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The purpose of this paper is to explore and critique the conceptual and terminological shift – particularly from “vulnerability” to “adult at risk” – in adult safeguarding under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014.

The paper compares the notion of the vulnerable adult in safeguarding, with the notion of an adult at risk under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014 and questions to what extent such a shift addresses existing criticisms of “vulnerability”.

The paper criticises the notion of the “vulnerable adult” for perpetuating the stigma associated with an impairment or disability, and for the types of legal and policy responses deemed appropriate under such an understanding of vulnerability. While efforts to replace the term “vulnerable adult” with “adult at risk” are, to some extent, to be welcomed, “adult at risk” under the legislation relies on the same characteristics for which the “vulnerable adult” has been criticised. Nevertheless, the safeguarding provisions under the two Acts have made some strides forward in comparison to their legal and policy predecessors and the notion of the “vulnerable adult”.

This paper’s originality and value lie in its scrutiny of the notion of “vulnerability” in adult safeguarding, in comparison to the newer terminology of an “adult at risk”, whilst also suggesting that in important respects – in relation to the interventions deemed appropriate where an adult is perceived to be at risk – the two pieces of legislation are a marked improvement on their predecessors. It also offers some thoughts as to how criticisms of the new legislation may be overcome.

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

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.

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.

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

The purpose of this paper is to identify aspects of leadership and evaluate their contribution to safeguarding vulnerable adults in healthcare organisations through conducting a critical review of literature. To identify or adapt a leadership framework to contribute to safeguarding vulnerable adults in healthcare organisations through analysis of the literature.

The methodology was qualitative and inductive. It was based on constructivism and an interpretive theoretical perspective, beginning without hypothesis. Themes emerged during the process. A critical review of literature was undertaken to answer the research question. Literature was sourced from a variety of health and social care databases and grey literature. All inclusions underwent rigorous critical appraisal and a total of 18 papers were explored.

The importance of clear leadership and direction was a common theme across the majority of sources. Aspects of leadership that can safeguard vulnerable adults in health care organisations include organisational culture, implementation of policies, procedures and frameworks, and reinforcing strong values and ethics around empowering individuals and delivering person-centred care. Through the meta-synthesis of findings, a model of leadership emerged.

The critical review utilised only one reviewer and the proposed leadership framework has not been empirically tested.

The paper proposes a leadership framework that can be applied within healthcare organisations to safeguard vulnerable adults.

This paper fulfils the need for evidence that supports the belief that strong leadership can safeguard vulnerable adults. It provides a comprehensive review of existing literature in this area.

The purpose of this paper is to report the findings from a study exploring the understanding of vulnerability and adult safeguarding within Christian faith-based settings. The paper concludes with recommendations for practitioners involved in safeguarding adults in faith-based Christian settings.

The paper considers a survey (n=3,182) into understanding of vulnerability and adult safeguarding for individuals who attend Church regularly or work in a Christian organisation

This study is the first to be undertaken with a UK sample and highlights a range of factors informing adult safeguarding practice within Christian organisations. This includes: complexity linked to understanding vulnerability and its role in safeguarding activity; lack of clarity about what to do with a safeguarding adult concern; and the need for safeguarding training pertinent to the particular needs of faith-based settings.

As there is currently a dearth of research in this area this paper makes a valuable contribution to the developing knowledge base around safeguarding and vulnerability within faith-based organisations.

Professionals need to develop increased understanding of the complexities involved in safeguarding activity, and specifically how those working in the wider context of supporting vulnerable adults make sense of safeguarding processes and procedures.

It is important that all organisations, including faith-based settings, working with adults have an understanding of their roles and responsibilities with respect to safeguarding those at risk of harm.

This paper is the first UK study to consider safeguarding adults at risk of harm in Christian faith contexts.

The purpose of this paper was to identify safeguarding concerns for vulnerable adults, including exploring the implementation of safeguarding policy and procedures into practice. This was achieved by reviewing the content of reflective assignments written by pre-registration student nurses, identifying areas of concerns and proposing action plans.

A qualitative approach was initially utilised to scrutinise a random 10 per cent sample of work, which was thematically analysed. From this, an audit tool was devised and then applied to evaluate a 35 per cent sample of work from the following cohort of students. Approval and consent was gained.

From the initial 10 per cent sample, themes emerged around: practice issues; areas for student's development and marking or assessment issues. The standardised audit tool was devised and applied to a 35 per cent random sample of work. This determined that students identified local safeguarding policies and procedures were being followed in the majority of placement areas, although application of the Mental Capacity Act remained inconsistent.

The assessor feedback from the reflective assignments was not available to the reviewers, limiting the reviewers ability to identify if assessors had recognised and corrected any policy or practice issues that the student raised. Only assignments from the adult field of nursing were considered within the scope of this study. The authors recommend further empirical investigation into this area.

