Adult Safeguarding Research Articles

Safeguarding adults: from realism to ritual

Purpose The landscape of adult social care, and in particular of adult safeguarding, has shifted considerably over the last decade. Alongside policy changes in the responses to adult abuse, there have been shifts in professional and public understanding of what falls within the remit of this area of work. This results, arguably, in differing understandings of how adult safeguarding is constructed and understood. Given the increasing emphasis on multi-agency inter-professional collaboration, service user involvement and lay advocacy, it is important to consider and reflect on how both professionals and lay people understand this area of work. The paper aims to discuss these issues. Design/methodology/approach This study employed Augusto Boal’s model of Forum Theatre to explore how a variety of professional and lay groups understood, related to and engaged with how the Care Act 2014 defines and describes “adult safeguarding”. Findings Lay participants responded to the scenario in a variety of ways, upholding the construct validity of “adult safeguarding” and the authority of the social worker. Social care and health practitioners sought orderly, professionalised and sometimes ritualistic solutions to the “adult safeguarding” scenario presented, seeking carefully to structure and to manage lay involvement. Inter-professional collaboration was often problematic. The role of lay advocates was regarded ambiguously and ambivalently. Originality/value This paper offers a number of practice and research recommendations. Safeguarding practitioners could benefit from more effective and reflexive inter-professional collaboration. Both practitioners and service users could benefit from the more thoughtful deployment of the lay advocates encouraged within the Care Act 2014 and associated guidance.

Parliamentary arguments on powers of access – the Care Bill debates

Purpose Opinion is divided on whether a new power of entry should be introduced for social workers in cases where individuals seem to be hindering safeguarding enquiries for community-dwelling adults at risk in England who have decision-making capacity. The purpose of this paper is to investigate the prevalence and circumstances of situations where access to an adult at risk is denied or difficult and what helps those in practice. The study consists of a literature review, a survey of adult safeguarding managers and interviews with social care staff in three case studies of local authorities. As part of the contextual literature review, during 2014 the authors located parliamentary debates on the subject and this paper reports on their analysis. Design/methodology/approach Following approaches were used in historical research, documentary analysis was carried out on transcripts of parliamentary debates available online from Hansard, supplemented by other materials that were referenced in speeches and set in the theoretical context of the representations of social problems. Findings The authors describe the content of debates on the risks and benefits of a new right to access for social workers and the role of parliamentary champions who determinedly pursued this policy, putting forward three unsuccessful amendments in efforts to insert such a new power into the Care Act 2014. Research limitations/implications There are limits to a focus on parliamentary reports and the limits of Hansard reporting are small but need to be acknowledged. However, adult safeguarding research has surprisingly not undertaken substantial analyses of political rhetoric despite the public theatre of the debate and the importance of legislative initiatives and monitoring. Originality/value This paper adds to the history of adult safeguarding in England. It also offers insight into politicians’ views on what is known/unknown about the prevalence and circumstances of the problems with gaining access to adults with capacity where there are safeguarding concerns and politicians’ views on the merits or hazards of a power of access.

Resolve: a community-based forensic learning disability service specialising in supporting male sex offenders – our model, approach and evidence base for effective intervention

Purpose The purpose of this paper is to examine a model of effective forensic practice with positive interventions for men with learning disabilities who have committed serious sexual offences. It outlines the theoretical and philosophical frameworks which have informed the model of care and support in a community-based setting and the evidence base for the efficacy of the approach. Design/methodology/approach This approach to a community-based forensic learning disability service is informed by systemic practice and underpinned by models of human occupation (Keilhofner, 2008) which informs occupational therapy and total attachment (Harbottle et al., 2014). This is a whole systems model for developing compassionate and participatory practice based on attachment theory and approaches to professional parenting drawn from foster care settings and prevention frameworks for adult safeguarding. It uses Klinean Thinking Environments (1999) to give practical communication to the model. Findings The attachment model which underpins both the support for staff and the framework for scaffolding the care and support provided for service users is building calm, consistent and respectful relationships. This enables workers and service users to feel accepted through the availability of support; to feel a sense of belonging and inclusion in which skills and confidence can flourish helping all to feel more effective. This is evidenced by the stability of the service user group and the staff team. Research limitations/implications The model of whole system care and support care outlined in this paper can help to provide a therapeutic environment in which men who have committed sexual offences can develop effective skills within a safe, supportive and effectively managed setting. This is on-going research but there is evidence of service users and staff in this model of practice, feeling scaffolded, able to enjoy and achieve progress and personal development. Practical implications This model appears to promote stable, sustained, supportive relationships. Placement breakdown has been minimal indicating that the disruption rate is low and therefore therapeutic interventions are likely to take place and be effective. This is a hopeful and positive approach which enables individuals to flourish in a safe environment. Social implications The social implications of this model are positive for creating a stable workforce in an industry plagued with rapid turn over of staff to the detriment of the quality of life for service users. It creates stability and confidence for the residents allowing them to begin to relax and thereafter achieve more positive relationships. Originality/value This paper examines the application of theoretical frameworks drawn from other disciplines and fuses them into a therapeutic approach to support this service user group. It is a model that can have great portability to other settings but it is its application in forensic services that is new and which is growing its evidence base for its effectiveness.

