Not sure where to start with our learning resources? Want to expand your adult safeguarding knowledge, but just have the feeling that you 'don't know what you don't know'? We've designed a learning pathway to take you on a journey through our key adult safeguarding learning resources.
Thank you for joining us for this short podcast, produced on behalf of the West Sussex Safeguarding Adults Board. Today, we’ll be looking at our Safeguarding Adults Review in respect of Colin, including the findings and key recommendations made by the reviewer.
Colin was a 77-year-old man who lived in his own home with his wife, Doreen, their son, and Doreen’s mother. He was described by his wife as the solid foundation of the family; a man who was physically and mentally strong, who could turn his hand to anything. He was interested in joinery and cars and kept parrots and parakeets. Doreen described their relationship as long and happy, and shared that Colin had a special relationship with his son. Unfortunately, during their son’s early childhood, Colin suffered a stroke, which led to Doreen taking on the role of Colin’s carer for the sixteen years before his death.
In October 2022 Colin was admitted to hospital. He died 18 days later, with a recorded cause of death of sepsis and multiple infected pressure sores. At the time he was admitted to hospital, Colin was physically disabled following a stroke, with limited mobility. He was diabetic and had an increased risk for pressure ulcers. The primary issue recorded in the Safeguarding Adults Review referral was the deterioration of Colin’s physical health in relation to pressure ulcers, as well as concerns around self-neglect.
Prior to his hospital admission, Colin’s contact with services was mainly with the GP, podiatry, community nursing, occupational therapy, and ambulance services. Services repeatedly recorded that Colin declined assessments, treatment, and equipment.
So, what did the reviewer find during their review process?
The reviewer identified five key findings. We’ll explore those findings here.
Key finding 1: Legal literacy
Cases involving self-neglect can be extremely difficult for staff. They require an understanding of capacity, identified lifestyle choices, and risk, with often no legal basis for intervention. For this reason, it’s important that staff understand the interface between self-neglect, and legislation, namely the Mental Capacity Act, and the Care Act. This is known as ‘legal literacy’.
Key finding 2: Multi-agency coordination
To ensure effective multi-agency communication, risk assessment, and escalation, staff need to familiarise themselves with our self-neglect procedures. These provide a clear framework for managing self-neglect cases.
Key finding 3: Professional or concerned curiosity
Professional curiosity, also known as concerned curiosity, is a core responsibility for all staff across the health and social care sector. We must not be afraid to ‘dig deeper’ into areas where we feel we’re missing information; this information can help to inform our assessments and support our decision-making.
Key finding 4: Family involvement
Family involvement, and seeking the views of the family unit, are important aspects of working with adults with care and support needs, especially where a family member has the role of carer. Staff need to have confident and courageous conversations with the adult, their carer, and other important family members.
Key finding 5: Making Safeguarding Personal
We know that the principles of Making Safeguarding Personal are central to all adult safeguarding work. Staff need to ensure that they never lose sight of this, and that they understand how to apply these principles into their practice, at every stage.
So, now that we know what the review found, how can we begin to share the learning and improve our practice?
To ensure your practice reflects learning from Colin’s review, please support these recommendations by considering the following:
If the answer to any of these questions is ‘no’, speak with your line manager or safeguarding lead to clarify the processes in your organisation. And don’t forget to visit our website to access our learning resources relating to many of the themes identified in this review.
We’ll end by leaving you with this message from the reviewer:
“This review shines a light on the different ways that the system as a whole could have responded to self-neglect and worked with him and his family in a different way.
It is likely that Colin would have experienced an improved quality of life […] if his overall care and support had been responded to in a more connected and multi-agency way using the range of legal powers available.”
Thank you for listening.
