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Article
Publication date: 14 April 2023

Elisabeth Alton, Barry Tolchard and Margaret Stark

The purpose of this study was to provide proof of concept and evaluate the project for the development of a forensic service in safeguarding adults at risk of harm who may have…

Abstract

Purpose

The purpose of this study was to provide proof of concept and evaluate the project for the development of a forensic service in safeguarding adults at risk of harm who may have suffered a non-accidental injury as a result of physical abuse or neglect.

Design/methodology/approach

This pilot project arising from a Safeguarding Adults Review was designed using an iterative process. Opinion from all partners of the Safeguarding Adults’ Boards in two adjacent areas as well as using expert forensic advice from the Faculty of Forensic and Legal Medicine was sought.

Findings

All professionals recognised the need for a forensic service because at present decision-making around potential non-accidental injuries (NAI) may not be evidence based. The main barriers were seen as lack of knowledge and education combined with the area of work not being recognised as being needed and hence not commissioned. No similar service existed in England to aid the project being developed either academically or practically, other than reflecting what happens in children’s safeguarding.

Practical implications

The knowledge and skills as well as the resources developed for this project will aid safeguarding professionals to make more informed decisions when working with adults at risk of harm who have sustained a potential NAI.

Originality/value

This project has high originality with no other area in England offering a similar service or in the process of developing a service at present.

Details

The Journal of Adult Protection, vol. 25 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

Open Access
Article
Publication date: 15 March 2023

David Orr

Local Safeguarding Adults Board (SAB) policies, procedures, guidance and related documents on self-neglect were gathered and analysed, to map what approaches are being taken…

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Abstract

Purpose

Local Safeguarding Adults Board (SAB) policies, procedures, guidance and related documents on self-neglect were gathered and analysed, to map what approaches are being taken across England. This paper aims to identify areas of divergence to highlight innovations or challenges faced by SABs.

Design/methodology/approach

Self-neglect documents were identified by searching SAB websites. Data were extracted into a framework enabling synthesis and comparison between documents.

Findings

This paper reports on how English SAB documentation defines self-neglect, treats executive capacity, lays out pathways for self-neglect cases, advises on refusal of service input and multi-agency coordination and draws on theories or tools. Greater coherence in understanding self-neglect has developed since it was brought within safeguarding in 2014; however, variation remains regarding scope, referral pathways and threshold criteria.

Research limitations/implications

This review was limited to published SAB documentation at one point in time and could not consider either the wider context of safeguarding guidance and training or implementation in practice.

Practical implications

This review provides an overview of how SABs are interpreting national guidance and guiding practitioners. The trends and areas of uncertainty identified offer a resource for informed research and policy-making.

Originality/value

To the best of the author’s knowledge, this is the first systematic survey of SAB self-neglect policies, procedures and guidance since self-neglect was included under safeguarding.

Details

The Journal of Adult Protection, vol. 25 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 15 May 2023

Deborah Foss

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Originality/value

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.

Details

The Journal of Adult Protection, vol. 25 no. 5
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 17 July 2023

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. The initial data set was published…

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. 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.

Design/methodology/approach

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.

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. 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.

Research limitations/implications

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.

Practical implications

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.

Originality/value

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.

Details

The Journal of Adult Protection, vol. 25 no. 6
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 29 September 2023

Louise Jayne Whitehead

This paper aims to explore the links between being lonely and isolated, and increased risks of abuse for adults with care and support needs.

Abstract

Purpose

This paper aims to explore the links between being lonely and isolated, and increased risks of abuse for adults with care and support needs.

Design/methodology/approach

Thematic analysis was used to explore features of loneliness and social isolation present in South Yorkshire Safeguarding Adults Reviews (SARs) published since 2014.

Findings

Ten out of fifteen SARs indicated there had been issues of loneliness and/or social isolation for the person who was the subject of the SAR.

Research limitations/implications

The limitations of this paper are that it only included SARs from the South Yorkshire area. Future research should explore national and international perspectives on these issues.

Practical implications

Safeguarding Boards should include actions to address loneliness and social isolation as part of prevention strategies and services to develop approaches that can minimise or prevent abuse before it occurs. Practitioners should routinely explore whether the people they work with feel lonely and/or isolated and support people to take appropriate action to mitigate these risks.

Originality/value

This paper uses the existing body of literature about loneliness and social isolation to explore the risks of abuse and neglect for adults with care and support needs.

Details

The Journal of Adult Protection, vol. 25 no. 6
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 8 May 2023

Karl Mason

The purpose of this paper is to interrogate and develop the conceptualisation of discriminatory abuse in safeguarding adults policy and practice beyond the current interpersonal…

Abstract

Purpose

The purpose of this paper is to interrogate and develop the conceptualisation of discriminatory abuse in safeguarding adults policy and practice beyond the current interpersonal definition. The paper draws on Safeguarding Adults Reviews (SARs) that refer to discriminatory abuse or safeguarding practice with adults who have care and support needs and protected characteristics.

Design/methodology/approach

A search of the national network repository of SARs identified 27 published reviews for inclusion. The contents were thematically analysed to understand how discrimination was experienced in these cases. Fricker’s “Epistemic Injustice” theory was adopted as a conceptual framework, informing the analysis of findings.

Findings

Evidence from SARs provides a challenge to the interpersonal emphasis on language and behaviour in national policy. Although the reviews acknowledge that interpersonal abuse occurs, a close reading spotlights practitioner and institutional bias, and inattention to social, structural and contextual factors. The silence on these matters in policy provides a narrow frame for interpreting such abuse. This suggests significant potential for epistemic injustice and signals a need to acknowledge these social, structural and contextual factors in safeguarding practice.

