making safeguarding personal essay

Making Safeguarding Personal (MSP)

Developing a safeguarding culture that focuses on the personalised outcomes desired by people with care and support needs who may have been abused is a key operational and strategic goal. SABs, therefore, may want to consider the role they can play in embedding the ‘Making Safeguarding Personal’ approach across agencies by establishing and developing:

• a broader participation strategy
• accessible information to support participation of people in safeguarding support
• a focus on qualitative reporting on outcomes as well as quantitative measures
• person-centred approaches to working with risk
• policies and procedures that are in line with a personalised safeguarding approach
• strategies to enable practitioners to work in this way, by looking at the skills they need and the support they are getting to enable this shift in culture.

Making Safeguarding Personal

• 1.2 Values and principles: making safeguarding personal

Related guidance

Making Safeguarding Personal - Local Government Association

Introduction

Defining and measuring outcomes is an important part of Safeguarding Adults work. To ensure safeguarding is personal, effective outcomes play a crucial role in establishing a good overall quality assurance framework, at individual, agency and Safeguarding Adult Board (SAB) levels.

Outcomes need to reflect the ‘journey’ of the individual as they progress through the process of being safeguarded and it is imperative that, they are placed at the centre of this process.

Defining and measuring outcomes needs to go beyond collecting numbers. Although statistical outputs are necessary and useful when analysing data, they do not, give us information on the quality and effectiveness of the safeguarding from the point of view of the Adult At Risk.

Information and feedback from Adults At Risk themselves should form the basis for measuring how effective the safeguarding process has been and will form the basis for improving outcomes.

2. Translating Principles into Outcomes

The Care Act 2014 reiterates the following six principles of safeguarding, which apply to all sectors and settings including care and support services, further education colleges, commissioning, regulation and provision of health and care services, social work, healthcare, welfare benefits, housing, wider local authority functions and the criminal justice system. The principles should inform the ways in which professionals and other staff work with adults. The principles can also help SABs, and organisations more widely, by using them to examine and improve their local arrangements.

Six key principles underpin all adult safeguarding work:

• Empowerment  – People being supported and encouraged to make their owndecisions and informed consent. “I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens.”
• Prevention  – It is better to take action before harm occurs. “I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help.”
• Proportionality  – The least intrusive response appropriate to the risk presented.“I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed.”
• Protection  – Support and representation for those in greatest need. “I get help and support to report abuse and neglect. I get help so that I am able to take part in the safeguarding process to the extent to which I want.”
• Partnership  – Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. “I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”
• Accountability  – Accountability and transparency in delivering safeguarding. “I understand the role of everyone involved in my life and so do they.”

In addition to these principles, 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 if they suspect or are made aware of abuse or neglect.

Some people may express desired outcomes or wishes that are not possible, and this provides opportunities for frank discussion to establish what the next best option is within some broader boundaries and principles that they have stated. For other people their desired outcomes may not be possible for instance if they don’t want the police involved but the person who has abused or neglected them is in a position to do the same to others. Again there will be opportunities to explain this honestly and to find ways to most closely meet their wishes.

3. An Individual’s Perspective

Where the principles are applied effectively, an individual would be able to agree with the following statements.

People worked together to reduce the risk to my safety and wellbeing:

• I had the information I needed, in the way that I needed it;
• Professionals helped me to plan ahead and manage the risks that were important to me;
• People and services understood me - recognised and respected what I could do and what I needed help with;
• The people I wanted were involved;
• I had good quality care - I felt safe and in control;
• When things started to go wrong, people around me noticed and acted early.

People worked together and helped when I was harmed:

• People noticed and acted;
• People asked what I wanted to happen and worked together with me to get it;
• I got the help I needed by those in the best placed to give it;
• The help I received made my situation better;
• People will learn from my experience and use it to help others;
• I understood the reasons when decisions were made that I didn’t agree with.

4. An Organisational Perspective

From an organisational perspective, applying the principles effectively includes the following:

• Empowerment  - We give individuals the right information about how to recognise Abuse and what they can do to keep themselves safe. We consult with them before taking any action. Where someone lacks Capacity to make a decision we always act in his or her best interests;
• Prevention  - We help the community to identify and report signs of Abuse and suspected criminal offences.  We train staff how to recognise signs and take action to prevent Abuse occurring;
• Proportionality  - We discuss with the individual and where appropriate, with partner agencies, what to do where there is a risk of abuse or neglect  before we make a decision;
• Protection  - We have effective ways of assessing and managing risk. Our local complaints and reporting arrangements for Abuse and suspected criminal offences work well;
• Partnership  - We are good at sharing information locally. We have multi-agency arrangements in place and staff understand how to use these;
• Accountability  - The roles of all agencies are clear together with the lines of accountability. Staff understand what is expected of them and others.

