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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.

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.

Serious Case Reviews (SCRs, now Safeguarding Adults Reviews (SARs)) may be held at local level in England when a vulnerable adult dies or is harmed, and abuse or neglect is suspected, and there is cause for concern about multi-agency safeguarding practice. There has been no analysis of SCRs focussing on pressure ulcers. The purpose of this paper is to present findings from a documentary analysis of SCRs/SARs to investigate what recommendations are made about pressure ulcer prevention and treatment in a care home setting in the context of safeguarding. This analysis is presented in cognisance of the prevalence and risks of pressure ulcers among care home residents; and debates about the interface of care quality and safeguarding systems.

Identification of SCRs and SARs from England where the person who died or who was harmed had a pressure ulcer or its synonym. Narrative and textual analysis of documents summarising the reports was used to explore the Reviews’ observations and recommendations. The main themes were identified.

The authors located 18 relevant SCRs and 1 SAR covering pressure ulcer care in a care home setting. Most of these inquiries into practice, service communications and the events leading up to the death or harm of care home residents with pressure ulcers observed that there were failings in the care home, but also in the wider health and care systems. Overall, the reports reveal specific failings in multi-agency communication and in quality of care. Pressure ulcers featured in several SCRs, but it is problems and inadequacies with care and treatment that moved them to the safeguarding arena. The value of examining pressure ulcers as a key line of inquiry is that they are “visible” in the system, with consensus about what they are, how to measure them and what constitutes optimal care and treatment. In the new Care Act 2014 context they may continue to feature in safeguarding enquiries and investigations as they may be possible symptoms of system failures.

Reviews vary in content, structure and accessibility making it hard to compare their approach, findings and recommendations. There are risks in drawing too many conclusions from the corpus of Reviews since these are not published in full and contexts have subsequently changed. However, this is the first analysis of these documents to take pressure ulcers as the focus and it offers valuable insights into care home practices amid other systems and professional activity.

This analysis highlights that it is not inevitably poor quality care in a care home that gives rise to pressure ulcers among residents. Several SCRs note problems in wider communications with healthcare providers and their engagement. Nonetheless, poor care quality and negligence were reported in some cases. Various policies have commented on the potential overlap between the raising of concerns about poor quality care and about safeguarding. These were highlighted prior to the Care Act 2014 although current policy views problems with pressure ulcers more as care quality and clinical concerns.

The value of this documentary analysis is that it rests on real case examples and scrutiny at local level. Future research could consider the findings of SARs, similar documents from the rest of the UK, and international perspectives.

The value of having a set of documents about adult safeguarding is that they lend themselves to analysis and comparison. This first analysis to focus on pressure ulcers addresses wider considerations related to safeguarding policy and practice.

The purpose of this paper is to examine safeguarding adults reviews (SARs) that refer to mental health legislation in order to contribute to the review of English mental health law (2018).

Searches of a variety of sources were conducted to compile a list of relevant SARs. These are summarised and their contexts assessed for what they reveal about the use and coherence of mental health legislation.

The interaction of the statutes under consideration, in particular the Mental Health Act (MHA) 1983, the Mental Capacity Act (MCA) 2005, together with the Care Act 2014, presents challenges to practitioners and the efficacy of their application is variable.

In light of the absence of a duty to report SARs to a national register, it is possible that relevant SARs were missed in the search phase of this research, meaning that the results do not present a complete picture.

Examining cases where use of legislative provisions in mental health has been found wanting or legislation may not be easily implemented may inform initiatives to increase understanding of the law in this area.

This paper’s originality and value lie in its focus on mental health legislation as discussed in SARs at a time when both the MHA 1983 and the MCA 2005 are the focus of attention for reform.

The purpose of this paper is to highlight the role of housing in adult safeguarding under the Care Act (2014) in England.

The paper provides a summary of the implications for housing organisations and their staff of adult safeguarding under the Care Act. The implications, underpinned by the six safeguarding principles, are explained within a summary of the legal and practice framework for safeguarding in England.

