The discriminatory abuse self-assessment tool is intended to support councils, Safeguarding Adult Boards (SABs), practitioners from all sectors, staff responsible for reporting adult social care (ASC) performance; safeguarding leads and commissioners.
This tool aims to better identify, report and analyse activity; be aware of any bias and challenge discriminatory abuse in their practice; develop processes and policies on tackling discriminatory abuse; and embed good practice to deliver good equality outcomes for people who have care and support needs. In attempting to understand discriminatory abuse, all partners and professionals also need to understand the underlying principles and practice of equity, equality, diversity and inclusion.
Discriminatory abuse is described in the Care and Support Statutory Guidance in terms of ‘forms of harassment, slurs or similar treatment because of race, gender and gender identity, age, disability, sexual orientation, religion’ (Section 14.17). Beyond this, there is very little guidance on what discriminatory abuse looks like, especially as this was a new addition to the abuse type.
There has also been little development in the area, beyond ‘mate hate’ and sometimes this may reside in Community Safety or the police and may not be registered as a safeguarding concern. Safeguarding Adult Reviews, as recognised by both Mason et al (2022) and Biswas Sasidharan (2021) have often not made explicit connection between discriminatory actions and discriminatory abuse.
This requires a local authority and its partners to be able to:
recognise discrimination and discriminatory abuse
identify discriminatory practice, structural and institutional discrimination, both intentional or unintentional
identify areas of activity that local authorities and their partners need to address to deliver better outcomes for people across all the equality strands.
Additionally, those public sector partners are expected to demonstrate ‘due regard' to the Public Sector Equality Duty as set out in the Equality Act 2010.
This self-assessment tool attempts to be a practical tool to promote the making of connections between the experiences of discriminatory abuse and adult safeguarding so that safeguarding teams, ASC, SABs and their partners can be the change and generate understanding. Regardless of methodologies or tools employed there is an urgency to address an overlooked abuse type in adult safeguarding.
This tool sets out what local authorities are required to do and allows them to measure their progress against three levels: developing; achieving; and excelling.
The levels are progressive and cumulative so an organisation can build, design and map their progress against different priorities. Organisations can be at different levels of the self-assessment tool for different categories.
The categories for the self-assessment tool are: SABs; practitioners; staff responsible for reporting on ASC performance; safeguarding adults leads; and commissioners.
This tool builds on a roundtable event on 14 July 2022, and our subsequent paper, which was developed from summaries of discussions from the breakout rooms and the presentations.
The discussions were structured in response to three questions:
What do you understand by the terms: discrimination and discriminatory abuse?
What do you know about discriminatory abuse in your area and how do you know it? (What don’t you know and what do you need to find out? What are the gaps and challenges?)
Is the safeguarding adults’ system discriminatory in of itself and what can we do to change this? What are the blocks and barriers (for example, culture terminology, reporting systems, and the like)?
The roundtable discussions recognised that discrimination was much broader than discriminatory abuse. Discriminatory abuse was specific to those with care and support needs, which was understood to be defined within the Care Act 2014 and related to the protected characteristics defined in the Equality Act 2010. There was also a recognition that there were groups of people that may experience discrimination, such as those who were experiencing homelessness or substance misuse, who may not be considered under the discriminatory abuse category.
It might be helpful to consider having some discussions to prompt action:
What are the blocks and barriers to recognition of discriminatory abuse across the different protected characteristics? Is there better understanding of some equality groups than others and why? How is assurance sought?
How can discriminatory practices be addressed in safeguarding adults’ strategies, policy practice and procedures?
What level of understanding do practitioners and managers have on discriminatory abuse and discriminatory practice?
How are SABs assured differences in languages and cultural difference (real or perceived) are broached?
How can professional curiosity, unconscious bias and equality and diversity be addressed in discriminatory abuse?
Are older people considered for domestic abuse services and resources such as refuge information? Are there other groups who are likewise not considered for domestic abuse services and resources?
Do you have a clear implementation plan to support teams to embed the work?
Developing: The SAB is beginning to develop its understandings of discriminatory abuse and with its partners locally.
The SAB has an agreed understanding of what constitutes discriminatory abuse.
The SAB ensures that equality intentions are embedded into safeguarding policies with an explicit commitment to addressing discriminatory abuse within safeguarding policies and procedures.
In the triaging of Safeguarding Adults Reviews (SARs), discriminatory abuse is considered if a factor in the SAR.
SABs recognise and collect equalities data on SARs or potential SARs they are carrying out.
Achieving: The organisation has shared understandings of discriminatory abuse with partners which supports changes to its services and priorities.
SAB members are assured that their organisation has had awareness raising/training to increase understanding of discriminatory abuse.
The SAB is assured that members of their organisation have identified and understood what microaggressions and indirect discriminatory practices are.
SAB members are assured that people in their organisation can challenge discriminatory practice.
SABs enable opportunities for reflective practice with partners around discriminatory abuse and culturally informed practice.
