• Learning from safeguarding adult reviews on self-neglect: addressing the challenge of change

      Preston-Shoot, Michael; University of Bedfordshire (Emerald, 2018-02-20)
      Abstract   Purpose – One purpose is to update the core data set of self-neglect safeguarding adult reviews and accompanying thematic analysis. A second purpose is 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 web sites of Safeguarding Adults Boards. 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 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 safeguarding adult reviews. 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 safeguarding adult reviews 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 safeguarding adult reviews by using the findings and recommendations systematically within a framework designed to embed change in policy and practice.     Keywords: Safeguarding adult reviews, change, self-neglect, action plans   Paper type: Research paper
    • Making any difference? conceptualising the impact of safeguarding adults boards

      Preston-Shoot, Michael; University of Bedfordshire (Emerald, 2019-11-25)
      Purpose Criticisms of the effectiveness of Local Safeguarding Children Boards (LSCBs) led to legislative reform in the shape of the Children and Social Work Act 2017. Given parallels between the mandates for LSCBs and Safeguarding Adults Boards (SABs), the onus is on SABs to demonstrate their effectiveness. The purpose of this paper is to explore how SABs might more effectively demonstrate their impact across the range of their mandated responsibilities. Design/methodology/approach The paper draws on definitions of impact from social work education, healthcare and from university research, exploring their relevance for capturing different types of data regarding the outcomes and impact of SAB activity. The paper also draws on frameworks for the process of capturing data and for implementing strategies designed to change practice and develop adult safeguarding services. Findings The paper argues that SABs have struggled to identify their impact and need to consider what types of impact they are seeking to demonstrate before choosing methods of seeking to capture that information. The paper also argues that SABs may have given insufficient thought to the process of change management, to the components needed to ensure that desired outcomes are embedded in procedural and practice change. Research limitations/implications This paper explores the challenges for SABs of identifying their impact and offers some theoretical frameworks that have defined different types of impact. The paper also draws on frameworks that identify the different components that are necessary for achieving change. This paper offers a contribution to theory building and is a response to the challenge of demonstrating the value that SABs add to adult safeguarding policy and practice. Practical implications A case study reviews the findings of the longitudinal service development and practice change initiative to embed making safeguarding personal in adult safeguarding. The findings of that initiative are mapped against the frameworks for identifying impact. Experience of implementing the initiative is mapped against the frameworks for effective implementation of change. Originality/value The paper presents frameworks for identifying the different types of outcomes and impact that SABs may achieve through their strategic business plans and for ensuring that the different components are present for the successful implementation and maintenance of change. The paper argues that the legal, policy and financial context within which SABs are located presents challenges as well as opportunities with respect to achieving and demonstrating impactful change. However, it also suggests that a more informed understanding of different types of impact may generate different approaches to data collection in order to capture what has been achieved.
    • Making Safeguarding Personal: progress of English local authorities

      Briggs, Mike; Cooper, Adi (Emerald Group Publishing Ltd., 2018-02-12)
      Purpose – The paper reports on the findings of a survey of 115 (76 per cent) of English local authorities in 2016 which compared progress on the implementation of the Making Safeguarding Personal (MSP) approach in local authorities through their Adult Social Care departments and in relation to their area Safeguarding Adults Boards (SABs) and partner organisations. The purpose of this paper is to evaluate the survey in relation to personalised social care and its impact on organisations, their staff and service users, and conclude with wider implications and recommendations for further work. Design/methodology/approach – A series of guided interviews were conducted with safeguarding leads from a sample comprising of 115 (76 per cent) of English local authorities during May and June 2016. The sample was randomly picked and balanced to give a fair representation of the different types of councils. The interviews were conducted by a team of five people. All interviewers had in-depth experience of adult safeguarding and were currently practicing independent chairs of SABs. The interviewers followed a prepared schedule consisting of a mixture of open and closed questions. All interviews were held over the phone and averaged one-hour duration. Findings – The results pointed to the impression that the majority of local authorities had completed the first step of introducing MSP, i.e. they had trained their workers and modified their systems. Most local authorities were moving into the next phase of embedding user-focussed work into their practice and culture, and were at various points along that journey. However, most had still to engage partner organisations beyond a mere acceptance of MSP as “a good thing”. Research limitations/implications – The research has wide ranging implications for organisations and their workers in the field of adult safeguarding based on its findings. Its limitations are that only organisational leaders and managers were interviewed, although reference is extensively made to initiatives that engage service users. The authors acknowledged the possible bias of interviewees when judging the performance of their own service and attempted to moderate their views in the final report. Practical implications – The report references many practical implications to improve the practice of adult safeguarding in an attempt to make it more person-centred. Examples of good practice are given and recommendations are made to organisations. Social implications – It is recognised that there are many people who may be at risk of harm through their environmental, personal, age or disability-related situations. In improving the way that services respond to their needs, they will be made to feel safer and their lives enhanced. Originality/value – This original research follows up previous research in the preceding year. It is the widest ranging in its coverage of 76 per cent of English local authorities. Its value is that it measures progress towards full implementation of MSP; reports information and views from safeguarding leaders; and makes 20 recommendations to improve the implementation of MSP within local authorities, SABs and their partners.
    • On (not) learning from self-neglect safeguarding adult reviews

      Preston-Shoot, Michael (Emerald Group Holdings Ltd., 2021-07-09)
      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.
    • Safeguarding adult reviews: informing and enriching policy and practice on self-neglect

