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The purpose of this paper is to consider the role of the Mental Health Act (MHA) 1983 in safeguarding adults at risk of abuse and neglect. The author has undertaken a thematic review of Safeguarding Adults Reviews (SARs) commissioned in England and Adult Practice Reviews (APRs) commissioned in Wales where the MHA 1983 was a central aspect to the review.

Reviews were included based on specific determinants, following analysis of SARs, APRs and executive summaries. This should not affect the credibility of the research, as themes were identified in conjunction with analysis of literature regarding use of the MHA in the context of adult safeguarding. Consequently, this review has been underpinned by evidence-based research in the area of study.

The interaction between statutes, such as the MHA 1983 and Care Act 2014, signify challenges to professionals, with variable application of mental health legislation in practice.

Lack of a complete national repository for review reports means that it is likely that the data set analysis is incomplete. It was noted that limitations to this research include the fact that Safeguarding Adults Boards in England may not publish SAR reports or may choose to publish an executive summary or practice brief instead of the full SAR report, therefore limiting the scope of disseminating learning from SARs, as this is difficult to achieve where the full report has not been published. The author aimed to mitigate this by undertaking comprehensive searches of Local Authority and SAB websites, in addition to submitting Information requests to ensure that this research encompassed as many relevant review reports as possible.

This is an important and timely topic for debate, given that the UK Government is proposing reform of the MHA 1983. In addition, existing thematic reviews of SARS tend to be generalised, rather than specifically focused on the MHA.

The purpose of this paper is to provide a literature review on what is known about unpaid family carers who are at risk of or have experienced abuse from the people they provide care for and relevant policy/legal and practice responses for affected family carers.

A literature search was carried out to locate literature relating to unpaid family carers who are at risk of or have experienced abuse from the people they provide care for. This also incorporated grey literature, including policy guidance and law, to determine the existing knowledge base, gaps in practice and areas that might require further research.

The findings suggest that although carer harm is serious, it is under-researched. In addition, the unique needs of unpaid family carers who are at risk of or have experienced abuse, violence and harm from the people they provide care for are subsumed in safeguarding policy/law processes and practice under the auspices of the protection of “adults at risk” rather than the protection of “carers at risk”.

It is important that those who support unpaid family carers who are at risk of abuse and harm know about their unique safeguarding needs and concerns to offer appropriate support. It is also apparent that policy and law need to address the gap in provision relating to the unique safeguarding concerns involving the abuse of unpaid family carers by the people they provide care for. This paper is based on this literature review and not on other types of research.

The paper provides insights into what is known about the abuse of unpaid family carers by the people they provide care for, and the policy/legal and practice responses to affected unpaid family carers. It contributes to the body of knowledge on carer abuse and safeguarding carers from abuse and harm.

Since the start of the Carers’ Movement research into unpaid care and carers has been used to advocate for policy change. The purpose of this paper is to address the changes in research into unpaid care and carers since the start of the Carers’ Movement and to explore the relationship between these changes and social policy.

This research paper is based on a qualitative study of documents within the Carers UK archive.

Research into unpaid care and carers has changed focus from caregiving as an identity and lifestyle to an interruption to “normal” life and employment. Changes in research are intertwined with changes in policy, with research evidencing advocation for policy change and policy change fuelling further research. Changes in the methodology of this research exposes transition points in the Carers’ Movement and in social research more broadly.

This paper contributes to critical understandings of the relationship between research into unpaid care and caring and policy. The paper also contributes to debates on methodology, exploring how the methodological zeitgeist presents in archived research.

Understanding how current research into unpaid care and carers has been developed and acknowledging the role of policy in research development brings available data on unpaid care and caring under scrutiny.

This paper is original in developing a critical analysis of the relationship between research into unpaid care and carers and social policy.

An appreciative inquiry process was collaboratively undertaken with an inner city local authority and personal advisors where systemic social work practice was embedded. The purpose of this study is to explore how systemic social work principles could be integrated into the support of young adults leaving the care system, especially when safeguarding concerns exist.

Three fortnightly, reflecting team-style, appreciative inquiry workshops explored the integration into practice of systemic concepts under the themes of safeguarding, uncertainty and new possibilities.

