Abuse of vulnerable adults – referrals for investigation up 4% this year

Caroline Norrie, Research Fellow at the Social Care Workforce Research Unit, examines figures published by the Health and Social Care Information Centre on the abuse of vulnerable adults in England in the context of the Models of Safeguarding research project being undertaken at the Unit.

English councils referred 112,000 cases of alleged abuse against vulnerable adults for investigation in 2012-13, a 4 per cent rise (from 108,000 in 2011-12) for the 151 councils which submitted data in both years. This is according to figures just released from the Health and Social Care Information Centre (HSCIC). This provisional report – Abuse of Vulnerable Adults in England 2012-13: Experimental Statisticsfinds the rate of referrals per 100,000 population was highest in the West Midlands (320), North West (300) and London (295) regions in 2012-13.

Safeguarding alerts (which are the initial point at which concerns are raised) have also increased during 2012-13.  A total of 173,000 alerts were recorded by 140 (out of 152) councils. Considering the 117 councils who recorded alerts in both years (comparing 2012-13 provisional data and 2011-12 final data), this is a sharp increase of approximately 19 per cent (rising from 134,000 to 159,000). However figure readers need to take into consideration councils’ different methods of categorising and defining alerts.  In some councils, all concerns received are recorded as referrals and cannot be split up for reporting, making this data complex to interpret.

We don’t know whether this steep rise is due to increased reporting as a result of greater public awareness about adult safeguarding, an actual rise in abuse – or a combination of the two.  From the point of view of public services however, it means more work at a time when resources are being cut.

HSCIC chair Kingsley Manning said the report, ‘plays an important role in laying bare issues affecting some of the most vulnerable in society, the role of our local authorities and also that of the public in alerting councils to cases of alleged abuse.’

A very similar picture to last year is presented with regards to the characteristics of the people alleged to have suffered abuse, alleged perpetrators, locations and forms of abuse.  In 109,000 (of 112,000) cases referred for investigation in 2012-13, the following key information was known:

About the person alleged to have suffered abuse:

  • Just over three in five (61 per cent, or 67,000)1 were aged 65 or over.
  • Half (50 per cent, or 55,000) had a physical disability.
  • Just over three in five (61 per cent, or 66,000)1 were women.

Considering the case details of those 109,000 referrals (noting that an individual referral can contain more than one type, location or perpetrator of alleged abuse):

About the types of alleged abuse

  • Physical abuse was recorded in 39,000 allegations (28 per cent)
  • Neglect was recorded in 37,000 allegations (27 per cent)

About the alleged perpetrators:

  • Social care workers were recorded in 35,000 allegations (31 per cent)
  • A family member was recorded in 25,000 allegations (23 per cent)

About the Location of alleged abuse

  • The vulnerable adult’s own home was recorded in 43,000 allegations (39 per cent)
  • A care home was recorded in 40,000 allegations (36 per cent)

About the Case outcomes

Considering the 86,000 completed referrals where a case conclusion was recorded:

  • 37,000 were either partly or fully substantiated (43 per cent)
  • 26,000 were not substantiated (30 per cent)
  • 23,000 were inconclusive (27 per cent)

HSCIC chair Kingsley Manning noted, ‘This report in many ways makes for uncomfortable reading, not only that thousands of cases of potential abuse against vulnerable adults are being investigated each year, but more particularly that a substantial number are proven to be of substance’.

A final, more detailed AVA Report 2012-13 will be published in March 2014 when post-submission validation checks will have been carried out on the data submitted by councils.

I am currently part of a research team investigating the advantages and disadvantages of different models of adult safeguarding. Our study has been funded by the NIHR School for Social Care Research and continues our long tradition at King’s College London of research on this subject. A key part of our present study will be analysing and comparing the AVA data for six selected councils which use different approaches to organising their adult safeguarding services. As part of this study, we have recently interviewed 24 adult safeguarding managers about how they organise adult safeguarding in their areas.  Comments about the AVA returns made during these interviews include that the AVA returns are valuable in making comparisons between local authorities, but the information is viewed as provisional, given the complexity of data collection.

