An appearance on a Radio 5 Live Investigates in February alerted ADASS President David Pearson to the growing misapprehension and misunderstanding of how adult safeguarding works in England. How do we make sure that the public understand more completely the complexities in the different responsibilities different agencies have for the task? Click here to read his views…
THE COMPLAINTS OF a number people ringing into a BBC Radio 5 Live Investigates programme I recently contributed to were that:
* It was difficult to get an inquiry or investigation instigated
* Callers were concerned about a lack of communication with carers
* There was a lack of discernible action to reduce risk, writes David Pearson.
Of course there is much good practice out there and one of the most encouraging developments is how enthusiastically local authority social workers and other staff have embraced Making Safeguarding Personal. The general view is that placing a clear legal framework around safeguarding is the right thing to do. It will rightly raise the stakes - but councils, directors and Safeguarding Boards will need to make sure that their arrangements are in line with a higher standard.
Crucially, though, what I took away with me from the radio experience was that if we do not communicate widely about what the safeguarding system is and the responsibilities of all organisations as we implement the expectations for the Care Act, there is a strong potential for confusion about its responsibilities.
We must continue to ensure that the raising of awareness and concerns about adults at risk of abuse or neglect is the right thing to do so that people can be given options to reduce the risk of abuse or where they lack capacity others can act in their best interests.
Misunderstanding of the role of safeguarding both in terms of the multi-agency nature of the responsibility and the fact that it works alongside the responsibility of providers and the Care Quality Commission for the quality of provision.
The role safeguarding plays is often misunderstood. The multi-agency nature of the responsibility is crucial and it works alongside responsibilities of providers and the Care Quality Commission to ensure the quality of provision.
Of those referred in care homes, how many are found to be events which amount to actual abuse or neglect? The Demos Commission into residential care (or, as they prefer - housing with care and support) provides some analysis of the extent of safeguarding in care homes. In relation to all care homes in 2012/13 there were 38,270 safeguarding referrals that were substantiated, 36 per cent of these were in a care home setting. Of these 23 per cent were the responsibility of a friend or family member and 12 per cent were by other people who were not care staff.
Care staff were responsible for 7,564 episodes. We know that there were 423,000 people living in care homes. Care staff were responsible for abuse or neglect against two per cent of the people living in care homes. This is two per cent too many and each one reflects a very distressing incident for the person concerned and their families and friends.
The statutory guidance for the Care Act 2014 makes it clear that Safeguarding is not a substitute for:
* Provider responsibilities to provide safe and high quality services.
* Commissioners regularly reassuring themselves of the safety and effectiveness of the services they have commissioned.
* The Care Quality Commission (CQC) ensuring that regulated providers comply with the fundamental standards of care or take enforcement action.
* The core duties of the police to prevent and detect crime and protect life and property.
This is the matrix in which adults are to be protected within our society. And it is the responsibility of all these agencies so to co-operate and collaborate in order to maximise the safety of all – not just in residential care, but at home, on the streets and in their communities.
There have been a number of peer reviews carried out by the Local Government Association over the last few years which as well as highlighting areas for improvement, have also found many areas of excellent practice.
Serious case reviews have emphasised the importance of sharing information across agencies and being able to identify patterns or trends in concerns that are identified. This means that it is more likely that safeguarding concerns can be considered alongside CQC inspections. There are different ways of ensuring that agencies work together and in recent years some areas have set up multi-agency safeguarding hubs including social care, health and the police.
It is clear that the very strength of good safeguarding is that it rests with many agencies and the appropriate pooling of their resources and skills can mean the sum of their focused responsibilities being far greater than their individual commitments can allow. This in turn can make it confusing for those who look for clarity and simplicity.
How we transfer our understanding of the web of responsibilities for safeguarding into a similar understanding shared with the wider community is a challenge we should all be considering, and applying ourselves to meeting.