Search

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. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present data about access to health and social care services during the COVID-19 pandemic for adults with learning disabilities across England, Northern Ireland, Scotland and Wales. Design/methodology/approach: Data were collected directly from 621 adults with learning disabilities and through separate proxy reports by family carers and paid support staff of another 378 adults with learning disabilities. The data were collected between December 2020 and February 2021 and concerned the use of health and social care services since the start of the first COVID-19 national lockdown in March 2020. Findings: Access to and use of health and social care services significantly reduced for adults with learning disabilities across the UK during the COVID-19 pandemic between March 2020 and February 2021, with many people not receiving any services at all during that period. Similar patterns were seen across England, Northern Ireland, Scotland and Wales. However, data suggest some variations between countries for some services. Practical implications: Future pandemic planning must ensure that access to these essential services is not completely lost for adults with learning disabilities and their family carers, as it was in some cases during the COVID-19 pandemic in 2020. Originality/value: This is the largest study about the impact of the COVID-19 pandemic on health and social care services for adults with learning disabilities in the UK. The authors primarily collected data directly from adults with learning disabilities, and worked with partner organisations of people with learning disabilities throughout the study. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to consider the impact of mental capacity legislation when applied to parents with learning difficulties who lack capacity within childcare and family law proceedings in England and Wales.Design/methodology/approach The paper relies on a range of material including reports published by independent mental health foundations, official inquiries and other public bodies. It also refers to academic and practitioner material in journals and government guidance.Findings The paper critically reviews the application of the guidance when assessing mental capacity legislation as applied in England and Wales and offers by way of illustration several case examples where psychological assessments, and the enhancement of capacity, have assisted parents who were involved in childcare and family law proceedings.Research limitations/implications There has been little published research or governmental reports on the number of cases when parents involved in childcare and family law proceedings have been found to lack capacity. No published prevalence data are available on the times when enhancing capacity has resulted in a change of outcome in childcare and family law proceedings.Practical implications The duty is on the mental health practitioners assessing mental capacity that they do so in a structured and supportive role adhering to good practice guidance and follow the guiding principles of mental capacity legislation assuming that the individual has capacity unless it is established that they lack capacity. Guidance and training is needed to ensure that the interpretation of the Mental Capacity Act (MCA) and its application is applied consistently.Social implications For those who are considered to lack mental capacity to make specific decisions, particularly within childcare and family law proceedings, safeguards are in place to better support such individuals and enhance their capacity in order that they can participate more fully in proceedings.Originality/value While the MCA legislation has now been enacted for over ten years, there is very little analysis of the implications of capacity assessments on parents involved in childcare and family law proceedings. This paper presents an overview and, in places, a critical analysis of the new safeguarding duties of mental health practitioners when assessing for, and enhancing capacity in parents. [ABSTRACT FROM AUTHOR]

Purpose Opportunities to gamble have boomed in the UK in recent years, since the passing of the Gambling Act 2005. The implications of this for adults with care and support needs and for safeguarding services have not been greatly investigated. The purpose of this paper is to address the interface of how gambling affects adults with care and support needs in England and adult safeguarding.Design/methodology/approach This paper reports on the scoping review which focussed on adults with care and support needs and gambling-related harm. It also included literature on perpetrators who exploit adults with care and support needs to fund their own or others’ gambling. The overall aims of this scoping review were to explore what is known about gambling-related harm affecting adults with care and support needs, the gaps in the evidence base, and specifically to refine the interview questions for the wider study.Findings There is some evidence that adults with care and support needs experience or are at risk of gambling-related harm. There is, however, lack of data from safeguarding services about this affecting adults at risk and safeguarding practice and systems. A public health approach to gambling is advocated by some, as well as effective regulation and support for people who have problems with their own or others’ gambling.Originality/value Industry operators, practitioners, and policymakers are increasingly paying attention to gambling-related harm but there is a lack of focus on adults with care and support needs or implications for adult safeguarding. [ABSTRACT FROM AUTHOR]

