safeguarding adults at risk – local approaches martin ... · safeguarding processes, law and...
TRANSCRIPT
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Research team: Martin Stevens, Caroline Norrie, Katherine Graham, Shereen Hussein, Jo Moriarty, & Jill Manthorpe.
Local approaches to safeguarding adults at risk:
Overview of research
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Acknowledgement and Disclaimer
• This presentation presents independent research funded by the NIHR (National Institute for Health Research) School for Social Care Research.
• The views expressed in this presentation are those of the authors and not necessarily those of the NIHR School for Social Care Research or the Department of Health
• We would like to thank all participants in the study
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Introduction
• Adult safeguarding background • Messages from the literature • Specialism • Decision-making and thresholds • Multiagency working • Models of Safeguarding - aims and methods • Models of Safeguarding • Safeguarding referral outcomes • Feedback on safeguarding • Priorities for training
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Adult safeguarding in England
• Protecting adults at risk from mistreatment and neglect through processes of referral, investigation, protection plans and monitoring (also known as elder abuse, adult protection).
• Local Authorities continue to be the lead agencies (since 2000)
• The Care Act 2014 created a duty on local authorities (for the first time) to: – ‘make enquiries, or ensure others do so, if it believes
an adult is, or is at risk of, abuse or neglect.’ (Care Act Statutory Guidance, 2014 p192)
• However, still no prescription on how Local authorities (LAs) organise adult safeguarding
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Specialism
• A ‘continuum of specialism’ from fully integrated into everyday social work practice to completely specialised (Parsons, 2006)
• Development of Adult Protection Coordinator as specialist practitioners (Cambridge & Parkes, 2006)
• Parallel development in Health and the Police (White & Lawry, 2009)
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Benefits and problems of specialism
Benefits • Increase objectivity
(Manthorpe & Jones, 2002) • Create ‘organisational
memory’ (Owen, 2008) • Facilitate good working
relationships with providers (Fyson & Kitson, 2012)
• More investigations in institutional cases (Cambridge, et al, 2011)
• Higher likelihood of substantiating alleged abuse (Cambridge, et al, 2011)
Problems • Sometimes create conflict with
operational social workers (Parsons, 2006)
• Reduce continuity (Fyson & Kitson, 2010)
• Deskill non specialist social workers (Cambridge & Parkes, 2006)
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Decision-making and thresholds
• More senior managers in decision making are less likely to allocate alert as safeguarding (Thacker, 2011)
• Likelihood of substantiated allegations (Johnson, 2012)
• Impact on the organisation (McCreadie et al, 2008)
• Blurred definitions of abuse - ‘cognitive masks’ (Ash, 2010, 2013)
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Multagency working
• Central to policy since 2000 • Definitional challenges • Lack of resources to develop
partnerships • Lack of clarity about different
professionals’ roles • Care Act 2014 requirements
perceived as good driver • Shared development of policies and
procedures are reportedly beneficial • Some improved communication with
co-location and the development of Multi Agency Safeguarding Hubs
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Models of Safeguarding
• This multi-phased and mixed-method study aimed to answer the following questions: – How have models of adult
safeguarding been addressed in the literature and other documentary evidence?
– What distinct different organisational models of safeguarding can be identified?
– What are the key variables between any different models?
– What outcomes are linked to different models of safeguarding?
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Methods • Phase 1
– Literature review – Interviews with adult
safeguarding managers
• Phase 2 – Five sites – Staff survey – Secondary statistical analysis of Abuse of Vulnerable Adults
Returns (Now Safeguarding Adults Returns) and Adult Social Care Survey
• Phase 3 – Same five sites – Interviews with safeguarding practitioners and managers – Feedback interviews with care home managers, housing staff,
IMCAS and LA solicitors
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Models of Safeguarding
Four models were identified in phase 1: • Dispersed-Generic – safeguarding referrals
managed and undertaken by operational social work teams
• Dispersed-Specialist – safeguarding enquiries managed and undertaken by a mix of locally based specialists and operational social work teams.
• Partly Centralised-Specialist- some high risk referrals managed or undertaken by central specialist team
• Fully Centralised-Specialist – Most safeguarding work undertaken by a central specialist safeguarding team
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Implications of models • Staff in less specialist sites perceived themselves to
have more knowledge of particular groups • Specialist staff valued the increased knowledge of
safeguarding processes, law and procedures including multi agency working
• In more specialist sites, mainstream social workers had less confidence in their safeguarding practice
• Prioritising work more challenging for social workers in less specialist models
• Some tensions over allocation of safeguarding work in more specialist sites
• More specialist safeguarding involvement means more ‘handovers’ and thereby less continuity
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Safeguarding referral outcomes
• Odds of substantiating referrals highest in Dispersed-Specialist sites
• Overall staff felt positive about their level of effectiveness in safeguarding
• Model had little impact on social workers’ views of effectiveness
• Good relationships with other teams and good support from managers related to higher views of effectiveness of safeguarding
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Care home managers valued:
• Positive: – The importance of a properly functioning
MASH – Knowledgeable and professional social workers – Supportive approach of social workers – Access to LA training for care home staff
• Critical – Social workers with high caseloads – Lack of access or involvement with social
workers – Inconsistent knowledge of the Mental Capacity
Act (2005)
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Priorities for training • Social care law particularly
the Mental Capacity Act 2005
• Deprivation of Liberty Safeguards
• Safeguarding implications of the Care Act 2014.
• Court work (less of a priority for the Centralised Specialist site)
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Conclusions
• Model of safeguarding less important than expected • Highlights the importance of
– Supportive management styles – Fostering good relationships between and within teams – Developing a rational and acceptable means of allocating safeguarding
work between specialists and mainstream social workers – Ongoing training
• Choice of model may be linked more to local factors such as stability of population and workforce (where less stable populations require the development of specialist approaches)
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Thanks for listening
Research Team:
• Martin Stevens ([email protected])
• Caroline Norrie ([email protected])
• Katherine Graham ([email protected])
• Jill Manthorpe ([email protected])
• Jo Moriarty ([email protected])
• Shereen Hussein ([email protected])