This paper offers knowledge that can be applied in practice within both academic and health care provider services that deliver and facilitate nursing education. It has generated an audit tool that can be utilised to evaluate the knowledge of pre-registration students and has resulted in the implementation of safeguarding adults policies within an academic institution.

Safeguarding adults concerns may be identified through studying pre-registration student assignments and promptly acting upon any concerns raised. Aspects of good practice can be acknowledged within health care provider services.

The purpose of this paper is to look at safeguarding documentation in relation to 50 adult safeguarding files for the period April 2010 to March 2011. This was followed up with semi-structured interviews with a small number of Designated Officers whose role it is to screen referrals and coordinate investigations. Findings from the research were used to redesign regional adult safeguarding documentation to ensure Designated Officers have access to the information necessary to assist them in reaching decisions. Designated and Investigating Officer training was also updated to reflect learning from the research thereby reducing the potential for variation in practice.

A file tool was developed which examined the recorded information in safeguarding documentation contained within 50 service user files. The review tool looked at the personal characteristics of the vulnerable adult, the nature of the alleged abuse and the decisions/outcomes reached by staff acting as safeguarding Designated Officers. A semi-structured interview schedule asked Designated Offices to comment on the training and understanding of the process as well as the factors they believed were central to the decision making process. Their responses were compared to data obtained from the file review.

A key finding in the research was that while factors such as type of abuse, the vulnerable adults’ consent to cooperate with proceedings, identity of the referrer, etc. did influence decisions taken there was a lack of clarity on the part of Designated Officers in relation to their roles and responsibilities and of the process to be followed.

The research was limited to one Health & Social Care Trust area and had a small sample size (n=50).

The findings of the research led to a revamping of existing safeguarding documentation which had failed to keep pace with developments and was no longer fit for purpose. Adult safeguarding training courses within the Trust were redesigned to bring greater focus to the role and responsibilities of designated and Investigating Officers and the stages in the safeguarding process. Adult Safeguarding leads were established within programmes of care and professional support mechanisms put in place for staff engaged in this area of work.

Better trained and supported staff alongside more efficient safeguarding systems should lead to better outcomes in the protection of vulnerable people from abuse and harm.

The research built on existing albeit limited research into what potentially influences staff involved in critical decision-making processes within adult safeguarding.

Adult protection has been a relatively recent concept for staff working within the health economy. Priorities have focused on raising awareness, developing an understanding of safeguarding responsibilities, challenging established practices and attitudes and embedding the concept within the culture of NHS organizations and the daily work of staff at all levels. Although social services have the lead for safeguarding activities (Department of Health, 2000), statutory health bodies have now begun to integrate their adult protection activities more effectively and positively with social services and the police. This paper reviews the journey undertaken by the three primary care trusts (PCTs) in Kent and Medway in developing adult protection expertise and sharing multi‐agency adult protection practice with both social services and the police. The three safeguarding vulnerable adults leads from the PCTs have joined together to look at how far we have come and what we still need to achieve.

The paper aims to appraise professional practice in safeguarding vulnerable adults. It will examine the mechanisms in place and discuss how future policy will affect multi‐agency working in this field.

The paper examines recent consultations, policy development, inspectorate reports and legal guidance surrounding the issue of safeguarding adults in England and Wales, and suggests ways in which inter‐agency working can be strengthened.

Safeguarding systems need to be timely, rigorous and transparent to increase levels of public confidence and to ensure that the people who are at most risk of being abused are safe when accessing public services. The concept of safeguarding adults is increasingly being integrated into government policy and there are many successful examples of safeguarding partnership working in England and Wales. However, there are also substantial barriers that hinder organisations from working together effectively, such as different cultures, practices and ideologies.

The paper explores the fact that there needs to be clarification of roles and responsibilities and integration of processes, and acceptance of true multi‐agency working. There is a danger that instead of providing extra protection for adults at risk, multiple routes will result in a lack of co‐ordination.

The purpose of this paper is to examine the outcome of referrals made to one police force in England by three local authorities between March 2010 and April 2011, in order to identify and understand the barriers to prosecuting suspects of abuse or harm against vulnerable adults, and improve inter-agency co-operation.

All referrals to this police force are given a crime number when they are recorded on the Criminal Justice System database together with a vulnerable adult flag and a status code which indicates the outcome following a police investigation. A search of the database using the vulnerable adult flag identifies the total number of referrals and outcomes for the selected period. This can then be imported into a Microsoft Excel spreadsheet to allow further analysis to take place.

Over 87 per cent of all referrals of alleged abuse to vulnerable adults made to this police force did not establish that a crime had been committed. Of those that did only 1 per cent resulted in either a caution or court proceedings.

This is a small sample from one, predominantly rural, police force.

The benefit of this research is that it contributes to a greater knowledge of the outcomes of adult safeguarding referrals made, primarily, by local authorities to the police and how police disclosures, on Disclosure and Barring Service checks, are being used as a means of providing employers of regulated activities with information on individuals who have been suspected of abusing vulnerable adults.

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.