2.17 Working with Adults affected by Child Sexual Exploitation and Organised Sexual Abuse

1. Introduction

In previous years the professional and media focus was only on children who were victims of sexual exploitation, not adults. However, there is now a greater understanding of the issues faced by those aged 18 and over in relation to previous sexual harm they have suffered, or are suffering, in adulthood.

There are a number of different groups of adult victims and survivors of this type of sexual abuse. First are those who were sexually abused as children and continue to be abused by perpetrators once they turn 18, who should subsequently become the subject of a safeguarding adult enquiry if they have not already been subject to safeguarding children procedures (see South Tyneside Safeguarding Children Procedures). Second are those who are no longer being abused but disclose historic CSE to which the statutory adult agencies have a duty to respond. Third, even when the sexual abuse, physical abuse and psychological abuse has stopped, many survivors will require some level of care and support as adults, due to the complex personal issues which they suffer as a result of the trauma they experienced.  These can include mental ill health, self-harm, problematic use of illicit drugs or alcohol which can be compounded by interrupted education resulting in unemployment or low paid jobs with resulting economic insecurity. They may have already been involved with children’s social care, especially if they have been looked after children (see Section 5.2, Transition from children’s to adults’ services).

In addition, some young adults may also be vulnerable to organised sexual abuse (OSA); being targeted for the first time as adults not as children. Those who have care and support needs due to learning or physical disabilities, especially if they are in residential accommodation, can be particularly vulnerable to abuse.

The needs of these adults must be recognised by the adult services which are responsible for their care and support, in order to be able to offer them the most appropriate support  and promote their wellbeing. Whilst the focus has been on girls and young women, it also applies to young men who are often hidden victims.

This chapter provides guidance to practitioners and managers working in adult care services about working with adults affected by CSE or OSA.

2. The Chief Social Workers’ Annual Report

The Chief Social Workers’ note in their Annual Report: 2019 to 2020:

‘Transitional safeguarding: criminal and sexual exploitation

It has been positive to see this subject aired more widely, but we still have some way to go in adult social care to understand how to respond to sexual and criminal exploitation.

It is important to remember this does not stop at eighteen and is not an issue which children’s services can tackle alone – our safeguarding services need a different response. Unfortunately, they are often configured in ways which do not support young people after the age of eighteen unless they have a disability.

Social work, informed and skilled in this area, could really make a difference with its strong professional influence in partnership arrangements, helping to prevent long-term mental health issues, avoid further harm and put an end to exploitation.

Building and sustaining relationships is fundamental to our profession, but in building them with people affected by exploitation, we need to be well-educated about trauma-informed practice.’ (Department of Health and Social Care, 2020; 3.1)

3. Definition and Terminology

3.1 Definition of sexual exploitation

McNamara (2017) states:

‘Sexual exploitation is a form of sexual abuse. A person can be a victim of sexual exploitation if sex takes place and:

• it is in exchange for basic necessities, such as food, shelter or protection
• it is in exchange for something they need or want
• they are made to feel frightened of the consequences if they do not (coercion)
• the person who is exploiting them stands to gain financially or socially.’

Newcastle Safeguarding Adult Board’s definition similarly states:

‘Someone taking advantage of you sexually, for their own benefit. Through threats, bribes, violence, humiliation, or by telling you that they love you, they will have the power to get you to do sexual things for their own or other people’s benefit or enjoyment (including: touching or kissing private parts, sex or taking sexual photos.)’ (Spicer, 2018; p27)

These definitions stress a particularly important factor – the adult’s vulnerability in the relationship with their abuser/s. It must be stressed that adults can be victims too and turning 18 does not automatically result in safety and security for all.

3.2 Definitions of gangs and groups

While there are undoubtedly perpetrators who operate alone, in this context sexual exploitation / abuse relates to organised, planned abuse by a number of criminals who are either:

• gangs who are street based, social groups who a) are involved in different types of crimes and violence; b) who operate in certain geographical areas; c) and are in conflict with similar groups. Sexual abuse and violence are part of their overall criminality, rather than their only focus;
• groups of two or more people connected through formal or informal associations or networks including, but not exclusively, friendship groups. Their main purpose is to sexually exploit others.