A preventable death? A family’s perspective on an adult safeguarding review regarding an adult with traumatic brain injury

Purpose The purpose of this paper is to review the care management of a man with a traumatic brain injury (TBI) from a family member’s perspective. Design/methodology/approach The paper provides a case history of “Tom” both prior to his TBI and after. Findings Tom was the subject of a safeguarding adults case review in Somerset following his death in 2014. Ultimately the paper highlights the shortcomings and failures in the care Tom received by various organisations which ultimately contributed to his suicide. Practical implications The paper highlights the need for more effective communication between professionals managing the care of those with TBI. Furthermore, professionals need training in the need for mental capacity assessments and improved safeguarding and risk assessments with adults with TBI. Originality/value This paper provides insight into the needs of an adult with TBI from the perspective of a family member who is also a trained psychologist.

Developing Vulnerability: A Situational Response to the Abuse of Women with Mental Disabilities

In this paper I present a critical analysis of the English law relating to the safeguarding of vulnerable adults, in particular how the law impacts on the sexual lives of adult women with mental disabilities. I consider the discourses of vulnerability that surround the different legal regimes and whether the emerging theoretical vulnerability literature can assist in developing more nuanced legal responses. I argue that the inherent jurisdiction and Care Act 2014 provide an opportunity to move away from the focus on inherent features of vulnerability such as mental disability towards a more nuanced, situational and embodied account of what it means to safeguard ‘vulnerable adults’. This has the potential to be developed in England through the new legal framework of the Care Act and can be achieved through targeting interventions against the situational causes of vulnerability, for example the perpetrators of sexual violence.

The role of the general practice surgery in safeguarding adults

Purpose First, the authors summarise arrangements expected from general practice (GP) surgeries, to optimize their safeguarding adults role. Second, using case-based discussions, the authors present specific safeguarding pathways (through which the authors have produced a downloadable interactive app) that the authors have developed to help Derbyshire GPs respond appropriately to safeguarding adults concerns. Third, the authors present the Derbyshire clinical commissioning Groups’ (CCG) approach to seeking assurance from their GPs that they have effective safeguarding adults arrangements in place. The paper aims to discuss these issues. Design/methodology/approach The authors have based the paper on relevant current UK legislation and national guidance, the local approach to seeking assurance from GP surgeries; the authors adjusted the pathways on the basis of feedback received from eight out of 103 (7.76 per cent response rate) Derbyshire GP safeguarding leads who responded to an e-mail containing draft pathways. Findings Primary care staff are ideally placed to identify safeguarding adults issues and to act to protect those who are at risk of abuse or neglect. Originality/value The authors are unaware of any other paper that does all of the following: summarises policies GP surgeries should implement regarding safeguarding adults; details core competencies required of GPs regarding safeguarding adults; presents how CCGs can seek assurance from GP surgeries regarding safeguarding adults; and presents straightforward pathways for specific safeguarding adults scenarios. In one paper, now published in the British Journal of General Practice, the authors presented a generic safeguarding adults pathway.

