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The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland, Wales and Northern Ireland.

National social care statistics (England, Scotland, Wales, Northern Ireland) reporting the living situations of adults with learning disabilities (residential and nursing care, living with family, other forms of accommodation) were accessed, with data extracted on trends over time and rate of service use.

There were substantial differences in the statistics collected across the UK. Overall, there were higher reported rates of adults with learning disabilities in residential/nursing accommodation in England than Scotland or Wales, but much lower reported rates of adults living in other forms of unsupported and supported accommodation and much lower reported rates of adults living with their families. In all three countries, trends over time suggest that reductions in residential care towards more independent living options may be stalling. In Northern Ireland reductions in currently extensive residential and nursing care services are continuing, unlike other parts of the UK.

Despite similar policy ambitions across the four parts of the UK, statistics on the living situations of adults with learning disabilities report substantial differences.

This paper is a first attempt to compare national social care statistics concerning the living situations of adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

Kent was one of the first social services departments to develop a specific adult protection policy in 1987. This paper charts the development of policy and references key landmarks on this journey from the perspective of the policy manager's role. Opportunities are also taken to identify the key learning from this experience and the main challenges for the newly emerging safeguarding agendas.

The police are key partners in adult protection work locally and take lead responsibility for investigating alleged crimes committed against vulnerable adults in our communities. They therefore play a critical role in many serious and complex adult protection investigations. This paper describes how a large police service has organised its adult protection resources and maps out the basic processes and responsibilities involved in leading criminal investigations involving vulnerable adults. Using a case study it also identifies and examines the different demands criminal work brings at the inter‐agency, agency and case levels and identifies solutions and pointers for best practice.

No day passes in the United States without the invention of new kinds of adult education programmes, in which new subjects are taught to new audiences of American adults whose educational needs have been neglected. Moreover, the established programmes grow ever larger. These learning activities take such a profusion of forms that we are forced to use abstract terms such as ‘programmes’ or even ‘experiences’ to encompass them. The motives of the continuing learners, are equally diverse; they study almost any subject one could mention, from the minutely practical to the sublimely abstract. Even now, almost every significant agency and institution in American society is involved, somehow, in the provision of these programmes, since the formal education system, though ever more deeply involved in adult education, can never meet all the educational requirements of these millions of adults.

Adult protection has been a relatively recent concept for staff working within the health economy. Priorities have focused on raising awareness, developing an understanding of safeguarding responsibilities, challenging established practices and attitudes and embedding the concept within the culture of NHS organizations and the daily work of staff at all levels. Although social services have the lead for safeguarding activities (Department of Health, 2000), statutory health bodies have now begun to integrate their adult protection activities more effectively and positively with social services and the police. This paper reviews the journey undertaken by the three primary care trusts (PCTs) in Kent and Medway in developing adult protection expertise and sharing multi‐agency adult protection practice with both social services and the police. The three safeguarding vulnerable adults leads from the PCTs have joined together to look at how far we have come and what we still need to achieve.

Adult ADHD is a neuro-developmental disorder. The current prevalence of ADHD in adults is around 1.9-4 per cent. The service for adults with ADHD based on NICE guideline recommendation. Hence, the author decides to audit the Adult ADHD case loads against the gold standard set by the NICE. The paper aims to discuss these issues.

The study was based on a retrospective analysis and collection of data from electronic patient records for a duration of five months between October 2011 and February 2012. The data findings were matched against the NICE standards. There were 15 standards identified. On top of that we used six service outcome questions to improve the Quality of the service provided.

As the service outcomes were set for 100 per cent, the performance fell short in few areas. The service managed to achieve roughly 80-95 per cent in areas such as medication monitoring, transition service and care plan with shared care guidelines for prescription in primary care. The service under performed in areas on non-pharmacological interventions such as cognitive-behavioural therapy (CBT). The service continues to provide a exceptional service for adults with intellectual disability and ADHD.

The research was limited by information and recall bias due to the retrospective nature of data analysis. There was also over representation of the numbers in co-morbid cases due to more than two diagnosis.

The paper outlines the regional outcome of the audit. However the findings have wider implications. For example the prevalence rate is more common in males than females. CBT is an important resource in the management of ADHD in adults. Priority and importance need to be given for providing a service for CBT in adults with ADHD.

The cost of sickness and non-employment due to ADHD is significantly high. Treating this complex group with medications and CBT improves the outcome and get them back in employment and reduce recidivism rates in offenders.

The author feels the adult ADHD service audit has huge service implications. Currently it is a controversial diagnosis significantly under-resourced. The outcome survey had highlighted the areas of need as a neurodevelopmental disorder.

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities.

In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing.

While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care.

This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.

In adult protection many of the concerns that are highlighted about possible abuse relate to non‐criminal situations in which neglect may have occured. Designated lead managers, often social services team managers, act as gatekeepers. In conjunction with police, health and inspectorate colleagues they have to determine if allegations and referrals should be dealt with either as possible abuse or as poor practice, triggering different mechanisms. A tool has been developed in Wales to promote and support consistency in decision‐making in ‘grey areas’. Also, the Welsh Assembly Government(2009) has published helpful guidance on the management of escalating concerns in care homes, which helpfully informs arrangements for adult protection and provider performance to be managed in tandem.

This article discusses the Law Commission's proposals for the reform of adult social care, with a particular emphasis on the specific proposals relating to adult protection. It argues that a future adult social care statute should clarify the existing legal position by placing a duty on local social services authorities to make enquiries and take appropriate action in adult protection cases. The definition of an adult at risk for the purposes of the duty to investigate is also considered and a proposal is put forward for how this might be defined in the statute. The article also proposes that the compulsory removal power under section 47 of the National Assistance Act 1948 (HM Government, 1948) should be repealed, that adult safeguarding boards should be placed on a statutory footing and that duties to co‐operate in adult protection should be introduced. Finally, concerns are raised that the current lack of statutory provision for adult protection may mean that there is confusion over the precise legal status of the guidance No Secrets (Department of Health & Home Office, 2000) and In Safe Hands (Welsh Assembly Government, 2000) and what actions this can authorise.

This paper aims to set out to share the reflections of safeguarding adult board managers as they worked through what is likely to be just the first wave of the coronavirus COVID-19 pandemic.

The paper draws on the experience of small number of safeguarding adult board managers who have provided reflections from practice.

This paper illustrates just some of the responses developed by safeguarding adult board managers and their boards to continue to deliver the work of safeguarding those at risk of abuse and harm in the face of unprecedented impact of the coronavirus COVID-19 pandemic on a key aspect of the safeguarding adult system in England.

The reflections reported here are not intended to offer a representative commentary on the experiences of those who oversee and manage safeguarding adults’ boards. It is intention to provide a flavour of some of the challenges and dilemmas faced and some of the creative solutions to address them used by one group of adult safeguarding practitioners.