The paper draws upon research by Imogen Parry (2014). It argues that past failings in adult safeguarding in England have placed it high on the housing agenda and that housing has a key role to play in adult safeguarding.

Housing organisations need to be proactive partners in local multi-agency arrangements for adult safeguarding. Staff and contractors need to receive training in line with their role to raise awareness of their safeguarding responsibilities.

The value of the paper is to increase and maintain awareness of the need for housing engagement in the adult safeguarding agenda.

The 2015 Modern Slavery Act focusses attention forms of modern slavery (human trafficking and forced labour), within the UK. The contemporaneous 2014 Care Act, identifies modern slavery as a new form of risk within adult social care, listing forms of abuse and vulnerability. However, it does not consider whether those providing care may themselves be vulnerable to forms of modern slavery. The paper aims to discuss these issues.

The authors describe the history of the development of modern slavery legislation in the UK, outline key provisions of the Care Act, illustrated with real-life cases. The analysis suggests that adult social care – characterised by informality, fragmentation and vulnerability – is one where instances of modern slavery may be more common than considered to date.

The data collected, though relatively modest, suggests that a thorough investigation should be undertaken into the possibility of modern slavery taking place within the realm of adult social care.

Data have been collected through a snowball process, rolling out a survey to relevant groups of individual and organisations. A more rigorous investigation is required to examine the extent of modern slavery within adult social care.

The training of those responsible for the regulation/management of adult social care needs to ensure that they are fully equipped to understand the nature of modern slavery and how to identify its symptoms and victims.

There is also a need for heightened awareness of those close to people being cared for that they may also identify the symptoms of modern slavery.

This area has not been explored to date.

The purpose of this paper is to formulate recommendations from international and local examples to aid the design and delivery affirmative housing and care options for older LGBT individuals in England.

This paper combines a desk-top review conducted by the author with personal views and recommendations for practice by discussing the levers within both the Care Act and Equality Act for greater LGBT participation in the design, delivery and evaluation of housing with care services.

The provision of LGBT affirmative housing and care options for individuals in England is currently limited. International and European evidence suggests that multi-faceted, person-centred approaches are central in delivering affirmative services to older LGBT individuals.

This paper adds to a growing literature on minority housing and care services. The author draws on both a professional and personal interest in facilitating the development of LGBT affirmative services in England.

The purpose of this paper is to consider the experiences of carers caring for an adult child, particularly as they affect the transition from midlife into older age. It explores aspects affecting the vast majority of carers, such as accessing information and services, but focuses on the specific concerns of those caring for a child with a life-long disability or a child who acquires a long-term health problem in adolescence or adulthood. In the context of the introduction of the Care Act (2014) in England, the paper highlights ways in which support for carers could be improved.

This paper draws on interview data which consisted of 86 face-to-face interviews with purposefully selected participants based in four local authorities. At the end of the study in 2014 the authors held a series of five focus groups for practitioners and carers to explore how the emerging findings chimed with their experiences and to refine the study’s messages for practice. The data from interviews are set in the context of policy and practice developments in social care in England.

The paper draws attention to the need for practitioners to find ways of involving carers in decision making without compromising the rights to autonomy and choice on the part of the person cared for. Both those commissioning services and practitioners need to acknowledge that parent carers need assurances about the long-term viability and quality of the plans that are developed for the person they support.

This paper is drawn on interviews with carers and practitioners in four areas of England; most of the carers interviewed were white British and female. The implications of planning research and conducting research with family carers are explored and their similarities with practice encounters identified.

The key practice point in this paper highlights the necessity of talking about the future with parent carers, making plans for possible and highly likely events, addressing mortality, and being aware of the potential for a deeply held sense of pessimism and unspoken distress among carers. Some participants seemed to feel that practitioners conveyed a sense that they were inadequate or unwilling to discuss these matters and practitioners who suspect this may apply to them or their team could usefully consider seeking skills development to improve their practice.

This paper is the first to consider practice perspectives in the context of the Care Act (2014) and personal budgets in England relating to parent carers.