1.4 Making Safeguarding Personal

 1. Making Safeguarding Personal

1.1 Introduction

Making Safeguarding Personal (MSP) is a person-centred and outcome focused approach to safeguarding adults. It emphasises that the adult concerned must always be at the centre of adult safeguarding, and that their wishes and views should be sought at the earliest opportunity. MSP requires professionals to see adults as experts in their own lives and to work with them in order to identify strengths-based and outcomes focused solutions. Professionals must work in a way that enhances individual involvement, choice and control as part of improving quality of life, wellbeing and safety.

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 (outcomes) rather than just the process of ‘investigation’ and reaching a ‘conclusion’;
• an approach that utilises social work skills rather than just ‘putting people through a process’, with the ultimate aim of improving outcomes for people at risk of, or experiencing, abuse or neglect.

MSP is led by the Local Government Association (LGA) Safeguarding Adults Programme and by Association of Directors of Adult Social Services (ADASS).

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 for effective practice

MSP can essentially be divided into the following key areas:

• person led and person centred: being safe and well means different things to different people, this means the safeguarding process should be person-led and recognise people as the experts in their own lives. 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. Professionals should be interested and look for the full picture of a person’s experience.
• focused on outcomes, not process: safeguarding is not about undertaking a process but is a commitment to improve outcomes by working 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.

3. Safeguarding Outcomes

A high quality service must be one which keeps people safe from harm. 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 have highlighted the clear benefits of asking adults about their experiences of care and support services.

4. Dignity, Compassion and Respect

4.1 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).

4.2 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 chatpers);
• 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).

4.3 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).

4.4 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.

Risks should be managed in a positive way.