3. Summary of safeguarding activity in South Gloucestershire
The Safeguarding Adults Board oversees analysed data for safeguarding in South Gloucestershire via the Quality Monitoring subgroup. 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 an alert. Trained staff within South Gloucestershire make a decision based on the information they have been given as to whether the situation is one which requires further investigation within the safeguarding process. If so, 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 investigation including a risk assessment and the development and implementation of a safeguarding plan. This section of the report looks at data we have for safeguarding activity between April 2014 and March 2015.
From 2007 there has been a consistent increase in alert rates and this has continued into 2014-5. There was a rise from 1051 alerts in 2011-12 to 1226 in 2013-4 and in 2014-15 there have been 1586 alerts. About 50% of these alerts go on to have further work done. This used to be the point at which the process became a referral, however in order to ensure consistency across the country the point at which an alert is deemed to become a referral has changed and it is now further into the process which means that the number of “referrals” has reduced. The work however has continued to increase as each alert needs to be examined as before.
Completed referral by outcome
All alerts are carefully assessed. With further information gathering, some are found not to be safeguarding, some will concern an episode of abuse that has already been resolved and some will need further investigation. Whenever the episode is closed a decision will need to be made about whether the abuse is thought to have been substantiated. The charts below show a comparison between 2013-14 and 2014-15. The team who undertake most of the individual safeguarding has worked to ensure more clarity and avoid the use of “inconclusive” as an outcome except where there is no alternative. There has been a slight rise in the number which are fully substantiated and a significant rise in those which have not been substantiated, this would mean for example that the threshold of significant harm has not been reached or that there is no evidence the alleged abuse took place.
The slight rise in the numbers where the service user withdrew from the process may reflect the work under “making safeguarding personal” (see Spotlight section.)
Alerts by age and service user group 2014-15
There has been a fairly equal rise in alerts across all age groups. The Department of Health has changed definitions so the subsets within the age groups are not comparable and have become difficult to compare year on year. For example the numbers of people with mental health issues in the over 85 age group is known to have risen, however because people are now defined by the services they receive and many people are supported by mainstream social care services they are not showing as having a mental health issue.
N.B: No valid PCG recorded means that there is no definition of the person’s needs on the system.
Referrals by category of abuse 2013-14 and 2014-15
The changes in definition by the Department of Health were implemented in 2013/14 so these charts are directly comparable. This information is based on the referrals not the alerts and shows a slight increase in instances of neglect and a slight decrease in instances of physical abuse referred to South Gloucestershire for investigation.
Location of alleged abuse 2014-15
Source of referral 2014-15
The majority of referrals continue to come from alerts made by social care staff. The numbers coming from health staff have remained static, while the numbers from the police have doubled as have those from family and friends.
Institutional investigations 2014-15
There continues to be a significant number of full institutional investigations. The level of enquiry is proportionate and varies from a desk top review to a full investigation which can last for many months.
Based on the number registered with the Care Quality Commission, there are 22 care homes with nursing and 61 care homes without nursing in South Gloucestershire. There are 43 domiciliary care providers, 8 supported living services and 6 extra care housing services. There are 861 beds within the care homes with nursing and 968 within the care homes without nursing. The majority of nursing homes are for older people and have between 40 and 80 beds. The care homes range from 4 to 50 beds and many are small with between 4 and 10 beds providing services for people with learning difficulties.
During 2014/15 a significant number of services were subject to examination by the institutional safeguarding team. This was triggered either when someone raised a concern about the whole service or the institution had 3 individual alerts in a six month period. Each investigation involves examining the alerts to establish if there are any themes and also reviewing whether the alerts were substantiated. If there are concerns contact is 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.
There were 84 occasions where concerns progressed beyond the initial screening. Of these 52 went to a full review with other services from relevant agencies and this was sufficient to satisfy the teams that no further action was needed. In five instances the services were within the Bristol area who took the lead with our support and involvement. Of the remaining 27 in South Gloucestershire there was more significant multi-agency engagement and action. In handful it was necessary to stop placing people with a service whilst action was taken to ensure a safe provision. Of the 27 circumstances, 13 investigations related to nursing homes. Three homes were involved twice and one home has remained in safeguarding for most of the year and continues to be monitored. Two care homes and two supported living providers also required this level of intervention. In all of these 27 cases there was strong multi-agency work including Care Quality Commission, local health services and commissioners.