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Safeguarding Outcomes Measure Pilot Study

Background

The Care and Support white paper stated that a high quality service must be one which keeps people safe from harm. In setting out safeguarding as one of the domains in the Adult Social Care Outcomes Framework (ASCOF), the government has reflected this priority and has emphasised the need for services to safeguard adults at risk whose circumstances make them vulnerable and to protect them from avoidable harm. The Department of Health (DH) and the Association of Directors of Adult Social Services (ADASS) co-chair the Data and Outcomes Board (DOB), formerly known as the Outcomes and Information Development Board (OIDB) which has oversight of ASCOF. DOB have agreed that the development of a national measure of safeguarding outcomes is of high priority and this was signalled in the 2014/15 ASCOF, published in November 2013.

A steering group was convened in April 2013 comprising representatives from the Department of Health, The Health and Social Care Information Centre (HSCIC), Social Care Workforce Research Unit (King's College London), Local Government Association, Local Authority and ADASS to guide the development of the safeguarding outcomes measure. Membership included:-

  • Pritpal Rayat (Chair), HSCIC
  • Cher Cartwright, HSCIC
  • Rosemary Main, Department of Health
  • Niall Fry, Department of Health
  • Adi Cooper, Association of Directors of Adult Social Services
  • Cathie Williams, Local Government Association
  • Jill Manthorpe, Social Care Workforce Research Unit, King's College
  • Caroline Norrie, Social Care Workforce Research Unit, King's College
  • Hilary Paxton, Local Authority Lead

Why is this work important?

This work is potentially of great value to adult social services departments and Safeguarding Adults Boards. Currently there are no national safeguarding outcome measures that focus on people who have been through an adult safeguarding case. Social workers and their colleagues therefore report feeling unsure whether adults at risk are satisfied with how their safeguarding investigation was dealt with. This lack of data means it is not possible to make comparisons between councils as there is no national benchmark for whether adults at risk felt safer after a safeguarding investigation. It is therefore hard to identify best practice in a systematic way in adult safeguarding - or to share it across councils. The lack of outcome data also has implications for resource allocations. Commissioners have little way of comparing how well their council is performing in relation to others and whether more money or other resource is needed for effective safeguarding.

Development Work

A call for evidence was made by the HSCIC, and examples of work already being undertaken were collected to examine the process and outcomes of safeguarding. There have been discussions with the Personal Social Services Research Unit (PSSRU), Local Government Authorities, the Department of Health and ADASS to clarify what information is required and how it should be collected. A set of questions were developed along with guidance on how to conduct the survey. Cognitive testing of the survey and staff guidance took place at the start of 2014 with council staff, adults at risk, relatives/friends/carers or Independent Mental Capacity Advocates (IMCAs). Learning from the cognitive testing was used to make changes to the survey questions and guidance ahead of piloting the survey in a number of volunteer councils.

Aim of the Pilot Study

An invitation was sent out to all councils in England in December 2013 asking for expressions of interest in participating in a pilot study to test the developed survey; 40 councils agreed to participate. The primary purpose of the pilot study was to establish if participating councils could practically use the survey to measure if adults at risk and those that support them think the safeguarding process was effective and to see if implemented as an annual survey whether it would be cost-effective.

Each participating council aimed to survey approximately 20 adults at risk or their relatives/friends/carers/IMCAs over a period of 12 weeks (May to August 2014). The survey questions were asked during a face to face interview. Participating councils also completed an impact assessment to estimate the costs of running the survey as a national annual collection.

Pilot Study Objectives:-

  • To test the developed survey questions in a range of councils in England and to assess if the survey is practical to roll out nationally.
  • To determine if question 6 could potentially be used as a safeguarding outcomes measure for inclusion in the ASCOF.
  • To ascertain the impact or additional costs and burdens this will place on councils if implemented as a national survey.
  • If the pilot study demonstrates the measure is feasible, to consider how best to implement it nationally to inform a new national safeguarding outcome measure for inclusion in the ASCOF.

Reporting

The final report (updated November 2014) "pdf icon Developing an Adult Safeguarding Outcomes Measure for Inclusion in the Adult Social Care Outcomes Framework - Findings from the Pilot Study [1Mb]" has now been completed and delivered to the Data and Outcomes Board (DOB) which is jointly chaired by DH and ADASS. DOB are supportive of the recommendations set out within the report.

Acknowledgement

We would like to thank all those who participated in this development work, particularly those councils that participated in the cognitive testing and the pilot study and the individuals that took part in the survey. In addition, we would like to thank The Social Care Workforce Research Unit (King's College London) and members of the Adult Social Care reference groups, in particular the Safeguarding Steering Group and Working Group, who provided expertise, advice and assurance throughout which was invaluable to the success of the project.

Relationship to other work in the sector

Making Safeguarding Personal (MSP) is a sector led initiative in adult safeguarding. It aims to develop an outcomes focus to adult safeguarding work which should result in safeguarding being done with, and not to, people. MSP began in 2009 and is a programme led by the Local Government Association (LGA) Safeguarding Adults Programme and by ADASS. In 2013/14, supported by funding from DH and the LGA Safeguarding Adults Programme, over 50 councils volunteered to participate in one or more levels of improvement activity. This work under MSP aims to shift emphasis from processes to a commitment to improving outcomes for people at risk of harm. The key focus is on developing understanding of what people wish to achieve, recording their desired outcomes, and then seeing how effectively these have been met.

Some of the councils who have been involved in the MSP programme are assisting the HSCIC with the development of the national Safeguarding Adults Outcomes Measure and/or have participated in the Pilot Study. The developmental work has made it clear that the HSCIC work and MSP activity are complementary and not duplicate activities.

Survey Documents

We encourage Safeguarding Adult Boards to implement the survey within their council. The survey will help gather information about safeguarding services and how improvements could be made. If all councils use the same validated survey this would enable councils to undertake local benchmarking and share ideas between councils and regions to shape best practice. The survey will also help to capture information about whether services are meeting the principles set out within the Adult Safeguarding section of the Care and Support Statutory Guidance issued under the Care Act 2014. The survey documents are available for councils to use.

pdf icon Adult Social Care Safeguarding Survey Guidance v1.0 [511kb]

zip icon Contacting participants [865kb]

zip icon Interview scripts and show cards [485kb]

zip icon Consent forms and help leaflets [697kb]

Queries

Any queries about the Pilot Study or general queries about the Safeguarding Outcomes Measure development work please contact HSCICsgoutcomes@hscic.gov.uk

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