Highlights: Safeguarding adults

Published: September 2017

This is a snapshot of safeguarding adults practice and challenges based on SCIE’s work in this area and experience of providing training and consultancy support to care and health providers. It is not a comprehensive review of safeguarding practice, but we hope it provokes further thinking about how to improve safeguarding, and the partnerships that need to develop for that to happen.

Definition of adult safeguarding

It is important to be clear about who the formal adult safeguarding process applies to. The Care Act statutory guidance defines adult safeguarding as:

‘Protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.’

This definition hints at the challenges of safeguarding, but it is important to be clear about which adults we are discussing. A local authority must act when it has ‘reasonable cause to suspect that an adult in its area (whether or not ordinarily resident there):

So safeguarding is for people who, because of issues such as dementia, learning disability, mental ill-health or substance abuse, have care and support needs that may make them more vulnerable to abuse or neglect.

The Six Principles

First introduced by the Department of Health in 2011, but now embedded in the Care Act, these six principles apply to all health and care settings.

  1. Empowerment People being supported and encouraged to make their own decisions and informed consent
  2. Prevention It is better to take action before harm occurs.
  3. Proportionality The least intrusive response appropriate to the risk presented.
  4. Protection Support and representation for those in greatest need.
  5. Partnership Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
  6. Accountability Accountability and transparency in safeguarding practice.
     

Key issues

Several themes and messages come up as SCIE engages with the social care, health and related sectors, in relation to safeguarding adults

Care and health providers’ responsibilities

Providers of health and social care services should ensure they have the key people, relationships, values and systems in place that will help them to keep safe the people they serve. These include:

Case study - Friends of the Elderly

Friends of the Elderly is a charity operating care homes, home care services, day centres, volunteer-led befriending and a grants programme, as well as campaigning to alleviate loneliness and isolation among older people. A CQC inspection on one of its care homes in 2015 delivered an ‘Inadequate’ rating because of safeguarding concerns, and this prompted a wholesale rethink of how the organisation approached safeguarding.

Senior managers met with residents, families and staff, to discuss what had gone wrong, and developed a remediation plan with the local Safeguarding Adults Board (SAB). Commissioning SCIE as consultants to help shape and advise on the work, Friends of the Elderly instituted a number of changes:

The end result of these efforts was that, nine months after the ‘Inadequate’ rating, the home was judged to be ‘Good’, and safeguarding practice had improved across the organisation. Even in difficult circumstances, engaging with users and their families, and reviewing practice across the board, can quickly and effectively improve safeguarding outcomes.

Case study - Royal Mencap Society (Mencap)

Mencap is a large national charity providing an extensive range of services to people with learning disabilities and their carers. Supporting so many people with potential vulnerabilities places a great deal of responsibility on Mencap to get safeguarding right.

Over the last three years, Mencap has embarked on a programme of work to make sure its safeguarding structures and systems represent best practice in the sector, including:

Keen to develop further, Mencap commissioned SCIE to review its progress to date, and suggest considerations for future work. These are some of the key suggestions:

The work has demonstrated the value of a cycle of improvement and reflection in improving practice in complex areas of work.

On the horizon – a Vulnerable Adults Bill?

Autism Together, the Association for Real Change, and lawyer Alex Ruck-Keene of 39 Essex Chambers have submitted to the Law Commission a proposal for a Vulnerable Adults Bill.

The bill aims to establish a set of principles that would underpin interventions to protect vulnerable people who, although capacitated, are at risk of coercion and duress. the decision whether to proceed with drafting a bill is awaited from the law commission.

Support from SCIE

SCIE provides CPD-accredited safeguarding training, which is tailored to specific audiences. Local authorities, provider organisations, GPs, and national bodies such as the Home Office and the Independent Enquiry into Child Sexual Abuse have all benefitted from our support.

SCIE provides expert safeguarding consultancy. This includes our Learning Together model for conducting Safeguarding Adults Reviews and audits of safeguarding. SCIE also helps to develop or review and improve safeguarding policies and procedures.

SCIE clients include the Church of England, the Chelsea Pensioners, the University of Kent, and large local authority areas such as Manchester and the tri-borough partnership in west London. SCIE also offers a range of MCA training and support.

For more information visit the training and consultancy sections of the SCIE website:

Further information

The following is a list of useful resources on safeguarding adults: