8.3 Working with Adults Affected by Child Sexual Exploitation and Organised Sexual Abuse

1. Introduction

Whilst children are more often associated with sexual exploitation, practitioners should be aware that adults can also be affected too; there are different groups of adult victims-survivors of child sexual exploitation (CSE) and organised sexual abuse.

First are those who were sexually abused as children and continue to be abused by perpetrators once they turn 18, who should be responded to through safeguarding adult processes. Second are those who are no longer being abused but disclose historic or previous CSE to which adult social care and the police have a duty to respond if it is reported to them. Third, even when the sexual abuse, physical abuse and psychological abuse has ended, many survivors will require some level of care and support as adults, due to the complex personal issues which they may suffer as a result of the trauma they experienced. These can include mental ill health, self-harm, problematic use of illicit drugs or alcohol and interrupted schooling or college resulting in unemployment or low paid jobs. They may have already been involved with children’s social care, especially if they were a looked after child (see Section 5, Transition from children’s to adults’ services).

The vulnerabilities of these adults must be recognised by staff who are responsible for their care and support, so they can offer them the most appropriate support  and promote their wellbeing. Whilst the focus is often on girls and young women, young men can be victims too, although it can be even harder for them to report their abuse, which therefore, remains hidden.

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

2. Definition and Terminology

2.1 Definition of sexual exploitation

Sexual exploitation is a form of abuse. It occurs where a person, or group of people, take advantage of an adult (including those with care and support needs) to coerce, manipulate or deceive them into sexual activity for the perpetrator/s advantage. The perpetrator uses their power to get the adult to do sexual acts for the perpetrator’s own – or other people’s – benefit or enjoyment. Children and young people can also be victims (see LLR Safeguarding Children Procedures).

An imbalance of power is at the core of the ‘relationship’ between the perpetrator and their victim, which allows them to coerce, manipulate and / or deceive the adult. Psychological, physical and sexual abuse are often used to control them, especially to prevent them reporting the abuse to family, friends or professionals.

Sexual exploitation can vary from a one-off exploitative situation between a couple for example, to organised crimes where adults are sexually abused on a large scale, including being trafficked to different places.

Sexual exploitation may also take place in exchange for basic necessities such as food, accommodation or protection or something else that the victim needs or wants.

Sexual exploitation and abuse are often criminal offences. Practitioners can ask advice about anonymised cases from the local police public protection unit or specialised sexual exploitation multi-agency team, if required.

2.2 Definitions of gangs and groups

While some perpetrators operate alone, sexual exploitation / abuse can also be organised and planned abuse by a number of criminals who are either:

• gangs who are street based, social groups who are a) involved in different types of criminal activity and violence; b) who operate in certain geographical areas; and c) are in conflict with other similar groups. Sexual abuse and violence are just some of the crimes they are involved in, rather than their only focus;
• groups of two or more people who are connected through associations or networks including friendship groups. Their main purpose is to sexually exploit victims.

2.3 Terms used

The term ‘exploitation’ is when a person to gain unfair advantage over another. It is commonly used to describe the behaviour of some perpetrators in relation to adults (and also children). However, whilst it may be appropriate at the grooming stage of adult sexual exploitation (ASE) (see Section 3, 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 such circumstances can disguise the level of harm that is perpetrated against the victim and the seriousness of the sexual offences being 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).

When working with adults who have been affected by child sexual exploitation and organised sexual abuse, this may also be called non-recent or historical sexual abuse.

2.4 Grooming

The following are important signs of sexual exploitation / organised abuse among adults. Practitioners working with adults who have care and support needs should look out for:

• 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 / friendship groups;
• unexplained absences from school, college or work;
• being excluded from school or college for unacceptable behaviour;
• leaving home / care without explanation and persistently going missing or coming back late;
• receiving lots of texts or phone calls, particularly when the adult will not say who they are from;
• returning home under the influence of drugs and / or alcohol;
• showing inappropriate sexualised behaviour and / or having sexually transmitted infections;
• there is evidence or concerns of physical or sexual assault;
• having relationships with people who are controlling in their behaviour;
• 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-harming or there are significant changes in their emotional wellbeing.

Some adults can be at increased risk of being sexually exploited. These include if they:

• are homeless
• are using drugs or alcohol
• do not have 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 Criminal Exploitation of Adults and Guidance for Working with Adults at Risk of Exploitation: Cuckooing chapters).

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 (see also Section 7, Taking Action).

4. 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 care / adult safeguarding.

5. 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. Assessments / Risk Assessments

6.1 Listening and building relationships

Many reports and inquiries about 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 were also other difficulties which prevent victims coming forward. Victims of abuse often find it difficult to speak out about what happened or what is happening to them, particularly if they have been sexually abused as it will require disclosing very personal details. Undertaking assessments is a very difficult time for victims-survivors, in both disclosing very distressing intimidate information as well as taking initial steps to form trusting relationships with the professionals who will be safeguarding them (see Record Keeping 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 (see Section 7, Taking Action).

6.2 Consent

Issues of consent are complex, and practitioners should seek advice from their manager, legal department or specialist service where they are unsure. The police should be contacted for advice if practitioners are concerned crimes have been committed against the adult.

In summary, if an adult lacks mental capacity, they cannot legally consent to have sex (see Mental Capacity chapter). Sexual acts with an adult who lacks the mental capacity to consent is sexual assault and is a criminal offence under Sexual Offences Act 2003.

But adults with mental capacity to make decisions about their sexual relationships may still be at risk of being manipulated, coerced or sexually exploited; their circumstances may still meet the safeguarding criteria. Section 42 safeguarding enquiries or other appropriate risk management planning and processes should work with the adult towards finding ways to support them in exiting the abusive situation.

In such circumstances, the power of Inherent Jurisdiction enables the courts (the High Court) to issue directions or orders to support the adult who has capacity, but is being coerced or controlled and where fear impacts their ability to give genuine and informed consent.

If the adult decides they want to receive a service relating to sexual exploitation – or any other intervention related to their care and support needs – they should be given all the necessary information for them to understand what is involved before giving consent for their information to be shared with other relevant practitioners as appropriate.

7. Taking Action

See also Flowchart for Responding to Disclosure Historical (non-recent) Abuse Allegations – see Appendix 1 (LLR Safeguarding Partnership Children Procedures)

Staff should follow LLR Safeguarding Adults procedures (see Safeguarding Enquiries section) and contact adult social care regarding any concerns. A safeguarding adults discussion / meeting – with the adult at the centre or discussions – may be needed to agree and plan action. This must involve the police whose role is to investigate crimes that may have been committed, collect evidence and present to the Crown Prosecution Service, if relevant, for a decision on whether it is appropriate to charge the perpetrator/s.

7.1 Post-abuse support

Whether or not alleged perpetrators will be charged, sexual abuse often has long-lasting effects for victim-survivors and their families. These include 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 need for 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. Leicester, Leicestershire and Rutland Safeguarding Adult Boards should work with their 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.