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The purpose of this paper is to look at the impacts on adult safeguarding partnerships and practice over 18 months following the implementation of the Care Act (2014) from the perspectives of an independent Chair of two Safeguarding Adults Boards (SABs) and a senior manager in adult social care in a local authority. They look at the areas of: wellbeing and safety, safeguarding activity and process, changing criteria and definitions, Making Safeguarding Personal, SABs, safeguarding adult reviews and advocacy.

The authors draw together information from published sources, experience and networks.

The paper argues that the impact on adult safeguarding and SABs has been greater than originally envisaged in a range of areas. This appears to be as a result of adult safeguarding having been made statutory, a new framework having been put in place, and added impetus given to a cultural change in adult safeguarding practice.

The authors have been engaged in delivering the adult safeguarding elements of the Care Act (2014) and so provide unique insight into the experience of making the changes required to meet the new statutory requirements and achieve the objective of protecting peoples’ rights to live in safety, free from abuse or neglect.

Is health care a right or an entitlement? This question persists in the ongoing political, legal, and social turbulence surrounding efforts toward accessible and affordable health care in the United States.

The analysis is drawn from a review of the literature and interviewing a subject matter expert employed by a health maintenance organization in Michigan.

Since the early 1900s, federal legislation has been proposed to establish some type of health care structure that could sufficiently address the varying health care needs of Americans. These multiple attempts toward national health care reform invoke the inquiry of the federal government’s role and function to facilitate access to and management of health care. The passage of the Patient Protection and Affordable Care Act (PPACA) amplifies the conditions and consequences of implementing health care reform effectively.

For college students, the complexities of both the health care and higher education systems can be overwhelming, especially for those students who may already be struggling to pay for and/or finance their schooling and satisfy academic requirements to matriculate while simultaneously striving to maintain a reasonable level of health to complete their education. College students are but one of many vulnerable populations in the United States impacted by the complicated policies and procedures of accessing, delivering, funding, and paying for health care.

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.

The purpose of this paper is to present a case study describing the progress that is being made in one city in England to increase access to Care Act 2014 assessments and personal budgets among people with experiences of homelessness and multiple exclusion.

A case study employing a “study group” to describe and reflect on local development work.

The authors focus on the “systems change” activity that was undertaken by one voluntary sector partnership project to address issues of referral and access to adult social care. This included the development of a “Multiple Needs Toolkit” designed to support voluntary sector workers to communicate more effectively with adult social care around the application of the new Care Act 2014 eligibility thresholds. The authors discuss the role of “persistent advocacy” in increasing access to assessments and also the limitations of this as regard the potential for poorer joint working.

Throughout, the authors draw on the “ambiguity-conflict” model of policy implementation to assess if the learning from this single case study might be applied elsewhere.

The purpose of this paper is to consider the background to the recent changes to adult safeguarding in Wales as a result of the new measures introduced by the Social Services and Well-being (Wales) Act 2014 and discuss their potential impact.

The paper relies on a range of material including reports published by the Law Commission, the National Assembly for Wales and other public bodies. It also refers to academic and practitioner material in journals and government guidance.

Although the Social Services and Well-being (Wales) Act 2014 introduced many changes in adult safeguarding in Wales, not least the duty to make enquiries, it does not take the opportunity to include statutory powers of barring and removal. The introduction of Adult Protection and Support Orders (APSOs) is a cautious step forward – perhaps it is too cautious. More research in needed on the different approaches across the UK.

At the time of publication, the full effect of the new legislation has not been seen. Local authorities and others are coming to terms with the new provisions. No data on the impact of the new legislation are yet available. The paper identifies future research evaluating the working of the different approaches to safeguarding within the UK.

For practitioners, the new legislation provides opportunities to rethink the approach to safeguarding. The lower threshold for referrals will mean an increase in caseloads and the need to react to both low- and high-risk cases. For authorised officers, the practical issues identified relate to the circumstances in which an APSO may be sought and what can be put in place to protect the adult at risk once the order has been used.

For those who experience abuse or neglect, the new legislation provides additional support when compared to the POVA process. The duty to make enquiries and the duty to report will hopefully strengthen protection and, with a lower threshold for referral, enable more preventative work to be done at an earlier stage. Whether the new APSO will make a difference remains to be seen.

As this is new legislation, there is very little analysis of the implications of the Social Services and Well-being (Wales) Act 2014 in relation to safeguarding. This paper presents an overview and, in places, a critical analysis of the new safeguarding duties.

The planning and provision of care for older people in the lesbian, gay, bisexual and trans (LGBT) communities is an increasing challenge to traditional welfare systems. The purpose of this paper is to explore the potential of the newly implemented Care Act 2014 in England for developing an anti-discriminatory approach.

