Led by Dr Adi Cooper, this interactive webinar draws on local authorities' experience of leading effective safeguarding with the new requirements of the Care Act. We will invite questions from attendees in advance of the webinar, discuss common issues and queries with the input of colleagues from practice, and share information about what is working effectively in this area. We anticipate a focus on implementing a 'Making Safeguarding Personal' approach into practice. Aimed at: Practitioners and managers involved in safeguarding adults

1. 1
Safeguarding in light of the
Care Act:
Knowledge exchange webinar
Dr Adi Cooper and Dr Lindsey Pike
4th November 2015

2. Webinar objectives
After the webinar, attendees will be able to:
› Detail the findings of the Making Safeguarding
Personal evaluation 2015
› Know where to find examples of innovative
practice in safeguarding
› Discuss and share ideas about effectively using
the approaches contained in the MSP toolkit
› Consider staff learning needs related to key
aspects of using a Making Safeguarding Personal
approach
› Outline key considerations in making sure that
their local authority is using a truly person centred
and outcomes-focussed approach in safeguarding
2

3. Safeguarding in light of the Care Act
3

4. What does good look like for an
adult at risk?
› Continuity of relationships with
professionals
› Being heard and involved
› Personalised safeguarding
› Ongoing assessment of need, risk,
capacity
› Use of chronology and understanding the
person
› Timely intervention and review
› Partnership working
› Professionals showing concerned curiosity
4

5. Making Safeguarding
Personal
Making Safeguarding Personal means
safeguarding:
› Is person-led
› Is outcome-focused
› Enhances involvement, choice and
control
› Improves quality of life, wellbeing and
safety
(Care Act Guidance) Download from
lga.org.uk
5

6. Safeguarding in the Care Act
guidance
› The adult should be involved at the beginning
of the enquiry, and their views and wishes
ascertained (14.77, 14.78)
› The wishes of an adult who lacks mental
capacity ‘are of equal importance’ to
someone with mental capacity (14.80)
› Safeguarding plans involve joint discussion,
decision making and planning with the adult
for their future safety and wellbeing’ (14.90)
› Safeguarding Adult Boards should ‘gain
effectiveness of the assurance of its
arrangements’ (14.110) and seek feedback
from adults who have been involved in an
enquiry (14.116)
6

7. Ensuring the person is at the centre
› Put the adult and their wishes and experiences at the centre
› Seek to enable people to resolve, recover and realise
› Key Questions for whoever is undertaking the safeguarding
enquiry
What does the person want
to happen?
How can we work with
people to enable that to
happen?
How do we know their
outcomes have been
understood and our
intervention has made a
difference?
Does the person feel
safer and protected, at
the start and throughout
the process?
7

8. MSP evaluation 2014/15
This evaluation aimed to find out the impact of the
approach on
The experience and outcomes of
people who use services and their
carers and families
The culture and practice of
safeguarding
Factors that have helped and
hindered using the approach
8

9. What did we do?
› RiPfA commissioned to
conduct evaluation
› 95 local authorities in
England took part
› Mixed methods approach
› Survey of MSP
leads: 95/ 151
respondents (63%)
› Survey of
multiagency staff:
63 respondents
(44%)
› 6 telephone focus
groups of MSP leads
(16 participants
total)
› 5 telephone
interviews with
senior leaders in
safeguarding 9

10. What did we find?
› 95% of respondents thought MSP was the right
approach to be taking in the current context
› Many respondents early in MSP journey
› The types of work that councils had undertaken
included:
− Partnership and project work
− Developing approaches to safeguarding
(such as family group conferencing)
− Staff development & awareness raising
− Changing systems
− Using feedback and evaluation
10

11. Is MSP providing good outcomes for
people?
› People with more direct experience of MSP were more likely to
think the impact on people was beneficial
› Methods used to understand people’s experience of
safeguarding included:
Case audit; questionnaire; not started; recording systems; interviews
(51%) (42%) (33%) (22%) (21%)
11

12. Some examples:
‘We did a small service user survey, we sent
surveys to about 50 people and got 14
back… It does seem that people are saying
that they understand what’s happening. So
for service users, it’s that they know
something is happening, they know people
will tell them what’s happening, they can
get involved if they choose. Some don’t
want to get involved but the difference is
they’ve had the choice.’ (FG1)
12

