Everyone wants to get safeguarding right. It’s vital to an organisation’s reputation, of course, but much more importantly it gets to the heart of providing the good care and support that every service wants to offer.
At SCIE, we engage with a huge range of health and social care providers on the topic of safeguarding, and we’ve collected some of the learning from the conversations we’ve been having in a new Highlights report.
A Number of Recurrent Themes Have Emerged
One is that there is a problematic inconsistency in the way local authorities carry out section 42 enquiries, with ostensibly similar cases being treated as safeguarding in some areas, but not in others. This can leave support organisations in a tricky position – if one local authority treats medication errors as a safeguarding issue, but a neighbouring one doesn’t, it can be difficult to develop consistent policies and procedures across an organisation that operates in more than one area. And just as local authorities can take a variable approach to safeguarding, SCIE has heard too of different CQC inspectors reaching different judgements as to what falls on either side of the blurred line between safeguarding and poor care.
Some providers meanwhile welcome the trust that is implied when a local authority asks them to conduct their own section 42 enquiry – something that is encouraged by the Care Act. But others have expressed concern to SCIE that resource pressures in councils mean providers are being asked to conduct their own enquiries even where there is a potential conflict of interest. Financial challenges have thrown up other concerns too, such as a lack of readily available advocates in safeguarding situations.
Another big theme is the use and misuse of the Mental Capacity Act (MCA). Getting the balance right between respecting autonomy and managing risk is an age-old social care challenge, and it isn’t going away. Providers have told us that when they do support appropriate risk-taking, they often face resistance from families or from commissioners, but we have also seen providers who have internalised a risk-averse approach.
So What Can Providers Do?
Having clear policies – developed with Safeguarding Adults Boards, but also with service users and families – is a great starting point. Training staff well, in safeguarding and the MCA, is vital too. Building links with local CQC inspectors and safeguarding teams means that safeguarding’s many grey areas can be debated constructively. And above all, providing respectful, individualised care, that recognises the value and humanity of each and every person being supported, can help prevent abusive situations occurring. That’s what getting safeguarding right looks like most of all.
