1. Making Safeguarding Personal

1.1 Introduction

Making Safeguarding Personal (MSP) is about professionals talking with adults and their carers about how they may all respond in safeguarding situations in a way that enhances the adult’s involvement, choice and control as well as improving their quality of life, wellbeing and safety. It means professionals seeing adults as experts in their own lives and work with them in order to enable them to reach the best possible resolution of their circumstances. It is also about collecting data to find out whether this change in approach has a positive impact on people’s lives.

‘MSP seeks to achieve:

  • a personalised approach that enables safeguarding to be done with, not to, people;
  • practice that focuses on achieving meaningful improvement to people’s circumstances rather than just on ‘investigation’ and ‘conclusion’;
  • an approach that utilises social work skills rather than just ‘putting people through a process’;
  • an approach that enables practitioners, families, teams and SABs to know what difference has been made.’ (LGA)

MSP is led by the Local Government Association (LGA) Safeguarding Adults Programme and by Association of Directors of Adult Social Services (ADASS). This work aims to shift emphasis from processes to a commitment to improving outcomes for people at risk of harm.

The Care and Support Statutory Guidance also states:

‘…it is also important that all safeguarding partners take a broad community approach to establishing safeguarding arrangements. It is vital that all organisations recognise that adult safeguarding arrangements are there to protect individuals. We all have different preferences, histories, circumstances and life-styles, so it is unhelpful to prescribe a process that must be followed whenever a concern is raised …. Making safeguarding personal means it should be person-led and outcome-focused. It engages the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety. Nevertheless, there are key issues that local authorities and their partners should consider. See diagrams 1A and 1B after para. 14.92 if they suspect or are made aware of abuse or neglect. See paragraph 14.231 for more detail about what such guidelines should cover’ (para 14.14-14.15)

1.2 Key areas

MSP can essentially be divided into a number of key areas:

  • effectiveness: it is a shift in culture and practice in response to what makes safeguarding more or less effective from the perspective of the person being safeguarded.
  • person led and outcome focused: it means the safeguarding process should be person-led and outcome- focused. It should engage the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety.
  • improving outcomes: it aims to facilitate a shift in emphasis in safeguarding from undertaking a process to a commitment to improving outcomes alongside people experiencing abuse or neglect. The key focus is on developing a real understanding of what people wish to achieve, agreeing, negotiating and recording their desired outcomes, working out with them (and their representatives or advocates if they lack capacity) how best those outcomes might be realised and then seeing, at the end, the extent to which desired outcomes have been realised. This approach involves adults being encouraged to define their own meaningful improvements to change their circumstances and then to be involved throughout the safeguarding investigation, support planning and response.
  • person centred: it also aims to encourage practice that puts the person more in control and generates a more person centred set of responses and outcomes. Having a person centred approach involves:
    • shifting from a process supported by conversations to a series of conversations supported by a process
    • collecting information about the extent to which this shift has a positive impact on people’s lives;
    • seeing people as experts in their own lives and working alongside them.

In this way the outcomes focus is integral to practice and the recording of practice in turn generates information about outcomes. This information needs to be capable of being aggregated for Safeguarding Adults Boards.

This work is ongoing; evaluation reports from previous years’ MSP work nationally are available via Local Government Association: Making Safeguarding Personal. 

1.3 Safeguarding outcomes

A high quality service must be one which keeps people safe from harm. In setting out safeguarding as one of the domains in the Adult Social Care Outcomes Framework (ASCOF), reflects this priority, and emphasises the need for services to safeguard adults whose circumstances make them vulnerable and protect them from avoidable harm. Findings from this work highlight that adults very much appreciated being asked about their experiences.

As a bench marking tool used by the sector to drive up standards, the ASCOF is a key part of the Care Act’s implementation and evaluation; demonstrating how the Act has impacted on key outcomes for people using services and their carers.

Linking into the implementation of the Care Act and other sector led priorities for safeguarding adults, many local authorities are now exploring how to mainstream the MSP approach to safeguarding practice and policy.

During the period 2015-17, ADASS commissioned an assessment to gauge the progress of MSP in local areas, as well as to support people to embed it within their local authority, their SAB and their partners. See the Making Safeguarding Personal Temperature Check 2016. The results showed a positive picture of dedication and innovation, with progress being made on the previous two year period. Most of those interviewed had embedded MSP into mainstream services and were achieving better outcomes for people needing care and support who had experienced abuse or neglect. Some local areas had not made such progress however, and there had been less interest in MSP from partner agencies such as the police and NHS.