Excelling: The organisation and its partners have a good understanding of discriminatory abuse and is embedding culturally informed practice
SABs are assured that anti-discriminatory practice and culturally informed practice are embedded in outcome-based approaches across the locality to reduce discriminatory abuse.
SABs use qualitative and quantitative reviews and audits to monitor the effectiveness of their work and partner agencies.
Through SAB subgroups and engaging with equality groups and experts by experience take a lead in developing policy and procedures to ensure a culture of culturally informed practice.
Consider multi-agency training opportunities addressing findings of SARs and audits where discriminatory abuse is identified to improve practice and outcomes.
Require all agencies to develop action plans for any improvement required to identify report and reduce discriminatory abuse.
Agencies and organisations share people experience of discriminatory abuse and report them to the SAB so that this can inform the Board’s work.
Consider how to approach discriminatory abuse in closed environments in the locality.
Developing: Practitioners are beginning to develop understandings of discriminatory abuse.
Practitioners adopt a person-centred approach, which includes culturally informed practice (which extends beyond race and ethnicity to gender, age, sexual orientation, faith, socioeconomic status, etc.).
Practitioners have a good and consistent understanding of what constitutes discriminatory abuse across all equality strands.
Practitioners are familiar with their organisational policies on discriminatory abuse and broader anti-discriminatory policies and practice.
Discriminatory abuse is identified and reported by front line staff either when concerns are reported or when enquiry is followed up.
The practitioner has had awareness raising/training to increase understanding of what discriminatory abuse is.
The LA has identified potential areas where discriminatory abuse and is working with partners to avoid hidden discriminatory abuse.
Practitioners ensure that that culturally informed information is shared with all relevant partners involved in care and support activities and that these are considered in any safeguarding concerns that emerge.
Achieving: Practitioners have shared understandings of discriminatory abuse, identifying patterns of negative safeguarding practice.
The practitioner recognises bias towards adults with care and support needs who have a protected characteristic.
The practitioner can identify and understand what microaggressions and indirect discriminatory practices are. They can apply that understanding to all the equality strands.
Beginning to identify additional considerations that may be needed to keep adults with protected characteristics safe from discriminatory abuse and neglect.
Identifying patterns of negative safeguarding experiences of people with care and support needs who share the same equality strand.
Being confident to challenge poor discriminatory abuse safeguarding practice.
Where appropriate, the adult is asked explicitly about their experience of discrimination. Being aware of poor culturally informed practice that leads to poor practice in safeguarding.
Practitioners understanding how best to access support for people experiencing abuse and neglect due to discriminatory abuse.
Ensuring that practitioners are aware of the preventative measures/ services that may be put in place to protect the adult experiencing discriminatory abuse.
Excelling: Practitioners have a good understanding of discriminatory abuse and are building on their learning to improve outcomes for adults.
Reporting regularly on discriminatory abuse and is everyday business in adult safeguarding.
Using thematic case files audits to improve recognition and identification of discriminatory abuse.
Working with partners to address identified gaps in understanding of discriminatory abuse.
Understanding the underlying issues or sources/causes of discriminatory abuse with a view to developing preventative work.
Understanding factors that increase the likelihood of discriminatory abuse and reducing that risk.
Working with communities and interest groups to gather expertise and experts by experience to better understand how discriminatory abuse is experienced.
Being able to demonstrate interpersonal skills in having culturally informed conversations, including ‘difficult conversations’.
Identify and respond effectively to factors that increase vulnerability to discriminatory abuse.
Knowledge of how discriminatory abuse may affect individuals’ decision-making processes.
Developing: The council has plans in place to collect and record discriminatory abuse as an abuse type and to share with NHS Digital through the Safeguarding Adults Collection (SAC).
ASC performance knows what equality information/data it currently collects about the people using care and support services.
ASC performance knows what gaps they have in their data about the people using care and support services.
Recording discriminatory abuse as an abuse type is incorporated when recording safeguarding concerns and enquiries.
System limitations/barriers to recording discriminatory abuse (for example only being able to note a ‘primary’ abuse type on the system) on their recording system are identified.
Achieving: The organisation has collected and recorded discriminatory abuse data which have been sent to NHS Digital as a part of the SAC.
The organisation has a good understanding of what the landscape looks like locally and areas that needs further development/investigation.
Performance Reports identify trends in reporting discriminatory abuse.
Quantitative data is compiled for discriminatory abuse and any improvement of quality of data is identified for the SAC returns.
Data is regularly reviewed and used to set safeguarding priorities by geography and protected characteristics.
Systems limitations/barriers to recording of discriminatory abuse data are being addressed.
Plans for developing and improving data collection for equality characteristics are being implemented.
Excelling: The organisation has a few years of equality and discriminatory abuse data, have identified gaps and are working to address them.
The organisation has also developed understanding about indirect discrimination and recording and reporting them.
Direct as well as indirect discriminatory abuse are being recorded and reported routinely.
There is timely collection of equality data regarding individuals prior to safeguarding issues arising, so that adults using services do not have to give this information at the point of the concern/enquiry.
