Search results

The purpose of this paper is to describe and discuss the pilot Making Safeguarding Personal (MSP) project that ran in three London boroughs in England in 2014-2015. The project aimed to help local authority social work practitioners better engage with adults at risk at the beginning, middle and end of safeguarding work and to develop a more outcomes focused approach to safeguarding.

Three adult social care teams volunteered to take part in the MSP pilot for four months, November 2014-February 2015. They were closely supported through telephone conferencing, bespoke training and individual mentoring. Evaluative data were collected from the participating teams about their work and the MSP change processes to assist in further implementation.

The findings suggested that staff felt that the open discussions with adults at risk that were encouraged by the MSP initiative enabled safeguarding to be more effective and provided a better basis of support for adults at risk. The support from the project team was appreciated. Staff reported their own increased confidence as a result of involving adults at risk in decisions about their situations and risks of harm. They also reported their increased awareness of cross-cutting subjects related to adult safeguarding, such as domestic abuse and working with coercive and controlling behaviours. Permission to exercise greater professional discretion to make responses more considered, rather than the need to adhere to time-limited imperatives, was received positively. Staff felt that this enhanced discussions about resolution and recovery with adults at risk although it required greater expertise, more extensive managerial support, and more time. These were available in the pilot.

The MSP pilot was confined to three teams and took place over four months. The numerical data reported in this paper are provided for illustrative purposes and are not statistically significant. As with other evaluations of implementation, the data provided need to be set in the local contexts of population profiles, care settings and the reporting source. The pilot also took place during the early implementation of the Care Act 2014 which affected the context of practice and training. The views of adults at risk were not collected. There is a risk of bias in that participants may have wished to convey positive views of MSP to their colleagues.

The paper indicates a need for the roll out of MSP philosophy and MSP approaches to be communicated with other agencies supporting adults at risk and for project support of some form to continue. It will be important to see if the overall enthusiasm, support and motivation reported by the pilot teams when taking a MSP approach in practice extend beyond a pilot period during which the staff received substantial support from a dedicated Professional Standards Safeguarding Team. Many of those staff participating in the pilot perceived the MSP approach as a return to core social work principles and welcomed putting these into practice.

The paper provides details of one pilot in which the feasibility of the MSP approach was tested by supporting three frontline teams working in different contexts. The pilot suggests that the level and type of support offered to the pilot teams were effective in a variety of practice settings. It draws attention to the need for the MSP concept and approach to be shared with other agencies and for implementation support to continue beyond initial pilot period.

Making Safeguarding Personal (MSP) is a national programme to increase the involvement of adults at risk in the adult safeguarding process. The paper aims to discuss this issue.

The implementation of MSP in the London Borough of Sutton involved three areas of analysis: a quantitative analysis of 47 safeguarding cases in which adults at risk were asked what they wanted the safeguarding intervention to achieve and whether or not these outcomes had been achieved; qualitative analysis of the service users’ experience of the safeguarding process using focus groups led by creative arts therapists; and interviews with social workers, team managers and administrators on their experience of the implementation of MSP.

In 81 per cent of safeguarding cases, outcomes were achieved satisfactorily. The focus groups identified the importance of freedom of movement, freedom of association, being listened to and regular communication with a consistent person. The practitioner interviews identified themes of increased efficiency, increased effectiveness, empowerment; the transformation of relationships and the practice of new skills.

This research shows that focus groups led by therapists can be used to explore safety and safeguarding and supports the effectiveness of MSP in achieving person-centred outcomes. No baselines or control groups were used, so the extent of effectiveness is difficult to determine. The sample size is relatively small, so results may not be generalised.

A number of learning points for practice are identified including how to chair and where to hold safeguarding meetings and changes to practice required to implement MSP.

This is the first research into MSP using art, drama and music therapists to explore the experiences and view of adults at risk of safety and safeguarding.

The purpose of this paper is to explore and critique the conceptual and terminological shift – particularly from “vulnerability” to “adult at risk” – in adult safeguarding under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014.

The paper compares the notion of the vulnerable adult in safeguarding, with the notion of an adult at risk under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014 and questions to what extent such a shift addresses existing criticisms of “vulnerability”.

The paper criticises the notion of the “vulnerable adult” for perpetuating the stigma associated with an impairment or disability, and for the types of legal and policy responses deemed appropriate under such an understanding of vulnerability. While efforts to replace the term “vulnerable adult” with “adult at risk” are, to some extent, to be welcomed, “adult at risk” under the legislation relies on the same characteristics for which the “vulnerable adult” has been criticised. Nevertheless, the safeguarding provisions under the two Acts have made some strides forward in comparison to their legal and policy predecessors and the notion of the “vulnerable adult”.

This paper’s originality and value lie in its scrutiny of the notion of “vulnerability” in adult safeguarding, in comparison to the newer terminology of an “adult at risk”, whilst also suggesting that in important respects – in relation to the interventions deemed appropriate where an adult is perceived to be at risk – the two pieces of legislation are a marked improvement on their predecessors. It also offers some thoughts as to how criticisms of the new legislation may be overcome.

Older adults’ sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. The increase in HIV/AIDS diagnoses in the older adult population ignites the need to understand the reasons why older adults are omitted from HIV/AIDS prevention education policy.

This chapter examines the social forces that influence HIV/AIDS policy at the state and community levels. Through qualitative methodology and analysis, including interviews with state policymakers and managers of AIDS service organizations in four Midwestern states (n=31), I look for trends and patterns as to whether or not older adults are considered as an “at-risk” group for HIV infection.

Findings reveal that HIV/AIDS policy may be impacted by enduring sexual scripts about older adults. To some extent both state policymakers and AIDS service organization personnel adhere to stereotypes about older adults’ sexuality and sexual activity, which is then implemented in their health promotion activities. The result is that gaps exist in HIV/AIDS prevention education for older adults, despite the fact that current trends show an increase in new HIV infections and AIDS diagnoses among people over the age of 50.

While this is an exploratory study of the available HIV/AIDS prevention education and health promotion activities for older adults, as well as the viewpoints of state policymakers and AIDS service organization personnel, the findings do indicate the need for additional research on the potentially dangerous sexual behaviors – lack of HIV testing, low condom usage, multiple partners – exhibited by older adults. Future research involving interviews with older adults, physicians, and medical personnel may add new perspectives to the current research.

As the baby boomers continue to age and challenge cultural stereotypes of sexual behaviors among older adults, research in the area of sexual health and HIV/AIDS prevention education will remain an important component of healthy aging. This research begins what will ultimately be a necessary conversation.

The Adult Support and Protection (Scotland) Act 2007 (ASP Act) mandates public bodies to investigate situations of harm and to support and protect adults at risk. One of the fundamental principles of the legislation is to involve the person in the adult protection process. Older people are highly represented among those defined as adults at risk and have the right to participate in decisions about their lives. However, contextual factors can impact participatory parity, and participation can be tokenistic. Drawing on the author’s practice experience, this paper aims to explore the supports and barriers to meaningful participation in adult protection.

Based on practice during the first decade of the ASP Act, this paper uses amalgamated scenarios involving older adults at risk to illustrate some of the key themes emanating from literature.

Despite Human Rights Conventions and law promoting participatory principles, research evidence and practice experience suggests that ethical principles do not always translate to practice. Within adult protection case conferences (APCCs), participation is nuanced and multifaceted, involving individual and structural facilitators and impediments. APCCs can be inhospitable environments for the adult at risk. But they also have the potential to be collaborative and supportive spaces, promoting the person’s self esteem and agency. The author plans to conduct research with service users and practitioners exploring the extent to which APCCs can facilitate meaningful participation.

This paper contributes to the wider debate about the participatory rights of service users and the value of experiential knowledge.

The purpose of this paper is to explore debates about the powers social workers may need to undertake safeguarding enquiries where access to the adult is denied.

The paper takes as a starting point a scoping review of the literature undertaken as part of a study exploring social work responses to situations where they are prevented from speaking to an adult at risk by a third party.

A power of entry might be one solution to situations where social workers are prevented from accessing an adult at risk. The paper focuses on the Scottish approach to legal powers in adult safeguarding, established by the Adult Support and Protection Act (Scotland) 2007 and draws out messages for adult safeguarding in England and elsewhere. The literature review identified that debates over the Scottish approach are underpinned by differing conceptualisations of vulnerability, autonomy and privacy, and the paper relates these conceptualisations to different theoretical stances.

The paper concludes that the literature suggests that a more socially mediated rather than an essentialist understanding of the concepts of vulnerability, autonomy and privacy allows for more nuanced approaches to social work practice in respect of using powers of entry and intervention with adults at risk who have capacity to make decisions.

This paper provides a novel perspective on debates over how to overcome challenges to accessing adults at risk in adult safeguarding through an exploration of understandings of vulnerability, privacy and autonomy.

Being able to speak in private to an adult about whom there is a safeguarding concern is central to English local authorities’ duty under the Care Act 2014 to make enquiries in such cases. While there has been an on-going debate about whether social workers or others should have new powers to effect these enquiries, it has been unclear how common obstructive behaviour by third parties is and how often this causes serious problems or is unresolved. The purpose of this paper is to address this knowledge gap.

