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Health and Wellbeing Board - Thursday, 12th December, 2024 10.00 am

December 12, 2024 View on council website
AI Generated

Summary

The Board agreed to adopt the refreshed Suicide Prevention Strategy for 2025-2027 and noted the progress that has been made on the Living and Working Well priority goals set out in the Calderdale Wellbeing Strategy. It was also asked to consider how it could support the recommendations made in the recent Living and Working Well strengths and needs assessment and to consider how they would like to be assured of the effectiveness of interventions and schemes designed to support good emotional health and wellbeing. It noted the progress made on the development of the Joint Strategic Needs Assessment, the annual Safeguarding Reports for children and adults and the Domestic Abuse annual report. The Board also discussed how to ensure that all of the Council’s needs assessments meet accessibility requirements.

Winter Plans

The Board discussed a report on planning for winter pressures on health and social care services. The report described what measures were in place to support the health and wellbeing of the local population during the winter months. The report identified the risks posed by winter to the four priority areas of the Calderdale Wellbeing Strategy – Starting Well, Developing Well, Living and Working Well and Ageing Well. For each area, it listed the steps being taken to mitigate those risks.

For example, on the topic of the Developing Well goal, the report stated that there is a risk of difficulties accessing healthcare services having an impact on hope and aspirations. To mitigate this risk, the report stated that the Calderdale CAMHS crisis team operate a phone line during operating hours, with the Night Owls service taking over when the team are unavailable. In addition, the service has a psychiatrist and a manager on call at all times to support the service, with the option of escalating issues to the director on call if needed.

Living and Working Well

The Board discussed a report on the Living and Working Well priority area of the Calderdale Wellbeing Strategy. The report noted that the wellbeing strategy included the goal that “working age people have good emotional wellbeing and fewer suicides”.

Emotional Wellbeing

The report noted that the initial baseline measurement for this area had been taken in October 2021 and found that 57% of working age people had good mental wellbeing. However, a follow up survey in November 2023 had a low response rate and was not deemed to be comparable. The Board is currently exploring adding questions on mental wellbeing to the annual Vision 2034 survey. If this is not possible, it was suggested that the Office of National Statistics Annual Population Survey be used to monitor progress.

Suicide

The report described the need to reduce suicides as “particularly urgent” in Calderdale, noting that the rate in Calderdale is significantly above the England and Yorkshire and Humber rates.

The rate of suicide in Yorkshire and Humber was 12.3 per 100,000 people. This is significantly higher than the England rate of 10.7. Within that Yorkshire and Humber footprint, Calderdale has the highest rate at 17.6.

The report stated that Calderdale has the second highest rate of male suicide in England. The rate for men in Calderdale was 30.9 per 100,000, compared to the England rate of 16.4 per 100,000. The report also noted that the Suspected Suicide Surveillance data showed a possible increase in deaths in Calderdale compared to the previous year. While this data is yet to be confirmed by the coroner, it is expected that the suicide rate in Calderdale will have increased in 2022-2024 when the Office for National Statistics releases the data. The report identified a “concerning” trend of increasing suicides in young adults in Calderdale. A new scheme to pilot a multi-agency rapid review process of deaths by suicide was mentioned as part of the Suicide Prevention Strategy for 2025-2027.

Updated Strategy and Re-Focussed Action Plan

The Board was asked to approve the refreshed Suicide Prevention Strategy and action plan for 2025-2027. The new strategy sets out to make clearer what everyone can do to play their part in reducing suicide. The strategy is focused on three areas:

  • Prevention - supporting people’s emotional health and wellbeing, and preventing crises.
  • Intervention - improving safety and offering help to people in crisis.
  • Postvention - providing support to those affected by suicide and identifying systemic changes needed to prevent future deaths.

Additional prevention and intervention will be targeted at groups identified as being at higher risk of suicide. This includes:

  • Men, with an initial focus on relationship breakdown or financial insecurity.
  • Young Adults, with an initial focus on those with neurodiversity.
  • People experiencing multiple disadvantage, with an initial focus on those using drugs and/or alcohol.
  • People in contact with the criminal justice system, with an initial focus on those leaving custody.
  • LGBTQ+ people, with an initial focus on those who have experienced stigma or prejudice.