In this section

• Report adult abuse, neglect or a safeguarding concern
• 1.1 Adult Safeguarding - What it is and why it matters
• 1.3 Out-of-area safeguarding adults arrangements
• 1.4 Plymouth Safeguarding Adults Partnership
• 1.5 Roles and responsibilities
• 1.6 Mental capacity
• 1.7 Safeguarding adults and human rights
• 1.8 Deprivation of liberty
• 1.9 Out of hours service
• 1.10 H.M. Coroner
• 2.1 Safeguarding Framework Flowchart
• 2.2 Adult safeguarding framework explained
• 2.3 Multi-agency pathway protocol
• 2.4 Adult safeguarding enquiry guidance
• 2.5 Involving commissioning in safeguarding enquiries
• 2.6 Gaining access to an adult suspected to be at risk of neglect or abuse
• 2.7 Involving service providers in the safeguarding adults process
• 2.8 Self-neglect, hoarding and risk management policy guidance
• 2.9 Large scale and whole service concerns
• 2.10 Escalation process to resolve professional disagreement
• 2.11 Complaints about the safeguarding process
• 3.1 Categories of abuse
• 3.2 Allegations against persons in a position of trust
• 3.4 Abuse by another adult at risk
• 3.5 Domestic violence and abuse
• 3.6 Child protection
• 3.7 Transitional safeguarding
• 3.8 Direct payments
• 3.9 Safer recruitment guidance
• 3.10 Adult Safeguarding Training
• 3.11 Information sharing
• 3.12 Whistleblowing
• 3.13 Ensuring quality in provider services
• 3.14 Care Quality Commission
• 3.15 Advocates
• 3.16 Multi-agency public protection arrangements (MAPPA)
• 3.17 Multi-agency risk assessment conferences (MARAC)
• 3.18 Disclosure and barring service
• 3.19 Safeguarding adult reviews
• 3.20 Office of the public guardian
• 3.21 Supporting people living with dementia through safeguarding processes
• 3.22 County Lines and Cuckooing
• 3.23 Pressure ulcers: how to safeguard adults
• 5.1 Local contacts
• 5.2 Local keywords
• National guidance
• Report abuse or a safeguarding concern
• Adult Safeguarding awareness information
• Adult safeguarding training
• Plymouth Safeguarding Adults Partnership
• Adult care and support
• Housing and care homes
• Raising a complaint or giving feedback about adult social care
• Plymouth Community Meals
• Social care information, advice and support services
• Integrated care

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Making Safeguarding Personal

Making safeguarding personal (msp) is a national approach to promote responses to safeguarding situations that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety..

It is about seeing people as experts in their own lives and working alongside them to identify the outcomes they want, with the aim of enabling them to resolve their circumstances and support their recovery.

The MSP Practice Toolkit, produced by the Local Government Association (LGA) outlines an approach to the effective application of safeguarding.

The MSP Case Studies produced by the LGA illustrate outcome-focused practice in line with the MSP approach. Myths and realities of MSP.

This LGA briefing, published in November 2019, emphasises that MSP is not just about safeguarding practice, but also about prevention, and strategic as well as operational safeguarding.

We work together with our Safeguarding Ambassadors in the communities of Kensington, Chelsea and Westminster to ensure that Making Safeguarding Personal is a core objective running through the safeguarding adults board’s strategic plan.

Safeguarding Ambassadors

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Article Contents

• Introduction
• Adult safeguarding policy and practice context in England
• Methodology
• Acknowledgements
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Making Safeguarding Personal and Social Work Practice with Older Adults: Findings from Local-Authority Survey Data in England

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Adi Cooper, Christine Cocker, Mike Briggs, Making Safeguarding Personal and Social Work Practice with Older Adults: Findings from Local-Authority Survey Data in England, The British Journal of Social Work , Volume 48, Issue 4, June 2018, Pages 1014–1032, https://doi.org/10.1093/bjsw/bcy044

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This article presents the results of a survey of English local authorities undertaken in 2016 about the implementation of Making Safeguarding Personal (MSP) in adult social care services. MSP is an approach to adult safeguarding practice that prioritises the needs and outcomes identified by the person being supported. The key findings from a survey of local authorities are described, emphasising issues for safeguarding older adults, who are the largest group of people who experience adult safeguarding enquiries. The survey showed that social workers are enthusiastic about MSP and suggests that this approach results in a more efficient use of resources. However, implementation and culture change are affected by different factors, including: austerity; local authority systems and structures; the support of leaders, managers and partners in implementing MSP; service capacity; and input to develop skills and knowledge in local authorities and partner organisations. There are specific challenges for social workers in using MSP with older adults, particularly regarding mental capacity issues for service users, communication skills with older people, family and carers, and the need to combat ageism in service delivery. Organisational blocks affecting local authorities developing this ‘risk enabling’ approach to adult safeguarding are discussed.