The review draws on existing research and conceptual literature to identify how key provisions of the new act can be interpreted in light of current knowledge.

Overall the provisions of the Care Act lend themselves well to positive interpretation in relation to the needs of older LGBT people and their support networks. A potential tension, however, arises in the locality focus of the legislation that could constrain good practice with geographically dispersed communities. There is also a need to challenge both heteronormative and ageist assumptions that lead to older LGBT people remaining unrecognised.

Applied with imagination and commitment, the provisions of the new act could enable new forms of person-centred care to emerge to support older LGBT people.

Social workers are in a key position to influence how the Care Act is interpreted and applied in practice and can act as change agents for a societal move towards older LGBT people having greater choice and control over their well-being.

This review presents examples of how the provisions of the legislation can be utilised to support positive change for older LGBT people.

The purpose of this paper is to discuss how the signs of safety and wellbeing practice framework offers a practical and logical reinforcement for the Making Safeguarding Personal programme within the practice context of the Care Act. The new practice framework orientates safeguarding practice to be person led and person centred while reinforcing an outcomes focus.

The principal social worker co-led the design and pilot programme where the new practice framework was developed and trialled.

A practice framework that houses the policy and practice updates needed to deliver the Care Act and Making Safeguarding Personal agenda is logical and necessary for the practitioners. An outcomes focus is encouraged because safeguarding practice is goal orientated and outcome focused.

A debate about how practice frameworks can help achieve the Making Safeguarding Personal approach and deliver on the Care Act principles is offered. This is a new and important debate for adult social care; a debate well-established across children’s services.

A debate about how practice frameworks can help achieve the Making Safeguarding Personal approach and deliver on the Care Act principles is offered. This is a new and important debate for adult social care; a debate well-established across children’s services.

The purpose of this paper is to look at family carers’ views and experiences of self-funded care for older people with an emphasis on attitudes to public intervention.

Semi-structured interviews were conducted with family carers in a densely populated city in Northern England. Study participants were recruited according to a purposive sampling strategy; data analysis was based on a qualitative content analysis approach.

The paper concludes that it may not be straightforward for local authorities to engage with family carers as appropriate under the Care Act 2014. An issue is that family carers do not envisage an intervention of the local authority in circumstances involving the use of privately paid social services.

Qualitative information gathered within a broad study of family carers’ views, attitudes and practices of care of dependent older people have been interpreted in the light of the provisions of the Care Act 2014 concerning self-funders. The qualitative approach and the limited number of study participants are issues with the generalisation of findings.

Only a handful of studies have attempted to look into family carers’ experiences of self-funded care and the paper aims to contribute to such limited literature. It also provides an evidence-based assessment of the challenges associated with the implementation of the Care Act 2014.

The purpose of this paper is to investigate health and social care integration in North Wales in a short window of time between the assent of the Social Services and Well-being (Wales) Act 2014 and its implementation in 2016.

The findings are based on the experiences of health and social care professionals from six Local Authorities and one Regional Health Board working in a management role with strategic responsibility, gathered from an online survey (n=43), semi-structured face-to-face interviews (n=14) and supplemented with reflective interviews with regional coordinators responsible for facilitating cross-organisational working (n=2).

Senior managers are devoting considerable energy to understanding the implications of the new legislation, ensuring that their organisations will be ready and able to successfully implement it. This work is perceived to be commensurate with wider agendas to transform and integrate working practices and services, influenced by a range of financial, environmental, organisational, social and policy factors.

This research has direct implications for stakeholders in North Wales, having already been used to shape conversations about integration in the region, and furthermore builds upon existing knowledge in the academic and professional field of integration, with additional limited wider implications for policy and research.

The safeguarding and protection components of the Social Services and Well-being (Wales) Act 2014 offers the culmination of four years consultation in England and Wales by the Law Commission and many years of evolving policy and practice with a view to protecting adults from harm. The purpose of this paper is to offer both scrutiny and challenge for Wales’ policy makers and practitioners alike.

The paper is a critical analysis of both current responses and forthcoming changes.

The paper proposes that Wales has failed to implement previous recommendations in relation to institutional abuse. Currently in Wales, there are individuals employed in safeguarding lead roles who have no social care qualification. This apparent “loophole” has not to date been highlighted to date by either of the regulatory bodies within Wales (CSSIW/CCfW).

The paper offers a viewpoint but leaves some questions unanswered.

The Williams Review in April 2014 is set to change the local authority landscape in Wales. There is scope for developing the function of adult safeguarding.

Wales’ failure to recognize institutionalized abuse as a distinct category may have had impacted on its ability to respond to abuse in nursing and care as well hospital settings.

The failure to recognize institutional abuse is not the only safeguarding anomaly within Wales’ arrangements for protecting those are risk of abuse. This paper describes gaps in the NHS and of professional accountability.