The report stated that the most significant new area of activity is in the area of postvention. A new rapid review process for deaths and attempted suicides will aim to identify and address factors that could have been changed to prevent those suicides.

Strengths and Needs Assessment

The report provided an executive summary of the recent Living and Working Well strengths and needs assessment, which was completed in 2024. The assessment identified four categories of risk and protective factors for suicide:

  • Individual Characteristics
  • Health-related Behaviours
  • Social and Community Networks
  • Economy, Housing and Environment

The assessment identified both risks and opportunities within each of these categories. For example, on the topic of social and community networks, the assessment noted the strong and active VCSE sector and the work it does to combat loneliness, as well as the recently launched Building Stronger Communities framework and the strategic focus on cultural and creative activities as positive factors that help to protect people. However, it also noted a lack of detailed local data about people affected by loneliness and social isolation, the need to ensure that the positive impact of cultural and creative activities is felt by all, and a need to ensure that victims and perpetrators of crime are being adequately supported.

The assessment made six recommendations:

  1. Develop a narrative to allow people to consider how their work contributes to the Living and Working Well goal.
  2. Strategies for working age adults should explicitly state how they contribute to the goal of supporting good emotional health and reducing suicide.
  3. People working or volunteering in Calderdale should understand the impact of adversity and trauma.
  4. People who feel included are more likely to have good emotional health and wellbeing.
  5. Data should be used to target support to those who would benefit most.
  6. Emotional health and wellbeing outcomes should be monitored.

Strategic Leadership

The report noted the existence of the Living and Working Well life course network. This network comprises the chairs and lead officers of groups that have responsibility for the drivers of good emotional health and wellbeing. This network met in July 2024 to consider how to provide collective leadership on this issue.

Next Steps

The recommendations made by the strengths and needs assessment will be discussed by each of the Living and Working Well partnership groups. The assessment’s findings will also be used to inform a Joint Strategic Needs Assessment workshop. The report also noted that Calderdale will be receiving funding from the Get Britain Working pilot scheme from 2025, which could have a significant positive impact on the emotional health and wellbeing of working age adults.

Joint Strategic Needs Assessment

The Board discussed a report on the progress made in the development of the Joint Strategic Needs Assessment (JSNA). The JSNA is a statutory requirement of all Health and Wellbeing Boards. In Calderdale, it is a web based assessment entitled All About Calderdale.

Starting Well

The report noted that a Starting Well needs assessment was completed in 2022, which informed the Calderdale Starting Well Strategy, adopted by the Board in December 2023. An infant feeding strategy has also been developed and published. An update on the progress towards the Starting Well goals was provided to the Board in July 2024.

Developing Well

The report noted that:

  • A summary of story gathering with young people, which aimed to understand what hope and aspiration means to them, has been published. The full report was not published as it did not meet the Council’s accessibility guidelines.
  • An overview of the School Health and Wellbeing Survey (previously known as the eHNA) has been published, with a link to the full report.
  • A summary of the public health outcomes framework has been updated.
  • A section on children with Special Educational Needs and Disability (SEND) has been updated.

Living and Working Well

The report noted that a strengths and needs assessment, which aimed to identify factors that affect emotional wellbeing and the risk of suicide, was completed in 2024. The chairs and lead officers of the strategic groups responsible for those risk and protective factors met in October to discuss the findings of the assessment. A drugs and alcohol needs assessment is also currently being completed to complement the existing drugs strategy.

Ageing Well

The report noted that the Ageing Well Partnership had completed an appreciative inquiry in 2022 to inform an ‘age-friendly’ Calderdale. The report also noted that a survey to establish a baseline for the wellbeing outcomes of older people had been conducted, and that a JSNA section on the needs of older people is in progress.

