The meeting considered two main topics: an update on the provision of services to children and young people with neurodevelopmental needs, such as Autism and Attention Deficit Hyperactivity Disorder, and an update on the Council's performance in relation to safeguarding adults. The committee made several recommendations on how services should be improved and asked the relevant officers to report back with progress on these at a later date.

Mindworks

The Committee received a report on the provision of support to children and young people with neurodevelopmental needs, such as Autism (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).

Councillors heard from two headteachers and a representative from the National Autistic Society (NAS). They spoke about the challenges they were facing in supporting children and young people, given the significant waiting lists for diagnosis and treatment of these conditions.

The Committee heard that there are an estimated 5,200 children with autism and 9,000 with ADHD in Surrey, many of whom need support to thrive in a school and home environment.

Mindworks, a partnership of NHS and voluntary organisations set up to provide support for children with neurodevelopmental needs, was placed into business continuity in December 2023 due to long waiting times.

The committee was particularly concerned about what it saw as a shift away from providing a medical model of care to a social model. In practice, this means that Mindworks is now offering consultations to schools to advise on strategies and resources to help children with neurodevelopmental needs, but not necessarily providing a diagnosis, which parents often see as a pre-requisite for accessing support.

The Committee heard that the reasons for this change were multi-faceted. Demand for neurodevelopmental diagnosis has grown substantially in recent years. This is partly because of a greater understanding of the prevalence of neurodiversity in the population, and partly as a result of the impact of Covid on children's development. In Surrey, demand is now running at 183% above the contracted capacity of the service. At the same time, the NHS is facing severe workforce and financial pressures which means there is a shortage of clinical staff who are able to diagnose and treat these conditions.

The Committee heard about the work that was being done across the system to address these challenges. The Integrated Care Board has invested £2.2 million in additional neurodevelopmental capacity in Surrey for 2023/24. However, it was acknowledged that these improvements would take time to have an impact. The Committee also heard that a transformation plan was being developed for Mindworks, which would set out a more holistic approach to supporting children with neurodevelopmental needs.

The Committee expressed concern that the information presented at the meeting did not match the experience of parents and schools, who told Councillors that they felt abandoned by Mindworks. The Committee asked that the Transformation plan address this dissonance and set out a clearer plan for how Mindworks would meet the needs of children and young people, both in terms of providing a diagnosis and treatment where required, and by increasing capacity for pre-diagnostic support.

Adult Safeguarding

The Committee received a report on the Council's performance in relation to safeguarding adults, covering the responsibilities under the Care Act 2014. Councillors were told about the work of the Surrey Safeguarding Adults Board (SAB), a multi-agency partnership which has the responsibility for developing and implementing a strategy for safeguarding adults in Surrey.

The Committee heard that there were an estimated 587,970 safeguarding concerns raised in England in 2022/23, an increase of 9% on the previous year. Neglect and acts of omission were the most common reasons for concern. This trend was reflected in Surrey, which received 17,785 new safeguarding concerns in 2022/23.

The committee heard that the adult social care team had a good track record in Making Safeguarding Personal, and that there had been a 33% reduction in the number of outstanding enquiries, with a dramatic drop of 80% in those open for longer than 52 weeks.

However, the Committee was concerned about evidence that a risk-averse culture within the adult social care system had led to a high volume of safeguarding referrals, many of which did not meet the threshold for a Section 42 enquiry. Councillors were told that the Adult Safeguarding team wanted to shift from risk-averse practice to a more positive risk management approach. A new proportionate process for managing safeguarding concerns was introduced in September 2023, which aimed to manage immediate risk whilst ensuring that people felt safe.

The Committee heard about the work that was being done to improve communication between agencies, including a new communications network established by the SAB in early 2024.

Councillors were also told about a new Safeguarding Improvement Group, which was set up to drive continuous improvement in safeguarding practice. The Head of Safeguarding outlined a range of measures that were being put in place to improve the effectiveness of the service, including a review of the Care Act training offer, new risk assessment tools, and a more robust process for disseminating lessons learned from Safeguarding Adult Reviews.

The Committee asked the Adult Safeguarding Team to provide a further update on progress against its Improvement Plan, with a particular focus on:

• Ensuring that communication is effective and timely, so that people who raise concerns are kept informed.
• Reviewing the effectiveness of the new proportionate process for managing safeguarding concerns.
• Examining best practice on whistleblowing.

The Committee also asked the Adult Safeguarding Team to provide an update on how it is working with commissioners to tackle issues around modern slavery in the care sector.