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Risks, rights, values and ethics: frontline briefing
- Author:
- GUTHRIE Lydia
- Publisher:
- Research in Practice for Adults
- Publication year:
- 2018
- Pagination:
- 20
- Place of publication:
- Dartington
When working with people who may be taking risks, it is imperative to understand how to balance their human rights, while enabling them to be safe and to live a full life. Building on work around risk enablement, this Frontline Briefing looks at what practitioners can bring in terms of their own perspective, balancing risks and rights, and recognising the role that our own values and ethics may play in practice. (Edited publisher abstract)
Deprivation of liberty applications concerning people with learning disabilities in England: trends over time and geographical variation
- Author:
- HATTON Chris
- Journal article citation:
- Tizard Learning Disability Review, 22(3), 2017, pp.177-183.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to analyse trends over time and geographical variation in Deprivation of Liberty Safeguards (DoLS) applications for adults with learning disabilities. Design/methodology/approach: Secondary analysis of national- and local authority-level statistics collected and reported by NHS Digital. Findings: There has been a sharp national increase in the number of completed and granted DoLS applications regarding adults with learning disabilities since the 2014 “Cheshire West” Supreme Court judgement, with a greater proportion of completed DoLS applications being granted. There is extreme geographical variation across local authorities in England in the rates at which DoLS applications are being made and granted. Practical implications: The extreme variation in DoLS applications regarding adults with learning disabilities is highly unlikely to be a function of differences in mental capacity and living circumstances experienced by adults with learning disabilities across local authorities, and urgent attention needs to be paid to this variation. Originality/value: This is the first paper to analyse the geographical variation at local authority level for completed and granted DoLS applications regarding adults with learning disabilities. (Publisher abstract)
Advocacy services for adults with health and social care needs [NG227]
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2022
- Pagination:
- 82
- Place of publication:
- London
This guideline covers advocacy for people using health and social care services in all adult settings (including young people under 18 using adult services). It describes how to commission and deliver effective advocacy, as well as identifying who should be offered advocacy (including who is legally entitled to it). It also covers monitoring and improving advocacy services, and training and skills for advocates and practitioners. Advocacy helps to ensure that people's voices, wishes and preferences are heard, their rights are upheld and their needs are met, particularly when they have difficulty in speaking up for themselves or are concerned that they are not being heard. This guideline covers advocacy delivered by a trained person whose sole engagement is to support the person and help ensure that their voice, needs and preferences are heard (referred to in law as 'independent advocacy'). Family members and friends play a vital role in the lives of people who draw on support, for example ensuring that the person's voice and concerns are heard. However, the focus of this guidance is on a trained person whose sole involvement is as an advocate. This guideline includes recommendations on the legal right to advocacy and others who may benefit from it; information about advocacy and improving access to it; effective advocacy and enabling effective advocacy; partnership working and relationships; planning and commissioning services; training and skills for advocates and for practitioners who work with them; monitoring for quality improvement. (Edited publisher abstract)
Protecting human rights in care settings: fourth report of session 2022-23
- Author:
- GREAT BRITAIN. Parliament. Joint Committee on Human Rights
- Publisher:
- Great Britain. Parliament
- Publication year:
- 2022
- Pagination:
- 47
- Place of publication:
- London
This inquiry has sought to consider what human rights issues need to be addressed in care settings, beyond the immediate concerns arising from the Covid-19 pandemic; how effective providers are at respecting the human rights of people under their care; how effective regulators are in protecting residents from human rights breaches and in supporting patients and residents who make complaints about their care provider; and what lessons need to be learned from the pandemic to prevent breaches of human rights legislation in the future. The inquiry heard that during the pandemic Do Not Attempt Cardio-Pulmonary Resuscitation Notices (DNACPR) were being applied to care users without their knowledge, in a blanket fashion, contrary to the right to life under Article 2 ECHR. There are also concerns about ongoing issues with Deprivation of Liberty Safeguards (DoLS), the check that is put in place to ensure that detention in care settings is within the law and in line with the prohibition of torture and inhuman or degrading treatment under Article 3 ECHR, and the right to liberty and security, under Article 5 ECHR. In addition, evidence submitted to this inquiry showed that through and beyond the pandemic problems relating to visiting arrangements for those in care settings persisted with providers following guidance. Finally, the report recommends changes to streamline the complaints process, with the roles of the CQC, the Local Government and Social Care Ombudsman (LGSCO), and the Parliamentary and Health Service Ombudsman (PHSO) clarified and with all three organisations operating a "no wrong door policy". (Edited publisher abstract)
Social care responses to self-neglect among older people: an evidence review of what works in practice
- Authors:
- MARTINEAU Stephen, et al
- Publisher:
- NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London
- Publication year:
- 2021
- Pagination:
- 48
- Place of publication:
- London
A review of the English-language research literature (published 2015-20), which focuses on adult social care responses to self-neglect among older people. The report also examines the law and policy context in England provided by the Care Act 2014 and the Mental Capacity Act 2005. The literature generally presents the building of good relationships between practitioners and people who self-neglect as the primary ‘intervention’. This is likely to involve a sustained engagement on the part of practitioners in order to build rapport and trust. The literature suggests that more concrete interventions work better if they take place against the backdrop of these trusting relationships. There is a potential interplay between negotiated and imposed interventions. These might involve, for example, making the person’s environment safe, or supporting the person managing their bills, through to statutory enforced action. It is also common for the literature under review to place a high value on multi-agency working because of the complexity self-neglect often involves. Researchers highlight the wide array of agencies that may be engaged and warn of the barriers to good practice, such as lack of joined-up systems (silo working), an ignorance of others’ roles, and the lack of a shared language around self-neglect. A recurring theme in the literature is the difficulty practitioners face in cases where the person has mental capacity with respect to the relevant decisions but is reluctant to alter behaviour that appears to be placing them at risk of harm. The value placed on the autonomy of the individual in these circumstances may be viewed in the light of recent debates on the nature of autonomy and the degree to which the concept should be approached in relational rather than narrowly individualistic terms. (Edited publisher abstract)