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Making safeguarding personal

The Care Act (2014) emphasises the importance of ‘Making Safeguarding Personal’ which aims to develop outcomes focus to safeguarding work, and a range of responses to support people to improve or resolve their circumstances. It is about engaging with people about the outcomes they want at the beginning and middle of working with them, and then ascertaining the extent to which those outcomes were realised at the end.

MSP means that the process of safeguarding adults at risk should be person-led, and outcome focussed; it engages the person in a conversation about how best to respond to his/her safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety  (Appendix 1 Care Act Statutory Guidance 14.15).

All adults should be supported to take control of their lives. The right balance needs to be sought between protecting adults and enabling them to manage their own risks. In order to do these, the adult involved need to be at the centre of any decision making around their own safety and wellbeing.

At the earliest opportunity, the adult at risk should be asked what they want to happen now, and what their desired outcomes are.

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• Making Safeguarding Personal

What is Making Safeguarding Personal?

• Making Safeguarding Personal Resources

" No decision about me without me" 

Making Safeguarding Personal (MSP) is about professionals working with adults at risk to ensure that they are making a difference to their lives. Considering, with them, what matters to them so that the interventions are personal and meaningful. It should empower, engage and inform individuals so that they can prevent and resolve abuse and neglect in their own lives and build their personal resilience. It must enhance their involvement, choice and control as well as improving quality of life, wellbeing and safety.

It is not “just another process”, it underpins all your interactions and involvement with the adult at risk. Processes should fit around the person to ensure that the persons views remain central in the safeguarding journey.

What does MSP look like in practice?

MSP applies to the whole safeguarding process, which starts at the point where someone thinks there is potential abuse.

• Speak to the adult at risk.
• Ask for their opinion, record their views as they have expressed them and work with them to help them achieve the outcomes that are best for them.
• Focus on individuals' strengths (including personal strengths and social and community networks).
• Make sure you find out who else they would like to be involved or spoken to as part of the process.
• Consider if the adult at risk requires a representative or advocate and, if so, ensure that representative/advocate is involved as well.
• Make sure the adult at risk understands any options open to them and that they understand why some options may not be available or are unachievable.
• Develop plans with the adult at risk to reduce or remove risks, including any immediate risks of harm.
• Should a person decide to remain living with the risk, make sure the person understands this and any actions they can take to maximise their safety.

Professional Curiosity and MSP

• Professional curiosity should be used to ensure that someone isn’t pushing professionals away because they are influenced, coerced or controlled by someone else.
• Professionals should use their own intuition about the circumstances in which a concern has been raised about the possibility of abuse or neglect.
• Someone may say they don’t want support to protect themselves for a range of reasons, for example they don’t trust agencies or have no confidence in them.
• Professionals should persevere and establish trust with people to support them to minimise any impact of unwise decisions on their health and well-being.

MSP is not …

• An excuse to close our involvement with someone if they say they don’t want anything to happen . Professional curiosity should be used to ensure that someone isn’t pushing professionals away.
• A tick box exercise or a separate process ; it underpins all contact and work with adults at risk.
• Just chatting with an Adult at Risk – conversations should be focused on establishing the adult’s wishes and reasoning behind those wishes. It is about using good communications skills to engage with people who may find the process difficult and distressing. 
• Unsuitable for those that lack Mental Capacity – conversations should still be had with the adult at risk or their representative.
• Your interpretation of what you think they want or just what you think is best for them .

No bias. No misinformation. No spin. Just what you need!

The Social Care Elf

What does evidence say for making safeguarding personal.

As forest-dwelling creatures, elves know the importance of effective organisation and structure of their camp. The question is, how is this best achieved – should all elves be able to light the camp fire or is it more effective to rely on specialist firelighters? And what sort of relationships should they have with the pixies to ensure harmony in the woods? Such important questions are explored in a different context here – that of adult safeguarding.

Adult safeguarding is identified as a core part of social work practice. It has evolved over time, from the scandals of the 1960s that raised awareness of the issue of adult abuse through to No Secrets which talked about the protection of vulnerable adults. The new Care Act 2014:

• Outlines a duty for local authorities to make, or cause to be made, enquiries into safeguarding concerns
• States that other multiagency partners must contribute to those enquiries;
• Places Safeguarding Adults Boards on a statutory footing
• Advocates serious case reviews as an opportunity for learning.

