Safeguarding Adults, England, 2018-19

This publication provides the findings from the Safeguarding Adults Collection (SAC) for the period 1 April 2018 to 31 March 2019. Safeguarding Adults is a statutory duty for Councils with Adult Social Services Responsibilities (CASSRs) in England under the Care Act 2014, in order to safeguard adults from abuse or neglect. For ease of reading and consistency ‘local authority’ will be used subsequently in this report to refer to CASSRs.

This publication presents information about safeguarding concerns that were raised and where enquiries took place during the year. It also contains case details for safeguarding enquiries which concluded during the reporting period. A safeguarding concern is where a local authority is notified about a risk of abuse or neglect which could instigate an enquiry under local safeguarding procedures.

The data used in this publication were collated by NHS Digital from the SAC mandatory data collection of all 152 local authorities in England. Data was provided in aggregate form and therefore no individual’s details have been passed to NHS Digital.

The publication consists of:

• data tables providing data at local authority, regional and national level
• data quality assessment, including data completeness and integrity measures
• supporting information
• open data
• the Adult Social Care Analytical Hub, an interactive business intelligence tool 

In order to prevent the risk of disclosure of data about individuals, figures 0, 1, 2, 3 and 4 are displayed as a "*" (star symbol) in the data tables. All other figures have been rounded to the nearest multiple of 5. Proportions (percentages) are calculated on the unrounded figures.

Within the collection and this publication we distinguish between Section 42 part 2 enquiries that met the criteria under Section 42 part 1 of the Care Act 2014 (referred to in the report as ‘Section 42 enquiries’) and those where the adult did not meet all of the Section 42 part 1 criteria, but the local authority considered it necessary and proportionate to have a safeguarding enquiry. These are referred to in the report as Other enquiries.

Data on Section 42 enquiries is mandatory to collect except for the data on ‘Making Safeguarding Personal’, which is voluntary.

Data on Other enquiries is voluntary to collect and submit, except for one table, which captures the overall number of Other enquiries that commenced in the reporting period.

Similarly, data on safeguarding concerns is voluntary to collect and submit, except for one table, which captures the overall number of concerns received in the reporting period.

This publication is labelled as Experimental Statistics, in line with previous publications of adult safeguarding statistics. Within the time of the SAC collection (since 2016) there has been a degree of change, although the collection has not changed in the latest year. Furthermore, limitations remain around interpretation and usage of the data due to local variation in how safeguarding activity is defined and reported (this is explained further within the Data Quality Key Information section). This is being addressed via alignment of the SAC to a framework to support local safeguarding decision making, developed by the Local Government Association and the Association for Directors of Adult Social Services. The Experimental label will be reviewed in subsequent releases, once the impact of this new framework is observed.

The Care Act 2014 came into effect on 1 April 2015. It reformed the way the adult social care system works in England, including how care is delivered. The changes included a range of new obligations for local authorities around the provision of information and advice, the integration of care and support with health-related services and eligibility assessments. It also strengthened the rights and recognition of carers in the social care system, and (relevant for this collection) provided a legal basis for safeguarding adults from abuse or neglect.

 Safeguarding Adults is a statutory duty of the Care Act, and must be seen within the context of broader Care Act reforms, which introduced a duty to promote wellbeing and to ‘adopt a flexible approach that allows for a focus on which aspects of wellbeing matter most to the individual concerned’. Application of the six statutory safeguarding principle and Making Safeguarding Personal supports practice capable of achieving a wide range of responses tailored to meet the needs of the individual.

Under the criteria set out in Section 42 part 1 of the Act:

Where a local authority has reasonable cause to suspect that an adult in its area (whether or not ordinarily resident there):

(a) has needs for care and support (whether or not the authority is meeting any of those needs) and

(b) is experiencing, or is at risk of, abuse or neglect and

(c) as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it,

then the local authority must, as set out in Section 42 part 2 of the Act, make (or cause to be made) whatever enquiries it thinks necessary to enable it to decide whether any action should be taken in the adult’s case and, if so, what and by whom.

