Safeguarding adults from abuse or neglect has too often been been characterised by a patronising, checklist-based approach to those in need of care.
But the Care Act looks set to change that. Councils now have legal duties to promote individuals’ wellbeing. This means assuming the individuals themselves are the best placed to decide on the help they need and ensuring any restriction on their freedom is kept to a minimum.
It’s a fundamental shift that alters how social workers must approach vulnerable adults who are subject to abuse, be it physical, sexual or financial, to name some of the most common. At the outset, practitioners must ask people what they want and be prepared to set aside their own anxieties to help them get what they want, without leaving them exposed to harm.
Social workers in 52 councils piloted this way of safeguarding under a scheme called Making Safeguarding Personal (MSP). “Beforehand, a typical safeguarding response could have been to remove the individual away from a risky situation,” explains Adi Cooper, safeguarding lead at the Association of Directors of Adult Social Services (Adass).
“But what is the point in taking someone to a place of safety, away from family and support, if they are unhappy? Surely, it is better to work with the person to help them to achieve what they want, try to reduce risks and support them to gain more control.”
Kate Metcalf, a senior social worker at Brighton and Hove council, recalls when her council began trialling MSP in 2013. “Social workers were relieved and reignited by working like this and it has been a chance to get rid of the terrible infantilisation that has unfortunately been part of what was process-driven safeguarding,” she says.
Every safeguarding case began with a conversation with the individual at risk – which, remarkably, may not always have happened under the old way of working. It included the question: “What would you like to happen?” and the answer governed how the case was handled by practitioners.
Most social workers involved in the MSP pilots have been positive about it, says Cooper. “This approach allows them to use their whole range of social work skills,” she says. “But some have not liked it because they feel more secure when faced with a difficult and risky situation in being able to resort to checklists, procedures and processes.”
And not everyone is convinced that the new law’s attempt to place more power in the hands of vulnerable people does enough to protect them, even though it also introduces council duties to establish multiagency safeguarding adults boards and initiate inquiries when there are concerns about someone. For the most vulnerable adults being abused behind closed doors, the Care Act does nothing to make them safer, argues Action on Elder Abuse chief executive Gary FitzGerald.
“The failure to give social workers a new power to gain entry into a property where someone is being harmed – rejected by ministers as draconian and potentially intrusive – is bitterly disappointing,” he says. “This act is all smoke and mirrors. If you look carefully what has actually changed?”
Pointing to the Adult Support and Protection Act 2007 in Scotland, FitzGerald lists a range of powers allowing social workers to intervene, which include orders banning perpetrators from visiting the home of their victim and a warrant of entry. In Wales too, legislation will be introduced in April 2016 giving social workers a power of entry.
“I now say to people – and only a bit tongue in cheek – if you want to be protected move to Scotland,” adds FitzGerald. In Scotland, social workers can seek a warrant, which lasts 72 hours, from the sheriff court if they have been prevented from entering a property or anticipate refusal.
It is a power rarely exercised. At Edinburgh council, warrants have been used just twice in seven years. “Any initial reluctance can be dissolved when the social worker explains their powers under the act,” says the council’s lead adult protection officer Kate Fennell. “People can be persuaded to let you in, but warrants of entry are still useful to have in your back pocket.”
Case study: “We have to respect she has a right to a private life”
When Susi became involved with a violent partner, concerned support staff alerted the local authority. An experienced social worker was handed the case and began working with her using the MSP approach. Asked what she wanted, she said she would like to continue the relationship but wanted her boyfriend’s behaviour to change.
“Susi had a history of relationship problems, where she was either very dominating or became involved with men who were abusive,” explains Slough council’s head of adult safeguarding and learning disabilities, Simon Broad.
“Her behaviour is very disinhibited and it was not unknown for her to go into town in the afternoon and pick up men in bars. We had already worked with her on managing this risk by making sure she had a mobile phone, a supply of condoms and so on. We have to respect she has a right to a private life.
“Before, if we had received a referral about a violent partner, we would have said to Susi that she should stop seeing him and done everything to protect her at all costs. Instead, we accepted it when she said she wanted to continue the relationship and we worked with her over the course of two or three very informal safeguarding meetings.
“It can be quite intimidating for someone to have to come and sit in a big council meeting room with a minute taker. So there were meetings at home, with different professionals, including a nurse. This is all about the skill of the conversation and getting her into a position where she was able to protect herself.
“In the end, she decided to end the relationship. It was very important she came to that view herself. If we had simply told her that she could no longer be in contact with her boyfriend, it would have been unenforceable, for a start – but it would also have had a detrimental effect on our relationship with her because it was not what she wanted.”
“This approach was more collaborative. There has been a shift in the way we work from saying ‘we will protect you’ to helping you protect yourself.”