Purpose: Social impact bonds (SIBs) have become a favoured way to fund public services, including housing, prison and homelessness projects, in an era of austerity. In a growing critical literature on SIBs, a largely absent voice is that of the link worker. This paper aims to focus on the views of link workers in a SIB funded project which works with long-term entrenched rough sleepers in the East of England. Design/methodology/approach: Interviews with link workers were conducted with a thematic analysis echoing many of the views expressed in the critical literature not only about the problems but also some of the advantages that SIBs offer to this type of project. Findings: Three key themes were discomfort with the funding mechanism; flexible and innovative interventions that SIBs make possible; and problems with the outcome measures that trigger payments. This study concludes that if SIBs are to achieve their promise of providing funding which leads to effective solutions to deeply ingrained social problems, there needs to be more careful evaluation of their true benefits in comparison to publicly funded projects, adoption of more appropriate and project-specific outcome measures and a much clearer explanation and justification of the way in which SIB funding works. Originality/value: Few studies have specifically explored the perceptions of front-line link workers in the homelessness sector. This study highlights not only the concerns but also the benefits associated with the use of SIB as a funding mechanism within the homelessness sector. [ABSTRACT FROM AUTHOR]

Purpose: The prominence of the best interests principle in the Mental Capacity Act 2005 represented an important transition to a more resolutely patient-centred model regarding decision-making for incapable adults ("P"). This paper aims to examine the courts' consideration of P's values, wishes and beliefs in the context of medical treatment, reflect on whether this has resulted in a wide interpretation of the best interests standard and consider how this impacts clinical decision makers. Design/methodology/approach: A particular focus will be on case law from the Court of Protection of England and Wales and the Supreme Court of the UK. Cases have been selected for discussion on the basis of the significance of their judgements for the field, the range of issues they illustrate and the extent of commentary and attention they have received in the literature. They are presented as a narrative review and are non-exhaustive. Findings: With respect to values, wishes and beliefs, the best interests standard's interpretation in the courts has been widely varied. Opposing tensions and thematic conflicts have emerged from this case law and were analysed from the perspective of the clinical decision maker. Originality/value: This review illustrates the complexity and gravity of decisions of the clinical decision makers and the courts have considered in the context of best interests determinations for incapacitated adults undergoing medical treatment. Subsequent to the first such case before the Supreme Court of the UK, emerging case law trends relating to capacity legislation are considered. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to expose and dispel some outdated dilemmas and straw men that have drawn attention away from debates of substance in social work. The paper presents what Frontline believes to be the substantive dilemmas facing the social work profession, as it looks into the future.Design/methodology/approach The paper draws on the insights and experiences of the past four years during which Frontline has been innovating in the field of social work education and leadership development.Findings Building a better social work system requires addressing several important questions, namely, whether social work; first, is a practical or intellectual task; second, is a generic or specialist profession; third, focuses on social or therapeutic change; fourth, requires bureaucrats or change agents; and fifth, involves measuring inspections or measuring outcomes.Originality/value The paper sets out the key dilemmas facing the social work profession, which must be debated and addressed in order to build a better social work system. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present an analysis of media reactions to the BBC Television Panorama programme, Behind Closed Doors’ and to set this in the context of interviews with care staff about their reflections on publicity about poor practice in the care sector.Design/methodology/approach This paper reports on an analysis of media reactions to recent exposé of abuse in social care in England and data from an interview-based study of care workers. The interviews were analysed to consider the impact of such media reports on staff and to explore their views of action that might be need to be taken about care failings.Findings There are mixed reactions to exposé of poor care on television and to the debates that precede and follow their broadcast. Debates occur in print and on television, but also in social media. The particular exposé of care home practices by the Panorama programme, Behind Closed Doors, led to debate in England about the potential role of covert cameras in care homes. The interviews revealed that while care staff are affected by scandals in the media about social care, they do not necessarily focus on themes that the media stories subsequently highlight. Overall some are disenchanted while others have ideas of what needs to change to improve practice. Care staff consider that there remain problems in raising concerns about practices and some staff feel unable to stay in workplaces where they have made complaints.Research limitations/implications The care workers interviewed may not be representative of the sector and they may have wished to provide socially acceptable answers to the researchers. Practice was not observed.Practical implications Local Safeguarding Adult Boards may wish to develop a communications strategy to deal with requests for reactions to media reports locally and nationally. Safeguarding practitioners may wish to prepare for increased referrals following media coverage of poor care in their areas. They may later be able to use media reports to discuss any local differences of interpretation over matters such as prosecutions for abuse. Trainers and educationalists may wish to clarify the importance given by care providers to raising concerns, the ways in which difficult conversations can be held, and the protections available to whistle-blowers or those raising concerns – with local examples to provide assurance that this is not mere rhetoric.Originality/value Television reports of problems with social care attract wide media interest but the authors know very little about how care workers respond to depictions of their work and their occupational grouping. This paper links media and expert commentator reactions to television exposé with data acquired from interviews with those on the frontline of care. [ABSTRACT FROM AUTHOR]

