Government admits to ‘limited’ understanding of home-based care abuse

The government has admitted it has a “limited” understanding of the abuse of disabled people at the hands of their carers and care workers in their own homes.

The government review calls for a “stronger” response to protect disabled and older people from the people who provide them with support at home.

The 86-page Safe Care at Home Review, which was published quietly this week, more than two years after ministers were pushed into carrying out the work by disabled peers, examines the gaps in the protection of adults who risk abuse in their own homes from paid and unpaid carers and care workers.

Among the evidence it heard was cases of disabled people being targeted and groomed to provide sexual favours or money to their carers or care workers.

But it also highlighted the lack of data on the prevalence of abuse in care relationships and found that what data is available is “poorly utilised”.

Data collected by the police on abuse in care relationships varies from force to force, while the Crown Prosecution Service reported “difficulties” in producing data on abuse and neglect within care relationships on its IT systems.

Coroners do not collect information on cases where there might have been a concern about care leading to a death in a person’s home, the review adds.

The government document admits: “This review shows that our understanding of the prevalence and nature of abuse in care relationships is limited.”

Home Office-funded research has previously found that one in six domestic abuse-related deaths involved carers or people receiving care.

The Safe Care at Home Review, which was led by the Home Office and the Department of Health and Social Care (DHSC) and applies only to England, found there were “challenges” in detecting, reporting and investigating abuse in care relationships, with much of it likely to be “hidden from plain sight”.

This is often because the victims are dependent on their carers, have placed trust in them, or have been manipulated or even systematically groomed by the perpetrators, the review says.

Disabled people, their organisations and other experts consulted by the government – including police and social care organisations – said they believed there was a lack of national and local “oversight and accountability” for safeguarding.

They said it was “unclear who holds strategic oversight” for safeguarding adults with care and support needs, at both local and national levels, and that more needs to be done to “hold organisations and agencies to account” to ensure lessons are learned from safeguarding failures.

The review only came across one police force area with a team that was “solely focused on people with care and support needs”.

The review was also told that wider pressures on health and social care services were impacting a system that was already “fragile, under strain and facing difficulties in upholding safeguarding provisions for people with care and support needs”.

There were concerns about the “patchy” long-term funding for specialist support services run by user-led organisations, with a call from “stakeholders” for an increase in sustainable, multi-year investment.

Among its promised actions, the government says it will review key Care Act guidance, “identifying opportunities to clarify the roles and responsibilities of government departments and statutory agencies, and rights and redress for victims and survivors”.

It will also consider commissioning an analysis of past safeguarding adults reviews that have been linked to domestic abuse.

And it will “consider ways in which to incorporate the voices of victims and survivors in policy-making”.

The Home Office and DHSC also plan to consider how they can increase awareness among frontline staff of “the prevalence and signs of abuse of adults by people providing care in their own home”.

And they say they will work with other government departments and partners to “scope further research to better understand this form of abuse in line with the review’s findings”.

In an introduction to the review, care minister Helen Whately writes: “We know that the issues highlighted in the report will not be fixed quickly or easily; this report is the start of a journey to highlight and tackle these issues.”

The government only agreed to carry out the review after refusing to extend protections included in its domestic abuse bill to disabled people abused in their homes by paid care workers and personal assistants, and friends and neighbours who carry out unpaid caring duties.

Attempts to extend those protections had been led in the Lords by Baroness [Jane] Campbell and another disabled crossbench peer, Baroness [Tanni] Grey-Thompson.

But after securing cross-party support in the Lords, their amendments were overturned by MPs, with the junior Home Office minister Victoria Atkins promising instead “a review of the protections for people at risk of carer abuse”.

The bill became the Domestic Abuse Act in May 2021, without their amendments.

Baroness Campbell told peers at the time: “Carer abuse – as evidenced throughout the pandemic and during earlier debates and pre-legislative scrutiny – must not continue unchecked.

“Disabled people deserve to have equivalent protection – no less.”

She later told Disability News Service: “I pushed for the amendment largely to shine a light on this very hidden menace, which blights the lives of disabled people.”

Baroness Campbell and Baroness Grey-Thompson were not available to comment on the new review.

Picture: Baroness Grey-Thompson (left) and Baroness Campbell

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