Models of adult safeguarding in England and Wales

Within England there has been a policy framework to guide practice in relation to safeguarding adults from abuse since 2000 and at present legislative changes are in development. Alongside this there has been a growing awareness of the nature and extent of abuse experienced by adults who may be at risk and some high profile investigations of abuse (for example Winterbourne View) have occurred.

Nonetheless, empirical research in this area remains limited. Given that local authorities were given lead responsibility for the development and implementation of safeguarding procedures this paper focuses on how local authorities in England have developed and organised their safeguarding services.

This paper forms part of a wider study that is investigating adult safeguarding policies and procedures in England and comprises a review of the literature concerning how social work practice and local authority organisation have responded to safeguarding responsibilities.

Methods

The paper takes the form of a narrative review of literature spanning the period 2000 – 2013. Clear details are provided of search terms, databases interrogated, and inclusion/ exclusion criteria. One hundred and sixty two papers were included in the initial review with 16 being retained for the final review having been identified as being highly relevant.

A helpful table provides key details in relation to each of these 16 papers. Those papers deemed highly relevant were read by all members of the research team to determine work undertaken on organisational models, the assumptions underpinning these models, and other factors that might exert an influence on organisational issues.

There is a growing awareness of the nature and extent of abuse and some high profile investigations of abuse.

Findings

In relation to the organisation of adult safeguarding discussion focuses on the relative benefits of dedicated specialist safeguarding teams/ role as opposed to safeguarding being an integral part of wider case management responsibilities.

Differing approaches were evident in the literature with some specialist roles being strategic, others being operational whilst some combined both aspects. It is noted that the implications of specialisation have, however, only just begun to be explored.

Key features of safeguarding organisation and practice are identified as being decision making and thresholds, and issues relating to multi-agency working.

‘Ambiguity’ is noted as being an issue in terms of whether an incident should be considered as a safeguarding concern: this leads to different thresholds being applied in different areas (although tools have been developed to try and promote greater consistency of decision making).

A lack of clarity within policy frameworks is seen as creating challenges in relation to roles and relationships within multi-agency working but a consensus is apparent within the literature that such an approach is desirable and beneficial.

Ambiguity in whether an incident should be considered as a safeguarding concern leads to different thresholds being applied in different areas.

Conclusion

The authors recognise the limitations of their review most importantly the lack of research studies that were available for inclusion. In view of this they conclude that further research is required to determine how different models of safeguarding practice impact upon both the process and the outcomes of safeguarding investigations. In addition they argue that research is required in relation to the experience of being an ‘adult at risk’, the impact of specialist and mainstream organisational models, and the development of relationships that are necessary for multi-agency working. As has already been noted this review forms the first stage of a wider research project and that project aims to address these areas.

Comments

This paper provides a timely reminder that undertaking a literature review is important both to identify current knowledge and also to highlight those areas where gaps in our knowledge exist. The introduction of policy guidance in 2000 was a major step forward in recognising the issue of adult abuse and neglect within England and Wales. However, it is concerning that some 15 years later we are still in a position where empirical research to underpin developments in this area is limited.

We are on the brink of new legislation being introduced and this does beg the question as to what extent such new policy developments are evidence based. Ensuring that adults who are at risk of abuse and neglect are safeguarded must be fundamental to the support that we as a society provide but to do this effectively we need to know what works, what does not work, and what needs to change.

It is to be hoped therefore that the wider study referred to in this paper will help to address this but also that it will lead to a more extensive programme of research that focuses on safeguarding adults.

We need to ensure that adults at risk of abuse and neglect are safeguarded, but to do this effectively we need to know what works, what does not work, and what needs to change.

Link

Models of adult safeguarding in England: A review of the literature. Graham K, Norrie C, Stevens M, Moriarty J, Manthorpe Jo, Hussein S in Journal of Social Work [abstract]