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

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 support Lots of ways in which other people might mistreat or neglect them Lots of debate about what is safeguarding and what is the ‘problem’ This presentation covers ideas about ‘safeguarding’ and new(ish) areas and their implications for practice

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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 !

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

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

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