On (not) learning from self-neglect safeguarding adult reviews

Preston‐Shoot, Michael

doi:10.1108/jap-02-2021-0008

Cited by 7 publications

(9 citation statements)

References 19 publications

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“…In total, 20% of SARs contain recommendations about legal literacy. These overall percentages show only very small variations from the last thematic analysis (Preston-Shoot, 2021).…”

Section: Themes Within Recommendationsmentioning

confidence: 74%

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Hope springs: further learning on self-neglect from safeguarding adult reviews and practice

Preston‐Shoot

O’Donoghue

Binding

2022

JAP

Self Cite

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Purpose The first purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SAR) and accompanying thematic analysis. A second purpose is to rebalance the narrative about adult safeguarding and self-neglect by highlighting two case studies where the practice was informed by SAR and the evidence-base of best practice. Design/methodology/approach Further published reviews are added to the core data set, drawn from the websites of Safeguarding Adults Boards (SAB). Thematic analysis is updated using the four domains used previously. Two case studies are presented, using the four domains of direct practice, team around the person, organisational support and governance, to demonstrate that positive outcomes can be achieved when practice and support for practitioners align with the evidence-base. 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. The case studies are illustrative examples of what can be achieved and signpost SABs and SAR authors to question what enables and what obstructs best practice. Research limitations/implications A national database of reviews completed by SABs has been established (https://nationalnetwork.org.uk) with the expectation that, in time, this will become a comprehensive resource. It is possible, however, that this data set is incomplete. Drawing together the findings from the reviews nonetheless builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice. Although individual reviews might comment on good practice alongside shortfalls, no published SARs have been found that were commissioned specifically to learn lessons from what had worked out well. More emphasis could be given to what might be learned from such cases. Practical implications Answering the question “why” remains a significant challenge for SAR not only where concerns about how agencies worked together prompted review but also where positive outcomes have been achieved. 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 case studies with positive outcomes might enable learning about what enables positive system change. Originality/value The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further reinforcing the evidence base for practice. The paper presents two case studies where practice and the context within which practitioners were working closely aligned to the evidence-base for best practice. The paper suggests that SABs and SAR authors should focus explicitly on what enables and what obstructs the realisation of best practices.

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“…In total, 20% of SARs contain recommendations about legal literacy. These overall percentages show only very small variations from the last thematic analysis (Preston-Shoot, 2021).…”

Section: Themes Within Recommendationsmentioning

confidence: 74%

“…These overall percentages show only very minor changes from the last thematic analysis (Preston-Shoot, 2021). This invites questioning whether too much reliance is being placed on incremental change rather than a forensic critical analysis of the organisational and professional architecture of adult safeguarding.…”

Section: Methodsmentioning

confidence: 95%

Hope springs: further learning on self-neglect from safeguarding adult reviews and practice

Preston‐Shoot

O’Donoghue

Binding

2022

JAP

Self Cite

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“…A common finding in SARs is that it was unclear who was the lead agency or care coordinator (Preston-Shoot, 2021). Though most documents leave this to the discretion of the agencies involved, for example, the agency that “is best placed to lead […] and is currently involved” (Lancashire SAB, 2019, p. 7), four SABs helpfully set out explicit criteria for determining which of the practitioners involved may be best suited to taking on the lead coordinator role (e.g.…”

Section: Resultsmentioning

confidence: 99%

Section: Guidance On Multi-agency Coordinationmentioning

confidence: 99%

Mapping and review of self-neglect policies and procedures from safeguarding adults boards in England

Orr

2023

JAP

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Purpose Local Safeguarding Adults Board (SAB) policies, procedures, guidance and related documents on self-neglect were gathered and analysed, to map what approaches are being taken across England. This paper aims to identify areas of divergence to highlight innovations or challenges faced by SABs. Design/methodology/approach Self-neglect documents were identified by searching SAB websites. Data were extracted into a framework enabling synthesis and comparison between documents. Findings This paper reports on how English SAB documentation defines self-neglect, treats executive capacity, lays out pathways for self-neglect cases, advises on refusal of service input and multi-agency coordination and draws on theories or tools. Greater coherence in understanding self-neglect has developed since it was brought within safeguarding in 2014; however, variation remains regarding scope, referral pathways and threshold criteria. Research limitations/implications This review was limited to published SAB documentation at one point in time and could not consider either the wider context of safeguarding guidance and training or implementation in practice. Practical implications This review provides an overview of how SABs are interpreting national guidance and guiding practitioners. The trends and areas of uncertainty identified offer a resource for informed research and policy-making. Originality/value To the best of the author’s knowledge, this is the first systematic survey of SAB self-neglect policies, procedures and guidance since self-neglect was included under safeguarding.

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“…This again emphasises the need for professional curiosity and skilful professional judgment alongside any developed tool, as a tool alone cannot replace an in-depth assessment of the situation (Penhale, 2010). In particular, there is a growing body of evidence that an overfocus on the adult’s mental capacity within assessment can lead practitioners and agencies to overlook the impact that early life trauma, poor mental health and substance misuse can have on a person’s ability to protect themselves (Preston-Shoot, 2021).…”

Section: Introductionmentioning

confidence: 99%

Assessment tools used in adult safeguarding practice within the UK and Ireland: results from a small-scale qualitative study

Doyle

Montgomery

Donnelly

et al. 2023

JAP

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Purpose Across the UK and Ireland, there are a range of processes and interventions offered to adults who, because of personal characteristics or life circumstances, require help to keep themselves safe from potential harm or abuse. The ways in which the statutory and voluntary sectors have chosen to safeguard these adults varies. Different models of intervention and the utilisation of a range of assessment tools, frameworks and approaches have evolved, often in response to policy and practice wisdom. Empirical research in this area is limited. The primary research purpose of the project on which this paper is based is to gather information on the range of tools and frameworks that are used in adult safeguarding practice across the UK and Ireland. In so doing, this paper seeks to contribute and inform the future development of an evidence based adult safeguarding assessment framework. Design/methodology/approach A team of academics from England, Scotland, Northern Ireland and Ireland wanted to explore the possibility of adapting a pre-existing assessment framework currently in use in family and childcare social work to consider its utility in assessing carers involved in adult safeguarding referrals. This paper reports on a small pilot study which sought to inform the adaptation of this framework for use in adult safeguarding. This paper is based on a qualitative study involving 11 semi-structured telephone interviews with adult safeguarding social work managers and experienced practitioners. Two to four professionals from each region of England, Scotland, Northern Ireland and Ireland were interviewed to elicit their perceptions and experiences of engaging in adult safeguarding assessment processes and their views about models of assessment. Findings This study identified considerable variation in and between the nations under review, in terms of the assessment frameworks and tools used in adult safeguarding practice. To a large extent, the assessment frameworks and tools in use were not evidence based or accredited. Participants acknowledged the value of using assessment frameworks and tools whilst also identifying barriers in undertaking effective assessments. Originality/value There is limited evidence available in the literature regarding the utility of assessment frameworks and tools in adult safeguarding practice. This primary research identifies four themes derived from professional’s experiences of using such frameworks and identifies broader recommendations for policy and practice in this area.

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On (not) learning from self-neglect safeguarding adult reviews

Cited by 7 publications

References 19 publications

Hope springs: further learning on self-neglect from safeguarding adult reviews and practice

Hope springs: further learning on self-neglect from safeguarding adult reviews and practice

Mapping and review of self-neglect policies and procedures from safeguarding adults boards in England

Assessment tools used in adult safeguarding practice within the UK and Ireland: results from a small-scale qualitative study

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