The NHS Information Centre has just produced some annual statistics on safeguarding referrals received by Councils with Adult Social Services Responsibilities (CASSRs) in England. The NHS IC of course have produced a report, and it’s been picked up on in quite a few media outlets (Telegraph, the Mirror, Community Care, Financial Times). Apparently another, more detailed, report will be produced next March, but I couldn’t wait that long for a piece of work I’m doing at the moment so I had a play with the raw data. In my research into the Mental Capacity Act 2005, I’m particularly interested in issues for adults with learning disabilities and adults with dementia, so I tried to unpick the NHS IC data to look at the picture of abuse for these groups. Unfortunately ‘dementia’ isn’t a category in it’s own right for a lot of it, so I often just had to make do with looking at older people instead. Before I go on to present what I found, there are some issues with the data that are worth raising. Mithran Samuel at Community Care has summed them up well, so I hope he doesn’t mind if I quote him:
Of 73,600 completed referrals to council adult protection teams in 2010-11, 41% were wholly (32%) or partly substantiated (9%), meaning physical, sexual, emotional, financial, discriminatory or institutional abuse, or neglect had been found on the balance of probabilities.
Thirty one per cent were unsubstantiated and 28% were inconclusive, though the NHS Information Centre, which published the figures, advised that the results should be treated with caution due to data quality issues.
The figures were based on returns from 151 of the 152 councils with adult social services responsibility in England. It is the first year that councils were required to submit figures on adult protection referrals
So, I assume the working definition of ‘vulnerable adult’ is taken from No Secrets. We have to be careful extrapolating from these data to the national picture: not all of these abuse referrals were substantiated, and not all abuses get referred. I think we should be cautious of even assuming that the referrals are a representative sample of abuse across England: it may be that some forms of abuse, and abuse of some groups, is less likely to be detected. And it may be that some types of referrals are more likely to be baseless in reality.
So, with those caveats in mind – , how susceptible to abuse are older adults and adults with learning disabilities, what kinds of abuse, and by whom? For reference, according to some data collated by the Learning Disability Coalition, there are estimated to be 828,000 people with a learning disability in England. That’s 1.6% of the population. And I’ve used some data from the Office for National Statistics (for mid-2010) to compare figures with the population of England broken down by age: 87% of the population of England are aged 18-64; 6% are 65-74; 5% are 75-84; and 2% are 85+. Sometimes where I’ve wanted to just describe ‘older adults’ I’ve collapsed the data for those aged 75+, and that’s 2,463,786 people, or 7% of the population.
However, if you break this data down further you find huge age effects. So for adults under the age of 65, the overwhelming majority of safeguarding alerts concerned people with learning disabilities:
And among adults over the age of 65, the majority of safeguarding alerts relate to physical disabilities/frailty:
Susceptibility to different kinds of abuse
The cover sheet for the data says that physical abuse is the most common kind; but this really masks group differences in susceptibility for abuse. This chart shows that referrals all forms of abuse bar sexual abuse are more likely to relate to older people than people with learning disabilities. But it also shows that people whilst the most common form of abuse for adults with learning disabilities is physical abuse; for older adults it is neglect.
I have produced different tables showing the proportion of safeguarding alerts received for each different kind of abuse, broken down by primary client group. They’re fairly self-explanatory so I’ll just reproduce them here. Safeguarding referrals relating to physical abuse:
Safeguarding referrals relating to neglect: