Whilst safeguarding practice for adults at risk has improved significantly in recent years, concerns regarding plans have been identified in adult practice reviews in Wales and their equivalents in England.
“The Adult Protection Plan agreed by all agencies was not sufficiently robust to identify trigger points at which organisations should have met within a multidisciplinary team context. Similarly, there is no detail of individual organisations responsibilities. A detailed protection plan may have indicated the trigger points in this case”. (NWSB APR 3215)
“The reviewers did not see evidence that the action plan was being given strategic importance. The reviewers were unable to establish how it was been implemented and who was responsible for its implementation” (APR2/2016/Conwy)
Concerns identified include:
- adults at risk, who have been the subject to a plan, have felt a lack of control;
- lack of ownership, accountability and maintenance of safeguarding plans;
- poor co-ordination because no named individua assigned this task;
- practitioners lacking understanding as to what is expected of them;
- a lack of direction and focus led to drift with poor quality, if any, review;
- plans that are not robust, with contingency plans included if the abuse escalates and/or the plan is not delivering desired outcomes;
- failing to follow prescribed plans;
- an under and in some cases over-emphasis on personalisation. For example, in one adult review the risks posed to others were not addressed because the adult at risk rejected the interventions proposed by the agencies involved;
- failing to understand the adult at risk’s history, such as previous experiences of residential care, and relationships, such as complex family dynamics;
- giving up when the adult at risk appeared ‘challenging’;
- failing to identify the practitioner who best understands the adult at risk’s circumstances and ensures that context of risk is not lost in multi-agency discussions;
- mismatch between practitioners believing they had communicated with the family about risk and the family not feeling that was the case;
- a focus on outputs rather than outcomes with the intervention may be seen as an end in itself without due consideration of the impact or benefits associated with it.
With these findings in mind it is important that practitioners make sure that:
- It is clear at the earliest possible stage exactly what the process is seeking to achieve and monitors its progress against this.
- there is an understanding of the difference between the activity (output) associated with the process and the outcome itself.
- Serious attention is given to the outcomes desired by the adult at risk, or if they do not have the mental capacity to make this decision, what is in their best interests.
- Outcome measures and markers of progress are framed in terms of improvements expected by practitioners to the daily lived experience of the adult at risk that indicates they are safe from abuse and neglect.
- The rationale for the plan is understood by the adult at risk and their carers.
- The family understand fully the reason for the plan, what is expected of them, what should be achieved.
- An assessment of capacity to change of any carers involved in the plan is made and implications for the plan recognised.
- The adult at risk and their family’s strengths are recognised and utilised when developing the plan.
Do not:
- Use short-hand, for example ‘adult at risk to receive home care’. Rather:
- spell out what concerns have been identified
- how service provision or action should contribute to addressing the concern
- what the provision will look like
- how success will be measured in terms of demonstrably, improved outcomes to the daily lived experience.
- Ignore past history and engagement with services provided as this provides an indication of what may or may not work for the individual
- Become overly dependent on a particular service. Remember multifaceted problems require multi-faceted solutions.
For further information see:
Pachu D and Jackson C Analysis of Emerging Themes from Child Practice, Adult Practice and Domestic Homicide Reviews in Wales (1 April 2017 to 31 March 2018) Public Health Wales 2018
Learning from SARs A report for the London Safeguarding Adults Board S Braye and M Preston-Shoot 18th July 2017. (Accessed 21/7/2019)