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The purpose of this paper is to summarise findings of a review of service user and carer involvement in safeguarding and recommendations for good practice.

The study involved a review of selected literature and a consultation exercise with experts in the field of adult safeguarding and telephone interviews with 13 Adult Safeguarding Leads across England and Wales.

Service users value rights, independence, choice and support. Adult Safeguarding policy sets out an expectation of service user involvement in the process and expects agencies to balance rights to self‐determination with properly managed risk. In practice, agencies tend to be risk‐averse and service users often do not feel involved in their safeguarding processes. Processes such as collaborative risk enablement, training and capacity building, working with BME groups and evaluation of involvement help. Good practice examples of involvement in Safeguarding Boards or local forums, developing new methods of user feedback and community involvement were found. Recommendations include more involvement of service users in research, more effective forms of involvement of groups who may be more excluded, shared responsibility for risk, and more training in rights legislation.

The paper offers recommendations for good practice in improving involvement in adult safeguarding, which is a requirement and an essential component of delivering good services to vulnerable adults.

Service user involvement in health and social care is now widespread, but there is little knowledge of how to involve the most vulnerable service users who are in need of protection, or how to balance risk and empowerment. This paper addresses the dilemmas facing Adult Protection staff, summarises the experience of practitioners based on the first decade of adult safeguarding work and sets out guidance for improving practice.

The purpose of this paper is to describe the Making Safeguarding Personal (MSP) programme undertaken in 2013/2014 and summarises the learning and messages from this phase of work. This informed both the subsequent mainstreaming of the programme to all councils, and national policy on safeguarding adults in England.

Following the “test bed” phase in 2012/2013, MSP pilots were developed in 53 councils. They adopted a new outcomes focused and person led approach to adult safeguarding practice. Supported by the Local Government Association and partners, these councils changed their safeguarding practice and how adults were involved in safeguarding processes. Adults’ wishes were identified at the early stages of investigation, and reviewed during and at the end of the safeguarding process. In total, 43 councils provided impact statements on work undertaken, mainly between December 2013 and February 2014.

Key findings from the impact statements evidenced that adopting a personalised approach made safeguarding more effective and provided opportunities for developing social work practice. A range of challenges were encountered and overcome. The experiences of the MSP pilot sites informed the Care Act guidance issued in October 2014.

The MSP programme has stimulated an innovative culture change in safeguarding adults’ practice. It provides a means for Safeguarding Adults Boards to ascertain the effectiveness of local services in achieving the desired outcomes of vulnerable adults at risk of abuse or harm. Practitioners, managers and others will have an interest in this major change.

The purpose of this paper is to identify and encourage good practice in adult safeguarding by housing providers, despite their unclear and largely unregulated role in this area.

Literature search on policy and research on the role of housing in adult safeguarding. Good practice search, drawn from No Secrets consultation responses and more recently, from other housing providers.

Despite the current weak incentives for housing providers to engage in adult safeguarding, some have done so effectively, overcoming barriers to joint working.

This is not a comprehensive study of all good practice in this area; much will exist “unsung” and unrecognised.

Increase housing providers' involvement in adult safeguarding.

The paper is of value, as there is a dearth of literature on the role and potential of housing and adult safeguarding.

This paper presents the results of a thematic analysis of safeguarding adults reviews (SARs) where homelessness was a factor to illuminate and improve safeguarding practice and the support of adults who are homeless in England.

SARs were identified from a variety of sources and a thematic analysis was undertaken using data extraction tables.

In addition to identifying shortcomings in inter-agency co-operation, SARs highlighted a failure to recognize care needs and self-neglect among people with experience of homelessness and evidenced difficulties in engagement between professionals and people with experience of homelessness.

The authors may have failed to find some SARs in this category (there is no central registry). SARs vary in quality and in detail; some were not full reports. The approach to people’s experience of homelessness was broad and covered more than the circumstances of people who were rough sleeping or living on the streets.

This paper contributes to the current practice debates and policy initiatives in respect of homelessness and safeguarding in England. It may have wider relevance in the rest of the UK and internationally.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

This study aims to describe the sector-led response to the COVID-19 pandemic and national lockdown in terms of safeguarding adults.

This study uses a case study method to examine a sector-led improvement response to COVID-19 and safeguarding adults.

The study describes how safeguarding issues and concerns were identified and brought together, and then responded to. It reviews this initiative in the context of crisis intervention theory and discusses the achievements of this initiative regarding COVID-19 and safeguarding adults during the period April–July 2020.

The study describes a unique joint initiative between the Local Government Association and the Association of Directors of Adult Social Services, which worked with the Networks of Chairs of Safeguarding Adults Boards, Safeguarding Adults Boards’ managers and Principal Social Workers. This initiative developed resources and shared information and good practice to support a response in unprecedented circumstances.

Serious case reviews (SCRs) are one means of learning the lessons arising from adverse, salient incidents and tragedies. Adult Safeguarding Boards in England are expected to have an SCR policy and procedure, to commission SCRs, to abstract and act on the learning, and to monitor the resulting action plans.

Since SCRs reflect a wide range of processes, the authors undertook a general review, drawing on their experiences of conducting and contributing to SCRs. They chose to pose sets of question‐prompts regarding the commissioning process, the management of the process, the appointment of a chair and author, the terms of reference, information‐sharing, confidentiality, involving relatives and making findings public. The compliance of the process with human rights legislation is also considered.

Whilst the authors acknowledge the responsibility of organisations to promote continuous and cumulative professional learning, they do not promote SCRs as the sole means of learning about the ways in which professionals and agencies work together to safeguard adults at risk of abuse.

The paper challenges the perception that SCR can be streamlined, structured, codified, and constrained.

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.

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.

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.

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.

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.