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The Cambridgeshire and Peterborough Safeguarding Adult Board (CPSAB) has undertaken a number of Safeguarding Adult Reviews (SARs) and a recent multi-agency audit. From the audit and the SARs reoccurring practitioner themes when working with adults at risk and their families were found. These themes have also been identified within national SARs as lessons for agencies to learn and to put into practice;

Voice of the Adult at Risk: Ensuring that the adult’s voice is not just listened too but is actively heard. It is a phrase used to describe the real involvement and experiences of the adult at risk– not just what they tell us but ‘What is life like for them?’ – What do they understand / What could be different/ Why do or don’t they want help?

Professional Curiosity: is the capacity and communication skill to explore and understand what is happening within a family rather than making assumptions or accepting things at face value. In other words ask questions about ‘What is life like for the adult at risk living at home / in a care setting?’ ‘What is it like for the family?’ etc.

Make observations about the home/ setting environment- how does the adult at risk react to their family and to workers/staff? If the service user has walking aids / other aids are these easily available for them to access and if not why not?

If an adult at risk has a medical condition – what does this mean for them in their daily lives, ask them? If it’s a medical condition that you know nothing about or would like to know more about then ask the professionals who do (i.e. medical professionals).

Respectful Uncertainty: Meaning that Professionals must remain sceptical of the explanations, justifications or excuses they may hear. In other words professionals should not take what families/professionals and the adult at risk tell us at face value – they should ‘check out’ with other agencies / sources of information what is being said.

Cultural Competence: is a term used to describe a set of skills, values, behaviours and principals that enable professionals to work effectively with service users who have one or more of the protected characteristics, as defined by the Equality Act 2010. Illustrations of these include disability; ethnicity or race; gender; gender identity; religion and belief; sexual identity/orientation and mental health.

Professionals need to be culturally competent and should not make assumptions about an adult at risk nor their family and as part of ‘informed practice’ should be confident to ask about what their life experiences are in order to meet their needs and to provide the best service.

Think The Unthinkable: Is a phrase that has been used in Children’s Serious Case Reviews where professionals did not think that serious harm could ever be inflicted on a child by their parents. Professionals sometimes need to think about the worst case scenario and that family members might be harming children / adults at risk.

For working with an adult at risk think about the negatives and the risks, within their environment, as well as the protective factors…have a balanced approach to thinking about what might be happening in terms of safeguarding and potential abuse.

Working Together and Sharing Information. Within most Safeguarding Adult Reviews a recurring theme identified is that professionals working with the adult at risk did not work together or share information that could have safeguarded the service user. Each professional had bits of knowledge and information about the adult at risk which when put together gave the whole picture of abuse. In terms of safeguarding an adult at risk, share important information and work together, this minimises risk, avoids duplication of work and potentially shares resources.

Listening to the Carer’s Voice instead of the Adult at Risk. Sometimes family members and carers have a lot to say but this is often at the expense of actually hearing what the adult at risk has to say. As a professional think about how to focus on the service user and to give your attention to their needs whilst at the same time acknowledging what the family/carer is saying.

Think about the risk factors within the service users relationships. There have been cases where perpetrators of domestic violence and sexual abuse have been considered as the main care givers. These individuals had been worked with by professionals and the abuse was missed.

Disguised Compliance. Can involve the service user or family members giving the appearance of co-operating with agencies to avoid raising suspicions, to allay professional concerns and ultimately diffuse professional intervention. They may; tell professionals what they ‘want to hear’, not admit that they do not want to change or say that they have completed requests when they have not done so. Practitioners need to be aware of possible disguised compliance from service users and families and to always check out what is being said.

Recording. Always remember to update case records for others to see what work has been completed with the service user. Ensure that the records are readable, succinct, dated and avoid technical jargon to avoid miscommunication and confusion. Think about creating charts for recording the adult at risks needs, for example diet and medication charts and fill them in regularly! Sometimes records are an important lifesaving as well as safeguarding exercise.

Whistleblowing. If you see someone who you think maybe mistreating and abusing an adult at risk would you know what to do? Find your policies and procedures and the number to contact for reporting your concerns.

Further Information:

Safeguarding Board Website: https://www.safeguardingcambspeterborough.org.uk/adults-board/

Reporting a Safeguarding Concern: https://www.safeguardingcambspeterborough.org.uk/concerned/

SAB Leaflets: https://www.safeguardingcambspeterborough.org.uk/adults-board/resources-for-practitioners/

Multi-Agency Safeguarding Training: https://www.safeguardingcambspeterborough.org.uk/availabletraining/

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