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Article
Publication date: 26 September 2019

Helen Thacker, Ann Anka and Bridget Penhale

The purpose of this paper is to consider the importance of professional curiosity and partnership work in safeguarding adults from serious harm, abuse and neglect.

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2167

Abstract

Purpose

The purpose of this paper is to consider the importance of professional curiosity and partnership work in safeguarding adults from serious harm, abuse and neglect.

Design/methodology/approach

The paper draws on a range of materials including: review of published materials in relation to professional curiosity, reports from adult serious case reviews (SCRs) and safeguarding adult reviews (SARs); relevant materials drawn from the SAR Library, thematic reviews of SARs and Google searches; observations from practice and experience. It also refers to the relevant academic literature.

Findings

Lessons from SCRs and SARs show that a lack of professional curiosity and poor coordination of support can lead to poor assessments and intervention measures that can fail to support those at risk of harm and abuse. There are a number of barriers to professionals practicing with curiosity. Working in partnership enhances the likelihood that professional curiosity will flourish.

Practical implications

There are clear implications for improving practice by increasing professional curiosity amongst professionals. The authors argue that there is a scope to improve professional curiosity by utilising and developing existing partnerships, and ultimately to help reduce the number of deaths and incidents of serious harm.

Originality/value

The paper considers the importance of employing professional curiosity and partnership work in safeguarding adults’ practice, so enabling practitioners to better safeguard adults at risk of abuse and neglect.

Details

The Journal of Adult Protection, vol. 21 no. 5
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 11 April 2011

Richard Humphries

This report aims to summarise the principal conclusions from the pilot reviews and key learning points to assist the improvement of safeguarding policy and practice.

Abstract

Purpose

This report aims to summarise the principal conclusions from the pilot reviews and key learning points to assist the improvement of safeguarding policy and practice.

Design/methodology/approach

A pilot programme of peer reviews of adult safeguarding arrangements was carried out in four English local authorities by Local Government Improvement and Development in 2009‐2010. The pilot programme sought to customise, test and adapt this established peer review methodology to adult safeguarding.

Findings

Key messages from the peer reviews of the adult safeguarding arrangements include: outcomes and experience of people who use services; leadership, strategy and commissioning; service delivery, effective practice and performance and resource management; and working together.

Originality/value

Councils may need to revisit how they develop their safeguarding arrangements in the light of major policy, financial and demographic shifts over the next few years.

Details

The Journal of Adult Protection, vol. 13 no. 2
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 9 April 2018

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…

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2037

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

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Article
Publication date: 5 April 2013

Emma Stevens

The purpose of this paper is to highlight contemporary issues in achieving best practice in safeguarding adults across multi‐agency settings.

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8542

Abstract

Purpose

The purpose of this paper is to highlight contemporary issues in achieving best practice in safeguarding adults across multi‐agency settings.

Design/methodology/approach

The paper is an empirical exploration, reviewing a range of relevant literature and recent policy to present evidence suggesting that there continue to be challenges in achieving best practice in multi‐agency approaches to safeguarding. The literature review was undertaken using the following databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, PsycINFO and Medline. The inclusion criteria included being peer‐reviewed and published between 2004 and 2012. The key words used were: “safeguarding adults” and “abuse”. Further literature was found through adopting a “snowballing” technique, in which additional sources were found from the reference lists used in the initial articles.

Findings

Although guidance such as No Secrets from the Department of Health, in 2000, emphasises the importance of a multi‐agency approach, this continues to be problematic and presents challenges. In practice, differing professionals may not fully understand each other's roles and responsibilities and both thresholds and scope of adult abuse are still not universally agreed. Legislation could be used positively to mandate the multi‐agency approach to adult safeguarding, supported by local Safeguarding Adults Boards and local policies can be used to provide guidance and clarity for practitioners. Further empirical investigation into supporting the multi‐agency approach is required.

Originality/value

The paper fulfils the need for discussion on the complexities and challenges that continue to present in multi‐agency responses to adult safeguarding practice.

