Adult Support and Protection National Strategic Forum minutes: March 2020

Attendees and apologies

Attendees

• Clare Haughey (chair), Minister for Mental Health
• Vikki Milne, Scottish Government
• Paul Comley, Stirling University
• Fiona Brown, Office of the Public Guardian
• Suzi Moran, Police Scotland
• Fidelma Eggo, Care Inspectorate
• Alex Taylor, Chief Social Work Officers Group
• Cathie Cowan, NHS Chief Executives
• Austen Smyth, Coalition of Care and Support Providers in Scotland 
• Grace Gilling, NHS ASP Network
• Peter Quigley, Adults with Incapacity, Scottish Government
• Elaine Torrance, SASPICA National Convenors Group
• Marie McQuade, Mental Health Law, Scottish Government
• John Scott QC, Scottish Mental Health Law Review
• Kirsteen MacLennan, Care Inspectorate

Apologies

• Jamie MacDougall, Social Care Support Division, Scottish Government 
• Jeff Ace, NHS Chief Executives
• John Paterson, SASPICA National Convenors Group
• Mike Diamond, Mental Welfare Commission
• Stephen Brown, IJB Chief Officers Group
• Maureen Berry, Health Improvement Scotland
• David Thomson, Mental Health Nurse
• Karen Hedge, Scottish Care
• Shaben Begum, Scottish Independent Advocacy Alliance
• Donald Macaskill, Scottish Care
• Laura Caven, COSLA
• Brenda Walker, Social Work Scotland ASP Leads Network
• Caroline Deane, Scottish Care 

Items and actions

Chair’s welcome to the Forum (Clare Haughey)

Clare Haughey welcomed everyone to the Forum.

Apologies

Apologies noted.

Previous minutes and matters arising

The minutes of the previous meeting held on 03 December 2019 were agreed as an accurate record.

Vikki Milne summarised the actions from the previous meeting:

• legal advice on General data Protection Regulation (GDPR) and ASP information sharing with Law Society – Fiona Brown confirmed that there was no update on this item but will take it forward
• ASP Policy Team to share survey findings from service user and carer involvement work with Forum – ASP Policy Team will share the survey findings with the Forum
• Vikki Milne to update John Paterson on the guidance for the Biennial Report at the next convenors meeting on 12 February – Update guidance was discussed at the Convenors Group in Feb. Final version of the guidance has been shared with Convenors for comment. APCs expected to complete their reports by October. Vikki Milne to provide a written update on the Mental Health Review – Written update provided in meeting papers
• ASP Policy Team to invite John Scott QC to the Forum meeting in March – John Scott QC will be making a presentation on the independent review of the Mental Health Act Review to the Forum today
• ASP Policy Team to circulate interim SCR for comment – The team met with the care Inspectorate in Jan to formalise their role in supporting learning form SCRS. Care Inspectorate are in the process of developing the code of practice and appointing staff to undertake this role. Once this has been agreed the final version of the SCR will be circulated and published
• High Risk Register for adults placed in institutions a long way from home – this item is on-going

Under matters arsing from the minutes Elaine Torrance provided a verbal update on the 5 Nations Conference – Paper was included in the pack distributed to the Forum. The proposal is to hold a one and a half day event on 03 and 04 December 2020 in Edinburgh. There is still enough time to get people involved in this event and the Forum was invited to nominate anyone who may be interested in participating. Fiona Brown & Austen Smyth indicated that they were keen to get involved.

Independent review of the mental health legislation 

John Scott presented on the independent review to date (PowerPoint slides included in the minute). Key points:

• from the outset there has been a focus on gathering lived experience and a strong human rights approach
• an executive team has been set up for the Scotland-wide review and communication and engagement work is already under way. The executive team is a 50:50 split of mental health professionals and people with lived experience 
• while the review is of the legislation, it is key to gain an understanding of how this is actually applied ‘on the ground’
• the call for evidence was launched in February and will run to April
• a communications and engagement group has been established: a new website www.mentalhealthlawreview.scot has been launched and proactive engagement work with stakeholder groups has begun
• the communications and engagement group has informed the language used: for example the ‘call for evidence’ has been expressed as ‘your experience’; ‘case studies’ are ‘shared stories’
• a survey has been issued via networks to gain as a wide a reach as possible, ensuring that the “quieter voices” are also heard
• the review is seeking to understand the intersection between mental health, adults with incapacity and adult support and protection. The call for evdicne is not prescriptive, instead keen to capture how the cross over with legislation works in reality
• the review is gauging the experience of other countries, including evaluation of UNCRPD in practice
• while an interim report will be shared with the Minister in May, there is deliberately no fixed timescale for the review: fundamentally it is about ensuring the people’s voices are heard and that the process is transparent

Discussion – points raised as follows:

• worth considering as part of the review’s approach that it will be covering adults both with and without capacity to avoid any misconception
• important to include prisons in the mental health landscape; often this is not prioritised yet it is a significant area for mental health
• highlighted that a review is being conducted into forensics and it may be helpful for this work to be presented at the Forum
• agreement from Forum members that their organisations are happy to share widely the work of the Review

