Child criminal exploitation and the ‘cuckooing’ of vulnerable people are to be made criminal offences.

The measures in the Crime and Policing Bill, which will be introduced into Parliament this week, are designed to tackle the grooming and exploitation of children and vulnerable adults, including by county lines drug-dealing gangs.

Under the plans, adults could face up to 10 years in prison for using a child to commit criminal activity, while a separate offence will outlaw cuckooing, where criminals take control of a vulnerable person’s home without consent to carry out illegal activities like drug dealing.

Orders to restrict movements of those who exploit children

A separate measure in the bill would create child criminal exploitation (CCE) prevention orders, which would impose restrictions or requirements on people who pose a risk of exploiting children for criminality, such as limiting their ability to contact specific people or go to certain areas.

These would be imposed after criminal proceedings or through an application by the police.

CCE was identified as a factor in 15,750 children in need assessments in England in 2023-24, however, the government said this was likely to underestimate the scale of the problem because many children were not known to the authorities.

Punishing those who ‘prey on children and vulnerable people’

Announcing the new measures, home secretary Yvette Cooper said: “We are introducing these two offences to properly punish those who prey on [children and vulnerable people], ensure victims are properly protected and prevent these often-hidden crimes from occurring in the first place.”

The action was welcomed by Children’s Commissioner for England Rachel de Souza and charity the Children’s Society.

Children’s Commissioner for England Rachel de Souza (credit: Office of the Children’s Commissioner)

De Souza said that many exploited children were “ignored and overlooked” and faced “punishment instead of support”.

Commissioner hopes for earlier intervention by professionals

“Introducing this new offence and new prevention orders will help create that much needed clarity that exploited children are victims,” she added:

“I hope this will enable professionals to intervene at far earlier stages of intervention, backed by plans to create a unique identifying number for every child that helps services identify those in need of support.”

The unique identifier for every child, which is designed to improve inter-agency information sharing to safeguard children, is being legislated for through the Children’s Wellbeing and Schools Bill.

For the Children’s Society, chief executive Mark Russell said: “For too long, adults who groom children into criminal activity – forcing them to hold drugs or launder money or commit theft – have evaded accountability. Charges such as drug possession ignore the core truth; these are child abusers exploiting vulnerable young people.”

He said the offences needed to be backed by “strong enforcement, training for safeguarding professionals and a statutory definition of CCE to help end the postcode lottery in victim support”.

The government has launched an action plan to safeguard telecare users from the switching off of the UK’s analogue phone network.

Its replacement by a fully digital network will mean that existing services connected to the copper-based system, including many telecare devices, will need to be switched over by January 2027.

The switchover was initiated by the telecommunications industry, independently of government, with companies migrating customers to a digital service against an initial deadline of the end of 2025.

However, in December 2023, the then government said there had been a number of “serious incidents” in which telecare users’ devices had failed following migration, putting them at significant risk.

‘Telecare users must be protected’

“There is a risk that the process of migrating telecare users to digital landlines will disrupt their telecare services,” said minister for care Stephen Kinnock, in a statement launching the telecare action plan.

Stephen Kinnock (photo: Richard Townshend Photography)

“Telecare users must be protected during the digital phone switchover and every effort must be taken to avoid these risks.”

The telecare national action plan, which is targeted at councils, telecare providers, telecoms companies and housing providers, has four objectives:

1. That no telecare user will be migrated to digital landline services without the communication provider, the user or the telecare service provider confirming that the user has a compatible and functioning telecare solution in place.
2. That use of analogue telecare devices is phased out to ensure that only digital devices are being used by a deadline that the Department of Health and Social Care (DHSC) will set following talks with stakeholders.
3. That telecare users, their support networks and their service providers should understand what actions they need to take to ensure a safe migration to digital phone lines.
4. That stakeholders identified within the plan collaborate to safeguard telecare users through the digital phone switchover.

Councils sharing data with telecoms sector

The DHSC and Department for Science, Innovation and Technology (DSIT), which are jointly responsible for the action plan, said a key priority under objective 1 was that councils and telecare providers shared data about service users with telecoms providers, so they could put additional safeguards in place for them.

The Local Government Association (LGA) and London Office of Technology and Innovation (LOTI) have drawn up a data sharing template to streamline the process of councils and telecoms providers reaching agreements.

This stated that the lawful basis for councils sharing the data was “substantial public interest”, based on it being in the best interests of people with care and support needs using social care for them to do so.

The DSIT and DHSC said they would engage with local authorities who had not signed data sharing agreements to understand the barriers to doing so.

Continued use of analogue devices

The departments said objective 2 required action to stop the manufacture, sales and purchase of new analogue telecare devices. Ministers wrote to telecare suppliers in September 2024, requesting that they do not sell analogue-only devices, while the departments are also working with consumer groups to highlight the risk of people purchasing such equipment.

However, they added that, while their long-term ambitions were for telecare users to have fully digital devices that were resilient to power cuts, interim solutions that enabled the use of analogue devices on digital phone lines were permissible in the medium-term, so long as there was adequate risk assessment, testing and ongoing monitoring.

