The Overview and Scrutiny Committee met to discuss the Harrow Safeguarding Adult Board's annual report for 2024-25, which details the board's activities, strategic priorities and achievements in safeguarding adults at risk within the borough. Councillors asked questions and raised concerns about the report, and the committee noted the report and its action items.

Harrow Safeguarding Adult Board Annual Report 2024-25

The committee discussed the Harrow Safeguarding Adult Board's (HSAB) annual report for 2024-25, which was presented by Lesley Hutchinson, Independent Chair of the HSAB, and Mick Brims, interim strategic partnerships manager for the Safeguarding Adults Board and Hara Safeguarding Children's Partnership. The report highlights the work of the board in safeguarding adults at risk of abuse and neglect, and sets out the board's strategic priorities and achievements for the year.

Councillor Graham Henson, queried several areas of focus for 2025-26, including the creation of multi-agency safeguarding data sets, addressing contextual safeguarding concerns related to the exploitation of adults at risk, and the move from bi-monthly to quarterly meetings for the Quality Assurance and Performance subgroup.

Multi-agency data sets

Councillor Henson raised concerns about challenges encountered in developing the multi-agency data sets, particularly with NHS partners. Mr Brims explained that the board had held a development day in January 2025 to address this issue, and had worked with health partners to gather information from their reporting framework, known as the SHOF¹. He said that the challenges were not in obtaining the data, but in integrating it. He added that a data set had been drafted and was ready to be scrutinised, and that information from this scrutiny would be included in the 2025-26 report.

Ms Hutchinson added that the board's health partner from the Integrated Care Board (ICB) chairs the Quality Assurance and Performance subgroup, which is responsible for tackling these priorities. She also mentioned that she co-convenes the National Chairs Network, and is surveying other boards across the country to share examples of good multi-agency dashboards.

Contextual safeguarding

Councillor Henson asked how the board compiles information and ensures it captures those who are homeless, in Houses of Multiple Occupation (HMOs) or sofa surfing, particularly those with mental health issues who are continually moving.

Ms Hutchinson explained that the Safeguarding Adult Board has a responsibility to be abreast of what is going on with the homeless population, and to look at whether a review needs to be carried out if a rough sleeper or homeless person dies. She added that the board also has a responsibility to ensure that directorates work more closely together at an operational level.

Liz Barter, a colleague of Ms Hutchinson, added that adult social care is working with housing colleagues to look at a rough sleeper protocol, to ensure that rough sleepers are not inadvertently excluded from adult social care processes. She said that social workers are going out with outreach teams and liaising with local organisations like the Firm Foundation, and that referrals for any rough sleeper go through the Multi-Agency Safeguarding Hub (MASH.)), so they are picked up by a social work team irrespective of what criteria they fit.

Quality Assurance and Performance subgroup meetings

Councillor Henson questioned the safety of moving from bi-monthly to quarterly meetings for the Quality Assurance and Performance subgroup, given that this is a high-risk area.

Ms Hutchinson explained that the subgroup was initially meeting every two months because of the volume of work to be carried out in getting to a place where they were confident around the quality assurance and performance management side of things. She said that the group has now been in place for 16-18 months, and can step back to quarterly meetings, in line with what all the other groups are doing. She added that the subgroup can step back up to bi-monthly meetings if needed, and that there is an escalation point if they are not able to cover the work.

Communication and engagement plan

Councillor Henson raised concerns about how the communication and engagement plan will reach out to those with no access to IT, who do not use libraries or other council services.

Ms Hutchinson responded that the communications and engagement plan is being developed in different tranches, targeting different groups with different messaging. She said that the board needs help with reaching out to communities, and welcomed any suggestions. She also mentioned that she is working with elected members and the police in some areas to go out into community groups.

Ms Hutchinson stated that the board has developed its own website and has spent a lot of time this summer trying to make it more accessible, and would welcome views on whether it seems more accessible and what more can be done.

Councillor Henson suggested that the board could learn from the housing team, which had recently undertaken a wide-ranging survey by knocking on doors and had received a high response rate.

Survey responses

Councillor Henson asked what key issues were raised in the surveys that have been undertaken, that the council should be aware of and that could shape policies across the council.

Ms Hutchinson said that she did not know the answer off the top of her head, but would find out and send it to Councillor Henson directly. She also noted that the local authority sends out an annual survey to see how people feel about the support that they are receiving, and that one of the indicators that comes back is how safe people feel.

Ms Hutchinson observed that the conversation highlighted the need for better joint working, and that she would have liked the board to have been involved in the housing team's survey. Councillor Henson agreed, and said that more joined-up thinking was needed.

Abuse in care homes

Councillor Govind Bharadia raised concerns about a 3% increase (equating to a 25% percentage increase) in abuse in care homes, from 11% to 14%, as shown in a graph on page 15 of the report. He asked what type of abuses were occurring in care homes.

Ms Barter responded that the increase could be due to variations in reporting, with some providers over-reporting and some CQC inspectors taking a more reserved view. She added that some types of incidents, such as an unexplained bruise on somebody who is non-verbal, automatically become a safeguarding referral, even if there is not evidence of abuse.

Ms Barter said that the safeguarding team had done a deep dive into two providers that appeared to be outliers in terms of the number of concerns, and that one of them was an in-house provider.

Councillor Bharadia asked if there was any way to get more information about the 25% increase. Ms Hutchinson responded that page 10 of the report states that there has been an increase in organisational abuse, but that this may be due to how abuse was categorised this year, rather than a genuine increase in organisational abuse. She said that the council's Business Intelligence Unit will explore with the Safeguarding Adult Team what they believe the most appropriate categorisation is, and that the trend will be watched closely with targeted work with specific care homes as needed.

Ms Hutchinson agreed to take it as an action to ask the intelligence team and the safeguarding lead to look into the increase and come back to Councillor Bharadia separately.

Councillor Bharadia noted that abuse in people's own homes seemed to have gone down, while abuse in residential care homes had jumped, which was concerning.

Councillor Maxine Henson asked how many people there are in residential care homes, so that the 3% figure could be put into context. Ms Hutchinson said that she did not have that information, but that the commissioning team would have it. Ms Barter added that for learning disability and mental health, there are about 14 people with mental health needs and 122 with learning disabilities in residential care, but that the number of older adults is much higher.

Desired outcomes

Councillor Dr Antonio Weiss commented that he liked the executive summary and the case studies in the report, and suggested including a case study or two in the executive summary. He asked why some people are not asked about their desired outcomes, and what the bare minimum level of individuals who wouldn't be asked for their desired outcome should be.

Ms Hutchinson responded that there are multiple reasons why someone might not be asked, including their capacity, the availability of an advocate, or their circumstances. She said that the council keeps an eye on why that is, and asks for people to report on it. Ms Barter added that the principal social worker doing audits will also check, and will note things like somebody who has a very profound learning disability and doesn't communicate verbally, and there isn't an advocate available to speak on their behalf.

Ms Barter also mentioned that the council is working with the Association of Disabled Persons to integrate a safeguarding survey, so that rapid feedback can be gathered on how the experience was.

Budget

Councillor Weiss asked about the budget, given the uncertainty around NHS and ICB budgets, and what the implications for less or more budget could be.

Ms Hutchinson responded that the ICB will be giving a presentation on what the changes are going to be at the next board meeting on 8 October. She said that the issue has been raised with the executive team, which includes the local authority, the ICB and the police, and that they have concerns about the budget. However, she said that at the moment they have not been told that the budget will be different to what they currently have, so they are working on the assumption that it will remain the same or with an increase.

Ms Hutchinson added that she has met with MOPAC², who funds the police's contribution to the safeguarding board and the children's partnership, and has asked for each board to share what their percentage splits are for funding, so that all boards nationally can look at what the difference is that partners are putting into the work of the board. She said that the majority of the funding comes from the local authority, and that the local authority has stated that it will put in the funding that's needed to make sure the arrangements are effective.

Out-of-borough placements

Councillor Maxine Henson asked about people who are housed in care providers in Harrow but are from out of borough, and how that is monitored if a safeguarding alert is raised and there is little to no risk.

Ms Hutchinson responded that when a concern is highlighted, it is the area that the incident happens in that needs to respond. She said that there is an agreement between directors of adult social services called the out of area placement agreement, which sets out what each area is supposed to do as a placing authority. She said that Harrow would lead the safeguarding piece of work, but the commissioners would need to be working closely with the safeguarding team to make sure that the care and support plan was being delivered as expected.

Ms Barter added that if Harrow is the placing authority, the same thing applies, and that they will work closely with either the host provider or the placing provider.

Councillor Henson said that she had reported a concern about a person in the borough who was from another borough, and that she did not know what happened to the person. She said that it would have been good to be kept updated about the person's welfare.

Ms Hutchinson responded that there is a commitment to let referrers know what the outcome of their concern being raised is, but that they might not necessarily get to know the full outcome because it isn't necessarily their business to know everything.

Ms Barter added that it depends on the situation, and what the gentleman consented to. She said that the local authority may have thought that because they had told Councillor Henson that there was going to be a review of the care and support needs, that may have closed it off from their end. She added that people with substance misuse needs frequently fall through the gaps, and that they are working hard to prevent that.

Domestic abuse

Councillor Aneka Shah-Levy asked if anything specific is being done about the rise in domestic abuse.

Ms Hutchinson responded that the board has worked to strengthen its links with the Safer Harrow Community Safety Partnership with Violence Against Women and Girls subgroup, which meets regularly on a quarterly basis. She said that the strategic partnerships manager attends the meetings, and is aware of the trends within Violence Against Women and Girls and Domestic Abuse within the borough. She added that she has the ability to see those different trends within both the Children's Partnership and the Adults Board.

Ms Hutchinson said that the board will be looking at how it can work with domestic abuse within its strategic priorities, and that it is a key element within its strategic delivery plan. She noted that there has been a 20% reduction from 2023-24 to 2024-25 in the number of concerns that have come through, and a 21% reduction in the number of enquiries that have taken place in relation to domestic abuse.

Mr Brims added that the board is working with its domestic abuse provider, Cranston, about how it will support adults suffering or escaping domestic abuse. He said that London North West Healthcare NHS Trust is running the health safety field program, which is a program of workshops that digs into specific areas of domestic abuse and violence against women and girls, and that this is helping to raise awareness. He also mentioned that the board has a focus on the Multi-Agency Risk Assessment Conference (MARAC), which all professionals should know about to deal with very high and high level of risk.

Ms Hutchinson added that there was a review that took place which had a number of recommendations, and that the decision was taken to make sure that the London Borough of Harrow all support a trauma informed approach.

Ms Barter said that neglect is to do with the provider market that the council is commissioning from, and that the workforce development program is focused on strengths based practice. She said that any concerns that are identified with the broader concerns outside of something that might be raised as an individual safeguarding referral are being addressed with providers through the quality assurance team within commissioning.

Councillor Henson said that there is a lot of work being undertaken by agencies to raise the profile and make it easier to report domestic violence and violence against women and girls, and that he was therefore surprised that the number coming through the safeguarding panel has dropped. He asked if there was a blockage somewhere that he should make the board aware of.

Ms Hutchinson responded that the referrals from the police are still coming through, but that not all referrals for domestic abuse are people that the safeguarding board is supporting or looking at keeping an eye on. She said that the safeguarding board is interested in those people with care and support needs, the children's board is interested where there is a child where there is a family that's with domestic abuse but may not have care and support needs, and Safer Harrow is responsible for those who are suffering domestic abuse but haven't got care and support needs. She agreed to raise the issue at a meeting with Safer Harrow colleagues, and report back to Councillor Henson.

Mr Brims added that there are a lot of programs underway at the moment that would support domestic abuse reporting going forward, including the How Safe Do You Feel program and the IRIS program, which is about working with general practitioners to have similar conversations when seeing patients in their clinics.

Rough sleepers

Councillor Samir Sumaria asked how the board is supporting people who are sleeping rough, and whether it is working with housing associations with that.

Ms Hutchinson responded that the board received a ministerial letter in May 2024 with four recommendations, outlining the board's responsibility in relation to making sure that rough sleeping is on its agenda, and that people that have additional needs that need extra support are supported in the right way. She said that the board has oversight of what's happening with rough sleepers, that adult social care and housing are working closely together, and that if there is a rough sleeper or homeless person that dies, the board looks at whether they meet the criteria for having a safeguarding review. She offered to share a paper with the recommendations and the actions that are taking place.

Decision

The committee noted the report.