Originality/value

Discriminatory abuse is an under-researched and under-utilised category of abuse in safeguarding adults practice. The paper adopts Fricker’s theory of “Epistemic Injustice” to highlight the silencing potential of current policy approaches to discriminatory abuse to suggest a more inclusive and structural framing for safeguarding practice with those targeted due to their protected characteristics.

Article
Publication date: 12 January 2024

Scott Fleming

This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold…

Abstract

Purpose

This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process.

Design/methodology/approach

Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software.

Findings

This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process.

Originality/value

This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge.

Details

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

Keywords

Article
Publication date: 7 March 2023

Fiona Laskaris

This paper aims to highlight devastating consequences when professionals misappropriate the presumption of capacity in s1 Mental Capacity Act 2005.

118

Abstract

Purpose

This paper aims to highlight devastating consequences when professionals misappropriate the presumption of capacity in s1 Mental Capacity Act 2005.

Design/methodology/approach

This is the story of my vulnerable son's life and the failure of services to provide the professional help and support he needed in order to stay safe. I have flagged, with specific examples, how the law was perpetually misapplied in his case, with tragic consequences.

Findings

The application of the statutory presumption of capacity is widely misunderstood. The presumption is frequently misappropriated by health and social care professionals as well as by legal professionals. Concerned families are being ignored or blocked out by professionals, many of whom seem unclear as to when evidence based mental capacity assessments, with rationale, are required. This is rendering the legislation in place for the protection of vulnerable adults ineffective and then allowing preventable deaths to evade appropriate scrutiny.

Research limitations/implications

Some of the documents (e.g. police logs and records, some social care records) were withheld from the author or heavily redacted when the author requested them following her son's death.

Practical implications

Vulnerable people can frequently suffer neglect and abuse in the community. Their deaths, following state agency failures, are not being investigated as they should be, preventing learning from mistakes.

Social implications

We live in a society where, sadly, vulnerable people are often not appropriately supported by professional services. As a result, the police can be left to pick up the pieces following mental health service failures. Whilst there may now be a greater awareness of autism, this is not yet accompanied by a greater understanding of the condition.

Originality/value

Christopher's story is unique, raising issues of serious concern across many different agencies. These appear to stem from a widespread lack of understanding of the vulnerability of adults with high functioning autism/Asperger's syndrome and a significant discrepancy between their intelligence and their life skills.

Details

The Journal of Adult Protection, vol. 25 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 7 February 2024

Karl Mason, Rosslyn Dray, Jane C. Healy and Joanna Wells

The purpose of this paper is to consider what safeguarding responses to discriminatory abuse and hate crime might learn from existing research on restorative justice and to drive…

Abstract

Purpose

The purpose of this paper is to consider what safeguarding responses to discriminatory abuse and hate crime might learn from existing research on restorative justice and to drive practice development based on available evidence.

Design/methodology/approach

This paper is based on a scoping review of literature using four academic databases and reference harvesting. This comprised a critical appraisal of 30 articles, which were thematically analysed to appreciate the benefits and challenges of restorative justice responses to hate crime and how this might inform safeguarding responses to discriminatory abuse and hate crime.

Findings

The analysis identifies four domains where learning can be drawn. These relate to theory on restorative justice; restorative justice practices; perspectives from lived experience of restorative justice and hate crime; and an appraisal of critiques about restorative justice.

Originality/value

This paper connects the emerging evidence on restorative criminal justice responses to hate crime to the “turn” towards strengths-based practices in adult safeguarding. Although this provides a fertile environment for embedding restorative practices, the authors argue certain precautions are required based on evidence from existing research on hate crime and restorative justice.

Details

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

Keywords

Article
Publication date: 13 February 2023

Laura Doyle, Lorna Montgomery, Sarah Donnelly, Kathryn Mackay and Bridget Penhale

Across the UK and Ireland, there are a range of processes and interventions offered to adults who, because of personal characteristics or life circumstances, require help to keep…

Abstract

Purpose

Across the UK and Ireland, there are a range of processes and interventions offered to adults who, because of personal characteristics or life circumstances, require help to keep themselves safe from potential harm or abuse. The ways in which the statutory and voluntary sectors have chosen to safeguard these adults varies. Different models of intervention and the utilisation of a range of assessment tools, frameworks and approaches have evolved, often in response to policy and practice wisdom. Empirical research in this area is limited. The primary research purpose of the project on which this paper is based is to gather information on the range of tools and frameworks that are used in adult safeguarding practice across the UK and Ireland. In so doing, this paper seeks to contribute and inform the future development of an evidence based adult safeguarding assessment framework.

Design/methodology/approach

A team of academics from England, Scotland, Northern Ireland and Ireland wanted to explore the possibility of adapting a pre-existing assessment framework currently in use in family and childcare social work to consider its utility in assessing carers involved in adult safeguarding referrals. This paper reports on a small pilot study which sought to inform the adaptation of this framework for use in adult safeguarding. This paper is based on a qualitative study involving 11 semi-structured telephone interviews with adult safeguarding social work managers and experienced practitioners. Two to four professionals from each region of England, Scotland, Northern Ireland and Ireland were interviewed to elicit their perceptions and experiences of engaging in adult safeguarding assessment processes and their views about models of assessment.

Findings

This study identified considerable variation in and between the nations under review, in terms of the assessment frameworks and tools used in adult safeguarding practice. To a large extent, the assessment frameworks and tools in use were not evidence based or accredited. Participants acknowledged the value of using assessment frameworks and tools whilst also identifying barriers in undertaking effective assessments.

Originality/value

There is limited evidence available in the literature regarding the utility of assessment frameworks and tools in adult safeguarding practice. This primary research identifies four themes derived from professional’s experiences of using such frameworks and identifies broader recommendations for policy and practice in this area.

Details

The Journal of Adult Protection, vol. 25 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

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