Within the contexts of the organisation, other agencies and the relationship, six paired themes emerged: learning and navigating; positioning and risk-taking; and feeling and engaging. Core systemic concepts, such as self-reflexivity and mutual influence, can enable personal advisers to use themselves and their relationship with care leavers as a context for change. Considering responses to risk from different family member positions may support holding greater levels of uncertainty. Seeing resilience as a process rather than a personal attribute enabled personal advisors to think about how they connected with care leavers through shared life experiences, fostering narratives of hopes and dreams where new possibilities abound.

Appreciative inquiry is generally seen as a defined model for implementing large organisational changes; this study comprised a small sample group, and the model’s application was less defined.

A gap exists in the extensive care leaver research, addressing safeguarding and working systemically. A conceptual model for practice is offered, with potential utility in developing further systemically informed training and supervision for practitioners. A less structured and more relationally engaged model for appreciative inquiry is presented.

This study aims to explore which outcome measures are used by occupational therapy staff in adult social care settings in the UK, and the factors affecting use of outcome measures.

A quantitative descriptive research design was used, using a cross-sectional study to explore occupational therapy staff views on the use of outcome measures. A 38-question survey was developed on Microsoft Forms. Recruitment occurred online over a three-week period in 2021 via the social media platform “Twitter”. Results were analysed using Excel using descriptive statistics and qualitative results used thematic analysis.

Participants (n = 20) used a range of outcome measures (13) in adult social care settings in the previous 12 months. Standardised measures were used by half the sample in the previous 12 months. The Therapy Outcome Measure and Barthel Index were in most use. The breadth of adult social care practice and practical factors such as caseload and lack of a meaningful tool were found to be barriers to outcome measure use. Facilitators included service improvement, accountability, use of audit and professional occupational therapy leadership.

The overall use of outcome measures can be considered low in this setting, with manager support seen to be key to the use of outcome measures. Further research is needed to investigate nationwide use.

Training, time and manager support are key to use of standardised tests and outcome measures in the adult social care settings. The use of occupational performance measures should be considered to demonstrate unique professional impact.

This contemporary study reveals use of outcome measures within occupational therapy adult social care services in the UK, which is an under researched and under published area.

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. The initial data set was published in this journal in 2015 and has since been updated annually. The complete data set is available from the author. The second purpose is to reflect on the narratives about adult safeguarding and self-neglect by focusing on the stories that are told and untold in the reviews.

Further published reviews are added to the core data set, drawn from the national SAR library and the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the domains used previously, direct work, the team around the person, organisational support and governance. SAR findings and recommendations are also critiqued using three further domains: knowledge production, explanation and aesthetics.

Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. SAR findings emphasise the knowledge domain, namely, what is actually found, rather than the explanatory domain that seeks to answer the question “why?” Findings and recommendations appear to assume that learning can be implemented within the existing architecture of services rather than challenging taken-for-granted assumptions about the context within which adult safeguarding is situated.

A national database of reviews completed by SABs has been established (www.nationalnetwork.org.uk), but this data set remains incomplete. Drawing together the findings from the reviews nonetheless reinforces what is known about the components of effective practice, and effective policy and organisational arrangements for practice. Although individual reviews might comment on good practice alongside shortfalls, there is little analysis that seeks to explain rather than just report findings.

Answering the question “why?” remains a significant challenge for SARs, where concerns about how agencies worked together prompted review but also where positive outcomes have been achieved. The findings confirm the relevance of the evidence-base for effective practice, but SARs are limited in their analysis of what enables and what obstructs the components of best practice. The challenge for SAR authors and for partners within SABs is to reflect on the stories that are told and those that remain untold or untellable. This is an exercise of power and of ethical and political decision-making.

The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further reinforcing the evidence base for practice. The paper analyses the degree to which SARs answer the question “why?” as opposed simply to answering the question “what?” It also explores the degree to which SARs appear to accept or challenge the context for adult safeguarding. The paper suggests that SABs and SAR authors should focus explicitly on what enables and what obstructs the realisation of best practice, and on the choices they make about the stories that are told.