Summary of safeguarding activity in South Gloucestershire
The Safeguarding Adults Board oversees analysed performance data for safeguarding in South Gloucestershire via the Quality Assurance subgroup, and at the full Board.
When someone contacts the council’s customer service desk about a situation which concerns them, a record is made of that contact. This is called a safeguarding concern. Trained staff make a decision based on the information they have been given as to whether the situation is one which requires further enquiries within the safeguarding process.
Example of a safeguarding concern one
Mary’s mother was not given her medication this morning. When Mary speaks to the nursing home staff they check with a health colleague who says the medication can be given later. This would be recorded but not progressed as a safeguarding concern.
When a concern is raised, a referral is generated. The referral will be closed at the end of the safeguarding involvement whether this is after a few days of information gathering and analysis, or after several months of enquiry, including a risk assessment and the development and implementation of a safeguarding plan.
Example of a safeguarding concern two
Mary’s mother was not given her medication this morning. This is medication for Parkinson’s disease and is time specific. When Mary speaks to the nursing home staff they don’t seem worried and say she will just get her next dose on time. This is likely to progress to a further enquiry.
This section of the report looks at data we have for safeguarding activity between April 2016 and March 2017.
The reason for an apparent drop in referrals, is that lower level concerns, such as the example given about medication being missed with no risk (example one) are no longer counted as a safeguarding referral, but are recorded separately. If both sets of figures were to be combined, there would in fact be an increase.
There have not been major changes in the categories of abuse, they remain consistent with last year’s figures. There has been a slight change with referrals about organisational abuse, as in the previous year this was 0%. We have improved our recording of categories during this period.
This chart demonstrates a comparator with the rest of England from the most recent statistics available (NHS Digital). Our proportion of neglect cases are slightly higher than the national percentage, but overall our statistics are broadly in line with the rest of England.
The category elderly (not EMI) is an old category of recording and one that is no longer being used. For younger people, the majority of concerns relate to mental health and learning disability. These have a tendency to be lower level concerns. The number of all concerns reported for those over 65 is much greater and the majority of work happens with older members of the population.
The most recent national comparators (England) show that South Gloucestershire statistics are in line with the rest of England in terms of the primary support reason.
Physical Support is 42% for England and 39% for South Gloucestershire.
Learning Disability Support is 14% for England and 15.4% for South Gloucestershire and Mental Health Support is 12% for England, and 11% for South Gloucestershire.
The age statistics for England also show that South Gloucestershire’s statistics are as expected. For England 36% of alerts are for the 18-64 age group and in South Gloucestershire 37%. Both the England statistic for those aged 65 and above and the South Gloucestershire statistic are 63%.
The majority of safeguarding concerns continue to come from social care staff. Figures remain fairly constant when compared with previous years.
There has been a rise over this period in cases where risk has been identified. This has risen by 6.5% when compared to the data from 2015-16.
Organisational enquiries for 2016-2017 (previously institutional investigations)
In June 2016 South Gloucestershire Safeguarding Adults Board adopted the multi-agency procedures developed across five local authority areas of Bath & North East Somerset, Bristol, South Gloucestershire, North Somerset and Somerset. In September 2016 supplementary practice guidance was adopted to accompany the procedures in relation to responding to organisational abuse.
There is a need for assessment and judgement in determining when poor practice becomes an adult safeguarding issue. Addressing four key questions will support the decision to initiate an organisational abuse investigation:
- Is the incident of a type to indicate organisational abuse?
- Is the incident of a nature to indicate organisational abuse?
- Is the incident of a degree to indicate organisational abuse?
- Relating to these three questions, is there a pattern and prevalence of concerns about the organisation?
Based on Care Quality Commission numbers, within South Gloucestershire there are:
- 58 care homes
- 22 care homes with nursing
- 46 domiciliary care providers
- 9 supported living services
- 6 extra care housing services.
There are 921 beds within the care homes with nursing and 951 within the care homes.
This reflects the fact that the majority of nursing homes are for older people and have between 40 and 80 beds. The care homes will range from 4 to 50 beds with many being small homes in the 4 – 10 bed range providing services for people with learning difficulties.
There continue to be a significant number of full organisational enquiries. The level of enquiry is proportionate and varies from a desk top review to a full enquiry and follow up which can last for many months. These enquiries are triggered either when someone raises a concern about the whole service or the organisation, or where there are a pattern of concerns. Sometimes enquiries begin because no safeguarding concerns have ever been reported. This review involves examining the concerns to establish if there are any themes. If there are concerns, contact would be made with commissioning teams to determine next steps. The aim is to achieve the earliest intervention with providers in order that concerns are tackled effectively and promptly.
In 2016- 17 there were nine occasions where situations progressed beyond the initial screening and went to a full review with other services within the multi-agency forum. In a small number of situations it was necessary to stop placing people with a service whilst action was taken to ensure a safe provision.
We work closely with neighbouring local authorities and other placing authorities, especially where residents are from outside South Gloucestershire or residents of South Gloucestershire are placed elsewhere.
Equalities Impact Assessment
Each quarter the SGSAB receives a performance report which includes information related to equalities data.
Referrals into social care show that 85.5% of referrals are for people who describe themselves as White British. 5.4% of referrals are for people who describe themselves as ‘other ethnic group’. This shows that our referrals received for people of other ethnic groups is lower than would be expected when compared to the population of South Gloucestershire (8.3% other ethnic group). However, 3.5% of people refused to give ethnicity data and for 5.6% this data was not obtained.
For adults aged 18-64, 57% of referrals are for women and 43% for men. This shows that males are underrepresented when compared to expectations based on population data for South Gloucestershire. For adults aged 65+, 66.3% of referrals are for women, and 33.7% for men. Again this shows that males are underrepresented when compared to expectations based on population data for this age group in South Gloucestershire.
40.8% of referrals received are for adults where the primary support need is a physical disability and 16.4% where the primary support need is a learning disability. This is in line with national data which shows a similar rate of referrals in respect of the protected characteristic of ‘disability’ (England: 40% physical disability; 15% learning disability).
As a Board we will monitor on an ongoing basis throughout 2017-18 to look for any emerging trends. We will do this by examining the performance data on a quarterly basis.
Should trends emerge we will formulate a plan to address this.