Being an Always Care Practitioner
Leeds Safeguarding Adults Board has a statutory duty to arrange a Safeguarding Adults Review when an adult at risk of abuse dies or has experienced serious abuse/neglect, and there is concern that agencies could have worked together more effectively to protect them.
The purpose of the review is not to blame but to learn lessons about how professionals and organisations can better work together and consider how this learning can be used to improve future practice. These Always Care principles reflect our learning from these reviews in Leeds:
"ALWAYS Care" - ALWAYS respond to self-neglect, small steps make a big difference:
Self-neglect may involve:
- Lack of self-care to an extent that it threatens personal health and safety;
- Neglecting to care for personal hygiene, health or surroundings;
- Inability to avoid harm as a result of self-neglect;
- Not seeking help or access services to meet health and social care needs;
- Inability or unwillingness to manage one's personal affairs (SCIE)
Key messages from Safeguarding Adults Reviews in Leeds:
- Awareness: be aware of the signs and symptoms. Understand it's not a lifestyle choice. Develop your skills and knowledge about what self- neglect is and the symptoms, through learning from others, accessing supervision and reflecting on practice. Know the importance of seeking clarity and support from within your organisation and from other organisations and services.
- Look for the person behind the behaviour: Ask questions, be curious in a sensitive way to get the essential details of the person's life. Be interested about their history, identity and individual needs, as well as the help they want. What will keep them safe, what's the bigger picture?
- What is really happening? Does the person have the mental capacity to make these decisions? Are they able to carry out their decisions? Have they had traumatic life experiences? Recognise that something else may be causing this situation. Think wider than what can be seen and is known. Ask yourself questions like 'why are appointments missed or offers of help and support declined'?
- Assess the risk and the person's needs. Does anything seem or feel wrong or not quite right? It takes time to work with self-neglect and it is important to go at the person's pace and be patient. Be realistic and recognise that seemingly 'small' achievements may have real significance.
- Your time to act: engage with other agencies, seek advice, share information, access services; go that little bit further. Ask for support when you need it and do the right thing when you feel something isn't right. Make contacts count, be confident to reflect, take action, ask questions and challenge the 'usual' way of doing things. It is important to share information and challenge the practice and responses of others.
- Solutions focussed: be creative, work alongside the person to identify solutions that suit them. Work at the person's pace. Don't work or plan in isolation, be part of a consistent multi-agency 'team around the person' and know who is taking the lead and how multi-agency working is being coordinated. Consider all resources, specialists, support and advice, networks and community. Understand who needs to be involved and when, and always consider different options and plans, recognising strengths and the pace of change for the person.