Adult social care: Covid-19: winter plan 2020-2021 newsletter
- Authors:
- DAVIES Sian, BROACH Steve, ALLEN Neil
- Publisher:
- 39 Essex Chambers
- Publication year:
- 2020
- Pagination:
- 7
- Place of publication:
- London
This note provides an overview of the Department of Health and Social Care (non-statutory) guidance ‘Adult social care: our COVID-19 winter plan 2020 to 2021’. It discusses the key issues for local authorities, and in particular the interplay with the wellbeing principles of the Care Act 2014, including managing a potential conflict in terms of the wellbeing of both care home residents and those in the community with care and support needs as regards prevention of C-19. It also looks at the implications of the winter plan for the right to respect for family and private life, addressing the tension between the imperative to protect the health of social care users (and the social care workforce) and the need to respect the family life and private life rights of those who might be subject to protective restrictions. Finally, it explores the impact of the winter plan on deprivation of liberty safeguards, in particular in relation to testing and 14-day isolation requirements. (Edited publisher abstract)
Relationships and sexuality in adult social care services: guidance for CQC inspection staff and registered adult social care providers
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2019
- Pagination:
- 13
- Place of publication:
- Newcastle upon Tyne
This guidance provides advice for Care Quality Commission (CQC) inspection staff and registered providers on sexuality and relationships. It focuses on caring for people who need support to express their sexuality and to have their needs met. It highlights that providers need to understand the importance of enabling people to manage their sexuality needs. This includes making sure people have access to education and information to help them develop and maintain relationships and express their sexuality; understanding the risks associated with people’s sexual needs; and assessing capacity to consent to sexual relations. A list of resources and evidence for inspectors to include against Key Lines of Enquiry (KLOE) are included as appendices. (Edited publisher abstract)
Best interests assessor role: an opportunity or a ‘dead end’ for adult social workers?
- Author:
- HUBBARD Rachel
- Journal article citation:
- Practice: Social Work in Action, 30(2), 2018, pp.83-99.
- Publisher:
- Taylor and Francis
This opinion article explores the significance of the Best Interests Assessor (BIA) role in England and Wales for social workers working with adults. It considers the challenges of the role following the Supreme Court’s Cheshire West (2014) judgement and the implications for BIAs of the Law Commission’s 2017 plans for replacing Deprivation of Liberty Safeguards (DoLS) with the ‘Liberty Protection Safeguards’. The author explains why they consider the BIA role to be a valuable one for the status of adult social work as well as for people who may lack capacity to uphold their human rights, with some reservations about the risk of diluting the safeguards the current role represents for those vulnerable people. (Edited publisher abstract)
An evaluation of adult safeguarding outcomes’ focused recording in the context of Making Safeguarding Personal
- Author:
- GOUGH Matthew
- Journal article citation:
- Journal of Adult Protection, 18(4), 2016, pp.240-248.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to evaluate the impact in one local authority of Making Safeguarding Personal (MSP) upon the recording of outcomes in safeguarding interventions. To determine to what extent person centred outcomes were in evidence. Design/methodology/approach: Analysis of data provided by the local authority across adult safeguarding teams informed by a critical theory approach. Findings: There is a need for cultural and system change to fully embed MSP principles within local authority safeguarding. This case study identified that practitioner recording was inconsistent with the need for greater recognition of person centred approaches within adult safeguarding. Views of the service user are constructed and moderated by the assessing professional and the user voice is seldom evident in recording of safeguarding interventions. Research/limitations/implications: This study was wholly reliant upon the data provided rather than primary investigations with practitioners and service users. The focus on recorded data permitted variance and recorded data were open to worker interpretation. MSP. The starting premise of the methodology by adopting a critical perspective sought to elevate the perspective of marginalised service user groups. This may have unduly framed the practitioner provider from a deficit position. Practical implications: The need to ensure MSP approaches are embedded fully in all aspects of local authority safeguarding. There is a need for recording to greater reflect principles of empowerment with the wishes of service users, their narratives and actual words providing greater weight to assessment. Social implications: The power shifts apparent in the principles supporting The Care Act needed to be embedded in safeguarding to support marginalised adults. Originality/value: MSP is a relatively new development for safeguarding adults and the evidence base is building. This paper focuses on the recorded outputs of safeguarding interventions which complements work already produced which has focused on system and strategic changes. (Publisher abstract)
Beginning to explore the experience of managing a direct payment for someone with dementia: the perspectives of suitable people and adult social care practitioners
- Authors:
- LAYBOURNE Anne H., et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 15(1), 2016, pp.125-140.
- Publisher:
- Sage
Following legal improvements made around mental capacity together with the Health and Social Care Act, it is now possible for a direct payment to be paid to a ‘Suitable Person’ to manage on someone’s behalf to purchase directly care and support services. People with dementia are a key group affected by this change in England of adult social care. The authors interviewed nine social care practitioners and seven Suitable People for people with dementia across five English local authorities to begin to examine their experiences of this new method of social care provision. Findings from thematic analyses suggest positive outcomes and multiple beneficiaries, but some challenges: potentially inappropriate processes, support planning, divergence in attitudes towards care and support outcomes. Implications for practice include obfuscation of recipients’ and Suitable People’s best interests and supporting practitioners to explore fully clients’ aspirations for care and support. (Edited publisher abstract)