The potential uses and abuses of a power of entry for social workers in England: a re-analysis of responses to a government consultation

Purpose Whether social workers should have a power of entry in cases where individuals seem to be hindering safeguarding enquiries for community-dwelling adults at risk is a topical question in England. The purpose of this paper is to present the findings of a re-examination of relevant sections of the 2012 Government Safeguarding Power of Entry Consultation. Design/methodology/approach Re-analysis of responses to question three of the 2012 Government’s Safeguarding Power of Entry Consultation was undertaken in late 2015-early 2016. The consultation submissions were located and searched for information on views of the prevalence of the situations where access to an adult at risk (with decision-making capacity) is being hindered by a third party and the nature of examples where a new power of entry might be considered appropriate by consultation respondents. Findings The majority of respondents to the consultation generally reported that situations when a new power of entry would be required were not encountered regularly; however a minority of respondents stated these situations occurred more frequently. Examples of situations where third parties appeared to be hindering access were given across the different categories of adults at risk and types of abuse and current practices were described. Respondents observed that the risks of excessive or inappropriate use of any new powers needed to be considered carefully. Originality/value This re-analysis sheds light on the prevalence and circumstances of the problems encountered about access to adults at risk. The legal framework of adult safeguarding continues to be of interest to policy makers, researchers and practitioners.

‘I was just gobsmacked’: Care workers’ responses to BBC Panorama’s ‘Undercover Care: The Abuse Exposed’; invoking mental states as a means of distancing from abusive practices

This article draws upon discourse analytic techniques and discursive psychology to examine how care workers build accounts of viewing the BBC Panorama programme ‘Undercover Care: The Abuse Exposed’, which graphically documented the abuse of people with learning disabilities in a residential care setting. A total of 56 interviews were conducted as part of a project concerning adult safeguarding. The analysis considers how care workers report their reactions and the interactional strategies they use to construct themselves as shocked and disbelieving, and thus as oppositional to the extreme practices in the programme. Their role as care workers, and therefore as ‘insiders’ of the industry that allowed such abuse to happen, makes matters of stake and agency live issues for this particular group; and constructions of ‘shock’ and ‘disbelief’ are potential ways for participants to distance themselves from the abuse shown in the programme. More broadly, these data show how the invocation of mental states contributes to the management of other discursive business, namely, that of fending off any association with the aforementioned extreme practices.

Engaging with the New System of Safeguarding Adults Reviews Concerning Care Homes for Older People

Engaging with the New System of Safeguarding Adults Reviews Concerning Care Homes for Older People

Update on adult safeguarding

Purpose – The purpose of this paper is to provide an update for readers on recent issues relating to adult safeguarding, together with signposting of papers in this issue of the journal. Design/methodology/approach – A review of recent media, news and policy related items was undertaken and key findings are reported. Findings – A range of findings and information pertinent to adult safeguarding is presented in the paper for readers to consider. Practical implications – Some of the issues and perspectives presented in the paper may be of relevance for professional practice and readers may wish to disseminate such aspects to colleagues in order to inform practice initiatives. Originality/value – The paper provides an update and overview of recent topics that are linked to adult safeguarding and protection and draws these together in an accessible format.

An evaluation of adult safeguarding outcomes’ focused recording in the context of Making Safeguarding Personal

Purpose – The purpose of this paper is to evaluate the impact in one local authority of Making Safeguarding Personal (MSP) upon the recording of outcomes in safeguarding interventions. To determine to what extent person centred outcomes were in evidence. Design/methodology/approach – Analysis of data provided by the local authority across adult safeguarding teams informed by a critical theory approach. Findings – There is a need for cultural and system change to fully embed MSP principles within local authority safeguarding. This case study identified that practitioner recording was inconsistent with the need for greater recognition of person centred approaches within adult safeguarding. Views of the service user are constructed and moderated by the assessing professional and the user voice is seldom evident in recording of safeguarding interventions. Research limitations/implications – This study was wholly reliant upon the data provided rather than primary investigations with practitioners and service users. The focus on recorded data permitted variance and recorded data were open to worker interpretation. MSP. The starting premise of the methodology by adopting a critical perspective sought to elevate the perspective of marginalised service user groups. This may have unduly framed the practitioner provider from a deficit position. Practical implications – The need to ensure MSP approaches are embedded fully in all aspects of local authority safeguarding. There is a need for recording to greater reflect principles of empowerment with the wishes of service users, their narratives and actual words providing greater weight to assessment. Social implications – The power shifts apparent in the principles supporting The Care Act needed to be embedded in safeguarding to support marginalised adults. Originality/value – MSP is a relatively new development for safeguarding adults and the evidence base is building. This paper focuses on the recorded outputs of safeguarding interventions which complements work already produced which has focused on system and strategic changes.