This paper aims to find out how developments in policy are reflected in practice by asking how service responses are organised for safeguarding, and whether particular models of safeguarding are linked to outcomes.

It does so by reporting on a ‘narrative synthesis’ of the literature, and is part of a large study investigating adults safeguarding policy and practice in England. Narrative synthesis is described as an approach that integrates lots of different types of evidence in different themes. Qualitative evidence is seen as particularly important, as it explains ‘how’ and ‘why’ things are done.

Should we have specialists to undertake important tasks like lighting a campfire, or safeguarding adults?

An initial search specifically for models drew a bit of a blank, so the search terms were broadened. Literature between 2000 (when the seminal policy document No Secrets was published) and 2013 was searched. Literature around elder abuse was found to be more prevalent than for other groups, with corresponds to a greater proportion of referrals (60% in 2012-13) for this group.

The selection process for literature is clearly outlined, with 162 full text papers being retrieved. Of those, 16 were deemed to have relevance to the research question, e.g. exploring the organisation of safeguarding practice. All four researchers read each of the sixteen papers, which lessened the possibility of missing themes or important information.

Safeguarding as a concept has been described as elastic, adapting to different people’s thresholds.

The results of the analysis showed that decision-making and thresholds, and multiagency working were critical areas. The experience and outcomes of people who use services were also picked out as themes.

So is it better to have specialist safeguarding (or firelighting) practitioners, or should everyone play a part? This theme emerged frequently in the reviewed literature, though no studies focussed on it specifically. Numerous approaches are described, from Adult Protection Coordinator (APC) roles (which can be ill-defined so could vary between strategic and operational remits), to teams of safeguarding specialists, to safeguarding being integrated into case management.

APCs were found to increase the chances of ‘good’ outcomes such as confirming abuse, joint working, and post-abuse work – however the evidence on whether specialism leads to better outcomes than generalism in safeguarding is currently inconclusive.

What sort of processes exist for safeguarding adults? The paper notes that most processes mirror the guidance available at the time (No Secrets, 2000) encompassing a timeline of alert, referral, potentially leading to an investigation, case conference safeguarding plan and monitoring. Again, specialist teams are noted as having pros (objectivity, connecting events, clear leadership) as well as cons (lack of continuity, potential conflict with other teams, deskilling other workers).

Decision making and thresholds for action is another main theme emerging in the paper. Safeguarding is described as an ‘elastic’ concept, with thresholds depending on the referrer. Factors affecting decisions about what is considered as harm/ abuse and worth pursuing through safeguarding include:

• Likelihood of a substantiated allegation
• Needs and pressures on resources
• Formation of a ‘cognitive mask’ which prevents professionals ‘seeing’ low level abuse
• Impact on the organisation involved
• The wishes of the person who has been harmed – balancing ‘empowerment’ and ‘protection’.

Perhaps unsurprisingly, good multiagency working has been found to lead to better outcomes of safeguarding investigations. The challenges of multiagency working are highlighted as one of definition, lack of resources, poor communication and lack of clarity over roles and responsibilities.

The authors note that the Care Act guidance may assist multiagency working by placing a duty to engage on statutory agencies. Co-location is suggested as a way to aid multiagency working (e.g. through a Multi- Agency Safeguarding Hub (MASH)), although not everyone shares this view.

The final theme is the question of what safeguarding is meant to lead to – its outcome. Measures of this include:

• Levels of substantiation of abuse/ confirmation of abuse
• ‘ongoing monitoring’
• Speed of response
• Likelihood of investigation

Again, the paper notes that the APC role was associated with better outcomes in relation to these metrics.

Seeing the wood for the trees – is safeguarding research asking the right questions?

Conclusions

The authors conclude that

The implications of specialism have not been extensively explored. However, several important characteristics of safeguarding practice are identifiable from the literature including specialism within the organisation of adult safeguarding; decision-making and thresholds for safeguarding response; and multi-agency working.

The authors note limitations of the study as being an exclusion of non-English language papers, and a lack of inclusion of research studies, due to a lack of such research being carried out. They note that only one study looked specifically at models of safeguarding organisation.

A further limitation not of this paper, but generally for the application of the research to practice, is the changing policy context. The inclusion of a Making Safeguarding Personal (MSP) approach in the Care Act guidance may impact on numerous aspects of how safeguarding is carried out, not least by enabling practitioners to focus less on process and more on individuals’ wishes following an instance of abuse.

Early evidence from MSP (e.g. Lawson, Lewis and Williams 2014) suggests that relationships and involving people from the beginning are more important to people than process is, and this may act as a useful new focus for research – a perspective also picked up on in the review (Ash, 2013).

