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Article

Michael Preston-Shoot

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis and explore the degree to…

Abstract

Purpose

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis and explore the degree to which SARs draw upon available research and learning from other completed reviews.

Design/methodology/approach

Further published reviews are added to the core data set, mainly drawn from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains used previously. The four domains and the thematic analysis are rounded in the evidence-based model of good practice, reported in this journal previously. Multiple exclusion homelessness and alcohol misuse are prominent in this sample of reviews.

Findings

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. Multiple exclusion homelessness emerges as a subset within this sample, demonstrating that SABs are engaging in reviews of people who die on the streets or in temporary accommodation.

Research limitations/implications

The national database of reviews commissioned by SABs remains incomplete and does not contain many of the SARs reported in this evolving data set. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. NHS Digital annual data sets do not enable identification of reviews by types of abuse and neglect. It is possible, therefore, that this data set is also incomplete. Drawing together the findings from the reviews nonetheless builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice.

Practical implications

Answering the question “why” remains a significant challenge for safeguarding adult reviews. 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. Greater explicit use of research and other published SARs might assist with answering the “why” question, drawing attention where appropriate to policies being pursued by the central government that undermine any initiative to end rough sleeping.

Originality/value

This 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 evidence-base also supports practice with individuals who experience multiple exclusion homelessness. Policymakers and practitioners have an approach to follow in this complex, challenging and demanding area of practice.

Details

The Journal of Adult Protection, vol. 22 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

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Article

Michael Preston-Shoot

Criticisms of the effectiveness of Local Safeguarding Children Boards (LSCBs) led to legislative reform in the shape of the Children and Social Work Act 2017. Given…

Abstract

Purpose

Criticisms of the effectiveness of Local Safeguarding Children Boards (LSCBs) led to legislative reform in the shape of the Children and Social Work Act 2017. Given parallels between the mandates for LSCBs and Safeguarding Adults Boards (SABs), the onus is on SABs to demonstrate their effectiveness. The purpose of this paper is to explore how SABs might more effectively demonstrate their impact across the range of their mandated responsibilities.

Design/methodology/approach

The paper draws on definitions of impact from social work education, healthcare and from university research, exploring their relevance for capturing different types of data regarding the outcomes and impact of SAB activity. The paper also draws on frameworks for the process of capturing data and for implementing strategies designed to change practice and develop adult safeguarding services.

Findings

The paper argues that SABs have struggled to identify their impact and need to consider what types of impact they are seeking to demonstrate before choosing methods of seeking to capture that information. The paper also argues that SABs may have given insufficient thought to the process of change management, to the components needed to ensure that desired outcomes are embedded in procedural and practice change.

Research limitations/implications

This paper explores the challenges for SABs of identifying their impact and offers some theoretical frameworks that have defined different types of impact. The paper also draws on frameworks that identify the different components that are necessary for achieving change. This paper offers a contribution to theory building and is a response to the challenge of demonstrating the value that SABs add to adult safeguarding policy and practice.

Practical implications

A case study reviews the findings of the longitudinal service development and practice change initiative to embed making safeguarding personal in adult safeguarding. The findings of that initiative are mapped against the frameworks for identifying impact. Experience of implementing the initiative is mapped against the frameworks for effective implementation of change.

Originality/value

The paper presents frameworks for identifying the different types of outcomes and impact that SABs may achieve through their strategic business plans and for ensuring that the different components are present for the successful implementation and maintenance of change. The paper argues that the legal, policy and financial context within which SABs are located presents challenges as well as opportunities with respect to achieving and demonstrating impactful change. However, it also suggests that a more informed understanding of different types of impact may generate different approaches to data collection in order to capture what has been achieved.

Details

The Journal of Adult Protection, vol. 22 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

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Article

Michael Preston-Shoot

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis, and to address the challenge…

Abstract

Purpose

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis, and to address the challenge of change, exploring the necessary components beyond an action plan to ensure that findings and recommendations are embedded in policy and practice.

Design/methodology/approach

Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains employed previously. The repetitive nature of the findings prompts questions about how to embed policy and practice change, to ensure impactful use of learning from SARs. A framework for taking forward an action plan derived from an SAR findings and recommendations is presented.

Findings

Familiar, even repetitive findings emerge once again from the thematic analysis. This level of analysis enables an understanding of both local geography and the national legal, policy and financial climate within which it sits. Such learning is valuable in itself, contributing to the evidence base of what good practice with adults who self-neglect looks like. However, to avoid the accusation that lessons are not learned, something more than a straightforward action plan to implement the recommendations is necessary. A framework is conceptualised for a strategic and longer-term approach to embedding policy and practice change.

