Kate Terroni’s blog

Monthly column for providers and professionals working in adult social care from Kate Terroni, Chief Inspector of Adult Social Care.

This month we published our Promoting sexual safety through empowerment: A review of sexual safety and the support of people’s sexuality in adult social care report. Hopefully you will have seen or heard about the report, as we want this to be the start of an ongoing conversation about a sensitive topic that many people report feeling uncomfortable or poorly equipped to discuss.

Following a similar report into sexual safety incidents in mental health wards in 2018, we worked with families and people who receive social care and had experienced sexual assault or sexual abuse to develop the themes of this report, along with our inspectors, provider organisations and charities to shine the spotlight on this important topic.

We hope that by creating this report we are initiating a conversation in adult social care that will lead to a more open culture, where staff feel they can share concerns without fear of reprisal, where people and families are empowered to speak about their wants and needs in a sensitive way, and where managers and providers proactively enable conversations about sexuality to take place.

The starting point of the report was to analyse the 661 statutory notifications describing sexual incidents or alleged abuse across all adult social care services over a three-month period. These notifications told us that older women were disproportionately affected by sexual assault and abuse and that this abuse or alleged abuse is predominantly by other people in receipt of care. The percentage of people affected in social care are also broadly in line with other data which shows the occurrence of sexual assault and abuse on everyday life.

Recommendation’s in the report include;

• Providers and leaders across adult social care should develop a culture that encourages people and staff to talk about sexuality and raise concerns around safety.
• The development of co-produced guidance for care managers and staff that focuses on how to protect people using adult social care from sexual abuse and how to support them to develop and maintain relationships and express their sexuality.
• CQC should continue to improve the system of provider notifications and how they deal with reported incidents. Through regulation, Inspectors should consider how open cultures are to discuss sex and sexuality and ensure that care plans reflect this.

In the report we include case studies of shocking abuse, but I also want to be clear that the report shows that these incidents are few and far between. We know that working in adult social care is an incredibly hard job and that the majority of people using services are looked after by caring and skilled staff. To highlight this, the report also contains examples of good practice and has an equal focus on promoting sexuality and empowering people to have healthy relationships if they want to.

I encourage you to read the report if you haven’t already, and I hope that if you work in an adult social care service it will make you think about what you do well in this area and perhaps what you could look to improve. We need to work together across systems to improve this area of care and have a collaborative approach to make sure that people are kept safe from this kind of abuse.

To all the families, care providers, charities and stakeholders who invested time into this important piece of work I sincerely thank you.