Today, 19th November 2021, will mark Ireland's first Adult Safeguarding Day. According to Safeguarding Ireland, an organisation which promotes safeguarding of vulnerable adults to protect them from all forms of abuse by persons, organisations and institutions and to develop a national plan for promoting their welfare, Safeguarding is "putting measures in place to uphold our rights, to support our health and wellbeing, to reduce our risk of harm – and to empower us to protect ourselves."
National Adult Safeguarding Day raises awareness of safeguarding issues for adults who may be at risk of abuse. Types of abuse experienced by adults include: Physical, Emotional, Financial, Sexual, Organisational, Online abuse and Neglect.
Safeguarding in Ireland
There are nine HSE Safeguarding and Protection Teams (SPTs), one in each CHO (Community Healthcare Organisations) throughout Ireland. Each SPT is tasked with co-ordinating consistent responses to concerns of abuse and neglect. According to the 2020 Annual Report of the HSE National Safeguarding Office, since 2015 there have been some other key advances and developments:
- Setting up of a structure of over 1,900 designated officers across the social care sector with specific lead safeguarding roles.
- Compilation and management of a national database of designated officers who have a lead role for screening and notifying cases of alleged abuse and neglect.
- Development of an inter-sectoral national safeguarding committee now known as Safeguarding Ireland.
- Development and delivery of adult safeguarding training programmes nationally which includes a basic awareness raising training programme for all and specific training for designated officers. Since 2015, there has been over 100,000 completions of safeguarding training.
- Establishment of safeguarding committees in each of the nine CHOs with the aim of supporting the development of a culture which promotes the welfare of vulnerable adults and provide support and advice to the SPTs and senior management.
Key findings from the 2020 report in relation to Safeguarding are:
- Despite the pandemic and resultant societal restrictions, there were over 10,000 safeguarding concerns notified to the HSE in 2020 which is a 9% decline on the figure for 2019.
- Between the years 2016-2020, cumulatively there have been in excess of 51,000 concerns notified to the Safeguarding Teams of the HSE.
- The pattern of age profile of notifications is 66% for those under 65 years of age and 34% for persons aged over 65.
- The total number of notifications for persons aged over 65 was 3,412 in 2020 compared to 3,337 in 2019.
- For persons aged under 65 the most significant category of alleged abuse remains physical abuse followed by psychological abuse.
- For persons aged 65+ the most significant categories of alleged abuse are psychological abuse, physical abuse and financial abuse.
- Alleged financial abuse and neglect increase with age with the highest level of reporting in those over 80 years.
While the 10,153 reports made to the HSE Safeguarding teams amounts to just 2.84 reports per 1,000 of the population, the prevalence of reports increases with age. The rate of reporting per 1,000 adults aged 18 to 64 years was 2.30, compared to 5.35 - more than double - per 1,000 of adults aged 65+.
This is in contrast to a survey conducted by Safeguarding Ireland which found that one in two Irish adults claim experience of vulnerable adult abuse. Physical abuse of vulnerable adults has been witnessed, or suspected, by 1 in 3 adults; and emotional abuse is the most common type with over 1 in 3 having experienced it.
The majority of referrals (65 per cent) to the HSE Safeguarding teams are made by voluntary agencies, 8 per cent were made by Public Health Nurses, and just 2 per cent were made by the adult themselves.
Profile of Alledged Abuser
Consistent with previous years, more than half of all reports of alleged abuse of adults aged 18+ (53 per cent) were made in respect of another service user or peer. More than one in five (22 per cent) concerned an immediate family member, and 17 per cent concerned staff. Of the remaining reports, 3 per cent were in respect of a neighbour or friend, 3 per cent were in respect of an Other Relative, and 2 per cent referred to a stranger.
When disaggregated by age, the data indicates that over two thirds (66 per cent) of reported abuse of adults aged 18 to 64 years was made against another service user or peer, with 17 per cent alleged against staff and 10 per cent alleged against an immediate family member. This compares to reports in respect of adults aged 65+, where 50 per cent were made in respect of immediate family members, 23 per cent against another service user or peer, and 15 per cent against staff.
All reports received by the HSE Safeguarding teams are assessed to determine if there are reasonable grounds for concern. In 2020, 65 per cent of reports received were found to be based on reasonable grounds, with 26 per cent being found to have no reasonable grounds and 9 per cent requiring further information.
At a policy level, Social Justice Ireland has called for more resources for the HSE Safeguarding Teams to fully investigate and address safeguarding concerns and to roll out increased training for medical, social work, and communities engaging with vulnerable adults. In addition, it is beyond time that the Assisted Decision Making (Capacity) Act, 2015 is fully implemented, supported by the resources required to ensure its effectiveness.
For anyone who may be concerned about a vulnerable adult, Safeguarding Ireland's website contains a range of useful resources and supports on spotting and reporting issues of concern.