Covid delays in adult safeguarding have led to ‘severe consequences’ for people needing services

Pandemic-related delays in responding to adult safeguarding concerns have resulted in “severe consequences” for people accessing or in need of services, with many reports being made later, meaning problems have become far more acute, complex and harmful.

The warning came among a series of findings in the latest report from the Covid-19 Adult Safeguarding Insight Project, through which the Local Government Association has been tracking the impact of the pandemic on adult safeguarding work.

“Many safeguarding concerns have been reported to adult social care services later than prior to the pandemic,” the report said. “This has been the case for particular types of abuse, such domestic abuse and self-neglect where lockdowns have increased the isolation of those experiencing abuse.”

Some councils taking part in the study reported an increase in domestic homicide reviews, while others noted rising levels of gang violence and related exploitation such as cuckooing. One recorded “a number of deaths of young adults on railway tracks”, all of whom were known to mental health services.

“Delayed issues are less likely to be case managed, instead becoming safeguarding concerns,” the report said. “Delays in referral have meant that there have been more acute or severe consequences, making preventative measures more difficult to implement or situations have been more likely to require crisis management.”

Concerns continue long-term upward trend

The Insight Project’s third report, covering the period up to June 2021, found that safeguarding concerns continued to increase since the start of the pandemic, with dips during lockdowns being followed by spikes as they were eased.

Section 42 safeguarding enquiries likewise rose and fell in line with coronavirus restrictions, although they did not increase overall. The report emphasised that the picture has been very different from council to council depending on local circumstances.

Across the most recent period evaluated by the Insight Project – December 2020 to June 2021, spanning the winter and spring lockdown – 72% of 50 participating councils reported an increase in levels of safeguarding concerns.

Abuse within the home, which has predictably been more common since the onset of restrictions, remained higher at the end of the study period than it was pre-pandemic.

In line with earlier analyses, the latest report found domestic abuse and self-neglect had risen over the course of the pandemic, along with psychological abuse.

Section 42 enquiries concerning psychological abuse fluctuated from 3.1 per 100,000 of the population in April 2019 to 4.5 in March 2021, the study found. Meanwhile enquiries concerning domestic abuse fluctuated from 1.0 in January 2019 to 2.1 in October 2020 and enquiries concerning self-neglect fluctuated from 0.9 in February 2019 to 2.2 in May 2021. All of these figures, being population shares, were influenced by the overall volume of enquiries as well as the prevalence of the individual abuse types.

The research report highlighted disparities between councils, with, for instance, some reporting rises in domestic abuse safeguarding concerns of more than 50% while others saw little or no increase.

“The rise in domestic abuse cases sadly reflects the national picture during Covid-19,” said Liz Howard, a BASW England professional officer. “BASW England, along with many charitable organisations and women’s groups, have consistently been raising awareness and pressing government to do more to help victims of domestic abuse as we saw in our research that incidents spiked during lockdown periods.”

Growing ‘intensity’ of safeguarding issues

Sixteen of the councils taking part in the Insight Project study submitted qualitative as well as quantitative data, enabling situations to be examined in more detail.

Common themes discussed concerned challenges in the provider market, mental health impacts of lockdown and social isolation, issues for people with learning disabilities and people experiencing homelessness, increasing pressures on family carers, challenges regarding prevention and the changing use of technology.

Councils reported dealing with concerns of increasing complexity and “intensity”, for example where domestic abuse was coupled with other abuse types such as psychological, financial and physical abuse, and coercive control.

Preventative measures were often not able to be deployed at an earlier stage due to delayed reporting, increasing risk and harm, the report said. “Offending family members working from home further increased the vulnerability of those experiencing, or at risk of experiencing, domestic abuse,” it said.

People with learning disabilities also faced financial abuse from friends and families, as well as being targeted for Covid-based scams in the form of telephone calls, texts, phishing, social media, fake websites and on the doorstep scams, the review said.

It added that different age groups were being affected in specific ways by abuse and neglect since the start of the pandemic. Young adults were tending to get involved with more risky behaviour when support receded, with one council reporting “young people with mental health or other issues [becoming] vulnerable to being involved in gang related activity and receiving associated injuries”.

Besides higher incidence of “longstanding” domestic abuse concerns among older people, several councils reported “a sharp increase” in referrals related to pressure sores and related injuries sustained in care settings.

“We know from our BASW England Homes not Hospitals campaign the disproportionate impact on people with learning disabilities and autistic people, those in hospital assessment and treatment units and restricted care settings who have had very limited oversight of their care and treatment arrangements throughout the pandemic and particularly during periods of lockdown,” said Howard.

“Changes in local working arrangements and processes during the pandemic, differences in practices and application of statutory duties across local authorities and the complexity of issues that are presenting and being responded to are all factors contributing to the picture we see here in the report in relation to self-neglect, age-specific issues and mental health.”

New engagement opportunities

Many councils participating in the study unsurprisingly also observed “ongoing and increasing challenges” in their local care provider market, with persistent problems relating to the quality and availability of staff.

However some also reported having forged closer relationships with providers and other partners during the pandemic, with one recording a reduction in safeguarding referrals from care providers as a result of better engagement.

Other local authorities said that participation in the ‘Everyone In’ scheme to accommodate homeless people had “provided opportunities for safeguarding teams to support those people who previously they did not or could not engage with who had care and support needs”.

Councils were looking at how they were applying the criteria for assessing safeguarding in the context of homelessness, with some creating teams focusing on people experiencing homelessness, multiple disadvantage and complexity during the pandemic, the report said.