Adult Support and Protection National Strategic Forum minutes: September 2024

Attendees and apologies

• Maree Todd, Minister for Social Care, Mental Wellbeing and Sport (Chair) 
• Vikki Milne, SG: Adult Support & Protection
• Jamie Aarons, SG: Adult Support & Protection
• Gemma Graham, SG: Adult Support & Protection
• Iain Ramsay, SG: Office of the Chief Social Work Advisor (OCSWA)
• Sinead Power, SG: Office of the Chief Social Work Adviser (OCSWA)
• Fiona Brown, Office of the Public Guardian
• Gemma Ritchie, Social Work Scotland ASP Leads Network
• Grace Gilling, NHS ASP Network Group
• Stephen Grimason, Scottish Police
• Maureen Scott, NHS Healthcare Improvement Scotland (HIS)
• Mike Harkin, Care Inspectorate (CI)
• Alison Morrison, Care Inspectorate (CI)
• Brenda Walker, IRISS
• Stuart Muirhead, IRISS
• Holly Smith, IRISS
• Jeanette Sutton, IRISS
• Susan Maclaren, ASP Convenor, Aberdeenshire
• George Whitton, SG: Adult Support & Protection
• Lisa Corrigan, SG: Adult Support & Protection (Minutes)

Apologies

• Iain MacAllister, SG: Regulation, Improvement & Integration
• Robert Peterson, SG: Regulation, Improvement & Integration
• Neil Gibson, Social Work Scotland
• Mark Hargreaves, SG: HM Inspectorate of Constabulary Division
• Julie Paterson, NHS Mental Welfare Commission
• Suzanne Moran, SG: HM Inspectorate of Constabulary Division
• Brain Auld, SG: HM Inspectorate of Constabulary Division
• John Urquhart, COSLA
• Karen Hedge, Scottish Care
• Elaine Torrance, SASPICA, Conveners Group

Items and actions

Welcome, introductions and business from last meeting

Minister for Social Care, Mental Wellbeing and Sport Maree Todd welcomed everyone to the Forum. Ms Todd noted a copy of the previous meeting’s minutes, there were no ongoing actions from the last meeting. Ms Todd then invited the Forum to respond on whether the minutes were an accurate record of the last meeting. The minutes were approved.

Learning review

Grace Gilling, Associate Nurse Director (Public Protection) NHS Tayside presented the Learning review of Ms L. The aim of this learning review was to identify areas of improvement and how these could be developed. This would establish any new learning about the way in which local areas and professionals can work together and  individually safeguard adults at risk of harm. 

The Multi-Agency Risk Assessment Conference (MARAC) did not show a collective understanding of her circumstances, as no one checked with other agencies.  Ms L’s files were sent by Manchester council to Dundee when Ms L fled to escape Domestic Abuse, unfortunately there was no record of anyone in Tayside reviewing these.

Ms L’s family were notified of the review and were given an opportunity to provide views or questions in relation to the draft and final report and publication. Challenges were faced by Ms L’s mental and physical health, she had a complex history and the combination of needs including domestic abuse, homelessness, substance use, mental health issues, chronic physical health issues and isolation from family and friends.

The learning review has improved on the following areas:

• Dundee council have now opened a women’s hub
• weekly MARAC meetings instead of monthly
• Adult Support and Protection (ASP) details in meetings

In conclusion, the learning review details no single action that would have prevented Ms L’s death, but widely identified areas for improvement. Discussion followed on the points raised within the presentation.

Iriss Hub Launch

Jeanette Sutton presented the new Iriss online resources ASPire Hub. One year in Development, it was commissioned by the Scottish Government as part of the Iriss ASP programme and was launched on 28 August 2024. The hub is a place to share recourses and good practice in ASP. The hub will host all relevant and helpful publications local and national, in order to support the ASP sector, sharing good practice and knowledge.

Jeanette went into detail on how to navigate the hub, where people can access and share resources and good practice. The National Implementation Group and subgroups are currently developing new resources, which will become available on the hub. 

Jamie Aarons and Vikki Milne for the Scottish Government thanked Jeantte for her work and noted how useful and dynamic the space is.

Quality improvement Framework

Mike Harkin, Care inspectorate, gave a verbal update on the Quality Improvement framework (QIF). In June 2023 the Joint Inspection Partners commenced phase 2 of the ASP joint inspection programme. Phase 2 of the programme blends scrutiny activity with improvement support and include close collaboration with ASP partnerships.

As part of phase 2 the QIF was developed to be used by partnerships to develop consistent approaches to audit and self-evaluation and can inform future ASP Inspection activity.

To support the development of the QIF, 4 national events were held in Edinburgh, Glasgow, Dundee and online. 80 lead officers attended these events and  around 800 comments were received. These comments were analysed and detailed 4 key themes. In line with the ‘You said we did’ exercise, we went through all 4 themes. A final draft version of the QIF has been developed and will be published in the coming months. The QIF will not solve everything. It is for the sector to work out how it will implement the framework. Mike is happy with the support he has received from partnerships 

Joint inspection Summary Report

Alison Morrison, Care inspectorate, presented the joint inspection summary report. The reported detailed the overview of progress in partnerships inspections that were undertake in 2017-18. The team undertook review inspections in 23/24 from the six inspected partnerships; Dundee, North Ayrshire, East Dunbartonshire, Aberdeenshire, Highland and Midlothian.

