What is ‘Safeguarding’ Adults?
It means protecting an adult’s right to live in safety, free from abuse and neglect.
The aims of adult safeguarding are to:
- prevent harm and reduce the risk of abuse or neglect to adults with care and support needs (please click here for a One Minute Guide on ‘Care & Support Needs’).
- stop abuse or neglect wherever possible
- safeguard adults in a way that supports them in making choices and having control about how they want to live
- promote an approach that concentrates on improving life for the adults concerned
- raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect
- provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or well-being of an adult
- address what has caused the abuse or neglect.
Section 42 of the Care Act 2014 states that safeguarding enquiries should be made where:
- a person has needs for care and support;
- is experiencing, or at risk of, abuse or neglect; and
- as a result of their care and support needs, is unable to protect him or herself against the abuse or neglect, or the risk of it.
They may be a person who:
- is elderly and frail due to ill health, physical disability or cognitive impairment;
- has a learning disability
- has a physical disability and/or a sensory impairment
- has mental health needs, including dementia
- has a long-term illness or condition
- misuses substances or alcohol
- is a carer (family member/friend) and is subject to abuse
- does not have capacity to make a decision and is in need of care and support
Types of Abuse
- Financial abuse, such as; misusing, withholding or taking someone’s money and controlling someone financially.
- Domestic Abuse, such as; physically hitting someone, locking them in a room or pushing them.
- Psychological abuse, such as; a person subjecting or exposing another person to behaviour that may result in psychological trauma, including anxiety, chronic depression, or post-traumatic stress disorder.
- Emotional Abuse, such as; a person may be being bullied or humiliated.
Types of Neglect
- Self-neglect, such as; a person being in their own home and refusing to be seen by anybody i.e. family, carers.
- Physical neglect, such as; the person may not be being provided with the necessary food, medication or care and support that they need.
- Emotional Neglect, such as; failing to provide emotional support such as emotional security and encouragement.
Risks of Harm
- Another person’s conduct is causing (or is likely to cause) the adult to be harmed, or
- the adults engaging (or is likely to engage) in conduct which caused (or is likely to cause) self-harm.
What is Making Safeguarding Personal?
Making Safeguarding Personal (MSP) enables safeguarding to be done with, not to, people – ‘no decision about me, without me’.
MSP is an initiative which aims to develop a person-centred and outcome focused approach to safeguarding work. The adult concerned must always be at the centre of adult safeguarding enquiries, and their wishes and views sought at the earliest opportunity. This short film, ‘Risking Happiness’is a good example of how individuals thoughts and wishes can sometimes be overlooked during safeguarding, and highlights the negative effect this has on the individual (Gloucestershire CCG and Gloucestershire County Council).
When considering an individual’s wishes and thoughts, you must also consider:
Positive Risk Taking
As individuals we all have the ability & choice to take risks. The principle of making an ‘unwise decision’ is enshrined in the Mental Capacity Act 2005.
Supported Decision Making
A Care Act Advocate (CAA) must be appointed if the adult has significant difficulty following the process and has no family or friends to support them. If they lack capacity, an Independent Mental Capacity Advocate (IMCA) must be instructed to support them through the safeguarding intervention. Supported decision making focuses on the outcomes the person wishes to achieve, what is working in their lives and what is not. There should be a mechanism to clearly guide and record the ‘conversation’ about choice and risk.
Freedom from Undue Influence.
A person might decline an intervention because of undue influence or coercion, in which case, such a choice should not be taken at face value. Support may be required to help a person make a decision free from such influence.
Involving the Individual
When evaluating whether MSP was properly applied, recommended questions for the individual about their experience of the safeguarding journey are:
Did you understand why people did what they did to try and keep you safe?
Do you feel listened to during conversations and meetings with people about helping you feel safe?
How happy are you with the end result of what people did to keep you safe?
Do you feel safer now because of the help from people dealing with your concern?
What Does this mean for Safeguarding?
MSP is about engaging with people about the outcomes they want at the beginning and middle of working with them, and then ascertaining the extent to which those outcomes were realised at the end. MSP means adult safeguarding:
- is person-led
- is outcome-focused
- engages the person and enhances involvement,
- choice and control
- Improves quality of life, wellbeing and safety
- shifts the focus from process to people
Making Safeguarding Personal:
- Is NOT to be seen in the context of a formal safeguarding enquiry (Care Act, 2014, Section 42 enquiry)
- Is NOT about a focus on personalised front line practice
The Care Act 2014 guidance requires adult safeguarding practice to be person led and outcome focused, incorporating MSP as the recommended approach to safeguarding alongside the 6 safeguarding principles:
6 SAFEGUARDING PRINCIPLES
Empowerment – presumption of person led decisions and informed consent.
Prevention – it is better to take action before harm occurs.
Proportionality – proportionate and least intrusive response appropriate to the risk presented.
Protection – support and represent for those in greatest need.
Partnership – local solutions through services working in their communities. Communities have a part in preventing detecting and reporting abuse and neglect.
Accountability – Accountability and transparency in delivering safeguarding.
The Local Government Association (LGA) has a suite of resources which describe what ‘good’ might look like in MSP for a range of organisations, and promote ownership of this agenda within and across all organisations:
- Support for Boards across the Safeguarding Adult Partnership
- What might ‘good’ look like for health and social care commissioners and providers?
- What might ‘good’ look like for the police?
- What might ‘good’ look like for advocacy?
- What might ‘good’ look like for those working in the housing sector?
- Supporting involvement of service users