Developing: Safeguarding adult leads have begun to grow cultural informed practice amongst staff
You are assured that practitioners recognise and take appropriate action on discriminatory abuse.
There is provision of training and supervision to develop and promote culturally informed practice that is appropriate and proportionate.
There are clear policies and procedures that supports practitioner understanding and practice of discriminatory abuse.
There is evidence of professional curiosity and cultural competency in practice.
Staff are building their culturally informed competency.
There is consideration of how complaints and compliments are shared, and safeguarding concerns/enquiries where there has been discriminatory abuse. This is used to identify strengths and areas for development.
Objectives regarding discriminatory abuse are integrated into organisational strategies and plans. There is evidence of a link between culturally informed objectives, recognition, and action on addressing discriminatory abuse in business planning and performance management. Progress is regularly monitored and reviewed.
Achieving: Safeguarding adult leads are building an evidence-based understanding of how discriminatory abuse is being approached
You are assured that practitioners recognise and take appropriate action on discriminatory abuse.
There is provision of training and supervision to develop and promote culturally informed practice that is appropriate and proportionate.
There are clear policies and procedures that supports practitioner understanding and practice of discriminatory abuse.
There is evidence of professional curiosity and cultural competency in practice.
Staff are building their culturally informed competency.
There is consideration of how complaints and compliments are shared, and safeguarding concerns/enquiries where there has been discriminatory abuse. This is used to identify strengths and areas for development.
Objectives regarding discriminatory abuse are integrated into organisational strategies and plans. There is evidence of a link between culturally informed objectives, recognition, and action on addressing discriminatory abuse in business planning and performance management. Progress is regularly monitored and reviewed.
Safeguarding teams are responding to evidence of discriminatory (for example: performance data; case file audits; case studies; SARs; thematic reviews; etc.)
Services review safeguarding practice and seeks a consistent approach/emphasis on all the equality characteristics
Ensure that there is a shared understanding of discriminatory abuse and culturally informed practice in inter-agency and multi-agency working.
Continue effective monitoring and auditing of discriminatory abuse and culturally informed practice.
Data is used to identify and address changing safeguarding needs. The organisation is working with partners to reduce discriminatory abuse.
The services have a proportionate and appropriate approach to discriminatory abuse across all equality abuse types.
Embed equality considerations within a person-centred approach.
Ensure that professionals are working in a culturally informed way in their Making Safeguarding Personal approach.
Ensure that professionals understand that ‘choice’ recognises the equality identities of the individual.
Undertake a peer review or case file audit with a focus on discriminatory abuse.
Consider how safeguarding plans could include culturally appropriate considerations/questions.
Excelling: Safeguarding adult leads consider pro-active approaches such as trauma informed approaches that interacts with human rights based/equalities-based practice.
Information from performance data (including ASC performance data) is informing the way partners are developing increased levels of cultural competence amongst practitioners.
Quality Assurance teams/sub-groups to consider what information they collect and who have oversight of equality data
Pro-active approaches are considered to challenge discriminatory abuse, such as a rights-based approach
Trauma informed approaches are used, which interact with human rights based/equalities-based practice.
Experts by experience inform understanding of practice in terms of equity, equality, diversity and inclusion.
Practitioners are continuing to challenge practice.
There is good knowledge of the issues that impact on specific equality groups. There is work with groups and individuals locally to better understand some of the specific issues that contribute to discriminatory abuse.
Relationships are built with community connectors and organisations who represent or reflect the groups and priorities locally.
Consider how services are accessed and understood amongst local communities, and whether they are inclusive services.
Actions to achieve priority outcomes are reviewed and regularly updated. Steps are taken if deficiencies are identified.
Developing: Commissioners are developing guidance and understanding through the lens of cultural informed practice:
Commissioning and procurement guidance includes culturally informed clauses to ensure that services meet the diverse needs of adults who are in receipt of adult social care services. The collection of equality data regarding adults using services is expected in commissioned services.
Achieving: Commissioners are asking question how services are addressing different protected characteristics in safeguarding practice:
Monitoring of all abuse types (including discriminatory abuse) is built into contracts to ensure that providers understand their responsibilities regarding discriminatory abuse.
Data regarding the equalities strands is used in service planning, commissioning and decision making.
Specifications include culturally informed practice built into contracts to ensure challenge and recognition of discriminatory abuse.
Excelling: Commissioners have greater level of understanding and oversight over their data
They can positively influence how services understand discriminatory abuse and culture informed practice:
Based on local census, JSNA and evidence of those who are not accessing services, procurement of services is positively reaching out to all communities and there is recognition and identification of discriminatory issues to reduce discriminatory abuse.
There is evidence that outcomes for commissioned and procured services are monitored and reported on regarding the equality strands.
This self-assessment tool was created by Dr Anusree Biswas Sasidharan, Programme Adviser at Partners in Care and Health. Partners in Care and Health LGA and ADASS are Partners in Care and Health, supporting councils to improve the way they deliver adult social care and public health services; and helping Government understand the challenges faced by the sector.