Putting people at the centre: facilitating Making Safeguarding Personal approaches in the context of the Care Act 2014

Purpose – The purpose of this paper is to describe and discuss the pilot Making Safeguarding Personal (MSP) project that ran in three London boroughs in England in 2014-2015. The project aimed to help local authority social work practitioners better engage with adults at risk at the beginning, middle and end of safeguarding work and to develop a more outcomes focused approach to safeguarding. Design/methodology/approach – Three adult social care teams volunteered to take part in the MSP pilot for four months, November 2014-February 2015. They were closely supported through telephone conferencing, bespoke training and individual mentoring. Evaluative data were collected from the participating teams about their work and the MSP change processes to assist in further implementation. Findings – The findings suggested that staff felt that the open discussions with adults at risk that were encouraged by the MSP initiative enabled safeguarding to be more effective and provided a better basis of support for adults at risk. The support from the project team was appreciated. Staff reported their own increased confidence as a result of involving adults at risk in decisions about their situations and risks of harm. They also reported their increased awareness of cross-cutting subjects related to adult safeguarding, such as domestic abuse and working with coercive and controlling behaviours. Permission to exercise greater professional discretion to make responses more considered, rather than the need to adhere to time-limited imperatives, was received positively. Staff felt that this enhanced discussions about resolution and recovery with adults at risk although it required greater expertise, more extensive managerial support, and more time. These were available in the pilot. Research limitations/implications – The MSP pilot was confined to three teams and took place over four months. The numerical data reported in this paper are provided for illustrative purposes and are not statistically significant. As with other evaluations of implementation, the data provided need to be set in the local contexts of population profiles, care settings and the reporting source. The pilot also took place during the early implementation of the Care Act 2014 which affected the context of practice and training. The views of adults at risk were not collected. There is a risk of bias in that participants may have wished to convey positive views of MSP to their colleagues. Practical implications – The paper indicates a need for the roll out of MSP philosophy and MSP approaches to be communicated with other agencies supporting adults at risk and for project support of some form to continue. It will be important to see if the overall enthusiasm, support and motivation reported by the pilot teams when taking a MSP approach in practice extend beyond a pilot period during which the staff received substantial support from a dedicated Professional Standards Safeguarding Team. Many of those staff participating in the pilot perceived the MSP approach as a return to core social work principles and welcomed putting these into practice. Originality/value – The paper provides details of one pilot in which the feasibility of the MSP approach was tested by supporting three frontline teams working in different contexts. The pilot suggests that the level and type of support offered to the pilot teams were effective in a variety of practice settings. It draws attention to the need for the MSP concept and approach to be shared with other agencies and for implementation support to continue beyond initial pilot period.

The feasibility of introducing an adult safeguarding measure for inclusion in the Adult Social Care Outcomes Framework (ASCOF): findings from a pilot study.

BackgroundThere are currently no national measures in England reporting the experiences of people who have been involved with adult safeguarding services following concerns that they may be at risk of abuse or neglect. The Health and Social Care Information Centre (HSCIC) aimed to develop a new adult safeguarding outcome measure (survey) for local authorities (LAs) that could be added to the Adult Social Care Outcomes Framework (ASCOF). The ASCOF is a national collection of social care outcomes performance indicators collected from the perspective of people receiving partial or total funding from a LA for care services.MethodsAn outcome measure (a face-to-face interview based survey consisting of 7 questions) was piloted in 40 LAs with 382 adults at risk (or their representative) who had been the subject of a safeguarding investigation. The aim was to investigate the feasibility of the survey in three domains: i) if a statistically representative sample of adults at risk (or their family, friend, carer or advocate) could be recruited; ii) analysis of survey responses and its acceptability to participants iii) feedback from LAs about the survey’s administration.Results and discussionOverall the survey results met statistical confidence; however the individual results for adults at risk did not, due to the high proportion of representatives who responded because adults at risk were unable. Responses to the survey were generally positive; 72 % of participants felt that the help received during the safeguarding investigation had made them or the adult at risk (if reporting as a proxy) feel ‘quite a bit’ or ‘a lot safer’. These results are the most robust data collected in England on the perspectives of adults at risk and their representatives on safeguarding services. Participants reported they appreciated being asked for feedback. LAs suggested survey administration improvements.ConclusionsThis survey is one way LAs can meet their new legal requirement under the Care Act 2014 to ‘seek feedback’ from adults at risk about adult safeguarding services. The survey findings provide the first robust evidence that safeguarding services in the main meet their goals of promoting feelings of safety among adults at risk.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1464-9) contains supplementary material, which is available to authorized users.