The SAC has been in place since 2015-16 and is an updated version of the Safeguarding Adults Return (SAR) which collected safeguarding data for the 2013-14 and 2014-15 reporting periods. Changes were made to bring the collection in line with the Care Act (2014). Some of the categories collected have remained the same but there are also some significant differences. The main change was in how cases opened in the reporting year are categorised. Previous reports used individuals “Known” and “Unknown” to the local authority, but this distinction has been removed. Previous reports recorded details of individuals with Safeguarding Referrals, but the SAC now records individuals with Safeguarding Enquiries. While these will be largely equivalent, they may not be directly comparable, and care will need to be taken when comparing recent publications with data prior to the 2015-16 reporting period contained in the two SAR reports.

The data collection has evolved since then in fairly minor ways, with any changes being signed-off by the appropriate governance boards. The approval process involves the SAC Working Group (comprising a cohort of local authority safeguarding leads and performance leads to advise on the data collection), the Adult Social Care Data Delivery Action Group (a national group overseeing adult social care data collections, publications and the working groups, and which consists of NHS Digital, Association of Directors of Adult Social Services, Local Government Association, Care Quality Commission and Department of Health and Social Care) and the Adult Social Care Data Outcomes Board (a strategic national group setting the priorities for adult social care national data collections, publications and associated developments).

Any changes to the collection have been communicated to local authorities via the annual ‘September Letter’ and the associated social care collection materials.

There were no changes to the SAC data collection for 2018-19.

This publication may be of interest to members of the public, policy officials and other stakeholders at local and national level, to support adult safeguarding policy development and reforms and to monitor services.

In particular, local authorities may find this data helpful in shaping services and making improvements, especially in terms of evaluating their services and comparing them with previous years or to share best practice with colleagues in other authorities. It is recommended that this data be used alongside local data and other forms of information (such as audits, peer reviews, feedback from adults themselves and staff) by Safeguarding Adults Boards and local authorities to ask questions and to seek necessary assurances about the effectiveness of safeguarding practice and outcomes.

Officials in the Department of Health and Social Care (DHSC) can use the data contained within this publication to make decisions about national policy and practice.

Members of the public and other stakeholders, such as charity organisations, can also use this SAC publication to help to understand safeguarding procedures and their outcomes.  

In previous years an annual report has formed part of this publication. This provided a broad range of in-depth analysis and commentary around the data. This is not included this year, however the data released remains the same.

Instead of providing this analysis upfront, NHS Digital encourages any users wanting bespoke additional analysis to request this directly and we can work with you to understand your requirements and provide the data. We hope this will provide a more responsive and valuable service to meet your needs. Please send any such requests to [email protected]

Please note that although the data released remains the same the data tables have been reformatted. The table below shows last year’s annex tables and where they map to in this publication.

Annex G from the 2017-18 publication has been reformatted to a csv file. The data in the csv is the full data set submitted by each local authority and the same data as included in Table 5 of the 2017-18 Annex G. The data has been reformatted into a csv to allow easier manipulation and processing of the data by users.

There is a significant degree of variation between local authorities for certain measures. In many instances this variation will result from differing interpretations of the Care Act (2014) and different practices by local authorities, rather than from poor data quality per se.

In order to better understand local practice across England, NHS Digital undertook a voluntary survey of local authorities in 2018 to understand how they defined and recorded aspects of adult safeguarding within their SAC submission. Responses to the survey can be used to inform analysis of the data published in this release, in order to aid interpretation of the data submitted by local authorities and any differences between local authorities.

Additional care must be taken in particular when comparing the following areas:

Safeguarding concerns:

The data identify a wide variety in the numbers of concerns submitted by local authorities. Discussions with local authorities have identified that differing approaches to how concerns are addressed by the ‘front door’ services will vary between them. In some local authorities concerns are filtered out before they reach the safeguarding team and are not included in the submitted data. Where they exist, Multi Agency Safeguarding Hubs (MASHs) may have an impact on the numbers of concerns that are reported in the SAC.

Trigger for a safeguarding enquiry:  

A safeguarding enquiry starts when the initial information gathering has established that there is reasonable cause to suspect that all three of the Section 42 part 1 (S42(1)) criteria are met, or where the criteria are not met the decision has been made that it is necessary and proportionate to respond as a safeguarding enquiry (called Other enquiry).