Some difficulties with the AVA collection are outlined in the HSCIC report. There may be a great deal of under-reporting as the data does not include cases where partner agencies dealing with an allegation do not share the information with the council. The collection only covers abuse perpetrated by others (it does not include self -harm or self-neglect)  – and these issues also need to be addressed when considering the most effective ways to support adults at risk who may decline help or care. Also, a single referral can relate to different types of alleged abuse, locations or perpetrators and may have more than one outcome for the alleged victim and/or alleged perpetrator. It is also important to remember that these figures do not represent the number of adults at risk who have been referred. They relate to individual referrals: the same person may have multiple referrals in a year.

Councils in England submitted data voluntarily to the national Abuse of Vulnerable Adults (AVA) collection in 2009. Since 2010-11, the Minister for Care and Support mandated submission of AVA collections to the HSCIC, and for the 2012-13 period, 151 out of 152 local authorities have complied. This is a major development and one which is enriching our knowledge and helps develop services.

2012-13 is the last year for collection of the AVA return.  Information about adult safeguarding activity will be then be collected through a new Safeguarding Adults Return (SAR). The SAR is one of the outcomes of a review of adult social care data collections.  Many of the same data will be collected, but it will be more focused on outcomes of safeguarding and alert data will no longer be collected.

We look forward to studying the 2013 AVA returns in greater detail – and to making comparisons with the SARs in the future. If you are interested in receiving information about our current study or having a copy of our bibliography covering our other research and publications on adult safeguarding please get in touch.

You can contact Caroline Norrie at King’s here: caroline.norrie@kcl.ac.uk

  1. Figures have been rounded to the nearest thousand.

5 thoughts on “Abuse of vulnerable adults – referrals for investigation up 4% this year

  1. There’s a simple reason for rise in numbers. More people and services realise ASC have tighter and shorter timescales to respond to a SG Alert, than a regular request or referral for a needs assessment.

    SG Alerts are being used as a referral to receive a quick response, allocation and assessment, thus the high numbers of inconclusive or unsubstantiated. Would be interesting to see if of those how many actually did have services arranged. I suspect a fair few.

    • From experience this is definitely the case where e.g. health workers seek services / support for someone they deem in urgent need of services who is not in receipt of them.

      But unfortunately social workers not being too bright in many cases actually are unable to assess this correctly so think they have to investigate a safeguarding issue, but fail to do so adequately and those in need tend to not get immediate services either. Basically use of safeguarding alerts in this way is giving an idea of abuse levels which are false.

  2. Thank for your comments – and for opening up debate about the AVA returns.

    We will be carrying out research with service users to try and address the issue you have raised about clients’ satisfaction and real life experiences of adult safeguarding, rather than simply looking at the figures and assuming social worker judgements are correct. We will also be including a service user survey in our study.

    I think it is positive if this data collection can be used to pinpoint trends about adult abuse, giving councils better information for developing their services.

    • What you will not easily pick up, which is rather important because the push by adult social work to be seen as ‘experts’ in adult safeguarding is hiding the truth, is the inconsistent thresholds applied nationally for accepting a case as serious abuse which needs investigation / action by social services. Some lawyers and carers too have flagged up inconsistencies in the way safeguarding is undertaken from initial assessment to action (or even often inaction). The skills and sbilities of social workers are not high or robust, as the Daniel Pelka case once again shows. If this is so for child protection, it is not less so for adult abuse detection and protection, which is newer.

      This leads to inconsistent actions / outcomes and sometimes, as I have noted cases which could hardly be deemed serious abuse, the wasting of scarce resources.

  3. “…more particularly that a substantial number are proven to be of substance’.”

    It is interesting how a vested safeguarding industry presents rather skewed information. The fact is there are 57% (which is roughly as in previous years) of unsubstantiated / inconclusive cases reported in these figures. The figures also are rather geared towards assuming that social work judgements are correct in safeguarding (or any other aspects) work… which is factually not so if you look at real life experiences, rather than uncontested data.

    Also the myths about family being the greatest perpetrators, as often spouted by ‘the industry’ is not borne out here either. Social services do not seriously investigate care agency staff, assuming profitable agencies are ‘going to come clean and do the investigation thoroughly themselves’. Businesses would never lie would they?

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