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Article
Publication date: 14 August 2017

Adi Cooper and Claire Bruin

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…

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3397

Abstract

Purpose

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.

Design/methodology/approach

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

Findings

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.

Originality/value

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.

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Article
Publication date: 15 August 2011

Margaret Flynn and Shirley Williams

Adult Safeguarding Boards are the means by which local authorities in England and Wales seek to work collaboratively to protect adults at risk of abuse. The last two years…

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362

Abstract

Purpose

Adult Safeguarding Boards are the means by which local authorities in England and Wales seek to work collaboratively to protect adults at risk of abuse. The last two years have heralded the emergence of the role of Independent Chairs. This paper seeks to outline the experience of Adult Safeguarding Boards from around North West England.

Design/methodology/approach

A general review of the seven Independent Chairs and 15 employed chairs (typically Directors of Adult Social Services) in North West England endorsed the importance of having a virtual network to work on a shared portfolio of interests.

Findings

The review highlighted concerns regarding the independence of Independent Chairs, the challenges to partnership working created by the turnover of managers, the governance of Adult safeguarding Boards, and their performance and practice.

Originality/value

The paper confirms that diversity is the dominant characteristic of Adult Safeguarding Boards in North West England.

Details

The Journal of Adult Protection, vol. 13 no. 4
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 10 April 2017

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

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Article
Publication date: 9 October 2017

Jill Manthorpe and Stephen Martineau

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Practical implications

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.

Social implications

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.

Originality/value

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.

Details

The Journal of Adult Protection, vol. 19 no. 5
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 8 April 2014

Leo Quigley

The purpose of this paper is to review the reasons underlying the slow rate of progress towards developing a comprehensive policy underpinning for adult safeguarding in…

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1371

Abstract

Purpose

The purpose of this paper is to review the reasons underlying the slow rate of progress towards developing a comprehensive policy underpinning for adult safeguarding in England and proposes long-term solutions.

Design/methodology/approach

This paper uses a model of policy change to argue that adult safeguarding has been over-reliant on case histories to define its policy problems and influence its politics, while making insufficient progress on data collection and analysis. It uses examples from the parallel discipline of public health to explore four challenges, or “problems”, relevant to the further development of the knowledge base underpinning adult safeguarding policy.

Findings

Four recommendations emerge for closing the adult safeguarding “knowledge gap”, including the development of a national research strategy for adult safeguarding. In a fifth recommendation the paper also proposes a clearer recognition of the contribution that local public health professionals can make to local adult safeguarding policy making and programme development.

Practical implications

The first four recommendations of this paper would serve as the basis for developing a national research strategy for adult safeguarding. The fifth would strengthen the contribution of local public health departments to safeguarding adults boards.

Originality/value

The author is unaware of the existence of any other review of the limitations of the adult safeguarding knowledge base as a foundation for policy making, or which proposes strategic solutions. The work is valuable for its practical proposals.

Details

The Journal of Adult Protection, vol. 16 no. 2
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 9 July 2021

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. It also explores whether…

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. It also explores whether lessons are being learned from the findings and recommendations of an increasing number of reviews on self-neglect cases.

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 domains used previously. The domains and the thematic analysis are grounded in the evidence-based model of good practice, reported in this journal previously.

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 and alcohol misuse are prominent. Some SABs are having to return to further cases of self-neglect to review, inviting scrutiny of what is (not) being learned from earlier findings and recommendations.

Research limitations/implications

The national database of reviews commissioned by SABs remains incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. National Health Service Digital annual data sets do not enable the identification of reviews by types of abuse and neglect. However, the first national analysis of SARs has found self-neglect to be the most prominent type of abuse and/or neglect reviewed. Drawing together the findings 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 SARs. 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. Greater scrutiny is needed of the impact of the national legal, policy and financial context within which adult safeguarding is situated.

Originality/value

The paper extends the thematic analysis of available reviews that focus on study with adults who self-neglect, further reinforcing the evidence base for practice. Propositions are explored, concerned with whether learning is being maximised from the process of case review.

Details

The Journal of Adult Protection, vol. 23 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

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