At present we know there is variation in the point at which initial information gathering, following a concern being raised, then triggers a Section 42 part 2 enquiry (simply called a Section 42 enquiry in the SAC) or Other enquiry, according to explanations provided by data providers.

There is no fixed point during the early phase of an enquiry when a practitioner must determine how to report activity within the SAC return. It may be that this is determined, and therefore recorded and reported as a Section 42 enquiry, after the practitioner has already done part of it. Reporting and recording reflect practice decisions.

Section 42 and Other enquiries:

The methodology by which local authorities determine whether enquiries are undertaken under Section 42 part 2 of the Care Act (2014) or not varies, as can be seen from the counts of Other queries submitted in the SAC. As much of the data on Other enquiries is voluntary to submit, including demographics of the individuals involved and the nature of the risks faced, we are unable to reliably analyse this in further depth (58.4% of cells submitted in 2018-19). Therefore, care should be taken when comparing data as there may not be a complete picture of safeguarding in those authorities with high numbers or proportions of Other enquiries. It should be noted that the distinction between Section 42 and Other enquiries only exists within the SAC; as part of the survey of local practice 43.6% of completed responses stated that the distinction between Section 42 and Other was not used for local operational or reporting purposes.

‘Conversion rate’ of concerns to enquiries:

There should be no logical conclusion drawn that the number of safeguarding concerns that lead to a Safeguarding enquiry is a reliable indicator of whether people are protected. This must not be used as a comparator for effectiveness and care must be taken in analysing conversion rates and they cannot be used to inferring ‘good’ or ‘bad’ safeguarding practice. Local information about those circumstances that do not warrant such a statutory enquiry will support a broader picture about the effectiveness of safeguarding support in a local area. Aspects of the data and other available information should be used as a ‘can opener’ to ask questions rather than attempting to draw generalised conclusions.

Current developments:

As we have acknowledged the Care Act (2014) is open to local interpretation, however attempts are being undertaken to help develop a framework around elements of the Care Act to result in more consistent approach to defining these key elements and reduce variation. This is being led by the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS). In relation to safeguarding concerns, this aims to support consistent local authority decision making and achieve greater understanding across sectors of what constitutes a safeguarding concern so that people get a response that is right for them. This may have an impact on the data that is collected in the SAC and will be taken account of for future years.

In relation to safeguarding enquiries, the framework for Making Decisions on the duty to carry out Safeguarding Adults enquiries was published in August 2019 by LGA. Whilst this framework has been developed to support safeguarding practice it also offers clarity on elements of reporting in the SAC around Section 42 enquiries and we have refined the data collection guidance in order to improve consistency of reporting, in accordance with this new framework. The framework was published halfway through the reporting year 2019-20.  The full impact of this framework will only be seen in 2020-21 because this will be the first full year in which the framework can influence practice and reporting.   At this stage the Experimental Statistics label will be reviewed.  

The new framework emphasises that the SAC reports activity under Section 42 part 2 (S42(2)) as set out above. It does not reflect significant and effective early intervention and prevention in safeguarding people, which takes place within S42(1) information gathering, to find out whether there is reasonable cause to suspect that the three statutory criteria are met. The framework underlines the importance of generating and making available local information (to complement the data in the SAC) to give broader assurance of effectiveness of support outside of S42(2).

Other issues relating to 2018-19 data:

All local authorities submitted a return for all mandatory cells by the mandated deadline; the returns yielded a national completeness and validity score of 100%. A new validation report  was sent to each local authority following a successful upload. This includes a summary of measures of data integrity that identified logically inconsistent combinations of data, such as situations where table totals or total of rows within tables should be logically lower, higher or equal to other tables / rows within the submission template. Local authorities were then given a further opportunity to make amendments to their submission. The summary measures indicate that the data submitted was valid and complete to a high degree.  

Some local authorities gave comments in their data return to explain errors or issues with their data. NHS Digital would like to thank these local authorities for their transparency. Specific key issues relating to local authorities are given below

Please see the Data Quality Statement for more information on data quality.