St Helens Borough Council: local authority assessment

St Helens ensured they and their partners followed effective systems, processes, and practices to make sure people were protected from abuse and neglect using the St Helens multi-agency Safeguarding Adults Policy (2024). The Care Act 2014 set out a clear legal framework for how local authorities, and other parts of the system, should protect adults at risk of abuse or neglect. The purpose of the policy was to ensure those charged with duties and responsibilities relating to safeguarding vulnerable adults at risk of abuse or neglect under the Care Act 2014 had a clear understanding of what was expected in their role and what good practice looked like in St Helens.

Staff and leaders explained how the local authority worked with the Safeguarding Adults Board (SAB) and partners to deliver a co-ordinated approach to safeguarding adults in the area. There was a strong multi-agency safeguarding partnership, and the roles and responsibilities for identifying and responding to concerns were clear. Information sharing arrangements were in place, so concerns were raised quickly and investigated without delay.

The St Helens Safeguarding Annual Report (202-2023) recognised the ongoing challenges around the cost-of-living crisis, the increasing stress placed on health & social care systems due to demand for services, and the increasing demands placed on all services due to difficulties in the recruitment and retention of staff.

Staff and leaders told us the local authority’s Safeguarding Adult Unit received all safeguarding enquiries via Contact Cares. Contacts were initially triaged to identify the level of risk and if there was a need for any immediate actions to ensure people were safe. Concerns were then assessed against the local authority’s Section 42 enquiries threshold, with those concerns meeting these criteria being allocated to frontline locality teams to carry out further investigations. A Section 42 enquiry is a legal requirement under the Care Act 2014 for local authorities to make enquiries, or have others do so, if an adult may be at risk of abuse or neglect. Concerns relating to service providers were shared with the quality monitoring team and concerns which did not meet the threshold for a Section 42 enquiry were signposted to support, information, and advice services.

Senior leaders explained how all staff involved in safeguarding work were suitably skilled and supported to undertake safeguarding duties effectively. In 2023 the local authority commissioned ‘Conducting Adult Investigation’ training which was a 2-day course. Several sessions were facilitated to skill up frontline teams to complete safeguarding enquiries. A briefing session was held after the training for staff to discuss and share any ideas for improvement to practice. As a result, the IT system was updated to allow more detail on the visits and evidence any immediate safety actions taken to be recorded.

National data provided by the Skills for Care Workforce Estimates (2024) showed 43.90% of independent and local authority staff had completed MCA 2005 and DoLS training, tending towards a positive variation to the England average of 37.58%. The data also showed no statistical variation between St Helens and the national average for independent and local authority staff completing safeguarding adults training, with 52.03% completing in St Helens compared to an average for England of 48.70%.

There was a clear understanding of the safeguarding risks and issues in St Helens. The local authority worked with safeguarding partners to reduce risks and to prevent abuse and neglect from occurring. Senior leaders told us they had a number of Quality Assurance Frameworks, with a quarterly report presented to the SAB including the number of referrals, the nature of abuse demographics and other pertinent information. The report also provided insight into service users placed out-of-borough, helping to identify any cross-boundary work required.

Senior leaders told us the Safeguarding Adults and Quality Assurance Group (SAQAG) interrogated data, focusing on service providers with 3 or more quality or safeguarding concerns and identifying where there were themes and trends. For example, the local authority had worked closely with the ICB in introducing a new 'pick-up' service for care homes following the identification of delays in supporting people who had fallen without serious injury.

People told us the community falls and pick up services used assistive technologies to support people’s mobility needs, with some Borough Wards having additional service support due to complex need. For example, Newton & Haydock had a fragility service in place reflecting the higher rate of mobility issues in the area.

Staff and leaders told us they completed a self-neglect audit in 2023 following which, a policy was introduced to address the growing trend across the Borough. Training sessions were facilitated for all staff including presentations on hoarding as part of International Social Workday in March 2024. Senior leaders also share 7-minute briefings on professional curiosity and provided trauma-informed training as part of National Safeguarding Week in November 2024. Partners and people told us of a new adult social care and public health campaign in 2025 to raise awareness of suicide rates in the Borough, with the SAB looking to understanding data and oversee the campaign.

Partners explained how the local authority used the Multi-Agency Risk Assessment Meeting (MARAM) process to engage with people using services in identifying risks and to offer support to mitigate those risks. MARAM was also used to identify and mitigate risks for people who may not have care and support needs under the Care Act 2014 but would otherwise ‘fall through the gap’. Staff used this process to also identify who the person had the best relationship with and who could take the lead in offering advice and support using St Helens Multi-Agency Risk Assessment and Management Process 2022-2025.

Senior leaders told us there were a number of pathways in place to ensure lessons were learned when people had experienced serious abuse or neglect. Action was taken to reduce future risks and drive best practice. The SAB was responsible for commissioning Safeguarding Adults Reviews when an adult died or suffered serious injury in the area who had care and support needs, and where agencies could potentially have worked together more effectively to protect the adult from harm or death.

St Helens joined Merseyside Safeguarding Adults Review Group (MSARG) in 2023, to ensure regional learning was shared with frontline teams and partner organisations. St Helens had not had a SAR since 2019 and wanted to ensure learning was still taken from regional and national SARs as part of the performance and practice subgroup of the SAB.

Staff and leaders told us the safeguarding team completed audits of enquiries to ensure there was a consistent approach to safeguarding and safety plans and appropriate signposting had been completed. For example, discussions between the local authority and MerseyCare NHS Trust around risk management and places of safety led to process changes for supporting high risk and complex cases and people who refuse to engage with mental health services.

St Helens Safeguarding Adults Multi-Agency Policy and Procedure ensured there was clarity on what constituted a Section 42 safeguarding concern and when Section 42 safeguarding enquiries were required. There was a clear rationale and outcome from initial enquiries, including those which did not progress to a Section 42 enquiry, and this was applied consistently. When safeguarding enquiries were conducted by another agency, for example a care or health provider, the local authority retained responsibility for the enquiries and the outcome for the person concerned. Staff and leaders told us in more complex cases the Safeguarding Adults Unit maintained oversight until the assessment was completed to ensure robust safety plans were in place.

National data provided by the Safeguarding Adults Collection (SAC) showed St Helens had an average of 1,861 safeguarding concerns per year between 2019 and 2024, with an average of 1,161 progressed to Section 42 enquiries. This equated to 62% of all concerns leading to a Section 42 enquiry. Data provided by the local authority showed the number of safeguarding enquiries closed from 1 April to 1 June 2024 was 589, with 80% having the outcomes identified by the person at risk fully achieved or partially achieved. This was above the local authority’s target of 75%.

Staff and leaders told us there were clear standards and quality assurance arrangements in place for conducting Section 42 enquiries. The St Helens Safeguarding Adults Multi-Agency Policy and Procedure set out how Safeguarding Co-ordinators guided and supported frontline teams by providing an independent perspective of the perceived risks and required actions throughout the safeguarding process and contributing to decision-making by undertaking the role of Chair in safeguarding meetings and associated administrative tasks.

Staff and leaders told us upon receipt of concerns relating to risk of abuse or neglect an initial strategy discussion took place between the safeguarding coordinator who has picked it up and an Enquiry Manager within 24 hours. Data provided by the local authority showed 94% of these discussions took place within the 24 hours, with all others completed within 48 hours. If a visit to the vulnerable person was required, the local authority had a 48-hour timeframe for this to be undertaken from the decision being made by the coordinator and the enquiry manager. This was currently at 100% compliance at the time of the assessment.

Data provided by the local authority showed there were 334 referrals for DoLS assessments pending in July 2024. The median average waiting time for a DoLS assessment was 40 days with the maximum waiting time 225 days (2023 to 2024). Updated data provided by the local authority showed in March 2025 there were 226 referrals waiting for a DoLS assessment, with a maximum waiting time of 90 days. The local authority told us they had introduces a new prioritisation process with high-priority cases assigned immediately and Best Interest Advisors (BIAs) carrying out telephone consultations where appropriate. Staff and leaders told us additional monitoring was in place as part of reviewing those DoLS requests waiting for assessment. Care homes were sent an email monthly requesting an update on the status of the person, including any changes in need or risk.

Senior leaders told us the local authority were part of ADASS North-West DoLS group. All DoLs leads across the North-West met up monthly to discuss issues pertinent to the application and use of DoLS within their Borough. MCA 2005 training was organised via the local authority’s training section, advertised on the training website and open to all council employees.

Partners told us the role of the Safeguarding Quality Assurance Group was to seek assurance care services were both of good quality and safe. The group cross-referenced a range of safeguarding concerns, quality monitoring concerns and any other information to ensure key partners communicated and escalated issues and dealt with concerns in a proportionate, timely and appropriate manner. The Performance and Practice Group analysed safeguarding data and activity to provide insight and increase the SAB and local authority’s understanding of local safeguarding issues. This was achieved through themed audits into critical areas of performance. For example, in 2024 audits included a focus on pressure ulcer safeguarding practice in care homes, domestic abuse, and actions from recent learning reviews.

Staff and leaders told us safeguarding plans and actions to reduce future risks for individual people were in place and they were acted on. Relevant agencies were informed of the outcomes of safeguarding enquiries when it was necessary to the ongoing safety of the person concerned. The Safeguarding Adults Annual Report (2022-2023) included information on the Learning from Life and Deaths (LeDeR) programme, which was established nationally to support local areas to review the deaths of people with learning disabilities and to take forward the learning into service improvement initiatives.

St Helens highlighted making safeguarding personal as one of its priorities. The local authority used evidence-based audits to enhance their understanding of risk and ensured steps were taken to address and manage these. Safeguarding enquiries were carried out sensitively and without delay, keeping the wishes and best interests of the person concerned at the centre. People had the information they needed to understand safeguarding, what being safe meant to them, and how to raise concerns when they did not feel safe, or they had concerns about the safety of other people.

People could participate in the safeguarding process as much as they wanted to, and people could get support from an advocate if they wished to do so. People were supported to understand their rights, including their human rights, rights under the MCA 2005 and their rights under the Equality Act 2010 and they were supported to make choices which balanced risks with positive choice and control in their lives.

People told us their desired outcomes were identified as part of the safeguarding Section 42 enquiry and where they lacked capacity a significant other or advocate was offered. People were supported to define the outcomes they desired relating to their personal circumstances and the process was personalised and flexible. National data from SAC (2024) showed 100% of people lacking capacity were supported by an advocate, family member or friend. This was a significant positive variation to the England average of 83.38%.

Staff and leaders told us a person-centred approach was used to keep people at the heart of the safeguarding process. Trauma informed care was also taken into consideration during enquiries and staff highlighted their commitment to empowering individuals and upholding human rights throughout the process. Senior leaders told us audits found evidence of making safeguarding personal and people actively participating in the decision-making process, highlighting this within staff learning and development sessions and using case studies.

Partners told us they received data from the local authority about number of contacts, closures and conversion rates, and were assured in relation to safeguarding and making safeguarding personal. The local authority was working with partners to actively seek people with lived experience to be involved in the SAB and its activities. Partners told us the local authority recognised the value of feedback and was developing further opportunities to gather feedback on people with lived experience of safeguarding including the use of surveys, feedback form and QR codes for ease of accessibility.