Exploring the complexities of understanding vulnerability and adult safeguarding within Christian faith organisations

Purpose – The purpose of this paper is to report the findings from a study exploring the understanding of vulnerability and adult safeguarding within Christian faith-based settings. The paper concludes with recommendations for practitioners involved in safeguarding adults in faith-based Christian settings. Design/methodology/approach – The paper considers a survey (n=3,182) into understanding of vulnerability and adult safeguarding for individuals who attend Church regularly or work in a Christian organisation Findings – This study is the first to be undertaken with a UK sample and highlights a range of factors informing adult safeguarding practice within Christian organisations. This includes: complexity linked to understanding vulnerability and its role in safeguarding activity; lack of clarity about what to do with a safeguarding adult concern; and the need for safeguarding training pertinent to the particular needs of faith-based settings. Research limitations/implications – As there is currently a dearth of research in this area this paper makes a valuable contribution to the developing knowledge base around safeguarding and vulnerability within faith-based organisations. Practical implications – Professionals need to develop increased understanding of the complexities involved in safeguarding activity, and specifically how those working in the wider context of supporting vulnerable adults make sense of safeguarding processes and procedures. Social implications – It is important that all organisations, including faith-based settings, working with adults have an understanding of their roles and responsibilities with respect to safeguarding those at risk of harm. Originality/value – This paper is the first UK study to consider safeguarding adults at risk of harm in Christian faith contexts.

Implications of divergences in adult protection legislation

Purpose – The purpose of this paper is to explore the similarities and differences of legal responses to older adults who may be at risk of harm or abuse in the UK, Ireland, Australia and the USA. Design/methodology/approach – The authors draw upon a review of elder abuse and adult protection undertaken on behalf of the commissioner for older people in Northern Ireland. This paper focusses on the desk top mapping of the different legal approaches and draws upon wider literature to frame the discussion of the relative strengths and weaknesses of the different legal responses. Findings – Arguments exist both for and against each legal approach. Differences in defining the scope and powers of adult protection legislation in the UK and internationally are highlighted. Research limitations/implications – This review was undertaken in late 2013; while the authors have updated the mapping to take account of subsequent changes, some statutory guidance is not yet available. While the expertise of a group of experienced professionals in the field of adult safeguarding was utilized, it was not feasible to employ a formal survey or consensus model. Practical implications – Some countries have already introduced APL and others are considering doing so. The potential advantages and challenges of introducing APL are highlighted. Social implications – The introduction of legislation may give professionals increased powers to prevent and reduce abuse of adults, but this would also change the dynamic of relationships within families and between families and professionals. Originality/value – This paper provides an accessible discussion of APL across the UK and internationally which to date has been lacking from the literature.

Adult social work and high-risk domestic violence cases

Summary This article focuses on adult social work’s response in England to high-risk domestic violence cases and the role of adult social workers in multi-agency risk and assessment conferences. The research was undertaken between 2013 and 2014 and focused on one city in England and involved the research team attending multi-agency risk and assessment conferences. Interviews with 20 adult social workers, 24 multi-agency risk and assessment conferences attendees, 14 adult service users at time T1 (including follow-up interviews after six months, T2), focus groups with independent domestic violence advocates and Women’s Aid and an interview with a Women’s Aid service user. Findings The findings suggest that although adult social workers accept the need to be involved in domestic violence cases they are uncertain of what their role is and are confused with the need to operate a parallel domestic violence and adult safeguarding approach, which is further, complicated by issues of mental capacity. Multi-agency risk and assessment conferences are identified as overburdened, under-represented meetings staffed by committed managers. However, they are in danger of becoming managerial processes neglecting the service users they are meant to protect. Applications The article argues for a re-engagement of adult social workers with domestic violence that has increasingly become over identified with child protection. It also raises the issue whether multi-agency risk and assessment conferences remain fit for purpose and whether they still represent the best possible response to multi-agency coordination and practice in domestic violence.

