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Claire Crawley speaks on the Care Act 2014: Implications for adult safeguarding in the NHS

Claire CrawleyClaire Crawley

Claire began her presentation by stating that the new Care Act represents a seed change  - it is not business as usual for safeguarding. The Care Act 2014 is symbolic sending a clear message that this is really important. This is about a person and how the system will engage to support that person. Claire continued to say the act does have teeth giving partners the statutory basis to challenge practice. "We listened to people who had been through the safeguarding procedures and polcies, people felt they has no control over this system and we want to move away from that... Adult safeguarding should be about the person, the outcomes they want and their wishes and choices that should be respected".

Claire went on to discuss what safeguarding is not. Safeguarding is not a substitute for other processes for example Pressure Ulcers are not the business of a Section 42 inquiry. Pressure Ulcers are not a safeguarding inquiry under the Care Act. We need to have a partnership understanding that safe effective quality care is a basic minimum. The revised version of the act spells out in more detail what is and isn’t safeguarding. The NHS needs to take back responsibility for the care they provide, there is something about risk adverseness - if in doubt refer - and thats not good enough.  Safeguarding is also not a substitute for criminal investigations - fraud and theft should not be financial abuse due to the setting or the person.  There was much discussion over questions as to pressure ulcers but both Claire and the CQC made it clear that pressure ulcers and not a safeguarding inquiry issue but a quality of care issue.

Claire also discussed the importance of decision and reflection points. This is not a procedure or system – it is a way of working with people that doesn’t disempower or patronise them. Reflection is important at every point – this will be a challenge in practice.

Claire referred to “In Plain Sight” report with the 10 case studies as essential reading for everyone involved in safeguarding.

The issue of self neglect will also be more prominent in the revised Care Act. Self neglect is one of the difficult issues for practitioners. Recent research by SCIE on self neglect will be included in the new Care Act and emphasises that working with someone who hoards or self neglects is very much about relationship building which can be a very long process. The practice of moving someone out, cleaning up and moving them back in is very outdated. This is about relationships and causations.

The revised Care Act will be released in October 2014 along with guidance on what you must do by 1st April 2015.

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Download: Claire Crawley's Presentation

23 September 2014

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