Gateshead Safeguarding Adults Annual Report 2023/24

Volume of concerns and enquiries

For a Concern to progress to a Section 42 Enquiry it must meet the statutory criteria. The Safeguarding duties apply to an adult who:

• has needs for care and support (whether the local authority is meeting any of those needs)
• is experiencing, or at risk of, abuse or neglect
• as a result of those care and support need is unable to protect themselves from either the risk of, or the experience of abuse or neglect

In 2023/24 there were 3862 Safeguarding Adult Concerns which led to 929 Section 42 Safeguarding Enquiries. This demonstrates a significant increase in the number from 2022/23. During 2023/24 the Safeguarding Team introduced a change in process introducing a triage model for dealing with safeguarding concerns. This saw a significant increase in the volume of concerns. The change in process ensures the recording of safeguarding concerns is in line with statutory guidance. Recording of cases which meet section 42 criteria, but risks were managed was revised and this has also demonstrated an increase in S42 enquiries.

See slide 67 for further information on the bespoke strategic safeguarding support from the Local Government Association's Partners in Care and Health programme, which led to the new triage model being implemented permanently.

In percentage terms, 24% of Concerns led to a Section 42 Enquiry. The number of concerns progressing to an enquiry remains lower than both the 2023/24 NE (47.1%) and England (29.47%) averages.

The change in process and introduction of the triage process saw the volume of concerns significantly increase during 2023/24 from the previous years. It has also resulted in an increase in the number of s42 enquiries. This data also shows that a large proportion of concerns do not progress from a safeguarding concern and that people have received multiple concerns in the reporting year.

Work continues to improve the knowledge and understanding of practitioners in what constitutes a safeguarding concern and in providing a robust process for low level concerns.

Categories of abuse

Utilising a count of completed Section 42 Enquiries, and allowing for multiple recording of abuse, the most common category of abuse in Gateshead continues to be Neglect and Acts of Omission which represented 34.9%. In a change to previous years the second most common category was Financial and Material abuse (15.9%) an increase of nearly 4% from the previous year, followed by Physical Abuse (13.5%) a reduction of nearly 5% from the previous year.

Financial and Material abuse has been added to the Safeguarding Adults Board Data Group action plan for further analysis and investigation.

Demographics

In Gateshead in 2023/24 44.7% of section 42 enquiries were for adults aged 18 to 64 which is an increase of over 12% from the previous year. The other age groups saw smaller reductions from the previous year. As a proportion this is now closer aligned to regional and national figures for this age group (43-50%). The gender split is consistent throughout recent reporting years and is aligned to national and regional figures which show a 60:40 split in gender. Proportions of primary support reasons remain consistent with previous years and national data.

Location of abuse

The reporting year saw a shift in location of s42 enquiries where a greater proportion were in a person's own home (52.4%). This could be linked to the increase in the proportion of concerns coming from the 18-64 age group and the likelihood this age group do not reside in a care home. This also aligns our proportions to the previous national and regional figures which is around 45-50%.

Concluded S42 enquiries

The proportion of Action Taken from concluded s42 enquiries is equivalent to regional and national figures however this is the lowest for Gateshead in the past 5 years (Highest 94%, lowest 89.2%). Concluded s42 enquires where the risk remained (12.1%) is the highest it has been in the past 5 years and is slightly higher than previous national and regional figures (5-9%).

Risks expected outcomes and making safeguarding personal figures have been investigated and the service has acknowledged some data quality issues which were attributed to deadlines around the new system implementation and data to be migrated. Closing the volume of enquiries on the system was prioritised over the usual quality assurance to reduce the amount of manual work when Mosaic went live.

Deprivation of Liberty Safeguards (DoLS)

For the period April 2023 to March 2024 Gateshead Council received 2840 Deprivation of Liberty Safeguard applications. This was an increase in activity from the previous financial year (2246). The demands placed on local authorities in meeting statutory obligations remains high. Gateshead are compliant with care home DoLS, and do not have a waiting list.

The highest rate for DoLS applications remains with those over the age of 65. Within Gateshead this represents 2084 applications (73.4% of all applications) and for those aged under 65, 756 (26.6%) for those under 65.

There were 729 applications which have not been authorised, due to various standard reasons. The primary reason for non-authorisation of a DoLS was down to a 'Incomplete', which took place in 564 cases.

Commissioning Concerns

The number of provider concerns increased to 262 in 2023/24 from 237 in 2022/23. Medication was the highest category in 2022/23 at 21.3%, this has significantly reduced to 7.25% in 2023/24. Standards of Care was the highest category at 15.6%, followed by Hygiene Issues 11% and then Documentation Issues at 9.5%. Staffing issues remain high at 23.7% this is an increase on 19.5% in 2022/23 and demonstrates the continued difficulty in recruiting staff in the health and social care sector.

OP Residential & Nursing establishments receive the highest number of concerns at 55% of all concerns received, this is an increase from 47.7% in 2022/23 but in line with the figures from 2021/22 at 54.4%. This is followed by Generalist Homecare with 29% of the concerns.

Challenges remain in the system in relation to the high numbers of staff turnover within the health and social care system and the impact of this. There continues to be a poor understanding of the various reporting mechanisms for reporting safeguarding concerns, commissioning concerns and quality of care concerns, which impacts on commissioning's ability to address issues. This is being addressed by the review of the decision-making tool and introduction of more robust processes for triangulating information between adult social care, health and commissioning services.