Research limitations/implications

There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here enables conclusions to be reached about issues to address locally and nationally to transform adult safeguarding policy and practice.

Practical implications

Answering the question “how to create sustainable change” is a significant challenge for SARs. A framework is presented here, drawn from research on change management and learning from the review process itself. The critique of serious case reviews challenges those now engaged in SARs to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice.

Originality/value

The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of following up SARs by using the findings and recommendations systematically within a framework designed to embed change in policy and practice.

Details

The Journal of Adult Protection, vol. 20 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

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Article

Michael Preston-Shoot

The purpose of this paper is twofold: first, to update the core data set of self-neglect serious case reviews (SCRs) and safeguarding adult reviews (SARs), and…

Abstract

Purpose

The purpose of this paper is twofold: first, to update the core data set of self-neglect serious case reviews (SCRs) and safeguarding adult reviews (SARs), and accompanying thematic analysis; second, to respond to the critique in the Wood Report of SCRs commissioned by Local Safeguarding Children Boards (LSCBs) by exploring the degree to which the reviews scrutinised here can transform and improve the quality of adult safeguarding practice.

Design/methodology/approach

Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs) and from contacts with SAB independent chairs and business managers. Thematic analysis is updated using the four domains employed previously. The findings are then further used to respond to the critique in the Wood Report of SCRs commissioned by LSCBs, with implications discussed for Safeguarding Adult Boards.

Findings

Thematic analysis within and recommendations from reviews have tended to focus on the micro context, namely, what takes place between individual practitioners, their teams and adults who self-neglect. This level of analysis enables an understanding of local geography. However, there are other wider systems that impact on and influence this work. If review findings and recommendations are to fully answer the question “why”, systemic analysis should appreciate the influence of national geography. Review findings and recommendations may also be used to contest the critique of reviews, namely, that they fail to engage practitioners, are insufficiently systemic and of variable quality, and generate repetitive findings from which lessons are not learned.

Research limitations/implications

There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here against the strands in the critique of SCRs enables conclusions to be reached about their potential to transform adult safeguarding policy and practice.

Practical implications

Answering the question “why” is a significant challenge for SARs. Different approaches have been recommended, some rooted in systems theory. The critique of SCRs challenges those now engaged in SARs to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice.

Originality/value

The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of conducting SARs by using the analysis of themes and recommendations within this data set to evaluate the critique that reviews are insufficiently systemic, fail to engage those involved in reviewed cases and in their repetitive conclusions demonstrate that lessons are not being learned.

Details

The Journal of Adult Protection, vol. 19 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

Abstract

Details

The Journal of Adult Protection, vol. 21 no. 1
Type: Research Article
ISSN: 1466-8203

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Article

Michael Preston-Shoot

The purpose of this paper is twofold: first, to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis; second, to…

Abstract

Purpose

The purpose of this paper is twofold: first, to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis; second, to draw together the learning available from this data set of reviews to propose a model of good practice that can be used as the basis for subsequent SARs.

Design/methodology/approach

Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains employed previously. A sufficient number of reviews have been performed from which to construct an evidence-based model of good practice. A framework is presented with the proposition that this can be used as a proportional methodology for further SARs where self-neglect is in focus.

Findings

Familiar findings emerge from the thematic analysis. This level of analysis, constructed over time and across reviews, enables a framework to be developed that pulls together the findings into a model of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners involved in such cases. This framework can then be used as an evidence-based model with which to review new cases where SARs are commissioned.

Research limitations/implications

The national database of reviews commissioned by SABs is incomplete and does not contain many of the SARs reported in this evolving data set. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. It is possible, therefore, that this data set is also incomplete. Drawing together the findings from the reviews nonetheless enables conclusions to be proposed about the components of effective practice, and effective policy and organisational arrangements for practice. Future reviews can then explore what enables such effective to be achieved and what barriers obstruct the realisation of effective practice.

Practical implications

Answering the question “why” is a significant challenge for SARs. A framework is presented here, drawn from research on SARs featuring self-neglect, that enables those involved in reviews to explore the enablers and barriers with respect to an evidence-based model of effective practice. The framework introduces explicitly research and review evidence into the review process.

Originality/value

The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also proposes a new approach to SARs by using the findings and recommendations systematically within a framework designed to answer “why” questions – what promotes and what obstructs effective practice.

