue to see recognition and response of domestic abuse concerns for individuals who can have complex needs from a mental and physical health perspective with the use of the Domestic Abuse Stalking and Harassment (DASH) checklist playing a critical role in understanding risk. In many cases we see the traumatic impact of abuse, which can initially present as self-neglect.

n the case of Sam (name has been changed to protect identity) concerns presented as self-neglect, risk from exploitation, substance use and domestic abuse. During admission, steps were taken to refer Sam to the relevant substance misuse teams, to refer for domestic abuse support and to consider within the multi-agency arena risk management and protection plans.

A DASH risk assessment was completed, as the level of concern of harm from others was significant all steps were taken to advocate for alternative accommodation. An important aspect was conducting mental capacity assessments around treatment and care, given that Sam would often leave before treatment was concluded, Whilst Sam was in hospital, the allocated social worker and nursing team were provided with an opportunity to conduct joint assessments, including mental capacity assessments. Unfortunately, Sam continues to present as an individual who is still experiencing harm and abuse from others.

The Trust endeavours to feedback to front line staff the interventions that can come from their referrals. Highlighting the use of electronic records which ensures that there is visibility for staff of critical safeguarding information.

Regrettably, Sam represents many individuals who are experiencing harm, abuse, and neglect from others. The importance of supporting Sam through a non-judgemental approach whilst reinforcing that services are there to listen was essential in making sure Sam was provided with an escape route from the trauma of exploitation and domestic abuse. Ensuring Sam was aware that she was valued was a key message during her time at the Trust.

Health professionals are often in a good position to identify cases of domestic abuse, 1-1.5% of A&E attendances are due to domestic violence and 30% of domestic abuse commences during pregnancy. The Multi-Agency Risk Assessment Conference (MARAC) seeks to protect those patients who are at high risk of being killed or seriously injured from further abuse through a co-ordinated effort from all agencies and organisations. www.safelives.org.uk

Search Newcastle

This year at Search we revised our in-house induction, “Our Approach” to raise awareness of our new PiPOT (Person in a Position of Trust) policy, and workbooks were introduced for Volunteers to make Safeguarding training more accessible to those who prefer to learn that way.

Staff were all briefed on the introduction new online Safeguarding referral form and the improvements to our internal safeguarding log. In August we opened our “Pop In Centre” on Adelaide Terrace, which quickly became a popular place for older people to call for information, advice and company.

To raise awareness of Safeguarding among the public and encourage people to report suspected abuse we ensure that posters are prominently displayed to make talking about safeguarding easier.

Search contributed to NSAB Improving Practice Committee’s week of learning for Safeguarding Adults Week by facilitating 2 online workshops, one on “Financial Inclusion” and the other on “Engaging People Who Challenge Us”.

For Safeguarding Adults week in Search we ran “Safeguarding and Scran” sessions each lunch time throughout the week for our staff and volunteers, providing snacks and covering a different safeguarding topic each day.

Connected Voice Advocacy

Connected Voice has delivered free training to the Voluntary Community Social Enterprise Sector around safeguarding issues. Running regular sessions in the year on:

Introduction to Safeguarding gave an overview of the key issues about safeguarding for both adults and children that every community organisation, charity or social enterprise needs to know.
Role of the advocate in safeguarding – for anyone working in the Voluntary Community Social Enterprise Sector working with vulnerable people, so that they can understand their responsibilities and refer appropriately for one-to-one support.

Connected Voice has met the Voluntary Community Social Enterprise Sector to collate views on the needs of organisations around safeguarding practice and keeping people safe. We collate data on trends and support needs of individuals in our community which we share with the NSAB.

Policy and Procedures

In March 2024, the NSAB agreed an update to the Multi-Agency Safeguarding Adults Policy and Procedures. The policy and procedures are an important part of ensuring there are consistent and effective responses to the abuse or neglect of adults with care and support needs.

There were not any significant changes to overall approach to safeguarding adults in Newcastle, but changes were made in line with changes in legislation, learning from statutory reviews, audits and any changes in local operational practice. Some of the key changes include:

Reference to the Adult Missing Protocol
Ensuring LGA/ADASS guidance on Safeguarding Adults Concerns and Section 42 Enquiries is reflected. Particularly an update to Stage 1 of the process and the Local Authority triage of referrals based on safeguarding adult concern criteria.
Extension of Stage 2 timescale from 5 working days to 7 working days
Reference and links to new People in a Position of Trust (PiPoT) Framework
Mental capacity section updated to reinforce that all agencies are responsible for assessing capacity and also that repeated unwise decision-making warrants further exploration.
Directing professionals to refer online (rather than using other methods).
A new section on what happens when a referral is received about an adult already subject to a Safeguarding Adults Enquiry.
A new section covering a model for effective communication.
Updates to escalation procedure.
New sections on what happens when an adult at risk dies during a Safeguarding Adults Enquiry and when a referral is received about a person who has already died.
An additional paragraph about when an adult at risk goes into prison who is open to a safeguarding adults enquiry.

In addition to the full policy and procedure documents, there is a summary flowchart and a summary table of the key stages of the safeguarding adults process in Newcastle. Organisations should ensure that their single-agency policy and procedures are updated in line with the multi-agency policy and procedures.

Financial summary

In 2023-24, the NSAB was chaired by Vida Morris. The NSAB would like to offer thanks to Dr Clare Abley, Richard Scott, Maurya Cushlow and Lynne Colledge for their contributions to safeguarding adults and who all stepped down as NSAB members this year.