Safeguarding Adults

Safeguarding Adults A study of the effectiveness of arrangements to safeguard adults from abuse. Sue Toole and Louise Lawton

To inform the review of ‘No secrets’ To look at arrangements for safeguarding – not prevalence To look across councils and regulated services Aims of the study

Councils: Self-assessment data (all 150 councils) Service inspections (23 councils) In-depth case tracking and workshops (5 councils) Regulated services: Performance against National Minimum Standards (all 22,000 services) Thematic probe (250 services) In-depth thematic inspections (94 services) Evidence

Uneven progress in developing effective safeguarding arrangements by councils and care services leading to… Variability in quality of support to people who experience abuse – unacceptable in human rights context More needs to be done to ensure people directing their own support benefit from appropriate and individually tailored safeguards Overall picture

Variability in prevention of abuse and long term support after abuse Best councils – active leadership and strong partnerships but big distance between best and worst Councils performing well on safeguarding had more care services performing well in their area Care services with higher quality rating generally were better at safeguarding people Overall picture

People’s experiences of safeguarding arrangements Quality of support and care practice Checking and improving arrangements Local strategic work Looking in more detail at

Councils are getting information out to older and disabled people but this does not always reach all groups If abuse is reported, the response is quick but some people feel they lose control in the process Advocacy is valued, but in short supply People’s experiences of safeguarding arrangements

Councils are providing some options to help prevent abuse for people directing their own support, but no council had a systematic approach In care services, many people did not remember being given information about what to do if they have concerns about abuse 4 out of 5 people using care services felt able to speak to manager/staff if they felt unsafe 3 out of 5 were confident of action if they reported a concern People’s experiences of safeguarding arrangements

Unacceptable variability in gathering information, risk assessment, protection plans, case recording Distinguishing safeguarding allegations from other concerns - the best councils used broad definitions and a number of options of approach, depending on circumstances Information sharing protocols generally good – difficulties in practice with GPs, hospitals, mental health services and care providers Quality of support and care practice - councils

Support to people after abuse variable – a “menu” of options for support is needed People abused in residential settings need more individual support Patchy use of legal powers - many council staff need better understanding of legal remedies More staff are trained in safeguarding but the independent sector need more access to training on local arrangements Quality of support and care practice - councils

CSCI are more likely to receive safeguarding alerts about poor services % of regulated services meeting the National Minimum Standard (NMS) on ‘protection from abuse’ has risen across all service types since CSCI started regulation Private sector services are least likely to meet the protection standard Thematic inspection suggests performance on outcomes may be worse than NMS figures suggest Most common shortfalls: staff training and implementation in practice, policy/procedure and recruitment practice Quality of support and care practice – care services

Managers of care services in better performing councils knew more about local safeguarding procedures Providers’ policies need to dovetail with local procedures CRB checks are universally used, other recruitment checks less consistently evident 40% managers did not understand the POVA list Higher rated services had tended to have more staff trained in safeguarding Quality of support and care practice – care services

2/3 of councils are failing to monitor adequately at a casework level At a strategic level, levels of activity are monitored but most councils need to improve measures of experience and outcomes Commissioning safe services is variable – but 3 star councils have a higher % of services in the area meeting the NMS protection standard Checking and improving arrangements - councils

Checking and improving arrangements – care services • Only 38% of managers said they had used experience from a safeguarding incident to improve practice • Only 16% said that they enabled people using the service to feedback on how services could make people feel safer • High rated services were performing better in learning from incidents and using feedback surveys

Checking and improving arrangements – the regulator • CSCI have a protocol with ADASS and ACPO to ensure regulatory practices reduce the risk of abuse • and a policy to differentiate complaints and abuse allegations • Inspection work in care services now targets services needing closer monitoring • Safeguarding is a ‘key threshold’ in performance assessments of councils • A strengthened focus on safeguarding is needed in new regulatory frameworks

Local strategic work - councils • Variation in priority of safeguarding shown by differences in: resources, representation on Safeguarding Boards, profile in commissioning strategies and numbers of alerts • Only ½ Adult Safeguarding Boards are working well • Most struggle to engage people using services and other members of the public • Most are developing strategic work but safeguarding is not a theme across all relevant strategies • At different stages in including safeguarding in commissioning strategies

Conclusion - Improving the current situation • Mixed views about changes to the law • Most support for duty to co-operate and share information across agencies • Most support for change in council areas where difficulties are experienced with joint working • Regardless of changes to the law, more work to “design safeguarding into services” is essential….

Conclusion - Key elements of prevention/ early intervention • People supported to exercise the right to be free of abuse including access to advocacy • Vetted and competent workforce • Good universal services to reduce risk of abuse • Needs assessments and risk assessments to inform people’s choices • Sound confidentiality and information sharing • A range of options for support to keep safe that can be tailored to individual’s needs • Services promote safeguarding and independence • Public awareness of the abuse of adults

Safeguarding Adults