13. What kind of outcomes are
discussed?
To be and feel safer (45%)
To maintain key relationships (23%)
To gain or maintain control over the
situation’ / ‘to know that this won’t
happen to anyone else’ / ‘people have
not yet specified outcomes’ (21%)
13

14. Recommendations for providing
good outcomes to people
› Work to individuals’ stated outcomes
› Agree ‘desired’ and ‘negotiated’ outcomes
› Prepare people for meetings
› Build capacity for providing advocates
› Gather feedback as the enquiry is progressing
14

15. Reflective questions:
› Do you/ does safeguarding practice in
your local authority:
− Work to individuals’ stated outcomes?
− Agree ‘desired’ and ‘negotiated’ outcomes?
− Invite people to meeting (service users,
carers, advocates)?
− Spend time preparing people for meetings?
− Use advocacy where needed?
− Gather feedback as the enquiry is
progressing?
− Check whether outcomes are being met or
not?
15

16. Improving practice locally
› 42% of MSP lead survey respondents and 33% of all staff
survey respondents thought using MSP was improving
staff morale
› MSP was seen to improve practice in areas including
− Confidence in involving people in safeguarding
− Implementation of the Mental Capacity Act
− Implementing an outcomes approach
− Having honest discussions
− Managing risk
− Communicating the approach to multi-agency partners
− Enabling people to weigh up risks and benefits of different options
16

17. Key areas of learning and
development to focus on
› Mental Capacity Act
› Social work methods and
approaches
› Supporting and managing risk
› Safeguarding and the law
› Recording outcomes
› Using legal approaches
› Person-centred planning
› Having honest discussions
› Identifying and working with
controlling and coercive behaviours
Professional
judgement
Reflective
practice
17

18. Time and resource?
‘But I don’t know if
anyone’s mapped out
whether all the taking
longer will be offset by
all the less you’ll have
to do because some
won’t last as long as
they used to do.’FG5
Statement % of MSP lead
respondents
% of all staff
respondents
Overall, using an MSP approach is more time
consuming and resource intensive than our
previous approach 25 % 30 %
Overall, there is no difference in time taken or
resource used between the MSP approach and
previous approaches to safeguarding 6 % 41 %
Overall, using an MSP approach is less time
consuming and resource intensive than our
previous approach 3 % 10 %
Don't know 4 % 3 %
Too soon to say 61 % 16 %
Total 100 % 100 %
18

19. Time and resource?
‘You know from the
offset what you want to
achieve, and at the end
it doesn’t seem to drift
on indefinitely.’ (FG5)
‘The business system…
certainly doesn’t support
the idea of being able to
go and see the person
early on in the process-
just because of
volume.’(FG5).
‘It’s more time-consuming…
you’re asking more questions,
you’re using advocates,
[completing more] mental
capacity assessments …
although I …think a lot
practitioners are welcoming
it, it’s just that tension with
your case load, really.’ FG6
19

20. Recording and measuring outcomes
for individuals
› Recording has a long way to go
› People were most frequently using comment boxes on
electronic systems, case notes, and pre-coded outcomes
categories
› Available data on safeguarding outcomes is very patchy
‘Quite a few people have said
‘you commissioned this
service, you sort it out, I’m
not coming in to a meeting!’
and that’s absolutely right
and fair and we did.’ (FG1)
20

21. Recording system wish list
Survey respondents wanted:
 An updated system that could ‘prompt and record involvement
and outcomes’
 A wider range of personalised responses available to use
 A range of ‘pre-coded categories’ of outcomes
 More detail about outcomes (a narrative) rather than just
summaries
 A method of aggregating outcomes ‘so we can deliver some
data as well as case stories’
 Improved scope to record mental capacity assessments
 Dedicated MSP fields
 Integrated systems with health 21

22. Recommendations for practice:
› Councils in the early stages should focus on effective use
of the MCA, developing an outcomes focus, and providing
personalised information and advice
› Learn through sharing and celebrating good practice
(within and between councils)
› Support a range of methods for staff learning and
development and use existing resources (e.g. Knowledge
Hub)
› Practice guidance is needed (i.e. on timescales, risk
enablement, recording outcomes)
› Evaluate practice changes
22