The action plan said testing had shown that the reliability of such devices was dependent on the model, the telephone line type and provider and equipment used by the alarm receiving centre, meaning telecare providers needed to “ensure the reliability of the specific combination of equipment and services they use”.

Raising awareness among telecare users

It added that a national awareness raising campaign on the switchover, to be launched by the telecoms industry in early 2025, would be “tailored to the unique characteristics of telecare users and their support networks”.

The action plan also highlighted the risks of criminals exploiting the switchover to target people with scams, by tricking them into sharing personal information.

It pointed to LGA guidance on the issue, which advised councils to ensure that frontline staff were aware of the switchover and reported potential scams to trading standards while also raising them as safeguarding concerns.

The LGA guidance also urged co-ordination between children’s and adults’ social services teams and trading standards to identify which residents may be vulnerable to scams and to proactively safeguard them, for example, through setting up call blocking services.

Social care practitioners can get up to speed with the law around adult safeguarding at Community Care’s next masterclass.

Expert speakers will cover issues including the legal framework around adult safeguarding, its intersection with the Mental Capacity Act 2005 (MCA), the inherent jurisdiction and how to handle cases involving self-neglect or hoarding.

Alongside this, delegates will also learn the key lessons for practice from the safeguarding adults reviews (SARs).

The masterclass, which costs £325 plus VAT, takes place on 28 March 2025 at etc.venues, Manchester.

The adult safeguarding event builds on the success of last year’s legal masterclasses, in Manchester and London, on mental capacity.

Speaking at the adult safeguarding masterclass are:

• Tim Spencer-Lane, a lawyer specialising in adult social care, mental capacity and mental health, who will provide an overview of the legal framework around adult safeguarding in England and Wales, including the criteria for a safeguarding enquiry and the protection powers available to practitioners.
• Professor Michael Preston-Shoot, an academic specialising in adult safeguarding, who will share learning from the second national analysis of SARs, which he co-authored.
• Francesca Gardener, a specialist Court of Protection barrister from 39 Essex Chambers, who will discuss the inherent jurisdiction of the High Court, explaining the limits of its power to protect vulnerable adults sharing learning from key case law.
• Rebecca Clark, a barrister from Exchange Chambers, who will speak on the application of the MCA to adult safeguarding cases.
• Neil Allen, a barrister at 39 Essex Chambers and senior lecturer at the University of Manchester, who will help practitioners navigate the complex ethical dilemmas when deciding whether or not to intervene in self-neglect and hoarding cases.

You can find out more, and book your place, on our dedicated masterclass website.

A scam is a fraud. It’s an attempt to steal money or goods, usually through a scheme or ploy, and can involve intimidating and threatening behaviour.

There are a variety of different scams, ranging from the romance scam, to the pension scam, to the clairvoyant scam. Then there is the lottery scam and the doorstep scam. The list continues to grow.

In October 2023, National Trading Standards published research revealing that 73% of UK adults – or 40 million people – had been targeted by scams, with 35% (19 million) losing money as a result. But, it said, fewer than a third of victims (32%) report the crime to the authorities.

Scammers often target older and socially isolated people, who are made to feel unsafe and afraid.

The care and support statutory guidance to the Care Act 2014 is explicit in stating that scams targeting adults at risk are a form of financial abuse – which is where professionals come in.

Best practice tips

The goal of intervention should be to develop a protection plan and manage risks. Here are some key points to remember:

• Consider scams and mass marketing fraud as a form of financial abuse under the Care Act 2014 or Social Services and Well-being (Wales) Act 2014. If the client has care and support needs and is unable to protect themselves from the scam because of those needs, then the local authority is under a duty to make safeguarding enquiries. This provides an excellent forum to start protection planning.
• Work in a multi-agency manner. Safeguarding enquiries should involve safeguarding board partners such as the police, trading standards, third sector advocates and care providers. The statutory guidance to the Care Act says local authorities should always report cases of scams to trading standards and the police. A safeguarding planning meeting or case conference provides a useful arena for positive information sharing and protection planning.
• Act quickly. Scammers and fraudsters will often intensify the frequency and level of their fraud when they hear about professional involvement. Recognise that scammers will either find out about your involvement or sense that things have changed in terms of their access to the victim or the victim’s willingness to co-operate.
• Where you have proper reason to do so, consider the client’s mental capacity in relation to relevant decisions to do with the scam, including around accepting help. Ensure you provide all practicable support to the person to enable them to make decisions before concluding that they cannot. If a capacity assessment is required, then ensure that you have sufficient knowledge of the client’s background (in relation to how they have historically managed their finances) in order to help form a baseline against which to assess how they are managing now.
• Scams are crimes (normally falling under the Fraud Act 2006) and should be reported to trading standards, which may carry out a criminal investigation.
• Risk assess and protection plan: ensure that a comprehensive risk assessment is done, ideally one that involves the client and their wishes and outcomes. The resulting actions form the protection plan, which should be multi-agency in nature.
• Work in a manner that upholds the principle of making safeguarding personal (as explained in the Care Act statutory guidance). Communicate with the client and involve them in safeguarding, risk assessments and meetings.
• Keep checking on their desired outcomes as these may change as the safeguarding process moves forward. Remember the concept of slow burn social work as you will often be undoing years of relationship building between the scammer and the client. This will not happen overnight. Your relationship with the client will likely be the most important tool that you bring to the safeguarding plan.

