Purpose -The purpose of this paper is to highlight contemporary issues in achieving best practice in safeguarding adults across multi-agency settings. Design/methodology/approach -The paper is an empirical exploration, reviewing a range of relevant literature and recent policy to present evidence suggesting that there continue to be challenges in achieving best practice in multi-agency approaches to safeguarding. The literature review was undertaken using the following databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, PsycINFO and Medline. The inclusion criteria included being peer-reviewed and published between 2004 and 2012. The key words used were: ''safeguarding adults'' and ''abuse''. Further literature was found through adopting a ''snowballing'' technique, in which additional sources were found from the reference lists used in the initial articles.Findings -Although guidance such as No Secrets from the Department of Health, in 2000, emphasises the importance of a multi-agency approach, this continues to be problematic and presents challenges. In practice, differing professionals may not fully understand each other's roles and responsibilities and both thresholds and scope of adult abuse are still not universally agreed. Legislation could be used positively to mandate the multi-agency approach to adult safeguarding, supported by local Safeguarding Adults Boards and local policies can be used to provide guidance and clarity for practitioners. Further empirical investigation into supporting the multi-agency approach is required.Originality/value -The paper fulfils the need for discussion on the complexities and challenges that continue to present in multi-agency responses to adult safeguarding practice.

This article explores the main elements of the Mental Capacity Act 2005 and the implications for nurses. Many vulnerable adults have impaired capacity, and it is vital that nurses are confident in understanding when and how to assess an individual's capacity. Nurses should be supported and given training to ensure they can apply the principles of the Mental Capacity Act 2005 to practice. It is also important that nurses have a good understanding of the deprivation of liberty safeguards and can identify when their interventions may deprive patients of their liberty, ensuring that these are only undertaken legally.

Purpose -The purpose of this paper was to identify safeguarding concerns for vulnerable adults, including exploring the implementation of safeguarding policy and procedures into practice. This was achieved by reviewing the content of reflective assignments written by pre-registration student nurses, identifying areas of concerns and proposing action plans. Design/methodology/approach -A qualitative approach was initially utilised to scrutinise a random 10 per cent sample of work, which was thematically analysed. From this, an audit tool was devised and then applied to evaluate a 35 per cent sample of work from the following cohort of students. Approval and consent was gained. Findings -From the initial 10 per cent sample, themes emerged around: practice issues; areas for student's development and marking or assessment issues. The standardised audit tool was devised and applied to a 35 per cent random sample of work. This determined that students identified local safeguarding policies and procedures were being followed in the majority of placement areas, although application of the Mental Capacity Act remained inconsistent.Research limitations/implications -The assessor feedback from the reflective assignments was not available to the reviewers, limiting the reviewers ability to identify if assessors had recognised and corrected any policy or practice issues that the student raised. Only assignments from the adult field of nursing were considered within the scope of this study. The authors recommend further empirical investigation into this area. Practical implications -This paper offers knowledge that can be applied in practice within both academic and health care provider services that deliver and facilitate nursing education. It has generated an audit tool that can be utilised to evaluate the knowledge of pre-registration students and has resulted in the implementation of safeguarding adults policies within an academic institution. Originality/value -Safeguarding adults concerns may be identified through studying pre-registration student assignments and promptly acting upon any concerns raised. Aspects of good practice can be acknowledged within health care provider services.

The concept of dignity is core to community district nursing practice, yet it is profoundly complex with multiple meanings and interpretations. Dignity does not exist absolutely, but, rather, becomes socially (de)constructed through and within social interactions between nurses and older adult patients in relational aspects of care. It is a concept, however, which has, to date, received little attention in the context of the community nursing care of older adults. Previous research into dignity in health care has often focused on care within institutional environments, very little, however, explores the variety of ways in which dignity is operationalised in community settings where district nursing care is conducted ‘behind closed doors’, largely free from the external gaze. This means dignity (or the lack of it) may go unobserved in community settings. Drawing on observational and interview data, this paper highlights the significance of dignity for older adults receiving nursing care in their own homes. We will demonstrate, in particular, how dignity manifests within the relational aspects of district nursing care delivery and how tasks involving bodywork can be critical to the ways in which dignity is both promoted and undermined. We will further highlight how micro-articulations in caring relationships fundamentally shape the ‘dignity encounter’ through a consideration of the routine and, arguably, mundane aspects of community district nursing care in the home.