23. Reflective questions:
› How consistently is the Mental
Capacity Act used in your authority?
› How do you provide personalised
information and advice to people
accessing safeguarding?
› What additional practice guidance do
you need to undertake MSP?
› What are your learning needs around
MSP?
23

24. MSP and multi-agency partners
Most involved in MSP:
› Adult Social Care (53%) (a
‘social services thing’?)
› Advocacy (15%)
› Mental health Trusts
(13%)
› Care providers (12%)
Least involved in MSP:
› Ambulance Trusts (20%)
› Other council departments
(17%)
› Housing providers (16%)
48% of all staff survey respondents felt their confidence in
talking about MSP to multiagency colleagues had increased
24

25. MSP and providers
Shift away from
‘complaints’ /
‘judgemental’
approach
Focus on ‘quality
assurance’ and
preventative safeguarding
More productive
relationship
25

26. How have you brought providers and
multiagency partners on board with
MSP?
› How do partners react to a more
person-centred and outcome
focused approach to safeguarding?
› How have you worked with
providers in a different way?
› What support do you need to take
this forward?
26

27. MSP and the culture of
safeguarding
› Survey respondents felt MSP led to safeguarding
being less process focussed and more person-
centred.
› Still needs to ‘filter out’ and ‘embed’
› ‘Seeing the bigger picture’
› Leadership is critical
› Care Act as a driver
‘Before, we tried to fit MSP into
the process and now we
ensure that the process does
not encroach on MSP.’
‘I think culturally it’s a long
journey – people are up for
change, most people
saying we want to do this,
this is what we come in to
do this work for, it reflects
our professionalism and
values that we want to do
for public service.’FG5
27

28. MSP – what we do anyway…?
‘… Lots of people think ‘it’s what we do anyway and this
shouldn’t be too much of a problem for us’. Certainly our
neighbours had found that people said that at the beginning,
and then when they went back to talk to them … they found
how difficult in detail it is to engage people in terms of
discussing realistic outcomes, so we’re sort of anticipating
that.’ (FG5)
28

29. Recommendations for working together
and promoting culture change:
› Ensure partner / multi-agency commitment to
MSP/culture change through Safeguarding Adults
Boards
› Consider how MSP could lead to a more productive
relationship with providers
› Use the Care Act to lever broader culture change
› Support leaders in MSP at all levels of the
organisation
29

30. What will help us implement MSP?
 ‘Permission’ to work differently
 Development of the right skills
 Revise policy, procedures and systems
 Sharing good practice
 Effective use of the Mental Capacity Act
 Emphasis on and confidence in professional judgement
 Support from SAB and involve partners
 Acknowledge challenging financial climate and work on
understanding longer term resource impact of MSP
30

31. ‘MSP is unquestionably right,
it’s right in principle and
that’s it.’
‘It has outed how very
variable from good to
extremely poor people’s
understanding of the Mental
Capacity Act is, and the
application of that in their
practice.’
‘It’s difficult to move away
from process – [we] need
process and timeframes to
measure, otherwise how do
you know you’re doing a
good job?’
31

32. Final questions and comments?
What next?
› How can we help people achieve
resolution and recovery from
safeguarding?
› What works best in different
situations?
› How can we prevent the need for
adult safeguarding enquiries, e.g.
improve quality of care provision to
prevent risks of neglect and
institutional abuse?
32

33. Further resources from RiPfA
33

34. Further reading
› LGA Making Safeguarding Personal materials:
http://www.local.gov.uk/web/guest/adult-
social-care/-
/journal_content/56/10180/6074789/ARTICLE
› LGA Care and Support reform adult
safeguarding page:
http://www.local.gov.uk/care-support-
reform/-
/journal_content/56/10180/6523063/ARTICLE
› Preston-Shoot, M., & Cooper, A., (2015) eds.
Special Issue on Making Safeguarding
Personal, Journal of Adult Protection, Vol.17,
No.3
34

35. Create an online account
› You can access all of
our learning resources
by creating an online
account at:
› www.ripfa.org.uk/memb
ership/create-an-online-
account
35

36. Contact
36
www.ripfa.org.uk
help@ripfa.org.uk
@ripfa