The importance of multi-agency working

Dealing with complex fraud is not easy and is often protracted and complicated.

It is important that working to protect people from scams is not kept within trading standards and social work.

Consider all professionals who go across the threshold when engaging with clients, including police officers, such as those from local neighbourhood teams) domiciliary care workers, pendant alarm response officers, financial assessment officers, housing repair staff, third sector workers, tenancy officers and those working for meals on wheels type services.

All can be the eyes and ears for safeguarding and trading standards intervention to begin.

If you have a Community Care Inform Adults licence, log in to access the full guide. There, you can read more on the risk factors that make someone more likely to fall victim to scams as well as on the impact on people’s health, wellbeing and quality of life.

Sarah Erlacher’s neighbour once called her “a social worker of the world” and she quite literally is. She assists on cases where British adults abroad have become homeless, run out of funds or have been a victim of a crime, and it is her job to advise on cases involving British prisoners in jails abroad.

A large part of her role involves helping people settle back into the UK when their visa has expired or after an incident abroad. This can involve contacting family in the UK or signposting them to services they may need.

“Quite often people decide to come back to the UK thinking they will get access to housing and financial support straight away, but unfortunately that’s not the case, so we have to advise people what [coming back] may look like,” says Erlacher.

She is one of four practitioners that supports the Foreign, Commonwealth and Development Office (FCDO) to assist British nationals overseas.

Erlacher and her colleagues have various specialisms and are employed by Heathrow Travel Care, a charity set up to help people in crisis at Heathrow Airport.

The team of social workers is seconded to the FCDO, which employs 17,000 staff in the UK and its 237 British embassies, consulates and high commissions across the world.

Consular staff are not trained to advise people on issues that would usually require social services involvement. When vulnerable people are involved, staff can seek advice from the specialist social work team.

The four social workers do not hold cases directly but instead provide specialist advice when consular colleagues ask them for help.

British nationals can call the nearest British embassy, high commission or consulate, or the FCDO in UK, at any time. They consider all requests for assistance and have published guidance on how they can help in different circumstances. However the FCDO is not legally obliged to provide assistance to any British citizen under any current law.

The consulates abroad act as a front door for British nationals in distress. Referrals can come through in many ways, from friends, family members, concerned neighbours, healthcare professionals or the police.

Photo: Blanscape/AdobeStock

What does the team do?

Team manager Steve Davenport specialises in cases that involve older adults aged 65 and over.

“We’re giving advice based on our UK experience, knowledge and skills, but we also need to be mindful that doesn’t just automatically translate into the country the British national is in. So we’re relying on the expertise of our colleagues in that country to tell us what it is like on the ground. That will help shape the advice we give to them on how to manage that case.

“We could have two 85-year-olds with dementia, one is in Spain and one in Cambodia, so service provision or what might happen in that country can be really different,” he says.

Davenport explains that because of the different types of provision, or due to lack of services or funds, it is often best for the individual to come back to the UK.

Where the British national has a connection to a particular area, such as a previous home or a relative who lives there, that local authority will be contacted.

“On a daily basis, as a team, [we are] speaking to adult and children’s social care teams dotted around the UK trying to either get information or share information, or give them warning that somebody is coming back,” he says.

Photo: LN/AdobeStock. British Embassy in Moscow

Celebrate those who’ve inspired you

For our 50th anniversary, we’re expanding our My Brilliant Colleague series to include anyone who has inspired you in your career – whether current or former colleagues, managers, students, lecturers, mentors or prominent past or present sector figures whom you have admired from afar.

Photo by Daniel Laflor/peopleimages.com/ AdobeStock

Nominate your colleague or social work inspiration by either:

• Filling in our nominations form with a letter or a few paragraphs (100-250 words) explaining how and why the person has inspired you.
• Or sending a voice note of up to 90 seconds to +447887865218, including your and the nominee’s names and roles.

If you have any questions, email our community journalist, Anastasia Koutsounia, at anastasia.koutsounia@markallengroup.com

Children and families

Child welfare and safeguarding specialist Annika Dann’s cases often involve child abductions, domestic abuse, and general safeguarding concerns.

“We have a clear policy on what consular staff can and can’t do in cases involving children. My role is looking at [the case] and applying the principles of UK safeguarding. At the same time, we have to recognise that in another country’s jurisdiction, their legislation applies,” she says.

Some countries have very different approaches to child protection and safeguarding to the UK’s. Dann is reliant on British embassy colleagues to inform her what provision there is to safeguard children in that specific country.