Calderdale Intelligence Network

The report noted that the Calderdale Intelligence Network, comprising intelligence leads from partner organisations, was launched in February 2022. The network has recently completed area profiles for the Integrated Neighbourhood Teams. The report noted that other Councils have invested in joint posts to support the development of the JSNA. For example, East Riding of Yorkshire Council has used the Better Care Fund to fund two analysts to work jointly for the Council and the Integrated Care Board (ICB).

Challenges

The report noted several challenges:

  • There has been a lack of agreement on how to produce the one-to-two-page summaries of needs, meaning that work has stalled.
  • There is no dedicated capacity to produce the JSNA, meaning that work is often delayed.
  • Documents do not meet the Council’s digital accessibility guidance.

The report noted that Calderdale Communications, Involvement, Equalities and Experience Collaborative (CIEEC) had raised the need to improve how community insight is gathered. A new multi-agency community engagement framework is being developed to address this.

Public Health Peer Review

The report noted that Public Health England had conducted a peer review in June 2024 which recommended that partners need to develop a better understanding of the JSNA.

Proposed Process

The report set out a proposed process for updating the JSNA. The process would see each life course partnership provide an update at the Health and Wellbeing Board’s annual focused session. Each life course partnership would also hold a workshop to review the evidence and agree any new needs assessments that need to be completed.

Recommendations

The Board was asked to consider the following recommendations:

  • All needs assessments and community insights should be developed so that they meet accessibility requirements.
  • The Board should consider its role in shaping the JSNA.
  • The Board should consider how the multi-agency contribution to the JSNA can be strengthened.

Domestic Abuse

The Board received the annual Domestic Abuse report, which reported that the number of domestic abuse incidents reported to the Police had decreased by 12% in Calderdale compared to the previous year. This is a larger reduction than the 11% reduction seen across West Yorkshire.

Domestic Abuse Strategy and Action Plan

The report noted that the five year Domestic Abuse strategy had been signed off by the Domestic Abuse Strategic Board. It also noted the existence of a multi-agency action plan, overseen by the Domestic Abuse Operational Group.

Performance

The report noted that domestic abuse crimes, per 1,000 population, have reduced across West Yorkshire. In Calderdale the rate was 21 per 1,000 population, compared to the West Yorkshire average of 22.4 per 1,000.

Performance Management

The report noted that a new multi-agency performance report, which aligns with the strategic aims and objectives of the Domestic Abuse strategy, has been produced.

MARAC

The report noted that a fortnightly Multi-Agency Risk Assessment Conference (MARAC), which manages high-risk domestic abuse cases, has been introduced. A steering group, to oversee MARAC, was introduced in May 2024.

Domestic Homicide Reviews

The report noted that three Domestic Homicide Reviews (DHR) have been signed off by the Home Office since 2015, with one more currently awaiting approval and another in progress. The report noted that the national DHR guidance had been reviewed and that the revised guidance was expected to be published soon, potentially leading to an increase in the number of reviews undertaken.

Children as Victims

The report noted that since the Domestic Abuse Act 2021, children are now considered victims of domestic abuse. Multi-agency partnerships at the early help, child in need and child protection levels are in place to support children. However, the report noted that the borough is currently working to secure funding for therapeutic interventions for children.

Safe Accommodation

The report noted that Calderdale has 21 safe accommodation spaces. This matches the number recommended by the Council of Europe. A refresh of the safe accommodation needs assessment is due and is expected to commence at the end of 2024.

Challenges

The report noted that there is a lack of provision for perpetrator interventions, as well as a need to develop mechanisms for gathering lived experience. The possible increase in suicide notifications, where domestic abuse may have been a factor, was also mentioned as a challenge.

OFSTED

The report noted that OFSTED has announced that it will be inspecting how local partners work to protect children who are victims of domestic abuse from October 2024.

Victim Services

The report noted that 586 referrals had been made to Calderdale Staying Safe, which provides victim services, in the first quarter of 2024. 94% of those supported said that their situation had improved after receiving support. The report also noted that the Council has revised its Domestic Abuse policy for employers.