It could be argued that previous research has been driven by policy and practice rather than by an ambition to elucidate how services can lead to better experiences and outcomes for people. This review raises the question – has previous research missed the point of safeguarding – i.e. is anyone better off afterwards? Part of this may be down to the fallacy of ‘what’s measured, matters’ – it is easy to measure whether abuse is substantiated or not and much more difficult to measure if safeguarding improved the wellbeing and safety of the person concerned.

The MSP approach, which involves asking the person who has experienced harm about what they would like to happen, may ameliorate the issues raised above by focusing practitioners on the person and the outcomes they want. This change in practice may also support researchers to answer the more difficult questions around how effective, inclusive safeguarding can be achieved.

Graham K, Norrie C, Stevens M, Moriarty J, Manthorpe J, and Hussein S. (2014) Models of adult safeguarding in England: a review of the literature. Journal of Social Work , doi: 10.1177/1468017314556205 [ Abstract ]

Ash, A. (2013). A cognitive mask? Camouflaging dilemmas in street-level policy implementation to safeguard older people from abuse. British Journal of Social Work , 43(1),99–115. doi:10.1093/bjsw/bcr161 [ Abstract ]

Department of Health (2000) No Secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse . London, England: TSO. [ Full report ]

Department of Health (2014). Care Act 2014 . [ Full report ]

Department of Health (2014) Care Act 2014: statutory guidance for implementation . [ Full report ]

Lawson J, Lewis S and Williams C (2014) Making Safeguarding Personal 2013/14: Summary of Findings . Local Government Association and ADASS. [ Full report ]

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Great Blog @SocialCareElf from @Lindsey_Pike on our Models of Sgding Lit rev.Good sum& ID imp questions. http://t.co/7WUtND4x65

@MartinStevens2 @SocialCareElf Thanks Martin :)

My first @SocialCareElf blog is up! http://t.co/btnWAdwY9H on models of adult safeguarding & how this relates2 Making Safeguarding Personal

@Lindsey_Pike @SocialCareElf Nice one!

@rich_w @SocialCareElf thanks!

What does evidence say for Making Safeguarding Personal? http://t.co/qqhJwCIm7A post from @Lindsey_Pike at @SocialCareElf on @scwru study

How are service responses organised for safeguarding; how are particular models of safeguarding linked to outcomes? http://t.co/qqhJwCIm7A

Shouldn’t safeguarding be more about improving outcomes for person at risk? @Lindsey_Pike for @SocialCareElf http://t.co/ujRGsjUN8x

@Aspirantdiva @SocialCareElf ezzactly!

@Lindsey_Pike @SocialCareElf I will never be able to think about safeguarding except in terms of specialist firelighting elves from now on!

@Aspirantdiva @SocialCareElf haha, apologies if it’s taken you a bit off track!!

@Lindsey_Pike @Aspirantdiva @SocialCareElf In order to have the definition of outcomes, it would require risk to be recalibrated.

@AlresfordBear @Lindsey_Pike @SocialCareElf Yes – I like idea of risk/benefits analysis – risk to a person if something does NOT happen

@AlresfordBear @Lindsey_Pike @SocialCareElf So e.g risk to quality of life versus physical risk – in this heatmap https://t.co/xVnDi6owGd

@Aspirantdiva @Lindsey_Pike @SocialCareElf Indeed. Making truly reflective considered decisions. Although this can be used to hesitate.

@Aspirantdiva @Lindsey_Pike @SocialCareElf It often sees things in a singularity. More of a process, than solution.

@AlresfordBear @Lindsey_Pike @SocialCareElf That is not self promotion BTW – Simon Ricketts introduced us to concept and helped us with it

@Lindsey_Pike @Aspirantdiva @SocialCareElf Most certainly in its evaluation.

Super discussion on @SocialCareElf of research on adult safeguarding by @Lindsey_Pike from @ripfa http://t.co/a0TYBQKsTg

@Intipton @SocialCareElf @ripfa thank you!

Examining safeguarding models and arguments for and against safeguarding specialists – our very own @Lindsey_Pike http://t.co/2y5He5vpNU

Welcome to the woodland @Lindsey_Pike Great debut blog on #safeguarding http://t.co/zjSqF6bnKs nb. NEVER let a pixie near the campfire!

What does evidence say for Making Safeguarding Personal? http://t.co/aUM5GWYGzB via @sharethis

[…] to get good outcomes for people? Eagle eyed elves may have noticed that this study elaborates on a previous elf post, which summarised a paper outlining the literature on models of adult safeguarding. Here, we […]