• The joint inspection partners are comprised of inspectors from the Care Inspectorate, Healthcare Improvement Scotland, and His Majesty’s Inspectorate of Constabulary in Scotland(HMICS)
• Overview report presented summary of progress on each recommendation made in 2017 across the six partnerships. This also detailed improvement was still needed in particular areas of practise that were consistent with our phase 1 findings
•  The Overview report was published in August 2024.

The key messages and observations were that priority areas for improvement in the six areas that were inspected in 2017, were positively addressed. Chronologies, risk assessment and risk management remained key areas for improvement. All partnerships had considered council officer capacity and the impact of the revised code of practice.

There was a signification variation in how Interagency Referral Discussions (IRD) were utilised. Partnerships struggled with attendance of adults at risk of harm at their own case conferences. The offer of advocacy support was variable. 

NCS Stage 2 – ASP amendment proposal update

Gemma Graham, Adult Support and Protection Policy Manager, Scottish Government, shared the proposal update on section 5 amendment via the National Care Service (NCS) bill. The ASP policy team have been seeking views on broadening the act. This draft proposal will be finalised via NCS bill. If bill is agreed, specific parties would be named at a future date in legislation; GPs, dentists and community pharmacy.

Meetings have been held with Scottish General Practice committee, Senior medical advisors in SG and ASP leads and convenors. Over 80 stakeholders have been engaged with as part of their role including NHS public protection leads in Scotland.

Looking to take these views further, Gemma has been working closely with legal advisors and further engagements will be scheduled as we develop relationships with  independent  contractors who are working with adults at risk of harm day in day out. This is an enabling amendment, any inclusion would have to be done by a Scottish Statuary instrument(SSI).

National Implementation Group

Iain Ramsay, Professional Social Work Adviser, OCSWA, Scottish Government, gave an overview of the subgroups and a recap of the NIG, formed when revised code of practice was published in 2022. The aim of the group is to take a collaborative approach to ASP. The 4 subgroups were created alongside this. The last forum in march there was a resource presented, from enquiry role of council officer subgroup, which was endorsed by National Strategic Forum (NSF).

Iain gave an update on 4 subgroups:

• The Chronologies subgroup has now widened its remit and membership to include children’s services and child protection; justice; Education; GIRFEC and GIRFE. This expansion ensures that resources are relevant for undertaking a lifespan approach, building on Iriss’ review in 2023 of chronologies in ASP.
• The Self Evaluation group is working with inspection partners to develop the Quality Improvement Framework as part of phase 2 of the ASP joint inspection programme. The sub-group is also working with Brenda Walker on the ASPire event to tie in with the Care Inspectorate’s formal launch of the framework later this year.
• The Advocacy & the Voice of the Service User subgroup has developed a good practice guide for case conferences. The group has also been linking with the National Care Service Independent Advocacy workstream. Guidance related to advocacy is in progress, with the ambition to complete.
• The Inquiries, Investigative Powers & Role of the Council Officer subgroup was the first to produce a national resource. This was best practice guidance for the role of the non-council officer. It was successfully endorsed by the ASP National Strategic Forum in March 2024.

Good practice for effective participation

Susan Maclaren introduced the resource for endorsement. The guidance was developed by representatives from a range of agencies and services who participated in the work of the ‘User Voice’ Subgroup of the national Code of Practice Implementation Group. This document offers good practice guidance for effective participation of adults being supported and protected under the Adult Support & Protection (Scotland) Act 2007, particularly in relation to ASP Case Conferences. It provides pointers as to how to facilitate meaningful engagement, taking a holistic view of the perspective and circumstances of the adult, including experience of trauma.

Susan detailed how they worked closely with Mike on the QIF. The guide was developed through workshops. Views and feedback on the draft publication was taken from stakeholders. Susan noted they took on learning from the pandemic. The NSF group agreed to endorse the guidance.

Learning and Development Framework

Brenda Walker gave an overview of the learning and development framework. The purpose of this framework is to have a shared understanding of multi-agency experience, skills and knowledge required across a range of disciplines when dealing with different levels of ASP responsibilities. It is hoped the framework will lead to a better understanding of how best to support staff in various roles to acquire the relevant experience, skills and knowledge they require. Ultimately, this should ensure that more adults are appropriately identified, supported and protected across Scotland.

Brenda details how Iriss are planning to have a stakeholder session at the end of October 2024 for the wider ASP community and where they will invite members of the NIG, convenors, lead network. The anticipated timescale for producing the framework is around 9 months, which is early summer 2025. Children’s Services have already gone through this process. They recognise there is a difference in the language use in ASP. This is an opportunity to strengthen links for ASP and Child Protection(CP) with a possibility for there to be joint training in the future.

Vikki Milne thanked Brenda for the overview and detailed the huge amount of work being undertaken to develop the framework. Noting how useful this resource is going to be for the ASP community. This is the first time this framework has been taken forward since it was considered in 2014.

Final Remarks

Ms Todd, closed the meeting thanking all the speakers and members for attending from what was another engaging sessions. The next Forum meeting will take place on 6 months, with the date to be confirmed.