On self-neglect and safeguarding adult reviews: diminishing returns or adding value?
| DOI | https://doi.org/10.1108/JAP-11-2016-0028 |
| Date | 10 April 2017 |
| Pages | 53-66 |
| Published date | 10 April 2017 |
| Author | Michael Preston-Shoot |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
On self-neglect and safeguarding
adult reviews: diminishing returns
or adding value?
Michael Preston-Shoot
Abstract
Purpose –The purpose of this paper is twofold: first, to update the core data set of self-neglect serious case
reviews (SCRs) and safeguarding adult reviews (SARs), and accompanying thematic analysis; second, to
respond to the critique in the Wood Report of SCRs commissioned by Local Safeguarding Children Boards
(LSCBs) by exploring the degree to which the reviews scrutinised here can transform and improve the quality
of adult safeguarding practice.
Design/methodology/approach –Further published reviews are added to the core data set from the
websites of Safeguarding Adults Boards (SABs) and from contacts with SAB independent chairs and
business managers. Thematic analysis is updated using the four domains employed previously. The findings
are then further used to respond to the critique in the Wood Report of SCRs commissioned by LSCBs, with
implications discussed for Safeguarding Adult Boards.
Findings –Thematic analysis within and recommendations from reviews have tended to focus on the micro
context, namely, what takes place between individual practitioners, their teams and adults who self-neglect.
This level of analysis enables an understanding of local geography. However, there are other wider systems
that impact on and influence this work. If review findings and recommendations are to fully answer the
question “why”, systemic analysis should appreciate the influence of national geography. Review findings and
recommendations may also be used to contest the critique of reviews, namely, that they fail to engage
practitioners, are insufficiently systemic and of variable quality, and generate repetitive findings from which
lessons are not learned.
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 against the strands in the critique of SCRs
enables conclusions to be reached about their potential to transform adult safeguarding policy and practice.
Practical implications –Answering the question “why”is a significant challenge for SARs. Different
approaches have been recommended, some rooted in systems theory. The critique of SCRs 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 conducting SARs by using the analysis of themes and recommendations
within this data set to evaluate the critique that reviews are insufficiently systemic, fail to engage those
involved in reviewed cases and in their repetitive conclusions demonstrate that lessons are not being learned.
Keywords Safeguarding, Learning, Systems, Wood Report, Reviews, Self-neglect
Paper type Research paper
Introduction
This paperhas two purposes.The first is to update thelearning availablefrom the growing evidence
base of safeguardingadult reviews (SARs)featuring self-neglect. Thisis prompted by the continuing
absence ofa nationaldatabase, which restricts dissemination of messagesfor practice and service
development. There are, however, emerging initiatives at regional level to create repositories.
Received 18 November 2016
Revised 31 January 2017
12 February 2017
Accepted 15 February 2017
Michael Preston-Shoot is a
Professor (Emeritus) Social
Work and Independent
Consultant at the Faculty of
Health and Social Sciences,
University of Bedfordshire,
Luton, UK.
DOI 10.1108/JAP-11-2016-0028 VOL. 19 NO. 2 2017, pp. 53-66, © Emerald Publishing Limited, ISSN 1466-8203
j
THE JOURNAL OF ADULT PROTECTION
j
PAG E 53
To continue reading
Request your trial