Report 41: Prevention in adult safeguarding - Emerging evidence
Operation Comfort: NHS Great Yarmouth and Waveney Community Services with Norfolk Constabulary
An innovative preventative project in Great Yarmouth that involves Police Community Support Officers accompanying district nurses as they go on their rounds once a week has opened up communication between the police and vulnerable, often isolated, older adults. Walter Lloyd-Smith, Safeguarding Adults Lead for NHS Great Yarmouth and Waveney Community Services, explains the scheme.
Operation Comfort was developed during 2010 in a partnership between NHS Great Yarmouth and Waveney Community Services and Norfolk Constabulary. In practice it involves a Police Community Support Officer (PCSO) accompanying a district nurse on their visits in the community on set days, at least one or two days per week. At the moment, three dedicated PCSOs are involved, working with nurses across a number of district nurse teams.
The nurses identify people they have concerns about and then offer those people the opportunity to meet with the PCSO if they wish. Vulnerable adults, particularly older and isolated people with long-term health problems, are able to take the chance to raise their concerns directly with police about a range of issues relating to criminal and anti-social behaviour, and personal safety.
The nurse leads the process in order to preserve confidentiality and ensure that the PCSO only enters the person's home with their permission. If the nurse needs to provide personal care or something arises that is confidential, the nurse can ask the PCSO to withdraw. The PCSO dresses in a low profile uniform without high visibility jackets or unnecessary equipment. The value of this is to avoid alarming people unnecessarily about the nature of the visit.
The emphasis is on prevention and the need to reassure vulnerable people of the potential for resolving issues of concern before they become too serious. Another goal is to change people's perceptions of the police service so that they may feel more able to report things in the future.
The two organisations produced an information leaflet about Operation Comfort that can be handed out to any interested parties, including neighbours and family members.
Walter delivered some half-day training sessions for the PCSOs who were selected and committed to working on the project.
Both services – district nursing and the PCSO service – are already in place and share certain aspects of the responsibility for ensuring the safety of adult at risk, so both are doing the work as part of their usual roles.
What's worked wellOpen
The project has picked up on a range of issues, for example unreported crime, anti-social behaviour, cold and bogus callers, environmental issues and home security. It has identified some people who are scared to leave their homes due to concerns about personal safety. The PCSO service has been able to engage with a number of vulnerable people, some on an ongoing basis, and has helped to resolve some important issues.
In one sheltered housing complex, residents feared being knocked down by people on bicycles cutting through their close. This issue was taken up with the Borough Council. Another example concerned the presence of an unfamiliar car which turned out to contain drug paraphernalia and led to an arrest. On a couple of occasions, PCSOs have been able to support the nurse in situations where a person's behaviour has become threatening.
Both the health and police services have been through lots of organisational changes, and at times it has been hard to keep up the momentum of Operation Comfort, particularly with changes of staff.
Advice for othersOpen
It is important to get the right people together at the start and build positive relationships between the individuals who will be actually doing the work. Early on with Operation Comfort, this often involved arranging informal networking opportunities, with nurses and PCSOs just sitting down talking to one another over a cup of tea. This can take time but it is worth it.
It was particularly important to ensure that everyone felt comfortable about the principle of confidentiality. The nurse takes the lead on visits and can ask the PCSO to withdraw at any time if there are any concerns.
Keep it simple and keep it flexible. There are no referral forms. The district nurses bring their professional discretion to bear in how and when they involve the PCSOs.
The project has been extended into Lowestoft in partnership with the Suffolk Constabulary (here it is known as Operation Safe) and discussions have started with colleagues in King's Lynn to set up a pilot.
A spin-off from Operation Comfort has been the launch in February 2011 of one-hour information sharing and networking sessions between mental health teams and the police. Each service takes turns to lead the monthly sessions.
Walter Lloyd-Smith, email: firstname.lastname@example.org tel: 01493 334 113