Details

The Journal of Adult Protection, vol. 21 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

Abstract

Details

The Journal of Adult Protection, vol. 19 no. 4
Type: Research Article
ISSN: 1466-8203

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Article

Michael Preston‐Shoot

Self‐determination is widely regarded as a core social work value and as central to work in adult protection. However, it is not unproblematic and raises difficult…

Abstract

Self‐determination is widely regarded as a core social work value and as central to work in adult protection. However, it is not unproblematic and raises difficult questions about how to balance empowerment and protection, or rights and risks. Inter‐agency procedures and the recent publication of policy guidance may reflect these difficult questions rather than assist practitioners and managers to resolve practice dilemmas they encounter.

Details

The Journal of Adult Protection, vol. 3 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

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Article

Michael Preston-Shoot and Sally Cornish

The purpose of this paper is to report the findings from research into the outcomes of adult protection in Scotland, with particular focus on how service users, family…

Abstract

Purpose

The purpose of this paper is to report the findings from research into the outcomes of adult protection in Scotland, with particular focus on how service users, family members and service delivery professionals perceive the effectiveness of the protection orders in the Adult Support and Protection (Scotland) Act 2007.

Design/methodology/approach

The study comprised analysis of Adult Protection Committee biennial reports on implementation of the 2007 Act to the Scottish Government, key informant interviews and workshops with professionals involved in adult protection leadership and practice, and case study interviews with service users, family members and practitioners.

Findings

Concerns about the potential for paternalistic practice and excessive use of the protection orders within the 2007 Act have not materialised. The principle of proportionality appears to be firmly embedded in adult protection practice. Service delivery professionals, service users and family members remain acutely aware of the tensions between autonomy and protection but point to beneficial outcomes for adults at risk from the careful use of protection orders, especially banning orders.

Research limitations/implications

Only ten case studies were able to be included in the study. However, the use of mixed methods enabled triangulation of the findings. Common themes emerge from across the data sources. The findings also resonate with conclusions drawn by other researchers.

Practical implications

The paper identifies outcomes and challenges in respect of protecting adults at risk in Scotland. Strengths and limitations of the 2007 Act are identified.

Originality/value

The paper offers a formal evaluation of the outcome of protection orders for adults at risk in Scotland. The findings are of wider policy relevance given the debates on how to legislate for adult safeguarding in England and Wales.

Details

The Journal of Adult Protection, vol. 16 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

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Article

Michael Preston-Shoot

The purpose of this paper is to draw on systemic and psychodynamic theories to subject published serious case reviews (SCRs) involving self-neglect to a deeper level of…

Abstract

Purpose

The purpose of this paper is to draw on systemic and psychodynamic theories to subject published serious case reviews (SCRs) involving self-neglect to a deeper level of scrutiny, in order to understand how complex contexts impact on self-neglect work. It also updates the dataset of self-neglect SCRs and accompanying thematic analysis.

Design/methodology/approach

Psychodynamic and systemic ideas are applied to the content of published SCRs in order to understand how different contexts – societal, legal, organisational, professional and personal – impact on and are influenced by work with adults who self-neglect. Further published reviews are added to the core dataset, with thematic analysis updated using four domains.

Findings

Thematic analysis within and recommendations from SCRs have focused on the micro context, what takes place between individual practitioners, their teams and adults who self-neglect. This level of analysis also commonly extends to how organisations have worked together and how Local Safeguarding Adults Board (LSABs) have supported and scrutinised their collaboration. This level of analysis enables an understanding of local geography. However, there are wider systems that impact on and influence this work, especially law and the societal context. If review findings and recommendations are to fully answer the question why, systemic analysis should be extended to appreciate the influence of national geography.

Research limitations/implications

There is still no national database of reviews commissioned by LSABs so the dataset reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in LSAB annual reports. This makes learning for service improvement challenging.

Practical implications

Answering the question why is a significant challenge for safeguarding adults reviews (SARs). Different approaches have been recommended, some rooted in systems theory. The theoretical formulations here extend the lens of systemic analysis on the different contexts that influence how practitioners work with adults who self-neglect and simultaneously are shaped by that work. This adds to the practice, management and organisational evidence base for working with adults who self-neglect but also shines the analytic lens on legal and policy mandates.

Originality/value

The paper extends the use of systemic theory for understanding and learning from practice with adults who self-neglect and additionally offers psychodynamic formulations to appreciate what happens within and between practitioners and their organisations. The paper therefore contributes new perspectives to the methodology for conducting SARs. It also extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice.

Details

The Journal of Adult Protection, vol. 18 no. 3
Type: Research Article
ISSN: 1466-8203

Keywords

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