Annual Safeguarding Reports

The Board received the annual safeguarding reports for children and adults (Item 10). The report explained the statutory responsibilities of the Safeguarding Adults Board (SAB) and the Safeguarding Children Partnership (SCP), and provided links to their annual reports and easy read summaries. It also included a link to a short animated film about the work of the SCP.

Multi-Agency Safeguarding Arrangements

The report noted that following the publication of Working Together to Safeguard Children in December 2023, the SCP reviewed its arrangements and concluded that no significant changes were needed.

Recommendations

The report asked the Board to consider how the priorities of the SAB and the SCP align with its own, and how the three organisations can work to support one another.

Safeguarding Adults

The Board received the Calderdale Safeguarding Adults Board (CSAB) Annual Report for 2023-2024. The Board also received a two-page easy read summary of the report (Appendix 2b).

Foreword

In her foreword, the Independent Chair of the CSAB, Marianne Huison, described the Board as a “mature” Board with broad, diverse membership. She noted the challenges faced by services due to the increasing complexity of cases and the ongoing impact of austerity. She highlighted Adult Services and Wellbeing’s ongoing transformation of service delivery, noting that a recent peer challenge had been positive about the changes being made. She highlighted the significant increase in attendance at safeguarding training events as a particular achievement for the year.

Calderdale Context

The report included a section describing the context for safeguarding in Calderdale. It highlighted the increasing age of the population, with a projected 29% increase in the number of over 75s. It also noted that Calderdale has a higher proportion of people with a disability than the England average. The report noted that 14.9% of Calderdale’s population lives in income deprivation. It highlighted the impact of poverty on life expectancy, noting that there is a gap of 10.6 years in male life expectancy and 9.1 years in female life expectancy between the most and least deprived areas of Calderdale.

The CSAB Approach to Safeguarding

The report set out the purpose of the CSAB as being to safeguard adults with care and support needs. This is achieved by:

  • Ensuring that safeguarding arrangements meet the requirements of the Care Act 2014.
  • Promoting a person-centred approach to safeguarding.
  • Working with partners to prevent abuse and neglect.
  • Coordinating responses to abuse and neglect.
  • Continuously improving safeguarding practices.

The report stated that the Board has three statutory duties:

  • Develop and publish a strategic plan.
  • Publish an annual report.
  • Commission Safeguarding Adult Reviews.

The report also described Making Safeguarding Personal, the approach to safeguarding that is used in Calderdale. Making Safeguarding Personal (MSP) was introduced by the Local Government Association in 2014, with the aim of ensuring that safeguarding practice is person-centred and focused on outcomes. It was designed to address the concerns that safeguarding practice at the time was too focused on process. The report noted that Marianne Huison chairs both the Calderdale and Barnsley Safeguarding Adults Boards, and is also a member of the Sunderland Safeguarding Children Partnership.

CSAB Achievements in 2023-2024

The report highlighted the following achievements for 2023-2024:

  • Attendance at face-to-face safeguarding training more than doubled.
  • The number of e-learning training sessions increased.
  • 29 learning sessions were delivered during Safeguarding Week, attended by more than 250 people.
  • Improvements to practice were noted in organisations that had been involved in the three safeguarding adult reviews (SAR) published in previous years.
  • The number of self-neglect referrals increased.
  • The number of safeguarding concerns raised is more closely aligned to comparator data.
  • The Local Authority’s responsiveness to Section 42 enquiries has improved.
  • Safeguarding training has led to improvements in practitioner performance.
  • 16 new multi-agency safeguarding procedures were implemented.
  • New local guidance on Self Neglect, Large Scale Enquiries, Adults with Fabricated or Induced Illnesses, and working with non-engaged adults was launched.

Engagement with Adults, Families and Communities

The report described the work of the new Joint Safeguarding Adults and Children Engagement Subgroup, which was launched in 2024. The group aims to:

  • Encourage the participation of adults and children in improving safeguarding services.
  • Gather feedback from adults and children.
  • Raise awareness of support services.
  • Disseminate key messages.

The group is producing a series of toolkits to support faith, sports and voluntary organisations to understand safeguarding, and has also launched a newsletter, the SWAY newsletter, to share information about safeguarding.

