The Health and Social Care Scrutiny Committee were scheduled to meet on Wednesday 29 October 2025 to discuss the City and Hackney Safeguarding Adults Board Annual Report 2024/25, the NHS NEL ICB operating model, dementia services, and adult social care direct payments.

City and Hackney Safeguarding Adults Board Annual Report 2024/25

The Health and Social Care Scrutiny Committee were scheduled to receive the City and Hackney Safeguarding Adults Board (CHSAB) Annual Report 2024/25.

The CHSAB is a statutory board required under section 43 of the Care Act 2014¹. The board has three statutory functions:

• To develop and publish a strategic plan outlining how the Board will meet its objectives.
• To publish an annual report detailing the safeguarding achievements for that financial year.
• To commission Safeguarding Adults Reviews (SARs) for any cases which meet the criteria.

The report outlines the key achievements of the Board as well as what the Board will prioritise in the coming year. It also includes an overview of safeguarding data for the City of London Corporation.

Some of the key achievements for the Board in 2024/25 include:

• The Board commissions a package of training for frontline staff working across the City and Hackney on a yearly basis. In total, over 150 people attended the various different training sessions on offer.
• The Board organised a series of events throughout the whole month of November, in recognition of Safeguarding Adults Week.
• Board partners undertook a self assessment using the Safeguarding Adult Partnership Assessment Tool in Feb 2025, which was analysed by the Board Manager and used as evidence to help guide discussions during the Boards Development Day in April 2025.
• The Chair of the Board hosted a Patient Panel on Safeguarding in the City of London which was open to residents and explained what safeguarding means, how to raise concerns, and what role the City and Hackney Safeguarding Adults Board plays.
• In 2024/25, the Board published two discretionary Safeguarding Adults Reviews: JL and Steve.

The Board has set itself the following strategic priorities for 2025/26:

• Develop and Implement a Community Engagement Strategy
• Establish a Multi-Agency Dashboard and Conduct regular multi-agency audits
• Ensure Learning from Safeguarding Adult Reviews (SARs) and Other Reviews are complete in a timely manner and learning is shared.
• Implement the updated London Association of Directors of Adult Social Services (ADASS) Pan-London Adult Safeguarding Policies and Procedure.
• Improve outcomes for people experiencing homelessness by preventing abuse and neglect and strengthening safeguarding responses.
• Minimise the risk of self-neglect and strengthen the multi-agency response.
• Minimise the risk of and strengthen the multi-agency response to financial abuse.

Key data was collected in relation to safeguarding for the City of London:

• 49 safeguarding concerns were raised.
• 30 of those concerns led to a Section 42 Enquiry².
• The trend over the last five years shows, concerns have decreased from 57 in 2020/21 to 49 in 2023/24 and have stayed the same in 2024/25.
• The most prevalent risk noted this year in safeguarding enquiries was Neglect and Acts of Omission, accounting for 32% of all cases. This was closely followed by Self-Neglect, which constituted 29% of the risks. Financial or Material Abuse represented 18% of the total risks identified.
• In line with the national and London average, the data shows 79% of client's risk comes from someone known to the individual. This is an increase from the previous year 2023-24 of 64%.
• The majority of safeguarding enquiries related to alleged abuse that happened within the person's own home.

The CHSAB Annual Strategic Plan 2025 – 2026 addresses the six key objectives contained in the CHSAB's Strategy for 2025 – 2028:

• Make safeguarding everybody's responsibility
• Embed the voice and lived experiences of residents
• Guarantee multi-agency systems are safe
• Continue to support learning and development
• Strengthen our use of data
• Build effective multi-agency partnerships

The report includes several case studies including those of Joan, Mr Wilkinson, Lewis, Anna, Kyle and Sara.

The report also contains safeguarding data for 2024/25 for the London Borough of Hackney and the East London NHS Foundation Trust.

Adult Social Care Direct Payments

The Health and Social Care Scrutiny Committee were scheduled to receive the report of Judith Finlay, Executive Director of Community and Children's Services, regarding Adult Social Care Direct Payments.

Direct payments provide independence, choice and control by enabling people to commission their own care and support in order to meet their eligible needs. The legislative context for direct payments is primarily set out in the Care Act 2014.

An internal audit was completed in May 2025 which examined the control framework in respect of Direct Payments for Adults with care and support needs. The key objective of this audit was to provide assurance in respect of the adequacy and effectiveness of the framework for ensuring that assessment and award of Direct Payments is in line with appropriate policy, only valid payments are made, and there is effective monitoring and oversight to obtain assurance that care needs are being met on a continuing basis.

Unpaid carers of adults with care and support needs also receive direct payments, where eligible, to meet their assessed needs. This is in addition to the commissioned carers support service provided by Imago.

Adults with care and support needs have the option to self-manage their own direct payment either themselves or through their own representative. Alternatively, they can opt for a managed account via a City of London commissioned third-party provider. As of September 2025, 2 out of 23 adults were managing their own direct payment, demonstrating a strong preference, within the cohort, for the financial aspects of direct payments to be managed on their behalf while retaining the choice and control over their method of support.

Direct payments for adults with care and support needs are often spent on direct care and support. For example, 6 out of 23 adults choose to use the money to purchase support from a home care agency of their choice, while 12 adults employ their own personal assistant to support them, others may choose a mix of both. This gives the adult more control in the way their needs are met, often based on culture, language and personal beliefs or interests.

Examples of how direct payment are being used for adults with care and support needs:

• Support to access the community
• Support to attend a church or mosque
• Gym membership or Personal Trainer
• Home exercise equipment/subscriptions
• Education and training courses
• Support with communication and interpreting needs

The Direct Payments internal audit report concluded that overall, 'Substantial Assurance' is provided in respect of the control environment within the scope of the audit. Audit sample testing found that controls have been established and generally applied effectively in all areas examined.

Examples of how direct payments are being used by carers:

• Yoga classes
• Gym Membership
• Holiday or break
• Socialising with friends
• Spa or Massage
• Laptop or internet connection
• Education and learning

There are currently 23 active direct payments for adults with care and support needs.

NHS NEL ICB Operating Model

The Health and Social Care Scrutiny Committee were scheduled to view a presentation on the NHS NEL ICB operating model.

Dementia Services

The Health and Social Care Scrutiny Committee were scheduled to view a presentation on dementia services.