      Preston-Shoot, Michael; (Emerald, 2020-04-25)
      Purpose – One purpose is to update the core dataset of self-neglect safeguarding adult reviews and accompanying thematic analysis. A second purpose is to explore the degree to which safeguarding adult reviews draw upon available research and learning from other completed reviews. Design/methodology/approach – Further published reviews are added to the core dataset, mainly drawn from the web sites of Safeguarding Adults Boards. Thematic analysis is updated using the four domains employed previously. The four domains and the thematic analysis are rounded in the evidence-based model of good practice, reported in this journal previously. Multiple exclusion homelessness and alcohol misuse are prominent in this sample of reviews. 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 emerges as a subset within this sample, demonstrating that SABs are engaging in reviews of people who die on the streets or in temporary accommodation.   Research limitations/implications – The national database of reviews commissioned by SABs remains incomplete and does not contain many of the safeguarding adult reviews reported in this evolving dataset. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. NHS Digital annual datasets do not enable identification of reviews by types of abuse and neglect. It is possible, therefore, that this dataset is also incomplete. Drawing together the findings from the reviews nonetheless 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 safeguarding adult reviews. 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, drawing attention where appropriate to policies being pursued by central government that undermine any initiative to end rough sleeping. 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 evidence-base also supports practice with individuals who experience multiple exclusion homelessness. Policy-makers and practitioners have an approach to follow in this complex, challenging and demanding area of practice.   Keywords: Safeguarding adult reviews, evidence, self-neglect, research, multiple exclusion homelessness, alcohol misuse
    • Safeguarding adults and COVID-19: a sector-led improvement response

      Cooper, Adi; University of Bedfordshire (Emerald Group Holdings Ltd., 2020-10-21)
      Purpose: This study aims to describe the sector-led response to the COVID-19 pandemic and national lockdown in terms of safeguarding adults. Design/methodology/approach: This study uses a case study method to examine a sector-led improvement response to COVID-19 and safeguarding adults. Findings: 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. Originality/value: 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.
    • Self-neglect and hoarding: a guide to safeguarding and support

      Preston-Shoot, Michael (Emerald Group Publishing Ltd., 2019-03-07)
    • Self-neglect and safeguarding adult reviews: towards a model of understanding facilitators and barriers to best practice

      Preston-Shoot, Michael (Emerald, 2019-08-01)
      Purpose – One purpose is to update the core dataset of self-neglect safeguarding adult reviews and accompanying thematic analysis. A second purpose is to draw together the learning available from this dataset of reviews to propose a model of good practice that can be used as the basis for subsequent safeguarding adult reviews. Design/methodology/approach – Further published reviews are added to the core dataset from the web sites of Safeguarding Adults Boards. Thematic analysis is updated using the four domains employed previously. A sufficient number of reviews have been done from which to construct an evidence-based model of good practice. A framework is presented with the proposition that this can be used as a proportional methodology for further safeguarding adult reviews where self-neglect is in focus. Findings – Familiar findings emerge from the thematic analysis. This level of analysis, constructed over time and across reviews, enables a framework to be developed that pulls together the findings into a model of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners involved in such cases. This framework can then be used as an evidence-based model with which to review new cases where safeguarding adult reviews are commissioned.   Research limitations/implications – The national database of reviews commissioned by SABs is incomplete and does not contain many of the safeguarding adult reviews reported in this evolving dataset. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. It is possible, therefore, that this dataset is also incomplete. Drawing together the findings from the reviews nonetheless enables conclusions to be proposed about the components of effective practice, and effective policy and organisational arrangements for practice. Future reviews can then explore what enables such effective to be achieved and what barriers obstruct the realisation of effective practice. Practical implications – Answering the question “why” is a significant challenge for safeguarding adult reviews. A framework is presented here, drawn from research on safeguarding adult reviews featuring self-neglect, that enables those involved in reviews to explore the enablers and barriers with respect to an evidence-based model of effective practice. The framework introduces explicitly research and review evidence into the review process. 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 proposes a new approach to safeguarding adult reviews by using the findings and recommendations systematically within a framework designed to answer “why” questions – what promotes and what obstructs effective practice.   Keywords: Safeguarding adult reviews, evidence, self-neglect, proportionality Paper type: Research paper
    • Transitional safeguarding: presenting the case for developing Making Safeguarding Personal for young people in England

      Cocker, Christine; Cooper, Adi; Holmes, Dez; Bateman, Fiona; University of East Anglia; University of Bedfordshire; Research in Practice for Adults (Emerald Group Holdings Ltd., 2021-01-25)
      Purpose: The purpose of this paper is to set out the similarities and differences between the legal frameworks for safeguarding children and adults. It presents the case for developing a Transitional Safeguarding approach to create an integrated paradigm for safeguarding young people that better meets their developmental needs and better reflects the nature of harms young people face. Design/methodology/approach: This paper draws on the key principles of the Children Act 1989 and the Care Act 2014 and discusses their similarities and differences. It then introduces two approaches to safeguarding: Making Safeguarding Personal (MSP); and transitional safeguarding; that can inform safeguarding work with young people. Other legal frameworks that influence safeguarding practices, such as the Mental Capacity Act 2005 and the Human Rights Act 1998, are also discussed. Findings: Safeguarding practice still operates within a child/adult binary; neither safeguarding system adequately meets the needs of young people. Transitional Safeguarding advocates an approach to working with young people that is relational, developmental and contextual. MSP focuses on the wishes of the person at risk from abuse or neglect and their desired outcomes. This is also central to a Transitional Safeguarding approach, which is participative, evidence informed and promotes equalities, diversity and inclusion. Practical implications: Building a case for developing MSP for young people means that local partnerships could create the type of service that best meets local needs, whilst ensuring their services are participative and responsive to the specific safeguarding needs of individual young people. Originality/value: This paper promotes applying the principles of MSP to safeguarding practice with young people. It argues that the differences between the children and adult legislative frameworks are not so great that they would inhibit this approach to safeguarding young people.