Learning and Improvement Activity

The report described the Safeguarding Adult Reviews (SAR) process. SARs are multi-agency reviews, that aim to identify any changes in practice that might prevent the future harm or death of adults. The report noted that SARs in Calderdale have identified a need to improve:

  • Multi-agency risk management.
  • Responses to self-neglect.
  • Sexual safety.
  • Understanding of mental capacity.

The report identified a number of improvements that have been made:

  • Awareness and identification of self-neglect has improved.
  • Multi-agency guidance has been developed.
  • There are plans to implement a Multi-Agency Safeguarding Hub (MASH).

The report noted that three SARs were published in the previous year, with two new reviews initiated in 2023-2024. One, concerning Adult F, is near completion, and another, concerning Adult G, concluded in 2023-2024 and is due to be published. The report also stated that all SARs are published on the CSAB website.

Training

The report noted that attendance at live safeguarding training has increased from 1,030 in 2022-2023 to 2,459 in 2023-2024. The report also noted that the number of e-learning sessions completed increased from 5,201 to 6,016. The report also included a selection of positive quotes from attendees of safeguarding training. For example, one attendee stated that they had “changed my approach after this training”.

Transitional Safeguarding

The report described the joint development day held by the CSAB and the CSCP on transitions between children’s and adults’ services. The report included a list of questions that all organisations should consider when delivering services. The questions aim to encourage organisations to make services more flexible and to identify the support that young people might need. For example, one question was:

Do services have age cut offs, inflexible provision? Or is your service person centred and does it support emotional, physical and psychological transition, no matter what their age? How can your service be more flexible?

A follow up event will be held in summer 2024 to discuss how organisations have addressed these questions.

Safeguarding Week

The report noted that 29 safeguarding training events were delivered during Safeguarding Week, with over 250 people attending. A session led by Cath Knibbs, author and child and adult trauma psychotherapist, was highlighted as being particularly successful. However, it was noted that engagement on social media was low during the week, with impressions on social media falling from 59,315 in 2021 to just 7,044. It was suggested that the reasons for the drop be investigated. The report included some positive feedback on the training events. For example, one attendee stated that the training was “amongst the best training I have ever attended in 20 years of practice”.

November Safeguarding Week

The report noted that Calderdale collaborated with partners across West Yorkshire to deliver several safeguarding training events during National Safeguarding Adults Week, which took place in November 2023.

Performance and Quality Assurance

The report noted the decrease in the number of safeguarding concerns raised from 4,862 in 2022-2023 to 4,433 in 2023-2024, and that this decrease was seen as positive.

Outcomes for Concluded Section 42 Enquiries

The report noted that 97% of people reported that their desired outcome had been achieved from a Section 42 enquiry. Section 42 of the Care Act 2014 places a duty on local authorities to make enquiries when they believe that an adult with care and support needs may be experiencing abuse or neglect and that they are unable to protect themselves because of those needs.

Use of Advocacy

The report noted that the number of people receiving advocacy support increased to 1,078 in 2023-2024. Advocacy is a process by which an independent advocate supports an individual who may lack the capacity, skills or confidence to represent themselves. This can involve helping the individual to understand their rights, express their wishes or challenge decisions.

Deprivation of Liberty

The report noted that the number of Deprivation of Liberty Safeguards (DoLS) applications increased by 29% in 2023-2024. DoLS were introduced in 2009 as part of the Mental Capacity Act 2005. They are a set of safeguards for people who lack the capacity to consent to their care or treatment and who are deprived of their liberty in a care home or hospital. The safeguards aim to ensure that any deprivation of liberty is in the person’s best interests, that it is proportionate and that there are regular reviews of the situation.

Areas of Focus for 2024 Onwards

The report listed the CSAB’s priorities for the next year:

  • Developing a Multi-Agency Safeguarding Hub (MASH). A MASH is a co-located team of professionals from different agencies, such as the police, social care, health and education, who work together to assess and manage safeguarding concerns.
  • Outcomes assurance - the CSAB will aim to improve how the outcomes of safeguarding interventions are measured.
  • Workforce development - the CSAB will encourage the development of workforce development strategies.
  • Cultural competence and equality - the CSAB will work to address inequalities in service delivery.
  • Regional policy alignment - policies and procedures across the region will be aligned.
  • Transitions and adolescence risk - working with the CSCP to ensure that young people have a safe transition to adult services.