3.3 Terminology

The term ‘exploitation’ means to make use of a situation by a person to gain unfair advantage over another. It is commonly used to describe the behaviour of some perpetrators in relation to children and also adults. However, whilst it may be appropriate at the grooming stage of adult sexual exploitation (ASE) (see Section 4, Indicators of Sexual Exploitation / Organised Abuse), in the most serious cases it involves rape, multiple rape, gang rape, which is often carried out with physical violence and emotional / psychological abuse. Using ‘exploitation’ in relation to such circumstances can disguise the level of harm that is perpetrated and the seriousness of sexual offences committed. This chapter therefore uses the term ‘sexual exploitation / organised abuse’. This is also the approach adopted by a number of agencies, including the National Crime Agency (NCA).

3.4 Grooming

Grooming is when someone builds an emotional connection with an adult, to gain their trust for the purposes of sexual abuse / exploitation. This can happen face to face and online. Groomers can spend considerable time gaining their victim’s trust, hiding their true abusive intentions. Their methods include:

• giving the victim a lot of attention and making them feel wanted and loved, often through flattery;
• being understanding and listening to them;
• buying or giving them gifts;
• taking them out,
• giving them drugs or alcohol – often for the first time – and making life with them seem exciting;
• making them believe they are in a relationship together.

Organised sexual abuse by groups includes:

• repeated sexual abuse / rape by their ‘boyfriend’ and his friends;
• being trafficked to other towns and cities for the purposes of organised sexual abuse;
• being verbally and physically threatened / abused if they try to exit the abuse;
• family and friends being physically threatened;
• attempts to groom younger siblings or friends;
• being plied with alcohol and drugs to make them compliant to the point of addiction.

4. Indicators of Sexual Exploitation / Organised Abuse

The following are key indicators of sexual exploitation / organised abuse, of which practitioners working with adults with care and support needs should be particularly aware:

• having money, clothes, mobile phones etc without an acceptable explanation of where they got them;
• being associated with gangs and / or no longer having the same friends or friendship groups;
• exclusion or unexplained absences from school, college or work;
• leaving home / care without explanation and persistently going missing or coming back late;
• receiving lots of texts or phone calls, particularly when they do not say who from;
• returning home under the influence of drugs / alcohol;
• showing inappropriate sexualised behaviour and / or having sexually transmitted infections;
• there is evidence or suspicions of physical or sexual assault;
• having relationships with people who are controlling in their behaviour or are significantly older than them;
• having a number of different people call for them or contact them (unknown adults);
• are seen or known to be in areas known for sex work;
• use of internet or other social media that causes concern;
• being increasingly secretive around behaviours; and
• self-harm or significant changes in emotional wellbeing.

McNamara (2017) says ‘there can be some circumstances where adults are at increased risk of being sexually exploited. For example, if they:

• are homeless
• are using drugs or alcohol
• are lacking the mental capacity to consent to sexual activity
• are being trafficked
• were sexually abused as a child.’

Adults who are being sexually exploited and abused can also be victims of ‘cuckooing’ – where criminals exploit people who are often vulnerable adults and take over their homes for criminal purposes usually supplying drugs (see County Lines: Criminal Exploitation of Adults, Cuckooing and Gang Activity, Youth Violence and Criminal Exploitation affecting Children, Young People and Vulnerable Adults chapters).

It is important that all practitioners are aware of the issues of sexual exploitation and organised abuse. Adult care services should provide appropriate training sessions for staff (see Section 7, Training and Supervision).

The Care Act 2014 places a duty on local authorities to make enquiries if there are concerns that an adult with care and support needs is experiencing or at risk of abuse or neglect, and, as a result of those needs, is unable to protect themselves. This applies, for example, where an adult discloses sexual exploitation / organised abuse or if a member of the public or parent expresses concerns about an adult.

