London Borough of Harrow: local authority assessment

There were effective systems, processes and practices to make sure people were protected from abuse and neglect. There was a clear adult safeguarding standard operational procedure which outlined the local authority’s duties to safeguard adults at risk of harm or abuse. The local authority worked with the Safeguarding Adults Board and partners to deliver a co-ordinated approach to safeguarding adults in the area.

There was a strong multi-agency safeguarding partnership, with clear roles and responsibilities. Information sharing arrangements were in place so that concerns could be raised and investigated without delay.

The Safeguarding Adults Board strategic plan 2024 to 2027 had 4 priorities, which were Prevention and early intervention, Engagement and Communication, Assurance and Working in Partnership.

The board used one set of data to inform about timeliness, which did not align with the council’s performance data following changes to the triage process. Further work was needed in this area to ensure all data was aligned.

National data showed that 67.86% of people who used services in Harrow felt safe. The England average was 69.69% (ASCS).  A further national data set showed 75% of carers living in Harrow felt safe. The England average was 80.51% (SACE).

All staff involved in safeguarding work had training available to them, although there was a low uptake of staff training in this area. National data showed that 19.57% of independent/local authority staff in Harrow had completed Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards DoLS training. The England average was 37.48% (SCWE). 29.73% had completed safeguarding adults training and the England average was 48.81%. The local authority had implemented The Harrow Adult Safeguarding Improvement Plan to deliver specific safeguarding training across the workforce, to ensure all staff were suitably skilled to undertake safeguarding duties effectively. 

There was a clear understanding of the safeguarding risks and issues in the area. The local authority worked with safeguarding partners to reduce risks and to prevent abuse and neglect from occurring.

The local authority had commissioned 2 independent reviews in 2023 on the effectiveness of the integrated adults and children’s safeguarding board. The reviews concluded that there was strong safeguarding partnership working, all partners were signed up to protecting the welfare of all citizens and the volume of safeguarding Harrow was experiencing were being met effectively.

It also indicated that the joint board should be separated to ensure a clear focus on adults and to strengthen the governance of the Harrow Safeguarding Adults Board (HSAB) and its partner agencies. As a result of this, there is now a strategic 3-year plan in place for the adult safeguarding board, which is underpinned by annual action plans targeting priorities.

At the time of our assessment, Harrow had not carried out any recent Safeguarding Adults Reviews (SARs) as referrals had not met the criteria. They confirmed any identified learning was shared with agencies to ensure actions could be put in place without delay.

A Section 42 enquiry is a legal requirement under the care Act  for local authorities to make enquiries, or have others do so, if an adult may be at risk of abuse or neglect. There were clear standards and quality assurance arrangements in place for conducting Section 42 enquiries. On 31 January 2024 the local authority had 41 safeguarding concerns awaiting an initial review. The local authority did not have any section 42 enquires awaiting allocation as they were immediately assigned to staff for investigation. On 1 April 2024 23 section 42 enquires had yet to be started by the staff they had been allocated to. 161 DoLS applications were awaiting allocation.

Staff understood what constituted a section 42 safeguarding concern and when section 42 safeguarding enquiries were required. There was a clear rationale and outcome from initial enquiries, including those which did not progress to a section 42 enquiry.

The safeguarding team triaged all referrals from partners which included high volumes of referrals which did not meet the safeguarding threshold and were signposted elsewhere. Between February 2023 and January 2024, 22.5% of the local authority’s safeguarding initial enquiries moved on to become section 24 enquiries. 443 safeguarding enquiries met the section 42 threshold in the last 12 months.

Providers told us they felt the safeguarding teams were responsive and knowledgeable, and that processes worked well, although, some providers advised it was not always clear whether the concerns they raised had been dealt with through safeguarding processes or as a complaint.

Frontline staff told us Harrow had a person centred, human rights-driven approach to managing risks around deprivations of liberty. The holistic impact on each person was considered when determining whether depriving anyone of their liberty was in their best interests, designated care providers allowed staff to explore the least restrictive options at all times.

The safeguarding and DoLS teams talked about how they were supported by managers when people's mental capacity made their work more complex, for example where mental capacity fluctuates or is harder to assess. They had taken part in recent training in the Mental Capacity Act 2005 (MCA). The safeguarding team often held case discussions around mental capacity and knew to contact the DoLS team if they needed specialist advice. They told us that the mental capacity forums Harrow used to put on were very useful for case discussions, but these had now stopped as had reflective discussions on themes or trends from SARs which had discontinued due to a change in the team.

We were told that improvements were needed around management oversight, data analysis and processes for DoLs. The local authority had a DoLs action plan dated January 2024 and an action plan tracker dated February 2024 to address this.

Some agencies told us they were not always informed of the outcomes of safeguarding enquiries when this should have been necessary for the ongoing safety of the person concerned. The local authority was aware improvements were needed in safeguarding which and they were addressing within their Adult Safeguarding Standard Operating Procedure dated November 2023 and in other documents we reviewed.

Principles of Harrow’s Making Safeguarding Personal statement recognised that adults had a right to independence, choice and self-determination including control over information about themselves. This meant a person should have accessible information to make informed choices about safeguarding; what it means, risks and benefits and possible consequences.

A carer described a breakdown in safeguarding communication relating to their care but stated the local authority demonstrated a good duty of candour response including lessons learned.

The local authority understood they needed to raise public awareness of safeguarding, so more people knew what safeguarding was and how to raise a concern when they did not feel safe, or they had concerns about the safety of other people.

The independent chair of the Harrow Safeguarding Adults Board was confident Harrow were Making Safeguarding Personal. The new board structure involved increased use of data and putting people's experiences at the forefront of the board through use of interviews with people with lived experience and case studies. The safeguarding team spoke proudly about the work they did and described personalised approaches to safeguarding. Making Safeguarding Personal was embedded in their work.

National data showed that in Harrow 66.67% of individuals lacking capacity were supported by an advocate, family or friend. The England average was 83.12% Safeguarding Adults Collection (SAC). Further improvement was needed to ensure people lacking capacity had appropriate support.