Purpose – At a time when funding arrangements are under review, the purpose of this paper is to come to a better understanding of victim needs and to inform future developments of services in England and Wales. Design/methodology/approach – This paper is based on qualitative data gathered from a series of interviews with 33 individuals working with victims of crime in one police area in England and Wales. Findings – Better practice and outcomes were associated in respondent’s accounts with the multi-agency working and end to end case management of needs associated with some victims of rape and domestic abuse assessed as high risk of harm. Research limitations/implications – Small-scale qualitative study. Practical implications – It is argued Police and Crime Commissioners (PCCs) should explore mechanisms for extending such services to more victims of crime and ensuring better co-ordination of service delivery. Originality/value – From October 2014 onwards PCCs are set to take over responsibility for funding victim services in England and Wales. Though not an uncontroversial development, this sets the context for practice with victims to be considered afresh and accordingly this paper explores the needs of victims and how they are met in one police and crime area. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to outline four scenarios developed for the future of the South West Midlands region of England. Like many depressed regions in the UK, the foundation industries that initially developed the region have gone. Manufacturing is continuing to decline and the low-skilled economic underpinnings of the region have all but disappeared. The population, however, has not changed with the times, but remains low-skilled and largely unemployable to many of the industries the region is trying to attract to regenerate itself. Despite this economically depressed picture, the region is renowned for its sense of community and regional identity, and hence crime is uncharacteristically low given the economic and demographic circumstances of the region.Design/methodology/approach – A range of methodologies were employed to inform scenario building for the future of the region, including a literature review, interviews with employers and community leaders, a word association exercise and questionnaire with children approaching school leaving age, and data analysis of demographic and economic trends.Findings – Four scenarios were developed as possible futures for the region to help inform policy making, in particular educational policy to encourage more young people to remain in education for longer and gain higher qualifications.Practical implications – The paper offers practical ideas for (re)engaging young people in education in a depressed region where the value of education has never really been appreciated.Originality/value – This paper offers readers alternative perspectives on an area of education that might otherwise be ignored and finds positive ways forwards to further promote education in the region. [ABSTRACT FROM AUTHOR]

Purpose - With the introduction of the personalisation agenda (Department of Health, 2008) within social care (and health), this paper aims to discursively explore two themes: improving the lives of people with acquired brain injury through the introduction of more personalised services and support; and the impact of the culture shift on Headway Cambridgeshire as a service provider.Design/methodology/approach - The paper presents examples to illustrate how it is possible to plan in a way that is broad enough to meet the needs of the majority whilst being flexible enough to deal with differing individualised circumstances.Findings - The paper highlights the challenges faced by individuals and service provider organisations when introducing personalised services and suggests some approaches that can be taken to overcome them.Practical implications - Recommendations for good practice in personalised services.Originality/value - This paper sets out a framework for organisations working with people with acquired brain injury in a social care setting in the community and how the principles embodied by the personalisation agenda can be introduced into existing service provision. [ABSTRACT FROM AUTHOR]

