Independent review published of seven adult safeguarding cases in Cornwall

Cornwall's Safeguarding Adults Board says they are making improvements and their deepest sympathies go out to all involved

Author: Sarah YeomanPublished 20th Jun 2022

An independent review has been published into seven adult safeguarding cases in Cornwall.

This independent thematic Safeguarding Adult Review (SAR) was commissioned by the Adult Safeguarding Board in 2020, following a number of cases in which vulnerable, elderly people died or were admitted to hospital with safeguarding concerns present.

Officials say each case, whilst having its own distinct issues, exhibited themes that were similar to the others being considered.

In each case, a carer was involved in providing varying levels of support, personal care and emotional well-being to an adult at risk.

The review found that in these cases, the carers were often family members who were also in need of, or were receiving, community-based services from health and social care. Some of the carers were diagnosed with complex mental health issues or learning disabilities.

In some of the cases there appeared to have been a lack of consistency in effectively assessing the individual’s capacity to consent to their support, care and treatment. There was also lack of clarity in identifying when there was a need for advocacy support to ensure that the vulnerable person’s voice was heard.

This potentially led to a lack of consistency in safe, quality services being delivered to adults at risk and their subsequent support and care plans as completed by health and social care agencies.

In some cases, this may have led to carers managing complex, risky situations on an ongoing basis, that resulted in the individual at risk becoming “invisible” and not being known to health and social care services until there was a breakdown of the situation, a crisis or a serious incident.

Fiona Field, Chair of the Cornwall and the Isles of Scilly Safeguarding Adults Board said: “Our deepest sympathy goes out to the people involved in these reviews and their families. The purpose of this review is to make sure that lessons are learned. The Board has taken on the recommendations made in this report and is working with the partners involved to make the improvements.”

Work is already underway on the recommendations made within the review, which includes:

• Working with Kernow Clinical Commissioning Group to improve the way that GPs engage with reviews when safeguarding issues have been identified.

• Working across partnerships to ensure that carers’ needs are central when assessing the support needed for a family member to live at home.

• Making sure partners are working effectively to identify risk situations in a person’s home and a plan is in place to minimise the risks.

• Organising a conference during Safeguarding Adults Week (November 21-27) that will raise awareness of the issues found in this report.

Fiona Field added: “It is important that all agencies make sure that everyone’s wellbeing is maintained and supported when assessing an individual’s needs. An assessment of the carer as potentially ‘an adult at risk’ should be considered at an early stage. This should also consider the impact on the individual if that arrangement breaks down, along with the contingency plan that would be needed.

“We recognise the invaluable role that family carers provide to their loved ones, but we also need to ensure that services support family members to provide this care in a safe way to meet the needs of the individual.”

The review also sought the views, opinions and experiences of local charities and groups that support carers to inform the final report and recommendations.

If you are a member of the public and are worried about someone, call Adult social care on 0300 1234 131. In an emergency, always dial 999 and for police non-emergencies, dial 101.

You can read the report in full on the SAB website here.

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