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New areas for adult safeguarding?

This presentation explores new areas in adult safeguarding, including modern slavery, older renters, internet abuse, pressure ulcers, coercion and control, gambling, and the successor to the Deprivation of Liberty Safeguards. Implications for practice are discussed, highlighting the need for recording, supervision, and local maps.

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New areas for adult safeguarding?

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  1. New areas for adult safeguarding? Jill Manthorpe Social Care Workforce Research Unit, King’s College London @jillmanthorpe @scwru

  2. Adults at risk who have care and support needs and are unable to protect themselves (Care Act 2014) Local Authorities (LAs) and partners are responsible for safeguarding or protecting adults at risk from neglect and abuse Lots of reasons why people need care and supportLots of ways in which other people might mistreat or neglect themLots of debate about what is safeguarding and what is the ‘problem’This presentation covers ideas about ‘safeguarding’ and new(ish) areasand their implications for practice

  3. Seven ‘new’ areas? • Modern slavery • Older renters • Internet • Pressure ulcers • Coercion & control • Gambling • DoLS successor

  4. In the beginning (nearly) • Granny battering • Family violence • Carer stress

  5. And institutional scandals • Poor care • Care for the poor • Systems and/or bad apples

  6. Modern slavery • Under ‘umbrella’ of safeguarding • Can also include human trafficking or human smuggling • Prevention – supply chains; response chains • Illegal exploitation or trapped into servitude • Some people may be adults with care & support needs

  7. Implications for practice • Domestic servitude – in care situations • Forced labour and coercion of people with disabilities • Forced marriage concerns when appearing lack of consent • Need to know local systems & protocols & keep eyes open; raise concerns

  8. Internet • Scams, fraud etc – part of financial abuse • Challenge to ‘abuse within a relationship of trust’ • Was encouragement of IT accompanied by cautions? • What have we learned from this? • Social exclusion of IT non-users

  9. Implications for practice • Remembering indicators of financial abuse eg debt, hardship • False friends and grooming • Relationships with trading standards • Power of peer advice

  10. Private renting • Vulnerability & precariousness of some older renters • Links to coercion • Invisible pressures • Fear • Confidence & capacity of ‘helping professionals’ • Potential to confuse with self-neglect • NB cuckooing https://www.ageuk.org.uk/brandpartnerglobal/londonvpp/documents/opstp/living%20in%20fear%20-%20experiences%20of%20older%20private%20renters%20in%20london.pdf

  11. Implications for practice • Recording of housing status (& conditions) • Linkages to housing and environmental health • Making Safeguarding Personal approaches • Power of Access to people with apparent capacity when refused by third party – negotiation and creativity (Helping and Hindering study)

  12. Pressure ulcers • Pre-Care Act 2014 – in many areas automatic referral to safeguarding • Many NFA – no further action • Now – only if cause for safeguarding concern • Seen as barometer for care quality • Also ‘measurable’ (grades) and photographable

  13. Implications for practice • Still barometer of care • Knowledge of prevention and treatments • Ask, see, record • Can be safeguarding concern – was it avoidable or not? • Liaison with health vital

  14. Coercion and control • Links with DV • Not just a ‘Helen’ issue • Long interest in Adult Safeguarding and Domestic Violence interface eg DV graduates, Punch & Judy, role reversal • Also interest in DV as part of behavioural symptoms

  15. Implications for practice • Is it safe to ask? • Ask • Frame the question and validate • Assess • Action and recording • Victim/perpetrator labels sometimes unhelpful

  16. Gambling • Among adults with care and support needs – risks of exploitation, lack of insight, etc • Gabling related harm from problem gambling of others eg theft • Public health issue • Gabling Act 2005 requires industry to protect ‘vulnerable people’ • Much gambling online

  17. Deprivation of Liberty Safeguards (DoLS) 2009 • The people the law forgot… • Did the ‘S’ for safeguarding get lost? • Strong criticisms but some charm? • Squeezing of safeguarding resource? • Light shone on some self-funders not known to local services

  18. Implications for practice • Holding our breath • Risk of focusing on DoLS rather than whole of Mental Capacity Act 2005 • MCA – continued chorus of concern about lack of recording and thinking through • Be or find the local DoLS and successor expert !

  19. Concluding points • Safeguarding – elastic • How do multiple sectors respond to this ever-inclusive debate? • Should safeguarding focus on core business? • Keep eye on children’s safeguarding • Need for recording; supervision discussion and local maps

  20. Help needed • James Lind Alliance Priority Setting Partnership – Research on Adult Social Work • What are the unanswered questions? (excluding training) • Please complete – social workers, other professionals, users/carers

  21. Thanks for listening! (& thanks to studies’ participants and funders – the usual disclaimers apply) jill.manthorpe@kcl.ac.uk

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