A survey of local authority adult safeguarding managers was conducted in 2016 and interviews were undertaken with managers and social workers in three local authorities. Data were analysed descriptively.

Estimates of numbers and frequency of cases of obstruction varied widely. Most survey respondents and interview participants described situations where there had been some problems in accessing an adult at risk. Those that were serious and long-standing problems of access were few in number, but were time consuming and often distressing for the professionals involved.

Further survey research on the prevalence of obstructive behaviour of third parties may not command greater response rates unless there is a specific policy proposal or a case that has “hit the headlines”. Other forms of data collection and reporting may be worth considering. Interview data likewise potentially suffer from problems of recall and definition.

At times professionals will hear of, or encounter, difficulties in accessing an adult at risk about whom there is concern. Support from supervisors and managers is needed by practitioners as such cases can be distressing. Localities may wish to collect and reflect upon such cases so that there is learning from practice about possible resolution and outcomes.

There is no evidence of large numbers of cases where access is denied or very difficult. Those cases where there are problems are memorable to practitioners. Small numbers of cases, however, do not necessarily mean that the problem of gaining access is insignificant.

This study addressed a question which is topical in England and provides evidence about the frequency of the problem of gaining access to adults at risk. There has been no comparable study in England.

Whether social workers should have a power of entry in cases where individuals seem to be hindering safeguarding enquiries for community-dwelling adults at risk is a topical question in England. The purpose of this paper is to present the findings of a re-examination of relevant sections of the 2012 Government Safeguarding Power of Entry Consultation.

Re-analysis of responses to question three of the 2012 Government’s Safeguarding Power of Entry Consultation was undertaken in late 2015-early 2016. The consultation submissions were located and searched for information on views of the prevalence of the situations where access to an adult at risk (with decision-making capacity) is being hindered by a third party and the nature of examples where a new power of entry might be considered appropriate by consultation respondents.

The majority of respondents to the consultation generally reported that situations when a new power of entry would be required were not encountered regularly; however a minority of respondents stated these situations occurred more frequently. Examples of situations where third parties appeared to be hindering access were given across the different categories of adults at risk and types of abuse and current practices were described. Respondents observed that the risks of excessive or inappropriate use of any new powers needed to be considered carefully.

This re-analysis sheds light on the prevalence and circumstances of the problems encountered about access to adults at risk. The legal framework of adult safeguarding continues to be of interest to policy makers, researchers and practitioners.

Opportunities to gamble have boomed in the UK in recent years, since the passing of the Gambling Act 2005. The implications of this for adults with care and support needs and for safeguarding services have not been greatly investigated. The purpose of this paper is to address the interface of how gambling affects adults with care and support needs in England and adult safeguarding.

This paper reports on the scoping review which focussed on adults with care and support needs and gambling-related harm. It also included literature on perpetrators who exploit adults with care and support needs to fund their own or others’ gambling. The overall aims of this scoping review were to explore what is known about gambling-related harm affecting adults with care and support needs, the gaps in the evidence base, and specifically to refine the interview questions for the wider study.

There is some evidence that adults with care and support needs experience or are at risk of gambling-related harm. There is, however, lack of data from safeguarding services about this affecting adults at risk and safeguarding practice and systems. A public health approach to gambling is advocated by some, as well as effective regulation and support for people who have problems with their own or others’ gambling.

Industry operators, practitioners, and policymakers are increasingly paying attention to gambling-related harm but there is a lack of focus on adults with care and support needs or implications for adult safeguarding.

There are currently no national adult safeguarding outcome measures that focus on people who have been through an adult safeguarding investigation in England. There is a need for local authorities (LAs) and their partners to be able to measure whether the services provided to adults at risk of abuse and neglect are effective. The paper aims to discuss these issues.

This paper describes the cognitive testing phase of a study to develop and implement a standardised adult at risk outcome measure in adult safeguarding for use by LAs in England. An outcome measure (a set of seven survey questions administered in a face to face interview) was cognitively tested in three LAs with adults at risk (or their carers/advocates) for whom an investigation of abuse had been concluded (n=40), with the aim of assessing whether it was commonly understood. A set of guidance notes was designed and LA staff (n=12) who assisted with the survey were interviewed about its usability and the feasibility of administering the survey.

The survey questions required modifications to improve their reliability, validity and comparability. LA staff also suggested improvements were needed in the guidance document and survey. LA managers, adults at risk (and their relatives/carers/advocates) were willing to be involved in the survey and it was considered feasible to proceed with piloting the measure.

The development of this unique survey is of interest to those working in adult safeguarding, user involvement, survey management and outcome measurement in LAs.