No Secrets review: whose business is safeguarding?

No Secrets brought about a major change in adult protection procedures when it was issued by the Department of Health and Home Office as a guidance document in March 2000.

It was successful because it brought together a large number of stakeholders – including the police, the NHS Confederation, Association of Directors of Social Services and key voluntary organisations – in defining a consensus around the protection of vulnerable adults. It laid down for the first time a framework for responding to the abuse of vulnerable adults in all settings.

Eight years on, much has been learned from the experience of operating the No Secrets guidance. Some is positive, some is not – as the Cornwall and the Sutton & Merton reports highlighted. It is time for a review.

So the launch of the No Secrets review in February led to high expectations. Fundamental questions were raised about what parts of the safeguarding system to strengthen and how to do it. One of the key questions is whether the responsibility for safeguarding should remain with social services, or whether it should become a wider local government role?

Do housing departments, leisure services and transport all play a part in effective safeguarding? And what is the role of neighbourhood policing, housing officers and public health staff? How do we really keep our more vulnerable citizens safe on our estates and in our communities?

Another set of key questions is about the role of social workers. Some participants at the launch event thought the new emphasis on direct payments and individualised budgets needed to be brought together with a new look at safeguarding. Are social workers and care managers being supported to look at this new balance? Is there enough training in risk management? How do we weigh up a higher quality of life – for example enabling vulnerable people to make choices, some of which will be unwise choices – with the need to help them make safe choices?

Other questions focus on how we protect as well as prevent. Does the present system focus on “protecting” individuals who have already suffered abuse, at the expense of “enabling” and early intervention approaches involving a wider range of local partners in preventing abuse? Is there a need to integrate the systems we already have for keeping people safe? Or do we need new systems? Would legislation ensure people are not abused or is it improved policies and practices that really matter?

Finally there are big questions about definitions. We need to establish whether we have vulnerable adults or adults who are in vulnerable situations. Is vulnerability part of the characteristics of an individual with, for example, learning disabilities? Or is it the context, the setting, or the place which makes someone with a learning disability vulnerable?

After the review

These are difficult and challenging questions. It may be far harder today to reach consensus about the role of safeguarding in modern society than it was when No Secrets was written.

The review will proceed in stages. First, there will be a review of current practice and strategic arrangements, identifying key areas for improvement and putting forward options for change. A framework document consulting on key choices and options will be published in the summer.

After the consultation is completed, a number of options will be taken forward. This may take the form of further guidance, or other policy and practice initiatives or even legislation.

Care services minister Ivan Lewis (pictured right) made it clear at the launch event that he wishes to make safeguarding adults everyone’s business. This is ambitious, but without it the review would be at risk of tackling superficial details while ignoring structural flaws.

The reviewers welcome contributions by everyone interested in and involved with social care. How do we make the present system better? And how do we do this in the context of greater personalisation and greater choices for service users? What changes would you make?

Further information

Have your say on the review

More on abuse of older people

Lucy Bonnerjea is the policy lead on the No Secrets review in the Department of Health. Leo Quigley is the service manager for safeguarding adults at Sheffield Council and has been seconded to work part -time on the No Secrets review.

This article appeared in the 27 March issue under the headline “Whose job is it to protect?”