As consular staff are not social workers, they cannot visit children and families and investigate concerns. Part of Dann’s role is to work out if a concern has reached the threshold to involve authorities in the country in question and what action, if any, can be taken.

“There are a lot of domestic abuse cases where one parent wants to leave the relationship with children in their care, but faces challenges to leave the country or return to the UK without the other parent’s consent,” she says.

Dann and colleagues can signpost to services, such as local refuges, or to legal advice for cases involving child abduction, where one parent takes a child across borders without the other’s consent.

“It’s obviously much more challenging in countries where there [aren’t] equivalent social services or a child safeguarding framework and it can be quite limited in what we can do to support. But it’s a collaborative approach where everybody is drawing on their own expertise and knowledge to try and find the best option for the child.”

When British tourists have been involved in domestic or substance abuse abroad and will be returning to the UK, Dann will decide whether they should be flagged to social services. She can also request information from a local authority to help her decide what to do.

Photo: Dominic Dudley/AdobeStock. Sign by the main entrance of the FCDO London, UK.

Mental health

Where there is an obvious primary mental health need, Chris Heywood, the approved mental health professional (AMHP) in the team, will assist. Mental health problems appear across the entire spectrum of what the team does so often there is overlap with cases and the team must work closely together.

Although there has been a lot of progress in the UK in recent decades on the provision of mental health services, this is not always the case in other countries.

“Mental health is still incredibly under-resourced. In many countries, it’s not spoken about – it’s stigmatised – all of the things that used to be more applicable to the UK. Indeed in a lot of countries, there’s no such thing as mental health, it’s not even recognised in law,” says Heywood.

Family members or social workers may flag up a person abroad who needs intervention due to mental health problems but often there is no legal framework in place for this to be possible.

“It can be incredibly difficult,” says Heywood. “Sometimes it really is going back to basics and doing the investigative work. What’s this person’s background? What has helped them in the past? Are there any strategies we can deploy to help this person, given the lack of resources in whichever country they are in? And are there any resources that we know of that may not be apparent to the individual, to which we can signpost or refer them?”

Often the team can be left frustrated when they are unable to proceed because a country does not have the legal framework or guidance in place.

“People, understandably so, become increasingly frustrated or even angered with us for what they perceive as a failure to act or [us] wilfully neglecting to act.

“But actually it’s not for our lack of trying or wanting to provide the assistance this person might need. But where things fall outside of our remit, or if there’s no legal basis for us to do the things that people would like us to do, it may be that there is nothing we can do or indeed, that we are not permitted to do things that people would like us to do. A good example would be where we cannot share information with family members due to GDPR,” says Heywood.

Training

Delivering training and attending conferences in the UK and abroad is an important part of working for FCDO. This gives the team a chance to learn about different social work cultures, look at what services might be available in different regions and impart their own knowledge.

Davenport says: “It’s a real perk and privilege of the job. […] If time allows we can sometimes spend a bit of time with the consular team in that country and go to visit services, social care teams if they exist, hospitals, be that general or psychiatric, care homes, prisons, immigration detention centres – all the places that British nationals end up.”

Mental health trust leaders ignored staff concerns over the safety of services at a hospital over many years before abuse was uncovered there in 2022, a damning review has found.

Managers, in some cases, reprimanded workers who raised concerns about issues such as unsafe staffing levels at the Edenfield Centre, creating a “toxic” culture that enabled the abuse exposed by BBC Panorama to take place, concluded the inquiry.

These issues went beyond the forensic service hospital itself to the wider Greater Manchester Mental Health NHS Foundation Trust (GMMH), of which it is a part, found the independent review into the trust commissioned by NHS England in the wake of the abuse scandal.

The review, chaired by former NHS trust chief executive and mental health nurse Oliver Shanley, also found that the lack of value placed on patients’ and families’ voices was a significant contributory factor behind what the BBC uncovered.

‘Appalling levels of abuse, humiliation and bullying’

In 2022, Panorama sent an undercover reporter into Edenfield, a low and medium-secure mental health hospital for people transferred from the criminal justice system or with behaviours deemed to put themselves or others at risk.

The programme, which aired in September 2022, showed what the review described as “appalling levels of abuse, humiliation and bullying” from staff towards patients.

This prompted a police investigation, which is ongoing, the suspension – and ultimately, dismissal – of some staff and the closure of the centre to new admissions.

The Care Quality Commission also downgraded GMMH from requires improvement to inadequate overall in 2023, and NHS England placed it in the bottom rung of its recovery support programme, for health bodies with the most serious performance issues.

The Shanley review stressed the highly challenging context of forensic services, where patients, often with extensive histories of trauma, are typically admitted against their will because of the serious risk they pose to themselves or others, in locked services away from loved ones.

‘Unsafe’ staffing

While working in these environments had the potential to be “damaging and destructive”, this was exacerbated at Edenfield by “unsafe staffing levels” dating back years.

