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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.

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safeguarding adults

Safeguarding Adults

A study of the effectiveness of arrangements to safeguard adults from abuse.

Sue Toole and Louise Lawton

aims of the study
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
evidence
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
overall picture
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
overall picture5
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
looking in more detail at
People’s experiences of safeguarding arrangements

Quality of support and care practice

Checking and improving arrangements

Local strategic work

Looking in more detail at
people s experiences of safeguarding arrangements
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
people s experiences of safeguarding arrangements8
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
quality of support and care practice councils
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
quality of support and care practice councils10
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
quality of support and care practice care services
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
quality of support and care practice care services12
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
checking and improving arrangements councils
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
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
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
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
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
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