Learning from safeguarding adult reviews on self-neglect: addressing the challenge of change
| Published date | 09 April 2018 |
| DOI | https://doi.org/10.1108/JAP-01-2018-0001 |
| Date | 09 April 2018 |
| Pages | 78-92 |
| Author | Michael Preston-Shoot |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
Learning from safeguarding adult reviews
on self-neglect: addressing the challenge
of change
Michael Preston-Shoot
Abstract
Purpose –The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews
(SARs) and accompanying thematic analysis, and to address the challenge of change, exploring the
necessary components beyond an action plan to ensure that findings and recommendations are embedded
in policy and practice.
Design/methodology/approach –Further published reviews are added to the core data set from the
websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains
employed previously. The repetitive nature of the findings prompts questions about how to embed policy and
practice change, to ensure impactful use of learning from SARs. A framework for taking forward an action
plan derived from an SAR findings and recommendations is presented.
Findings –Familiar, even repeti tive findings emerge onc e again from the thematic a nalysis. This level of
analysis enables an understanding of both local geography and the national legal, policy and financial
climate within which it sits. Such learning is valuable in itself, contributing to the evidence base of what good
practice with adults who self-neglect looks like. However, to avoid the accusation that lessons are not
learned, something more than a straightforward action plan to implement the recommendations is
necessary. A framework is conceptualised for a strategic and longer-term approach to embedding policy
and practice change.
Research limitations/implications –There is still no national database of reviews commissioned by SABs
so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports
but only a summary of findings and recommendations in SAB annual reports. This makes learning for service
improvement challenging. Reading the reviews reported here enables conclusions to be reached about
issues to address locally and nationally to transform adult safeguarding policy and practice.
Practical implications –Answering the question “how to create sustainable change”is a significant
challenge for SARs. A framework is presented here, drawn from research on change management and
learning from the review process itself. The critique of serious case reviews challenges those now engaged in
SARs to reflect on how transformational change can be achieved to improve the quality of adult safeguarding
policy and practice.
Originality/value –The paper extends the thematic analysis of available reviews that focus on work with
adults who self-neglect, further building on the evidence base for practice. The paper also contributes new
perspectives to the process of following up SARs by using the findings and recommendations systematically
within a framework designed to embed change in policy and practice.
Keywords England, Change, Self-neglect, Care Act 2014, Action plans, Safeguarding adult reviews
Paper type Research paper
Introduction
The cases of adults who self-neglect continue to challenge practitioners, the agencies for which
they work, and Safeguarding Adults Boards (SABs). One thematic review of safeguarding adult
reviews (SARs) (n¼27), commissioned and completed by SABs in the London region between
April 2015 and April 2017, found that 33 per cent centrally involved self-neglect (Braye and
Preston-Shoot, 2017). A second thematic review (Preston-Shoot, 2017a), of serious case
Received 5 January 2018
Revised 14 February 2018
Accepted 20 February 2018
Michael Preston-Shoot is a
Professor Emeritus Social Work
at the Faculty of Health &
Social Sciences, University of
Bedfordshire, Luton, UK and
an Independent Chair at Brent
Safeguarding Adults Board,
London, UK and Lewisham
Safeguarding Adults Board,
London, UK.
PAG E 78
j
THE JOURNAL OF ADULT PROTECTION
j
VOL. 20 NO. 2 2018, pp. 78-92, © Emerald Publishing Limited, ISSN 1466-8203 DOI 10.1108/JAP-01-2018-0001
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