From 2019-20 to 2022-23, vacancy rates across GMMH’s adult forensic services – which includes Edenfield – averaged 23%, with a 26% rate among nurses and midwives, while sickness levels, turnover and use of temporary staff were also high.

The review found that 13-hour shifts on Edenfield, sometimes without a break, were “commonplace”, with staff regularly working over 48 hours a week.

It heard that it was not uncommon in Edenfield for a single nurse to hold responsibility for three wards, newly qualified nurses were sometimes the only registered member of staff on a ward and unregistered staff were left unsupported and unsupervised on shift.

Nurses ‘often did not know patients well’

Staff also had to move wards during shift to maintain minimal coverage. Consultants told the review that, as a result, nurses often did not know the patients on their wards well or were not able to attend clinical meetings.

“This had a serious impact upon patient care with, on occasion, poor adherence to their care plans,” the report said.

Recruitment and retention problems “depleted the service of forensic nursing experience”. As a result, staff supervision rates at Edenfield had dropped markedly over the past three years, while few practitioners reported a positive view of supervision or on-the-job support.

The staffing situation had a significantly adverse impact on patient care with the review hearing “numerous accounts” of care tasks not being “safely and reliably completed”.

For example, patients told the review that bank and agency night staff were not responsive to routine requests and often told patients not to bother them or ask someone else.

Staff ‘ignored’ and ‘reprimanded’ for raising concerns

Despite a 2018 report commissioned by the trust finding that forensic staff were struggling with stress and overload and not feeling able to speak up, the review found little evidence that the trust had acted on this.

Edenfield staff who raised concerns about unsafe staffing and care were “ignored” and, in some cases “reprimanded”, the review found.

The report said that “a great many staff, of all professions and levels, were highly distressed when telling their stories”, with several saying the review was the first opportunity they had had to talk about their experience of working at Edenfield.

“Reporting of concerns (such as unsafe nurse staffing levels) was actively discouraged and was described by numerous people as being ‘career limiting’, with staff having an “almost unanimous lack of faith” that anything would change as a result.

Poor leadership behaviours

This issue went beyond the leadership at Edenfield to the wider trust. The 2022 NHS national staff survey found that:

• 7% of GMMH staff disagreed that the trust encouraged staff to report errors, near misses or incidents, the highest of any mental health trust.
• 13% disagreed that GMMH treated staff involved in an error, near miss or incident fairly, also the highest of any mental health trust.
• GMMH had the second lowest score among mental health trusts in relation to staff feeling they had a voice
• About 15% disagreed that GMMH acted on concerns raised by patients.

Trust leaders were described as engaging in poor behaviour including “shouting, swearing, telling staff to retract incident reports and to withdraw written staffing concerns, over-riding clinicians’ decisions made based on patient safety, and fostering an attitude of intimidation”.

The review also criticised the lack of oversight provided by the trust board, which it said was more focused on GMMH’s expansion and reputation and meeting operational targets than on quality of care.

This led to “insufficient curiosity” about patient and staff experience, with board members visible in few services and Edenfield a particular blind spot.

Leadership changes

In the months following the Panorama programme, the then chair and chief executive of GMMH, Rupert Nichols and Neil Thwaite, left the organisation.

Staff told the review that their interim replacements, Bill McCarthy (chair) and Jan Ditheridge (chief executive), were more visible, with McCarthy being regularly seen at Edenfield. He has since been replaced by a new chair, Tony Warne.

However, several managers who had been subject to HR investigations after being accused of poor behaviour remained in senior roles within the organisation, the review said.

“It is critical that the trust assures itself that those in senior leadership positions now are exhibiting and role modelling the values and behaviours the trust requires, in order to reset and reshape its culture to one which can provide safe services.”

Recommendations

Among its 11 recommendations, the inquiry called for the GMMH board to strengthen the voices of patients and families, and of clinicians, within the organisation, and to develop and lead a culture that made quality of care its “utmost priority…underpinned by compassionate leadership”.

As part of this the board should “develop a clear set of expectations about the values and behaviours expected from all staff”, along with systems for measuring key aspects of culture so that staff and leaders can be held to account.

The review also called on the trust to develop a staff recruitment and retention strategy and develop systems “to ensure that staff are encouraged to speak freely and that they are listened to
when they raise areas of concern or areas for improvement”.

Improvement plan ‘commendable but focused on process’

GMMH is currently working to an improvement plan, issued in July 2023, whose objectives include:

• Making sure it has enough registered, competent, skilled and experienced staff who feel supported and able to deliver high standards of care.
• Reducing the use of restrictive practices such as restraint, seclusion and rapid tranquilisation.
• Enabling leaders to uphold the trust’s values and provide a safe and supportive working environment.
• Strengthening the service user and carer voice and ensuring it is heard at all levels of the organisation.
• Fundamentally changing its culture to create a healthy environment that supports the delivery of high quality care, and creating opportunities to empower the staff voice across the trust.

The review said the plan was “commendable” in its breadth and scope though had “disproportionate focus on processes and inputs, with insufficient weight given to the cultural work needed to embed sustainable improvements for patients and staff”.