5. Local Information

In order to protect both children and adults from organised sexual abuse the following information should be shared between children’s and adult services:

• the profile of young adults currently found to be most likely to be at risk in the local area;
• particular residential homes which have been / are targeted by perpetrators (see below);
• the profile of offenders (for example, gang associated, single perpetrator or organised groups);
• specific ‘hotspots’/ locations (such as takeaway shops, hostels, party houses or transport hubs); and
• local structures for response (for example, voluntary and statutory sector service providers, referral pathways, multi-agency working arrangements).

5.1 Residential care / supported living

When managers suspect that adults living in residential homes or supported living arrangements – for which they are responsible – are being targeted by perpetrators, they should undertake an assessment in relation to this specific risk and in order to  identify adults who are experiencing or at risk of sexual exploitation/organised abuse. This should include people in residential care, supported living environments, and those in the process of transition from children’s services (including child protection) to adult / safeguarding services.

5.2 Transition from children’s to adults’ services

For those transitioning from children’s services to adult care who have been sexually exploited / abused, it is crucial that the needs of the young person are clearly identified and action is put in place to ensure ongoing support and protection, and that the support needs of their parents are also identified and addressed. See also Transition to Adult Care and Support chapter.

6. Social Work Assessments / Risk Assessments

6.1 Initial contact and building relationships

CSE and OSA reports and inquiries have often found that professionals, family members and the public who were raising concerns were not properly listened to. There are other difficulties which prevent victims coming forward. Those who may be victims of abuse often find it difficult to speak out about their situation, particularly when they have been sexually abused as it will require disclosing very personal details. Undertaking assessments is a key time for victims / survivors, in both disclosing very distressing intimidate information as well as taking initial steps to form trusting relationships with the professionals tasked with protecting them (see Case Recording chapter).

Relationships of trust need to be built over time and staff need to be appropriately skilled in active listening to pick up on small clues or unexplained changes in behaviour, which may arise during contact with adults who are experiencing / have experienced sexual abuse. Where adults do disclose concerns about sexual exploitation/abuse, these must be ‘heard’, taken seriously and acted upon.

7. Taking Action

Staff should follow local safeguarding procedures and  involve a discussion / meeting to plan who takes what action. This must  include the police whose role is to investigate crimes that have been committed, collect evidence and – where they believe they have a case – present to the Crown Prosecution Service to decide whether it is appropriate to charge individuals. If  there is no law enforcement action against alleged perpetrators, it allows them to further traumatise current victims and groom new ones. This has a significant impact on families of victims, who feel unable to help their child / sibling, or may be victims of bullying and intimidation from the perpetrators themselves (see Safeguarding Enquiries Process).

7.1 Post-abuse support

It is recognised that sexual abuse, including that of an organised nature, has long-lasting effects for victims and their families. These may range from psychological and emotional trauma affecting relationships and future parenting abilities, to mental health and substance misuse issues. These place further stress on victims and their families and further demand on health and social care services.

The provision of appropriate support to those who have suffered trauma can significantly improve their lives in terms of health and family relationships. Survivors are likely to require support and therapeutic intervention for an extended period of time. The South Tyneside Safeguarding Children and Adults Partnership should work with its partners to ensure the delivery of post-abuse support, and that staff, frontline managers and victims and their families know how to access this support.

8. Training and Supervision

See also Supervision chapter

Services should ensure that their staff receive regular, high quality supervision which enables them to reflect on their practice. Those who offer direct support to sexually exploited adults may also require further intensive training and specialist support.

For social workers involved in adult safeguarding, it is suggested that the standards for employers of social workers in England including standard 5 which covers supervision for social workers are in place, or local policy and procedure on supervision is followed. All other professionals should follow their own profession’s supervision standards, and/or their agency’s supervision policy and procedures. Social work and other professional interventions need to be supported by clear skills and set of competences.