Decisions to safeguard adults with learning disabilities can make them less safe

Safeguarding processes and procedures are important for both the wellbeing of people with learning disabilities and the providers and individuals who support them on a day-to-day basis.

But some decisions taken to protect vulnerable people make them less safe, serving to protect the decision makers instead.

Liability avoidance

Take the case of Ben, a support worker, who has been supporting John for the past eight years. However, when Ben changed jobs, he was told that he wasn’t allowed to keep in touch with John, despite both men wanting this to happen.

Then there is Alice, also a support worker, who was told by her manager that she was not allowed to buy and apply suncream on a hot day for someone she supports because “suncream needs to be prescribed by a GP”.

These are two real-life stories, chosen from a larger pool of similar stories. We are in a situation where decisions allegedly made in the interests of the safety of people with learning disabilities can actually make them less safe. And support workers are being made to feel that they need to leave their common sense and moral compass behind in their work.

As John O’Brien, a leading thinker in the field of disability, puts it, “we have created a rigorously managed space that too often trades off opportunity for community participation and the exercise of autonomy for liability avoidance”[i]. Valuing people means not only having a regard for the safety of people with learning disabilities, but also having a commitment to respecting their preferences and their right to live life in the way they want.

Blame versus accountability

Wellbeing is a key feature of the Care Act 2014, and the main thrust of the government’s current green paper consultation on the care and support received by people with learning disabilities, autism and mental health conditions is focused on having their voices heard and rights respected. Keeping people safe needs to be set firmly in that context.

There are too many instances where the focus on the safety of people with learning disabilities seems more concerned with doing the thing which will attract the least amount of criticism should something go wrong.

Blame assigns responsibility to individuals or groups when things go wrong. Accountability, however, assumes the acceptance of responsibility and the rightful need to justify actions should things go wrong. Where we seem to have got to is that the lives of many people with learning disabilities are unduly restricted because the people they rely on in order to live an ordinary life are fearful of having to go through the process of justification if something negative happens.

What is needed is a more sanguine look at what actually makes people safe. This is not only in the interests of people with learning disabilities but also of those who fear blame as an outcome of the decisions they make.

Conducive to wellbeing

Many safeguarding processes are concerned with clarifying how harm occurred and ensuring that the likelihood of it occurring again in the same way are avoided. These are important and necessary processes, but also reactive ones.

Preventing harm occurring in the first place can, however, generate unforeseen consequences if safeguarding ends up stopping people having access to things that are conducive to their wellbeing.

When we look past the professional paraphernalia, it is the things that are often most prevalent in our lives that serve to make people safe and affect our wellbeing – the presence of people we know and increasingly, the use of technology. Most of us feel safer when we have our mobile phones with us, for example.

The more we are known and looked out for by people who know us, the safer we are likely to be. So if adults with learning disabilities are out and about in their communities it can lead to others being concerned about their wellbeing, not just the professionals working with them.

Technology’s potential

Technology, too, offers great potential. For example, MyChoicePad, a language programme for tablets that makes communication easier – developed by social enterprise Insane Logic – has been used in over one million user sessions.

Developments like this that can help people with learning disabilities communicate what upsets or pleases them, when they were previously unable to, is a powerful and fundamental part of keeping safe.

The importance of being vigilant about abuse, acting when it happens and using the learning from it to minimise recurrences can’t and shouldn’t be used to justify unnecessary restrictive decisions that pass themselves off as forms of prevention.

Similarly, professionalised, regulated environments are not automatically synonymous with safe environments, as experience has shown.

The answer does not lie in ratcheting up the rules, which people with learning disabilities are often subject to, rarely consulted about, and often negatively affected by, but in setting professional support firmly in the context of supporting people to meet and develop relationships with others.

The wider the circle, the greater the protection. The more enabling the technology, the greater the degree of control. In that way, rights are more likely to be respected and voices heard.

Bob Tindall is director of Fettle Consultancy which provides support to third sector and public sector organisations