Apology from trust

In response to the report, GMMH interim chief executive Jan Ditheridge said: “We are truly sorry for the events described in the report. We worked openly and constructively with Professor Shanley and the team during their time at GMMH last year, we take the findings seriously and accept the recommendations.

“We cannot change the past, but we are committed to a much-improved future – one in which all service users and carers feel safe and supported, and our people are able to do their best work.

“Our improvement plan sets out a range of actions that are addressing the issues raised in this report. Many of these actions have been completed but we know there is more to do to ensure all of our communities get high quality and safe care all of the time.

“Service users are already safer, staff are more supported, leadership and governance is stronger, and our culture is getting better – for example, we have recruited more than 350 nurses in the last six months alone, and we have two full time Freedom to Speak Up Guardians [whose role is to enable staff to voice concerns] and a network of new champions appointed, giving our people a voice and clear ways of raising issues and driving progress.

“We are working with the review team, partners, and colleagues to fully implement the recommendations ensuring our service users and their carers are central to everything we do.”

Wider concerns about speaking up

The report’s findings echoed – in stronger language – those of a rapid national review of the safety of inpatient mental health settings commissioned by the government in response to the abuse uncovered at Edenfield.

This review, which reported last year, found that staff did not always feel empowered to speak up when things went wrong and sometimes felt intimidated raising concerns with Freedom to Speak Up Guardians.

Some staff also said that concerns they had raised had not been acted upon, though others were more positive about this and about guardians’ role.

The government has also commissioned the Health Services Safety Investigations Body to carry out a review into mental health inpatient settings, which will report by the end of 2024. 

By James Codling

With a worrying frequency, I am hearing in training sessions, and in practice across the country, the following statements:

• “We require the person’s consent before we undertake a safeguarding adults enquiry.”
• “Have we assessed [insert name]’s capacity to consent to the safeguarding enquiry?”

Neither of these are in line with the Care Act 2014 or the Mental Capacity Act 2005 (MCA) and both should be removed from training and practice immediately. In this short article, I hope to explain why this is the case.

What section 42 says

Section 42 of the Care Act 2014 sets out local authorities’ duty to make safeguarding enquiries:

(1) This section applies where a local authority has reasonable cause to suspect that an adult in its area (whether or not ordinarily resident there) –(a) has needs for care and support (whether or not the authority is meeting any of those needs),

(b) is experiencing, or is at risk of, abuse or neglect, and

(c) as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it.

(2) The local authority must make (or cause to be made) whatever enquiries it thinks necessary to enable it to decide whether any action should be taken in the adult’s case (whether under this Part or otherwise) and, if so, what and by whom.

Photo: Gary Brigden

No requirement for consent

At no point is section 42 saying that an enquiry may only be undertaken with the person’s consent or, if the person lacks capacity to consent, if it is seen to be in their best interests.

The word to focus on in section 42 is ‘must’.

Where the requirements of section 42 (1) are met, the local authority ‘must make (or cause to be made) whatever enquiries it thinks necessary to enable it to decide whether any action should be taken in the adult’s case (whether under this Part or otherwise) and, if so, what and by whom’ (section 42(2)).

So why is there confusion?

The key misinterpretation that I see is confusing:

• trying to involve a person in a process, with
• carrying out an act that requires a person’s consent/permission before you carry it out.

So, if we start with involving the person in the safeguarding adults enquiry, the Care and support statutory guidance states clearly, at paragraph 14.80, that:

“The adult should always be involved from the beginning of the enquiry unless there are exceptional circumstances that would increase the risk of abuse. If the adult has substantial difficulty in being involved, and where there is no one appropriate to support them, then the local authority must arrange for an independent advocate to represent them for the purpose of facilitating their involvement.”

Involvement is not consent

As you see from this quote, involving the person in the safeguarding adults enquiry is not the same as requiring the person’s consent to undertake the enquiry.

This is because local authorities ‘must’ undertake a safeguarding enquiry where the requirements of section 42(1) of the Care Act are met.

We do not require the person’s consent, but we do, of course, want to do everything we can to involve the person in the process.

When consent and the MCA may be relevant in safeguarding cases

I am not saying that consent and the Mental Capacity Act are not relevant to the safeguarding adults process.

It is just that it is not relevant to the question of whether or not a safeguarding adults enquiry is undertaken by a local authority.

My summary below may help you think this through in practice.

Facilitating involvement

Whilst we do not require the person’s consent to undertake the enquiry, we must take steps to facilitate the person’s involvement at the beginning of the enquiry and throughout the safeguarding adults process (Care and support statutory guidance, 14.80).

The person may require the support of an appropriate person, such as a relative, or, if unavailable, an independent advocate, because it appears that the person would have ‘substantial difficulty’ in ‘being involved’ (see safeguarding enquiries and reviews, section 68 of the Care Act 2014).

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In such cases, a person may not be regarded as ‘appropriate’ unless the adult consents to being represented by them or, where they lack capacity to consent, “the local authority is satisfied that being represented and supported by that person would be in the adult’s best interests” (section 68 (5)).

Asking about outcomes

As part of the enquiry, we should take steps to find out what outcomes the person would like to achieve, in line with the principle of empowerment set out in the Care and support statutory guidance at paragraph 14.13:

“I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens.”

Again, this is not a consent/capacity question as, at this stage, no ‘act’ is being carried out for which we require the person’s consent.

This is about gathering the person’s views and wishes, which either the person can do independently or, if not, would be achieved with the support of an appropriate person or an independent advocate. So, it is still about facilitating involvement in the enquiry.

Taking action as a result of an enquiry

The final stage of the process is where an action is being taken as a result of the section 42 enquiry.

The statutory guidance states at 14.79:

“What happens as a result of an enquiry should reflect the adult‘s wishes wherever possible, as stated by them or by their representative or advocate. If they lack capacity it should be in their best interests if they are not able to make the decision, and be proportionate to the level of concern.”

Actions that do not require consent

However, there might be some actions taken as a result of a safeguarding adults enquiry for which we do not require a person’s consent and the Mental Capacity Act would also not apply.

This is by no means an exhaustive list but examples include the police investigating the abuse of a person or the local authority or Care Quality Commission taking contractual/regulatory action against an organisation.

Where consent should be considered

In other cases, we would need to consider whether the person has consented, for example, when asking the person if they would like to change care setting or agency or have support with financial management, managing their online safety or limiting their contact with another person.

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Should the person refuse any action being taken, it would be helpful to reflect on this very important section from 39 Essex Chambers’ Mental Capacity Guidance Note: Assessment and Recording of Capacity: ‘…If you have proper reason to think that the person may lack capacity to take a relevant decision, especially if the consequence of what they are wanting to do is likely to lead to serious consequences for them, it would be simply inadequate for you simply to record (for instance) “as there is a presumption of capacity, [X] decision was the person’s choice.” Indeed, the more serious the issue, the more one should document the risks that have been discussed with P and the reasons why it is considered that P is able and willing to take those risks.’

Should there be a reason to doubt the person’s capacity to make the relevant decision about the action being taken, then the Mental Capacity Act would apply.

Consent issues beyond the MCA

We should also consider whether there may be issues around a person’s decision making that sit outside the Mental Capacity Act.

One example might be where there is coercion or undue influence that limits a person’s ability to make decisions for themselves, but the MCA test isn’t met, ie they are not unable to make the decision because of a mental impairment/disturbance.

In these situations, you may need to call on the inherent jurisdiction of the High Court, through which it can make declarations and orders to protect adults who have mental capacity to make relevant decisions, but are vulnerable and at risk from the actions or inactions of other people (see 39 Essex Chambers’ Mental Capacity Guidance Note – Inherent Jurisdiction for further guidance).

A mindset of empowerment

I hope that this article has given frontline practitioners, safeguarding adult leads, MCA leads and principal social workers some food for thought on this topic.

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I would also hope that by adopting a mindset of involvement, empowerment, and engagement, rather than an illusory – and sometimes ‘tick box’ – requirement to obtain the person’s consent to the enquiry, our approach will be much more person-centred.

It is also vitally important that all local authorities develop accessible resources for the people that they support that explains their rights and our responsibilities, in line with the Care and support statutory guidance‘s principle of accountability:

“I understand the role of everyone involved in my life and so do they.”

For anyone interested in furthering their learning in this area, the webinar ‘An Introduction to Safeguarding Adults with Katie Scott and Nyasha Weinberg’, which is part of 39 Essex Chambers’ The Public Law Podcast series, is a perfect place to start.

James Codling is Mental Capacity Act and Deprivation and Liberty Safeguards training and development manager at Cambridgeshire County Council

If you have a Community Care Inform Adults licence, log in to access more infographics that focus on the essential aspects of social work in relation to domestic abuse.

Hoarding can be described as the collecting of, and inability to discard, large quantities of, goods, objects or information. It may involve neglecting aspects of the home and/or self, resulting in poor sanitary conditions and social isolation.

Hoarding has implications for physical and mental health, wellbeing, housing tenure and safety, which is why intervention to help the person change their hoarding behaviour is so important.

The earlier the intervention, the easier it is for the person to consider change.

When working with someone who hoards, seek to:

1. Develop a rapport.
2. Find activities, work or education that the person enjoyed doing and try to help them engage in community activities.
3. Understand what feelings the person has about themselves, their house and why things are the way they are.
4. Use a strengths-based approach to determine the positive things that a person has in their life or can achieve for themselves and how they would like to manage risk.
5. Consider trauma-informed approaches and methods of motivation and communication.
6. Create cognitive dissonance – the difference between the person and their behaviours – to help them see themselves more positively.
7. Take one small step at a time with lots of encouragement.
8. Use a multi-agency response.
9. Consider wider safeguarding issues such as hate crime, domestic abuse, anti-social behaviour, safeguarding other adults or children in the property or historical abuse.
10. Do not force change if at all possible.