2. Dignity, Compassion and Respect

2.1 Introduction

Staff across all organisations must treat adults with care and support needs, and their carers, friends and family with dignity, compassion and respect at all times and in all circumstance.

Staff must adopt a culture of care that respects the privacy, dignity, culture and individuality of all patients under its care and staff (see also Equality, Diversity and Human Rights).

2.2 Principles

All staff must:

  • recognise the diversity, values and human rights of adults
  • uphold and maintain their privacy, dignity and independence;
  • provide care, support and treatment in a way that ensures their dignity, and treats them with compassion and respect at all times;
  • ensure that they have privacy when they want it, treating them as equals;
  • provide any support they might need to be autonomous, independent and involved in their community;
  • help adults maintain relationships that are important to them
  • put adults at the centre of their care and support by enabling them to make decisions (see Section 1, Making Safeguarding Personal);
  • all communication with adults and their families must be respectful and compassionate. This includes using or facilitating the most suitable means of communication and respecting their right to engage or not to engage in communication;
  • provide information that supports them in the safeguarding process, or others acting on their behalf, to make decisions;
  • support adults, or others acting on their behalf, to understand the care and support provided, including risk and benefits and their rights to make decisions;
  • staff must make sure that they provide appropriate care and support that meets people’s needs, but this does not mean that care and support should be given if it would be against the consent of the person (see Consent in Safeguarding Enquiries and Mental Capacity);
  • address them in the way they prefer, including their favoured name;
  • have regard for the protected characteristics as defined in the Equality Act 2010, that is: age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex; sexual orientation (see also Equality, Diversity and Human Rights).

2.3 Personalised care and support through involvement

Adults should be involved in and receive care and support that respects their right to make or influence decisions. Staff should:

  • explain and discuss their care and support options with them in a way that makes sense to them;
  • respect their right to take informed risks, while balancing the need for preference and choice with safety and effectiveness (see Managing Risk);
  • ensure that things that are important to the adult in relation to their care and support are established as part of their assessment, development and review of their plans;
  • promote and respect their autonomy, privacy, dignity, compassion, independence and human rights at all times by:
    • placing their needs, wishes, preferences and decisions at the centre of assessment, planning and delivery of care and support;
      • respect their personal preferences, lifestyle and care choices;
      • when providing intimate or personal care, the organisation must make every reasonable effort to make sure that they respect the preferences of individuals in relation to who delivers their care and treatment, such as requesting staff of a specified gender;
    • have clear procedures followed in practice, monitored and reviewed that ensure staff understand the concepts of privacy, dignity, independence and human rights and how they should be applied;
    • ensuring that the need to maintain confidentiality or disclose information is taken account in the assessment of the individual circumstances (see Information Sharing);
    • actively listening to and involving adults, or others acting on their behalf, in decision making and ensuring there are clear records that evidence the decisions made and methods in which the decision was achieved;
    • provide information to help them, or others acting on their behalf, to understand their care and support, including the risks and benefits, and their rights to make decisions;
    • make adults aware of independent advocacy services wherever they are available, and cooperate with independent advocacy services (see Independent Advocacy);
    • know how to raise a concern or complaint about the organisation, and how it will be dealt with (see Whistleblowing).

1.4 Managing risk through effective procedures about involvement

Procedures must ensure that:

  • care and support options, and the risks and benefits of those options, are explained to the adult / their representative;
  • choices and preference of the adult are expressed by them or others acting on their behalf;
  • the choices of adults are respected and accommodated unless:
    • the choice places other people at risk of harm or injury;
    • it would not be reasonable to expect the service to have the resources needed to achieve the choice;
    • if to meet choice is not within the stated aims, objectives and purpose of the service provided;
    • the adult does not have capacity to make that decision or is subject to a legal restriction that prohibits them making a choice (see Mental Capacity and Consent in Safeguarding Enquiries);
  • individualised assessments and plans of care and support are based on the adult’s needs, choices and preferences;
  • any reasonable adjustments are made so that the adult is enabled to be involved in decision making.