Safeguarding Adults in Kent and Medway: Processes and Outcomes of Adult Protection

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Safeguarding Adults in Kent and Medway Processes
and Outcomes of Adult Protection

• Paul Cambridge

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Whats special about Kent and Medway?

• Different authorities sharing AP culture and
  systems
• Early development of AP recording and monitoring
  processes
• Established AP machinery with stakeholder
  representation
• Targeted us of specialist AP posts in both
  authorities
• Good liaison with the police locally and
  strategically with AP specialisation within the
  police
• Record of research and evaluation
• Early development pf policies and protocols and
  ongoing review
• Comprehensive multi-agency training strategy

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Processes and outcomes in brief

• In 84 of alerts an investigation was conducted
• 79 involved consultation with other agencies
• abuse was confirmed in 41 of alerts
• 39 had insufficient evidence
• 18.5 were discontinued
• 13 no further action taken
• 43 some form of ongoing monitoring

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alerts by process factors/ time
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alerts by year/ outcome
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alerts by territory/ outcome
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alerts by territory/ response
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Process associations

• PWLDs more likely to have a joint investigation
  and police involvement and less likely to have
  health authority involvement
• Older people more likely to have health authority
  involvement
• People with mental health problems more likely to
  have inspection and registration involved

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Outcome associations

• No association between outcome and user group,
  gender, age (over or under 65) or ethnicity
• Whether a case was confirmed or not was
  significantly associated with
• Whether people were OA. Those not from
  out-of-area were slightly less likely to have the
  case confirmed
• Location of abuse. For those living in
  residential care, cases confirmed were higher
  (50) generally less than 40 elsewhere and 29
  for multiple locations
• Type of abuse. The types of abuse least likely
  to be associated with the case being confirmed
  were financial and sexual (29 of cases
  confirmed) and psychological (35). Institutional
  abuse (78) was the most likely to be confirmed
• Relationship with the perpetrator. Abuse was
  least likely to be confirmed if perpetrator was a
  member of staff (57) and most likely if
  perpetrator was a member of residential care
  staff (97)

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Number of alerts by APC specialisation/ year
(2000 as index year)
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APC involvement

• More adult protection alerts (73 of total) from
  Kent districts with at least some APC
  specialisation
• More alerts of neglect, institutional and
  multiple abuse and abuse perpetrated by managers
  and staff with APC specialisation
• Investigations, joint investigations, health
  involvement and involvement of inspection/
  regulatory authorities more likely to happen with
  APC specialisation
• Increased monitoring, post abuse work with
  victims and post abuse work with vulnerable
  perpetrators more likely with APC specialisation
• But No association with other agency
  consultation, police involvement or outcomes of
  investigations

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What Kent and Medway do well

• Collation of long-term and relatively
  comprehensive adult protection monitoring
  information
• Investment in policy review, comprehensive
  training and systems development
• Joint/ shared adult protection policies and
  procedures
• Joint/ shared management and decision-making
  machinery
• Targeting specialist adult protection resources
  to needs and demands
• Research and evaluate activities in the field

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General lessons for AP data management

• Development of a single integrated AP data base
  across client groups, territories and time (e.g.
  capacity to readily interrogate data across
  hierarchies and access relevant data from other
  systems).
• The inclusion of detailed client level
  information or operational interface with other
  client databases (e.g. increased intelligence on
  the micro-organisational and individual
  characteristics of abuse/ perpetration)
• Incorporation of information on workload inputs
  and costs for workload planning and resource
  management (e.g. how costs are related to
  outcomes and the relative cost effectiveness of
  different interventions)
• The inclusion of more information on intermediate
  outcomes such as planning and strategy meetings
  (e.g. how additional organisational processes are
  related to outcomes)
• A clear analytical strategy for interrogating and
  interpreting adult protection data and
  disseminating evidence locally (e.g. informing
  prevention and risk management interventions at
  worker, agency and multi-agency levels)

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Concluding points

• In general, adult protection monitoring systems
  need to
• Include more intermediate/ organisational
  processes/ outcomes
• Develop and refine outcome assessment/
  measurement
• Improve understanding of the relationships
  between processes and outcomes
• Incorporate information on cost effectiveness
  (worker inputs and costs)

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• When using adult protection monitoring data
  particular caution should applied to
• Making performance comparisons
• Making comparisons within and between authorities
• Because
• More work is needed in order to compare like with
  like
• Account needs to be taken of different recording
  practices, case management processes,
  organisational variables, demographic factors and
  service distributions