Gaining a person’s trust and supporting them to make change often takes time. Social workers and occupational therapists should work with the pace of the individual concerned whenever possible. Where risks are identified, cases should not be closed because of a lack of engagement without a thorough risk assessment and alternative arrangements being made to continue supporting the person.

The government is reviewing the case for giving social workers in England powers of entry in adult safeguarding cases.

It made the pledge after a review it conducted found practitioners “often [lacked] the necessary tools and resources” to protect people with care needs who were experiencing, or at risk of, abuse from those caring for them.

Social workers who gave evidence to the review, jointly carried out by Home Office and Department of Health and Social Care (DHSC), said the lack of powers to enter people’s homes meant they had few options when families deliberately prevented them from speaking to adults at risk.

The Safe care at home review also found that practitioners struggled to understand or apply legislation, resulting in them not using existing powers effectively enough to protect people with care and support needs

The review, which engaged with 127 people representing 40 organisations, was designed to examine the “scope and accessibility” of existing protections for adults experiencing, or at risk of, abuse in their own home by people providing care.

Concerns over abuse not covered by domestic abuse law

It was triggered by concerns raised by disability groups about the abuse of people by carers who were not “personally connected” to them – ie relatives, partners and ex-partners – under the definition of domestic abuse set out in law.

This meant they were not afforded the protections of the Domestic Abuse Act 2021 (DAA), such as domestic abuse protection notices/orders (DAPNs/DAPOs), which will replace the existing domestic violence protection notices/orders (DVPNs/DVPOs) following pilots in three areas starting this year.

Like their predecessors, police-imposed DAPNs, which last up to 48 hours, and longer-term DAPOs, which must be granted by a magistrate, are designed to give victims immediate protection, including through requiring perpetrators to leave their homes. Unlike with DVPOs, specified third parties will be able to apply to the family court for a DAPO on behalf of someone else at risk.

Care Act ‘should provide protection’

Most stakeholders told the Safe care at home review found that people abused by carers not covered by the DAA domestic abuse definition, such as friends or volunteers, should be protected by the Care Act 2014’s adult safeguarding provisions.

Notably, section 42 of the 2014 act requires councils to make enquiries where it reasonably suspects that an adult in its area with care and support needs is experiencing – or at risk of – abuse or neglect, and is unable to protect themselves because of their needs.

However, stakeholders said that the experiences of victims abused by carers in their own homes “can vary significantly between areas”, with some authorities setting high thresholds for section 42 enquiries due to funding pressures. This included not believing that victims had care and support needs.

Lack of understanding of ‘complex framework’

Frontline practitioners, safeguarding adults board (SAB) chairs and academics also highlighted gaps in understanding of a “complex legal framework”, which meant it was sometimes not being used effectively to protect people.

Social workers and police representatives highlighted problems understanding the interaction between the Care Act and Mental Capacity Act, resulting in section 42 enquiries not being investigated fully where there were doubts about the victim’s capacity to make key decisions.

However, the review said that social workers “often referenced” their lack of a power of entry as a barrier to effectively protecting adults experiencing abuse at home from carers.

Powers of entry rejected during passage of Care Act

During the passage of the Care Act, the then coalition government rejected calls from social workers, charities and parliamentarians to introduce a power for practitioners to gain entry to premises to speak to potential victims of abuse, on the grounds that existing powers were sufficient.

However, an analysis by leading Court of Protection barrister Alex Ruck Keene and then chief executive of Action on Elder Abuse (now Hourglass), Gary FitzGerald, published in the same year (2014), identified gaps in these measures (briefly summarised in the box below).

Social workers in Scotland and Wales do have powers of entry in safeguarding cases, granted through warrants, under the Adult Support and Protection Act (Scotland) 2007 and Social Services and Well-being (Wales) Act 2014, respectively.

Pledge to review powers

The Safe at home review said that practitioners, SAB chairs and academics backed giving such powers to social workers in England to “enable them to better protect and support people with care and support needs who are, or are at risk of being, abused in their own home by the people providing their care”.

On the back of this, it added: “DHSC will review any new and relevant evidence on powers of entry for social workers since this issue was last considered by government during the passage of the Domestic Abuse Act 2021. This should include safeguarding adult reviews in England and the use of equivalent powers in Scotland and Wales.”

In response to the review, the British Association of Social Workers England said that “further exploration of the complexities and the unintended consequences of changes to the legislation is needed and an area which BASW will want to consult further with members on”.

Practitioners ‘under extreme pressures’

However, on behalf of BASW England’s adult thematic group, Michael Chapman said that the review’s recommendations did not reference the current pressures on practitioners.

“The extreme pressures of the Covid-19 pandemic have impacted dramatically on the social work workforce with increased waiting lists for assessments, higher workload and lack of availability and demand for social care services,” he added.

“This may mean that staff less experienced or even unqualified could be leading on investigations, coupled with the pressure to conclude investigations quickly.”