P188 Safeguarding adults attending an inner city sexual health service

Background/introduction Adult safeguarding is the process of protecting vulnerable adults from harm or exploitation. In 2014 our sexual health clinic introduced an adult safeguarding proforma and a regular adult safeguarding meeting. Aim(s)/objectives To evaluate the impact of a new safeguarding pathway. Methods Retrospective case note review of patients entered onto the safeguarding database from April-December 2015. Results Of 14833 adult attendances, 148 patients were identified as vulnerable (1.0% vs 0.3% in 2013, p Discussion/conclusion A large number of vulnerable adults attend our service, highlighting the importance of robust safeguarding procedures. Greater numbers were identified following introduction of a new safeguarding pathway.

Implementing safeguarding and personalisation in social work: Findings from practice

Summary This paper reports on part of a research study carried out in three local authority adult social care departments in England, which explored links between adult safeguarding and personalisation. The study included statistical analysis of data on safeguarding referrals and the take up of personal budgets and qualitative interviews with managers, social workers, other staff working on safeguarding and with service users. The paper reports the findings from 16 interviews with managers and social workers, highlighting their perspectives and experiences. Findings Five main themes emerged from our analysis: contexts and risk factors; views about risks associated with Direct Payments, approaches to minimising risk; balancing risk and choice; and weaving safeguarding and personalisation practice. Social workers identified similar ranges and kinds of risks to those identified in the national evaluation of Individual Budgets. They described a tension between policy objectives and their exercise of discretion to assess and manage risks. For example, some described how they would discourage certain people from taking their personal budget as a Direct Payment or suggest they take only part of a personal budget as a Direct Payment. Application This exploratory study supports the continued need for skilled social workers to deliver outcomes related to both safeguarding and personalisation policies. Implementing these policies may entail a new form of ‘care and control’, which may require specific approaches in supervision in order to ensure good practice is fostered and positive outcomes attained.

The Advantages and Disadvantages of Different Models of Organising Adult Safeguarding

Professionals express divergent views about whether adults at risk are best served by safeguarding work being incorporated into social workers’ casework or being undertaken by specialist workers within local area or centralised teams. This paper draws on findings from the final two phases of a three-phase study which aimed to identify a typology of different models of organising adult safeguarding and compare the advantages and disadvantages of these. We used mixed-methods to investigate four different models of organising adult safeguarding which we termed: A) Dispersed-Generic, B) Dispersed-Specialist, C) Partly-Centralised-Specialist and D) Fully-Centralised-Specialist. In each model, we analysed staff interviews (n = 38), staff survey responses (n = 206), feedback interviews (with care home managers, solicitors and Independent Mental Capacity Advocates) (n = 28), Abuse of Vulnerable Adults (AVA) Returns, Adult Social Care User Survey Returns (ASCS) and service costs. This paper focuses on qualitative data from staff and feedback interviews and the staff survey. Our findings focus on safeguarding as a specialism, safeguarding practice (including multi-agency working, prioritisation, tensions, handover, staff confidence and deskilling) and managing safeguarding. Local authority (LA) participants described and commented on the advantages and disadvantages of their organisational model. Feedback interviews offered different perspectives on safeguarding services and implications of different models.

Models of Adult Safeguarding in England: Findings from a Study of Costs and Referral Outcomes

Adult safeguarding is the subject of increasing attention in England and internationally. This article draws on research which developed a typology of ‘models of safeguarding’. ‘Models’ refer to different ways local authorities in England organise adult safeguarding (about which there is little evidence) rather than ‘model’ approaches to be emulated. The four models identified were: Dispersed-Generic (safeguarding work undertaken by operational teams); Dispersed-Specialist (safeguarding work undertaken partly by specialist social workers located in operational teams); Partially Centralised-Specialist (some safeguarding work undertaken by a central specialist safeguarding team); and Fully- Centralised-Specialist (all safeguarding work undertaken by a specialist safeguarding team). We explored associations between these models and other important variables (numbers of referrals, kinds of alleged abuse and characteristics of adults at risk) and outcomes. The article reports secondary analysis of English local authority safeguarding referral data and on the possible different costs of different models. Dispersed-Specialist sites appeared to have a higher rate of substantiating alleged abuse compared with other models. Statistical correlations were found with types of victim profiles and the perpetrator/victim relationship. It may be that decisions about local organisation of safeguarding are more affected by local organisational contexts than local authority model.