SAR Quality Marker 5: Commissioning
Strategic commissioning of the Safeguarding Adult Review takes into account a range of case and wider contextual factors in order to determine the right approach to identifying learning about what is facilitating or obstructing good practice and/or the progress of related improvement activities. Decisions are made by those with delegated responsibility in conjunction with the reviewers, and balance methodological rigour with the need to be proportionate.
Questions to consider for:
- Is the precise form and focus that has been agreed for this SAR best suited to have practical value by illuminating barriers and enablers to good practice, untangling systemic risks, and progressing improvement activities (see QM4) to the benefit of adults and their families?
- Have you explicitly endorsed those with delegated responsibility to identify an approach to the SAR that is fit for purpose for this case and current context, and moves away from a one-size-fits all approach that assumes a set process and long report?
- Is there adequate clarity in the commissioning specification about the proposed approach agreed, to allow confidence in the methodology being used and similar confidence in the analysis and conclusions?
- Are there any issues regarding the capacity of practitioners, SAB and member agencies, and experienced / qualified reviewers that may impact on the feasibility and/or quality of this SAR?
- Have multi-agency partners with delegated responsibility been involved in discussions with the reviewers about the precise form, focus and approach, as opposed to delegating these decisions to the Business Manager or equivalent?
- Have you agreed how learning from the SARs of other SABs, as well as research evidence, will be synthesized, in order that it can be used to develop a proportionate approach to the SAR that builds on the evidence base about what good looks like, barriers and enablers, rather than starting afresh?
- Has detail from any parallel processes or statutory reviews been utilized to avoid unnecessary duplication and agree joint-commissioning where appropriate (while not losing focus of SAR Care Act requirements of the process)?
- Have discussions about the precise form and focus of the SAR built on initial information gathering about case and local context (QM 2), drawing on the right range of information including:
- Evidence of impact on adults with care and support needs and their families, including of any serious public concern and/or potential media interest
- Other quality assurance and feedback sources e.g. audits/complaints
- Relevance to SAB strategic, current and/or future priorities
- Previous SARs locally, regionally and nationally (as relevant).
Agreeing the right approach
- Where it has been agreed that the review will focus on surfacing learning about what is facilitating or obstructing good practice in the case, have you made it clear whether or not you expect the SAR to:
- establish whether what obstructed or facilitated good practice in the case, was more widespread at the time and/or
- assess the current relevance of past practice barriers/facilitators identified in the case being reviewed?
- Where a similar case has been subject of an earlier SAR and/or the target of recent improvement activity, has there been adequate consideration of what a proportionate approach would look like?
- For example, beginning with the previous learning identified about barriers and enablers to good practice, and improvement actions proposed, and commissioning the new SAR to focus on where good practice has been facilitated, where barriers to good practice still need to be confronted and what has obstructed change, or whether the barriers have changed since the original SAR.
- For example, targeting the SAR only on practice areas / issues that appear to be new in comparison with the case previously reviewed.
- If consideration of the case and wider intelligence has identified an urgency to identifying and tackling the barriers to good practice in particular areas, have approaches that allow a speedy turn-around of learning been considered?
- For example, the SAR In Rapid Time model.
- Where similar cases or circumstances have been considered recently for a SAR, that suggest a local learning need in this practice area, has consideration been given to a themed SAR?
- Has there been adequate expertise in research methods and/or quality improvement to inform agreement of the detail of the methodology proposed?
- Does the approach proposed strike the right balance between methodological rigour and proportionate use of resources/capacity relative to the learning and impact expected?
- Have you been allowed adequate influence on the scope, nature and approach for the review?
- Has the scoping process covered all areas and issues covered by the SAR Quality Markers?
- Have agreements been captured with suitable clarity and specificity?
- Are there any disagreements or conflicts of interest that need to be escalated at the start?
- Have you made available a standard scoping document anchored in the SAR Quality Markers to support decision making about the form, focus and approach for this SAR?
- Have decisions about the precise form and focus of the SAR to be commissioned been captured in a Terms of Reference that is published at the start of the SAR?
- Has the Terms of Reference consideration, as standard, of how race, culture, ethnicity and other protected characteristics as codified by the Equality Act 2010 may have impacted on case management, including recognition of unconscious bias.
- Is there agreement about what level and precision of detail is required to be captured about the case characteristics and where this will be logged, e.g. in the report or in a database managed by the SAB?