Safeguarding Children

The Board received the Calderdale Safeguarding Children Partnership (CSCP) Annual Report for 2023-2024. It also received an easy read summary of the report (Appendix 2a). A link to a short film describing the work of the Partnership was also provided (Appendix 3).

Key Findings

The report listed the Partnership’s key findings for the year:

  • There are many professionals working to keep children safe.
  • Data is collected, shared and used to spot new risks.
  • Professionals act quickly to protect children at risk.
  • Services and organisations challenge issues.
  • Children, young people and families are involved and listened to.
  • Information is gathered and shared in the right ways.
  • There is a clear vision to improve children’s lives.
  • Leadership understands the quality of support for children and families.

Priorities for 2024-2025

The report listed the following priorities for 2024-2025:

  • To improve how vulnerable young people aged 10-24 are kept safe outside of the home.
  • To improve how domestic abuse is addressed, including how risks are spotted.
  • To make sure that services are reviewed in line with the Working Together to Safeguard Children 2023 guidance.
  • To work with the SAB to ensure that children get the right support when they transition to adult services.

Work Undertaken in 2023-2024

The easy read summary of the report, Appendix 2a, stated that the Partnership had improved its data collection processes and had listened to children, young people and families to understand how services can be improved. It had also worked to reduce the number of children being excluded from school. The report stated that professionals receive online training and attend courses, noting that 2,459 people had attended training courses and 6,016 had completed online training. The report noted that the Partnership works to reduce serious knife crime and other forms of violence. The report also highlighted the work of the Young Advisors group, a group of 9 young people aged 13-17 who review the work of the Partnership. The report noted that 23% of children in Calderdale live in poverty.

Health and Wellbeing Forward Plan

The Board received the Health and Wellbeing Forward Plan for 2024/25.

Key Points

The report noted that Health and Wellbeing Board agendas are now framed to reflect the key themes of the Wellbeing Strategy, the statutory duties of the Board, and business items.

Recommendations

The report asked the Board to consider:

  • Their contribution to the key themes.
  • How to ensure the Board hears from those with lived experience.
  • Any additional items that should be included in the plan.
  • Whether an informal session needs to be held ahead of the next meeting.

Planned Items

The plan included the following items:

13 March 2025

  • Ageing Well - a report on progress towards the Ageing Well outcomes will be presented.
  • Better Care Fund - a discussion on the Better Care Fund plan will take place to inform the 2025-2026 plan.
  • Transforming Care - an update on progress will be provided.

Action Log

The Board received the Action Log. The log noted that a letter to the Secretary of State citing evidence on Family Hubs and a letter to the Chair of School Governors on the importance of Family

Attendees

Profile image for Tim Swift
Tim Swift  Cabinet Member, Public Health •  Labour •  Town
Profile image for Mrs Geraldine Carter
Mrs Geraldine Carter  Conservative and Unionists Group •  Brighouse
Profile image for Diana Tremayne
Diana Tremayne  Deputy Mayor of Calderdale and Cabinet Member, Adult Services and Wellbeing •  Labour •  Todmorden
Profile image for Adam Wilkinson
Adam Wilkinson  Cabinet Member, Children and Young People's Services •  Labour •  Sowerby Bridge
Neil Smurthwaite
Robin Tuddenham
Karen Huntley
Penny Woodhead
Dr Steven Cleasby
Anna Basford
Sean Rayner
Darryl Thompson
Karen Jackson
Rachel Foster
Sue Lewis
Julie Robinson
Mick Brown
Cath Gormally
Sheron Hobson
Deborah Harkins
Julie Jenkins
Sophie Sabaljauskas
Profile image for Abigail White
Abigail White  Deputy Leader of the Liberal Democrats Group •  Liberal Democrats •  Warley