Learning lessons from Safeguarding Adult Reviews
The government’s Rough Sleeping Strategy (2018) makes a clear link between homelessness and adult safeguarding in relation to the deaths of people sleeping rough. In addition, statistics published in October 2019 by the Office for National Statistics (ONS) showed that 726 people had died across England and Wales in 2018 as a result of homelessness and rough sleeping, with an average age of death for homeless men at 45 and slightly lower for women at 43.
Against this background, one of several responses has been to highlight the relevance of adult safeguarding procedures for people who are sleeping rough and question how well this group is being served by agencies with legal duties to protect them from abuse and neglect, including self-neglect.
In one of the first studies of its kind, VOICES collaborated with the Health and Social Care Workforce Research Unit at King's College London on a study of 14 Safeguarding Adult Reviews (SARs) in which homelessness was a contributing factor. The purpose of SARs is to learn lessons to improve practice rather than to apportion fault. In our analysis of these reviews, five broad themes were identified:
- Poor co-operation, co-ordination and leadership
- Challenges in assessments linked to the Housing Act 1996, Care Act 2014 and the Mental Capacity Act 2005.
- Lack of suitable accommodation provision
- Hospital Discharge (poor discharge arrangements including care planning and coordination)
- Safeguarding (missed opportunities, self-neglect, making safeguarding personal, lack of professional curiosity, engagement, normalising risk, practitioner attitudes)
The report also reviewed work relating to safeguarding and homelessness from third sector agencies. The two main resources contributing to the review stemmed from Homeless Link’s briefing document on Safeguarding Vulnerable Adults, which provides a summary of adult protection law and how to raise a safeguarding concern with statutory agencies. In addition, Homeless Link’s resource on taking action following the death of someone sleeping rough describes the main components of a SAR and suggests how organisations can carry out internal and multi-agency reviews as alternatives or additions to the statutory SAR process.
SARs have an important part to play in policy development and systems change work, especially to highlight the individual human story. SARs have the potential to bring renewed accountability in relation to cross agency working and may push for better integration across sector boundaries and disciplines. This should include taking a closer look at custom and practice linked to values and beliefs, representations surrounding an individual’s capacity to make cognizant and competent choices, in particular where self-neglect and severe addiction intertwine, and the influence these notions have on individuals and multi-agency systems.
The full report Safeguarding, homelessness and rough sleeping: An analysis of Safeguarding Adults Reviews (2019) is available here.
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Head of Service and Safeguarding for VOICES and Brighter Futures Housing Association
Bruno Ornelas (@BrunoJOrnelas) is the Head of Service and Safeguarding for VOICES and Brighter Futures Housing Association.