Vulnerable Adults/at risk

In adult social care (England/UK context), a “vulnerable adult” (now more commonly referred to as an “adult at risk”) is someone aged 18+ who may need care and support and is unable to protect themselves from harm, abuse, or neglect.

A key point is that vulnerability is not just about a condition - it’s about the interaction between a person’s needs and their ability to stay safe.

Important safeguarding definition (Care Act 2014)

An adult is considered “at risk” if they:

• Has needs for care and support
• Is experiencing or at risk of abuse or neglect
• Is unable to protect themselves because of those needs

People with physical disabilities

• Mobility impairments
• Chronic illness (e.g. multiple sclerosis, Parkinson’s)
• Frailty (e.g. due to age)

People with learning disabilities

• Mild to profound learning disabilities
• Conditions affecting understanding, communication, or decision-making

People with mental health needs

• Severe mental illness (e.g. schizophrenia, bipolar disorder)
• Depression or anxiety impacting daily functioning

Older adults (especially with increased dependency)

• Frailty or age-related conditions
• Dementia (Alzheimer’s, vascular dementia)

People with sensory impairments

• Visual impairment (partial sight or blindness)
• Hearing loss or deafness

People with cognitive impairment

• Brain injury (acquired or traumatic)
• Dementia or other neurological conditions affecting thinking and memory

People with substance misuse issues

• Alcohol dependency
• Drug misuse that affects judgement, health, or safety

People experiencing social exclusion or instability

• Homelessness or insecure housing
• Isolation (little or no social support)
• Refugees or migrants with additional vulnerabilities

People at risk due to abuse or exploitation

• Domestic abuse survivors
• Victims of financial exploitation, coercion, or manipulation
• Modern slavery or trafficking victims

People who cannot protect themselves

• This is a key principle. Regardless of diagnosis, someone may be vulnerable if they:
  • Struggle to understand risks
  • Cannot communicate concerns
  • Depend heavily on others for care/support

All children are considered vulnerable by virtue of their age and immaturity, but which adults can be considered ‘vulnerable’?

Many people think of adults as being vulnerable if they’re permanently or temporarily unable to care for themselves and their interests, either through a mental or physical cause.

Vulnerable adults are open to risks of psychological and physical harm or being exploited for other people’s benefit.

The following groups of people could be considered as ‘vulnerable adults’:

• older people who are physically or mentally frail
• people with learning disabilities
• people with a mental health condition such as dementia or personality disorder
• people who are ill and need help to carry out normal daily functions
• people with physical disabilities
• people who have undergone a recent trauma – a bereavement, a divorce or loss of a job, for instance
• people who, for whatever reason, are in abusive relationships or are homeless.

But care needs to be taken about who are considered ‘vulnerable’. Just because someone is, for instance, older, or has a mental health condition or a learning disability, or has a physical disability, they are not necessarily ‘vulnerable’. Indeed, they may take great offence if you were to consider them so. Everyone needs to be wary of applying ‘labels’ to the people in our care.

it is also important to recognise that being vulnerable isn’t necessarily a long-term state. People who come into hospital for operations, for instance, will be very vulnerable immediately before, during and after the operation when they are not able to care for themselves and rely on health care staff to protect them and ensure their well-being. But in the vast majority of cases they will soon be completely independent again, so the vulnerable state is only temporary.

Individuals want to live rich and fulfilling lives, participating in their local community and contributing to its vibrancy. Families want this for their loved ones too.

They, and society at large, also want to ensure that those who need care and support – whether a young learning-disabled person or a 90 year-old with dementia – are supported in ways which enable them to feel safe, happy and where possible to take part in the life of their community. 

Those who work in or receive adult social care services recognise this. This is the core social purpose of care and support – not to control people’s lives for them but to work with them as equal partners to help them achieve what they want from life.

The vision and aims of the Government’s White Paper, Caring for our future (2012) include:

• Choice and control
• Working in partnership
• Personalised care
• Keeping people healthy and involved with their communities

Social care (‘care’) comprises personal care and practical support for adults with physical disabilities, learning disabilities, or physical or mental illnesses, as well as support for their carers. 

Adults’ care needs are often multiple and interrelated with other needs. Adult social care is therefore part of a complex system of related public services and forms of support.

How well services meet adults’ needs depends on all parts of the system working together. For example, good medical management of long-term conditions can prevent a person developing care needs, and welfare benefits can maintain independent living.

add details of approach

The Council and partners is developing an Adult Social Care Prevention Strategy (Summer 2026) and progressing work through a Prevention Task and Finish Group focused on unpaid carers, social isolation and reablement.

This has been developed in partnerships with Public Health and aims to strengthen the already published Prevention strategy for Wirral Council.

The Adult Social Care prevention strategy is supported by wider transformation activity to improve the use of integrated data to identify need earlier and target preventative support effectively.

Work underway: Developing our knowledge and insight

In terms of need in Wirral, emerging findings show that, compared to England and the North West:

• Self-reported disability is higher
• More people have long-term conditions that seem to be presenting earlier in life
• Sight impairment and preventable sight loss are higher
• Fewer ASC clients are free of pain or discomfort, but more are on prescribed painkillers
• Fewer ASC clients are free of anxiety or depression
• Wirral has more unpaid carers but half are flagged as such with their GP, and many of their outcomes need improving
• Wirral has more private renters aged 65+, with more older people living in single person households
• Fewer ASC clients and carers feel they have enough social contact
• Wirral has more fuel poverty, PIP claimants, and Housing Benefit claimants

In terms of demand in Wirral, emerging findings show that, compared to England and the North West:

• New requests for ASC are higher, both for those aged 18-64 and those aged 65+
• Short-term care has been falling while long-term care has been increasing
• The primary support reason for more than 70% of ASC clients in both long- and short-term care is physical health; this is higher than England and the North West
• Wirral provides more long-term care in the community
• New admissions to residential or nursing care homes of people aged 18-64 are higher
• Those aged 65+ see a higher rate of residential placements and a lower rate of nursing home placements
• The cost of nursing and residential care is lower, but more people use it, making our overall long-term care costs higher
• Substantially fewer people use self-directed support or Direct Payments, following a sudden drop in 2022/23

The Adult Social Care Outcomes Framework (ASCOF) measures how well care and support services achieve the outcomes that matter most to people. The ASCOF is used both locally and nationally to set priorities for care and support, measure progress and strengthen transparency and accountability.

Access to Wirral Adult Social Care ASCOF data

View Wirral data and insight on PHOF

The Public Health Outcomes Framework (PHOF) sets out a vision for public health. Its aim is to:

• improve and protect the nation's health
• improve the health of the poorest fastest

The framework focuses on the two high level outcomes we want to achieve across the public health system and beyond:

1. Increased healthy life expectancy.
2. Reduced differences in life expectancy and healthy life expectancy between communities.

Our focus is on reducing differences between people and communities from different backgrounds. This is not only for life expectancy, but also for healthy life expectancy.

Adult Social Care Priorities for Local Authorities: A Focus on Wirral (June 2026)
Web version and document 

In development (June 2026)

• Asylum Seekers and Refugees
• Hearing Impairment

On website

• Ageing Well - Wirral Health and Wellbeing Knowledge Hub

• Alcohol - Wirral Health and Wellbeing Knowledge Hub

• Carers - Wirral Health and Wellbeing Knowledge Hub

• Child & Family Poverty - Wirral Health and Wellbeing Knowledge Hub

• Dementia - Wirral Health and Wellbeing Knowledge Hub

• Disease Profiles - Wirral Health and Wellbeing Knowledge Hub

• Domestic Abuse - Wirral Health and Wellbeing Knowledge Hub

• Drug Misuse - Wirral Health and Wellbeing Knowledge Hub

• Eye Health (Adult) - Wirral Health and Wellbeing Knowledge Hub

• Falls (Older People) - Wirral Health and Wellbeing Knowledge Hub

• Health Inequalities - Wirral Health and Wellbeing Knowledge Hub

• Homelessness - Wirral Health and Wellbeing Knowledge Hub

• Housing - Wirral Health and Wellbeing Knowledge Hub

• Learning Disabilities - Wirral Health and Wellbeing Knowledge Hub

• Life Expectancy - Wirral Health and Wellbeing Knowledge Hub

• Social Isolation & Loneliness - Wirral Health and Wellbeing Knowledge Hub

• Sexual and Reproductive Health - Wirral Health and Wellbeing Knowledge Hub

• Wirral Indices of Deprivation - Wirral Health and Wellbeing Knowledge Hub

Our website presents a collection content that provides the broadest picture of Wirral residents.

From population and demographic reports to detailed JSNA assessments and everything in between.

Visit Wirral Health and Wellbeing Knowledge Hub for more information

Local Insight is an online community mapping and reporting tool that provides instant access to neighbourhood level data, specifically for Wirral.

It provides maps, tables and reports for specific areas of Wirral, as well as displaying where local services are located, e.g. Care Homes, GP practices and pharmacies in Wirral. 

Visit and use Wirral Local Insight

Our JSNA Health and Wellbeing Interactive Report, offers a comprehensive overview of Wirral’s population.

This enhanced version includes a broad range of indicators and metrics to deepen your understanding of local health and wellbeing. 

This includes content covering Population and Demographics, Living and Working Well,  Ageing Well, Place and Environment and at the same time refreshed the existing Marmot Indicators and Starting Well theme.

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• Wirral Market Position Statement for Wirral Health & Care Commissioning (2023 - 2026)
  This Market Position Statement describes to the market commissioning intentions in the future, and what will be the main priorities. Links to our other Public Health Intelligence sources will help providers of care and third sector to research Local Intelligence to support their business thinking and decision making.

• Vulnerable Adults: Comparison of Wirral to Kings Fund 360 (2020)
  The Kings Fund published a review into social care in April 2019, Social care 360, which set out key trends in adult social care and aimed to seek out themes in social care which drew on a wide range of reliable data sources in order to provide a comprehensive ‘360 degree’ view of adult. This document reflects Wirral in comparison to that National data and information presented by the King's Fund. 

• Older People Outcomes Baseline Profile (2019)
  This profile has been designed as a resource to accompany the Healthy Wirral Outcomes Framework for Older People.  Its primary focus is to provide a high-level baseline position, highlighting variation that will inform the development of population-based commissioning.

• Wirral Market Position Statement: Overview of needs (2016): Key Messages for Adult Social Care in Wirral
  This report provides an overview of local current and future population estimates aligned to key issues relating to the social care client group - in service and potential future service users.

• Estimates from the Population Ageing and Care Simulation (PACSim) modelling study (October 2018) 
  This study models the growing need for social care in older people using PACSim, a dynamic microsimulation model. It finds that, in the next 20 years, the English population aged 65 years or over will see increases in the number of individuals who are independent but also in those with complex care needs. This increase is due to more individuals reaching 85 years or older who have higher levels of dependency, dementia, and comorbidity.

• Adult social care market shaping (March 2017)    This Department of Health guidance is aimed at people who buy social care services, including local authority and clinical commissioning group commissioners, as well as personal budget holders and people who fund their own care, care service providers and potential investors in the care sector.

• Creating the five year forward view for social care: How transformed and integrated health and care could improve outcomes and cost-effectiveness (March 2017)The Five Year Forward View sets out a case for upfront investment in the NHS to transform it into a service which reaches people in their homes and communities with early, effective interventions and builds partnerships with people with long term health conditions and their families. It is widely accepted that this will only succeed where social care makes the same transformation.

• Adult Social Care tool
  This updated tool for older people and adults with learning disabilities provides comparative information on spending per head, quality of services and access to services. These are the two largest groups who receive adult social care. View the UK website for more information

• AQA Quality and Efficiency Scorecard for Frail Elderly (2017) This North West Benchmarking tool provides comparative information for local commissioners and service planners