Safeguarding adult reviews: informing and enriching policy and practice on self-neglect

Abstract

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