Research team: Martin Stevens,
Caroline Norrie, Katherine
Graham, Shereen Hussein, Jo
Moriarty, & Jill Manthorpe.
Local approaches to
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
Introduction
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Adult safeguarding background
•
Messages from the literature
•
Specialism
•
Decision-making and thresholds
•
Multiagency working
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Models of Safeguarding - aims and methods
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Models of Safeguarding
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Safeguarding referral outcomes
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Feedback on safeguarding
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
Specialism
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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
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)
Decision-making and thresholds
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More senior managers in decision making are less likely
to allocate alert as safeguarding (Thacker, 2011)
•
Likelihood of substantiated allegations (Johnson, 2012)
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Impact on the organisation (McCreadie et al, 2008)
•
Blurred definitions of abuse - ‘cognitive masks’ (Ash,
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
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
Methods
• Phase 1
– Literature review
– Interviews with adult safeguarding managers
• Phase 2
– Five sites – Staff survey
– Secondary analysis of Abuse of
Vulnerable Adults Returns (Now Safeguarding Adults Returns) and Adult Social Care Survey
• Phase 3
– Interviews with safeguarding practitioners and managers
– Feedback interviews with care home managers, housing staff, IMCAS and LA solicitors
Models of Safeguarding
• 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
Implications of models
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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
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Some tensions over allocation of safeguarding work in
more specialist sites
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More specialist safeguarding involvement means more
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
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)
Priorities for training
•
Social care law particularly
the Mental Capacity Act
2005
•
Deprivation of Liberty
Safeguards
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Safeguarding implications of the
Care Act 2014.
•
Court work (less of a priority for
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)
