Mediation and family group conferences in adult safeguarding
| Pages | 69-84 |
| Date | 05 April 2013 |
| Published date | 05 April 2013 |
| DOI | https://doi.org/10.1108/14668201311313587 |
| Author | Abbi Hobbs,Andrew Alonzi |
| Subject Matter | Health & social care,Sociology |
Mediation and family group conferences
in adult safeguarding
Abbi Hobbs and Andrew Alonzi
Abstract
Purpose – This paper presents an overview of research and practice literature on the use of Mediation
(M) and Family Group Conferences (FGC) in the context of adult safeguarding in the UK.
Design/methodology/approach – This paper describes the main features of M and FGC and explores
how such ‘‘family led’’ approaches to adult safeguarding fit within the wider agenda of personalisation
and empowerment, including the Mental Capacity Act 2005 and its associated Code of Practice. It also
considers the main implications for best practice and future research and service priorities.
Findings – M and FGC in an adult context are inclusive processes that enable people to explore
choices and options in a supportive environment, assuring maximum possible independence and
autonomous control over basic life decisions, while still addressing the person’s need for assistance.
When used appropriately, both approaches can be a valuable response to safeguarding concerns,
promoting choice and control at the same time as protecting people from risk of abuse and harm.
However,there are few robust evaluation studies currently available and no systematic research studies
were found on cost-effectiveness.
Originality/value – The paper shows that there is a clear need for further pilots of M and FGC in adult
safeguarding. If such research and pilot evaluations find M and/or FGC to be effective, then more
consideration will need to be given as to how to integrate such approaches into mainstreamsocial work
practice. There is also currently wide variation in the training and experience of mediators and FGC
co-ordinators, and further work is required to ensurethat there are appropriate training and accreditation
models in the UK for mediators and FGC co-ordinators working with at-risk adults.
Keywords United Kingdom, Elder care, Family,Adult protection, Mediation, Family group conference,
Elder mediation, Adult safeguarding, Personalisation, Family-led decision making
Paper type General review
Introduction
Mediation (M) and Family Group Conferences (FGCs) are now firmly established within the
context of child welfare, but they may also offer a different approach to adult safeguarding in
the UK. However, despite evidence of some promising and innovative practice, thereis little
systematic evidence about the use or effectiveness of M and FGC, either in the UK or
abroad. This paper describes the main features of M and FGC, explores how these
‘‘family-led’’ approaches to adult safeguarding fit within the wider context of personalisation
and empowerment in the UK, including the Mental Capacity Act 2005 (MCA, 2005) and its
associated Code of Practice (CoP), and considers the main implications for best practice
and future research and service priorities.
Background policy context: from ‘‘protecting’ ’ to ‘‘safeguarding’’ adults
The Department of Health’s (DH) No Secrets (adult protection) guidance, originally
published in 2000 (DH, 2000), defines a vulnerable adult as a person who is or may be in
need of community care services by reason of mental or other disability, age or illness,
DOI 10.1108/14668201311313587 VOL. 15 NO. 2 2013, pp. 69-84, QEmerald Group Publishing Limited, ISSN 1466-8203
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THE JOURNAL OF ADULT PROTECTION
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PAGE 69
Abbi Hobbs is an
Independent Consultant
based in the UK.
Andrew Alonzi is Managing
Director of Capacity Care
CIC, Newark, UK.
This research for this paper was
undertaken as part of a wider
project commissioned by SCIE
to produce a best practice tool
for M and FGCs to inform the
review of the Department of
Health’s ‘‘No Secrets’’
guidance on developing and
implementing multi-agency
policies and procedures to
protect vulnerable adults from
abuse.
and who is or may be unable to take care of themselves, or unable to protect themselves
against significant harm or exploitation. Vulnerable adults are at risk of abuse and neglect,
which can take many forms, including physical, financial and emotional.
Following a national consultation exercise in 2008 (DH, 2008), the DH announced a review of
the No Secrets guidance. The consultation responses emphasised that people in abusive
situations who may experience safeguarding procedures want to be empowered to find
solutions for themselves (DH, 2009). The government response stressed that safeguarding
encompasses three key concepts: protection, justice and empowerment, and stated that
government has a role in the empowerment of people at risk (DH, 2010a).
This shift from ‘‘protecting’’ to ‘‘safeguarding’ ’ adults has been accompanied by significant
legal and policy changes relating to adult social and health care since No Secrets was first
published, and the duty to provide protection to those who do not have mental capacity to
access it themselves has become clearer (Reece, 2010). In May 2011, in line with the
broader ‘‘personalisation’’ agenda (Carr, 2010a) and the recommendations of the Law
Commission’s (2011) review of adult social care law,the government announced its intention
to make Safeguarding Adults Boards statutory and underlined the importance of the
principle of empowerment in adult safeguarding (DH, 2011).
The need for a family-led approach
Increasing choice and control for people is central to the personalisation agenda, which Carr
(2010a, p. 3) has described as: ‘‘thinking about care and support services in an entirely
different way. This means starting with the person as an individual with strengths,
preferences and aspirations and putting them at the centre of the process of identifying their
needs and making choices about how and when they are supported to live their lives’’.
This personalised approach extends to the way professionals should respond to reports of
abuse or concerns about an individual’s safety; a person-centred approach to risk
management should assist a social worker working with an individual using services to
explore the levels of risk that they want to take, empowering the service user to speak out
and enabling them to make informed choices. A personalised approach to risk management
can establish a good support plan that can help individuals, and those who care about them,
think in a positive and productive way about how to achieve the lives they want, while
managing identified risks (DH, 2010b).
Using personalised approaches to adult safeguarding can be particularly helpful in
responding to complex cases of vulnerability and abuse (Carr, 2010b). Although media
attentionis often focused on abuse by caregivers in privatehomes or nursing homes, evidence
shows that a high percentage of abuse against vulnerable adults is carried out by family
members and, in some cases, by those with caring responsibilities (O’Keeffe et al., 2007).
Family situations and relationshipsare often complex and can be complicated further by age,
illness, disabilityand dependency. Many people experiencingabuse may choose, knowingly,
not to challenge the abuse for fear of damagingthe relationship with the person or people on
whom they most depend. Those with cognitive impairments may be unaware that they are
being abused and therefore unable to report it (Baladerian, 1998). There is increasing
recognitionthat it is important for safeguarding practitionersto listen to the victim and to ensure
that the safeguarding process does not negatively impact on his or her quality of life, family
relationships or right to self-determination. Personalisation is about designing systems of
support that work wellfor an individual and, where they wish it, their familyor circle of support.
It recognises the uniqueness of each person’s lifestyle and relationships(DH, 2010b).
In this wider context, a growing number of scholars and practitioners concerned with the
care of vulnerable adults have argued that the adversarial and confrontational approach that
characterises the criminal justice system may often not be the most suitable approach to
dealing with the problem. Rather, they have advocated the use of a ‘‘restorative justice’’
approach, which aims to restore social relationships, by involving the victim and other
members of the family or community as active participants in the safeguarding process
(Groh and Linden, 2011). M and FGC are two examples of holistic ‘‘family-led’’ decision-
making approaches that seek to empower families and wider networks to support each other
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