Making safeguarding about improving people’s lives not processing cases

How do we make sure that peopel using safeguarding adults services feel in control and achieve the outcomes that they want? How do we measure whether outcomes have been met? How do we find out about people’s experience of the service and use this information to make it better?

The recent report from Making Safeguarding Personal project presents the findings of a one-year programme that addresses these questions among others. It was commissioned by the Local Government Association, Association of Directors of Adult Social Services and Social Care Institute for Excellence.

Two of the test bed sites that took part in the programme, London Borough of Hackney and London Borough of Hounslow, looked at the outcomes for and experiences of people using safeguarding adults services.

Hackney used discovery interviews, which allow people to tell their stories, to find out people’s experience of using safeguarding services. Hounslow took two approaches: they asked people what outcomes they wanted to achieve and then audited whether or not these outcomes had been met; and they got feedback on the person’s experience of using the safeguarding adult service.

In addition to these two test bed sites a number of other councils were invited to share their experience of using the feedback of people who use safeguarding adults services. All of the councils who asked people about their experience of safeguarding adults services felt that it was worthwhile and led to service improvement.

Hounslow found that it was easier to audit whether outcomes had been met by building this into the existing safeguarding process at the beginning and then auditing whether outcomes had been realised, than to get people’s views about the service as an additional activity at the end. They asked people what outcomes they wanted to achieve at the beginning, middle and end of the safeguarding process. The templates social workers used were adapted to include this question.

An audit was carried out on 10% of cases. The majority felt that their outcomes had been met; when they were not it was largely because they felt there had been no retribution for the perpetrator. Discussing the outcomes helped the person to think about what they wanted; very often this changed throughout the process. When the outcomes that they wanted were not realistic, then this was discussed and expectation managed. As social workers became more experienced in discussing outcomes with people, they found that their practice changed to become more person-centred.

All of the councils that asked people about their experience of safeguarding adults services were challenged by the selection of people to take part. Most councils excluded people who lacked capacity to consent, apart from Kingston, which used a different questionnaire from Hounslow.

Hounslow prepared people for receiving the questionnaire. They offered to visit for a face-to-face interview when an advocate or family member was not available to support the person in responding to the questionnaire. Care was taken by both Hackney and Hounslow not to ask people to participate who might be distressed or further traumatised by the interview.

Key learning points

• Ask people about the outcomes that they want to achieve at the beginning, middle and end of the safeguarding process and record them;
  
• The outcomes that people want change and it is important to discuss this with them so that the social worker understands what they want;
  
• Audit whether or not outcomes have been met or ask the person at their last meeting and record this;
  
• Interviews and/or questionnaires can be useful in finding out people’s experience of the service;
  
• Consider who will be interviewed and the support that they might need;
  
• Interview in a place where they feel comfortable;
  
• Use the findings from interviews/questionnaires to improve the service.

The Health and Social Care Information Centre is piloting an indicator on whether a person feels safer following adult safeguarding interventions. This is helpful, but does not assess whether their quality of life improves or whether the intervention has made a positive difference to them.

Further work needs to be done to measure whether the person’s outcomes have been met. Asking a person what they want to achieve, recording this and checking whether it was achieved, is an important first step, which is relatively easy to implement. It can also change practice to a more personalised outcome-focused approach.

 Deborah Klée is an independent consultant and chair of Westminster’s and Barking and Dagenham’s safeguarding adults boards. She was project manager of the Making Safeguarding Personal project.

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