Purpose - At the English local authority level, there has been significant investment in e-government infrastructure (e-channels) in the last five years, but take-up of these e-channels is low. This paper aims to look at e-citizen, a £3 million project funded by the Department for Communities and Local Government (DCLG) and led by Norwich City Council, which has developed a methodology to enable local authorities to encourage their citizens to use e-channels. Design/methodology/approach - The paper undertakes a comprehensive research programme to inform the national approach towards the take-up and marketing of local authority e-channels. Findings - The study finds that there are a large number of English adults who are ready, willing and able to use e-channels, the so-called potential early adopters of e-government. Take-up is low, however, because awareness of e-channels is low. One solution to increase take-up is to run targeted marketing communications campaigns. The gross potential take-up market in England is 17.5 million adults aged 15 +. Research limitations/implications - The research conducted by e-citizen is the largest and most comprehensive study of the take-up of local government e-channels in the world. This work has established that there is a large potential market for e-government in England and that running marketing campaigns is one way of realising this potential. These findings can be applied throughout the UK and also internationally, although the project did not test whether different nationalities might have different reactions to marketing campaigns. e-citizen did not consider other variables which impact on take-up, such as accessibility of e-channels and their effectiveness. Practical implications - The methodology and findings from e-citizen have already been taken-up by a number of English local authorities. The UK Government, through the DCLG, has picked-up the e-citizen findings and applied them in a £4.6 million national marketing campaign. Originality/value - Work of this nature and scale has not been conducted before. It has been financed by central government but delivered by a consortium of English local authorities, government representatives and private sector suppliers. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to appraise local absent without leave/missing persons policy in use across the nine NHS mental health trusts providing services across the Greater London region. Design/methodology/approach -- A review of the literature on best practice management was conducted, evidence collated and an appraisal tool produced. This tool was used to systematically appraise individual policies. Findings -- Despite some core consistency in policy, there was some notable variability in guidance. Novel and unique approaches to management were also identified. Research limitations/implications -- It is recognised that policies often arise from pragmatic approaches using local multi-agency agreements and therefore some variability across London was expected. It is also recognised that the audit tool produced is unvalidated but does reflect the best available evidence. Practical implications -- The authors have shown policy variability in the management of what is a common psychiatric problem across a relatively homogenous population. Standardisation of policy is likely to improve the efficiency in managing these incidents as well as encourage sharing of innovative practice. The authors also illustrate practical implications for local policy benchmarking in the absence of clearly defined national standards. Originality/value -- This study has shown the variability of policy in managing a common problem faced on psychiatric wards. It also highlights issues related to policy development on a local and regional level. [ABSTRACT FROM AUTHOR]

Since the murder of Steven Hoskin, there have been considerable changes in the way that agencies in Cornwall operate. In order to prevent further tragedies on such a scale, a protocol was agreed by the agencies about when an alert should be triggered (Cornwall and Isles of Scilly Safeguarding Adults Board, 2008). This paper describes the process and implications of the protocol from the perspective of Devon and Cornwall Police, South Western Ambulance Service Trust and Cornwall and Isles of Scilly Primary Care Trust. The protocol has improved and encouraged information sharing within and between agencies, which will help to identify and reduce the risks to vulnerable adults. [ABSTRACT FROM AUTHOR]

Kent was one of the first social services departments to develop a specific adult protection policy in 1987. This paper charts the development of policy and references key landmarks on this journey from the perspective of the policy manager's role. Opportunities are also taken to identify the key learning from this experience and the main challenges for the newly emerging safeguarding agendas. [ABSTRACT FROM AUTHOR]