Sexual incidents in adults social care: evidence review briefing

This briefing summarises the Sexual Incidents in Adults Social Care Evidence review commissioned by the Department of Health and Social Care (DHSC). The evidence review aims to identify the scale and nature of sexual abuse in adult social care settings. The review consists of:

• administrative data analysis of statutory notifications received by the Care Quality Commission (CQC) and the Safeguarding Adults Collection held by NHS Digital
• a review of the literature
• analysis of relevant National Safeguarding Adults Reviews.

Seven review questions

The seven review questions are:

1. What is the incidence/prevalence of sexual abuse in adult social care settings in the UK?
2. How is sexual abuse defined in the studies and in the sector?
3. Which groups of people are most at risk of being affected by sexual abuse in adult social care settings?
4. What knowledge do we have about the perpetrators of sexual incidents?
5. What knowledge do we have about the contributing factors which allow abuse to happen in social care settings?
6. What do we know about how adult social care settings try to prevent or respond to sexual abuse?
7. What are the gaps in existing evidence?

Recommendations

This briefing and the recommendations are relevant to anyone working in adult social care or safeguarding including DHSC, CQC, NHS Digital, local authorities, safeguarding adults boards, commissioners, providers, and groups that work with victims of sexual incidents including the police, health services and victim support.

Recommendations are made under three themes and include:

Addressing the data and evidence gaps

• Support the current, ongoing work by the CQC to both standardise the reporting of incidents and harmonise data sets held by the CQC, which will be important to allow ongoing and meaningful analysis of the data.
• Support the ongoing work by NHS Digital to implement changes to the annual Safeguarding Adults Collection, which includes presenting the data in a way which cross-tabulates the abuse type and the setting of the abuse, and work to address the variation in how local authorities record and report abuse or neglect.
• Undertake further work to analyse additional data held by CQC and by local authorities, which is currently in the form of files attached to individual notifications and reports.
• Consider options for a collecting and analysing data on incidents where staff have experienced abuse.

Training and development for staff and people drawing on services

• Support the recommendations of the CQC (2020) report that training for staff in relation to personal relationships is needed
• The development of guidelines and training to support staff to identify sexual incidents, respond to incidents and manage the reporting of such incidents
• Greater education/training programmes for those with learning disabilities, to increase their understanding of their sexual rights
• Continue to support the current, ongoing work by Skills for Care and Supported Loving to develop training for staff in relation to sexuality and personal relationships, following the recommendation made in CQC’s (2020) report.

Risk assessments and safeguarding

• Review risk assessment processes and their use, in order that they include the mix of people in care settings, not just the individual
• Introduce a clearer safeguarding process for perpetrators of abuse, in addition to the safeguarding process for people who have experienced abuse
• Ensure that allegations of past abuse by staff are not lost in database changes
• Embed routine risk assessment meetings where a person with learning disabilities is charged with a sexual offence which does not result in a conviction, to produce a revised and robust risk management plan