Actions agreed:

• John expressed interest in attending the 5 Nations Conference. The work group to include the secretariat in the invitation list
• Mental Health review webpage to be disseminated through ASP networks
• Mental Health review secretariat to include ASP Convenor and Practitioner Network Groups as part of their engagement activity. ASP Team to provide dates for these meetings
• ASP Convenors and ASP Leads invited to proactively get in touch with the Mental Health review should they have evidence they wish to contribute to enable a broad range of views to feed into the review
• ASP Team to invite the Forensic Team Review to the next Forum
• Alex Taylor invited John to deliver session to the Chief Social Officers. Alex to email the secretariat with an invite

Review recommendations from the 2018 thematic inspection 

FE presented on the findings of the 2018 inspection and the scope and work of the current inspection (Powerpoint included in the online minute).  Key points:

• there has been considerable progress since the 2008 report.  Key themes identified include leadership, performance and improvement, and a focus on getting the basics right
• current inspection Phase 1 runs 2020-21 across the remaining 26 partnerships.  This focuses on leadership and the delivery of key processes
• phase 2 informed by Phase 1’s findings, will run 2021-24

The Minister then invited Suzi Moran (Police); Cathy Cowan (NHS) and Elaine Torrance (National Convenors Group) to reflect on the findings from the Thematic Inspection and identify the key priorities for ASP for the next two years. Key points:

• SM reported a focus on case conferences. A toolkit has been developed and piloted and this will be used by officers to provide consistency and clearer ownership. A partner agency is being developed, depending on funding. Consistency in IRDs is an issue and a more holistic approach is being developed
• CC presented on the health focus going forward. Clarity and consistency around the authorising and operation environments is key. There is also a need to make decisions rather than keep referring back – this can create ongoing discussion without progress. We need to balance risk and achieve choice and shared decision making. We need to demonstrate what good practice looks like. We need to think about how we engage with our prisons
• Elaine reported on behalf of convenors. ASP partnerships working closely with Care Inspectorate to generate improvements, particularly on the ground to get the basics right. Feedback from the thematic inspection has been helpful at both a national and a local level. Self-evaluation will be a useful area to develop. There is limited reporting back from people on their experience of the system and this should be explored. Training is important to ensure a good staff skills base. Partnerships are key and the need to work closely across public sector process and how these link to ASP (e.g information sharing)

The Minister thanked members for the three reflections.  

Adult Support and Protection Priorities 2020-2022 

The Minister then invited the Forum to consider the key priorities for ASP which can be taken forward by the Forum in the next two years, either by expanding on current work included in the ASP Improvement Plan or identifying new opportunities. 

The Minister noted that priorities will be reviewed at the end of Phase 1 of the current Inspection Programme in March 2022. 

The following key priorities were suggested:

Partnership working - Agencies should consider how they can work together to achieve genuine collaboration. PC highlighted discussion across the partnerships to promote the agenda both publicly and professionally. Good connection into Health and Social Care integration, how can this be maximised?

Refresh of the Code of Practice and APC Guidance - The Forum agreed in Dec that, as the review of the Mental Health legislation would take some time to complete and implications for the ASP Act to become clear, in the short to medium term it would be useful to explore a potential refresh of the code of practice and Adult Protection Committee guidance. This would bring the guidance up to date with changes in policy and legislation, as well as changes to practice and processes. Scottish Government undertook early discussions during January and February with Convenors and ASP Leads. Should Ministers agree, we will proceed with engagement on a refresh of current SG guidance following which then be considered by Ministers to approve and issue. Any changes to the Code of Practice and/or APC Guidance will be in line with the requirements under the ASP Act.

Getting the basics right - we need to define what that actually means and identify the three top priorities for our focus to achieve positive change across Scotland, for example ensuring a well informed and trained workforce able to implement robust policies procedures and processes at a local level. What areas are the assurance and inspection programme identifying for improvement?

Enable consistency in how ASP is applied in practice for example in data gathering and information sharing, enabling consistency across Scotland in a way in which links to local processes. An ASP Data Advisory Group has been established and agreed a work plan for the next two years to develop, test and roll out a revised ASP data set.

A national Adult Protection/Prevention Public Information strategy – A coordinated and consistent approach to raising awareness through the creation of a professional and public awareness group directed by the national forum, which could inform and coordinate local activity and inform national activity.

Amendment to national strategic forum meetings

The Minister outlined the proposed holding the Forum meetings twice yearly. The aim would be to encourage the Forum to focus on the strategic priorities with working groups and Committees taking forward any supporting actions and reporting back on progress. The Minister stressed that the agenda is shaped and supported by everyone at the Forum. This was agreed.  

The date of the next meeting will be 2 September 2020 at Atlantic Quay in Glasgow.

Scottish mental health law review: presentation

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