Calls for greater collaboration between professionals in health and social care have led to pressures to move towards interprofessional education at both pre‐ and postregistration levels. Whilst this move has evolved out of ‘common sense’ demands, such a multiple systems approach to education does not fit easily into existing traditional disciplinary frameworks and there is, as yet, no proven theoretical framework to guide its development. What is more, it lacks a clear causality and predictability and therefore does not fit easily into traditional scientific frameworks with their focus on analysis, prediction and control. This article considers how complexity theory, with its focus on connectivity, diversity, self‐organization, and emergence, can provide interprofessional education with a coherent theoretical foundation, freeing it from the constraints of a traditional linear framework, enabling it to be better understood, questioned and challenged as a new paradigm of learning.
Purpose – The purpose of this paper is to report the findings from research into 40 serious case reviews (SCRs) involving adults who self-neglect. Design/methodology/approach – The study comprised analysis of 40 SCRs where self-neglect featured. The reviews were found through detailed searching of Local Safeguarding Adult Board (LSAB) web sites and through contacts with Board managers and independent chairs. A four layer analysis is presented of the characteristics of each case and SCR, of the recommendations and of the emerging themes. Learning for service improvement is presented thematically, focusing on the adult and their immediate context, the team around the adult, the organisations around the team and the Local Safeguarding Board around the organisations. Findings – There is no one typical presentation of self-neglect; cases vary in terms of age, household composition, lack of self-care, lack of care of one's environment and/or refusal to engage. Recommendations foreground LSABs, adult social care and unspecified agencies, and focus on staff support, procedures and the components of best practice and effective SCRs. Reports emphasise the importance of a person-centred approach, within the context of ongoing assessment of mental capacity and risk, with agencies sharing information and working closely together, supported by management and supervision, and practising within detailed procedural guidance. Research limitations/implications – There is no national database of SCRs commissioned by LSABs and currently there is no requirement to publish the outcomes of such inquiries. It may be that there are further SCRs, or other forms of inquiry, that have been commissioned by Boards but not publicised. This limits the learning that has been available for service improvement. Practical implications – The paper identifies practice, management and organisational issues that should be considered when working with adults who self-neglect. These cases are often complex and stressful for those involved. The thematic analysis adds to the evidence-base of how best to approach engagement with adults who self-neglect and to engage the multi-agency network in assessing and managing risk and mental capacity. Originality/value – The paper offers the first formal evaluation of SCRs that focus on adults who self-neglect. The analysis of the findings and the recommendations from the investigations into the 40 cases adds to the evidence-base for effective practice with adults who self-neglect.
Article (Unspecified) http://sro.sussex.ac.uk Braye, Suzy and Preston-Shoot, Michael (2005) Emerging from out of the shadows? Service user and carer involvement in systematic reviews. Evidence and Policy, 1 (2). pp. 173-194.
Purpose -This article reports the findings from research into the governance of adult safeguarding policy and practice in England, with particular focus on interagency partnership arrangements expressed through Safeguarding Adults Boards.Design -The study comprised a systematic search and thematic analysis of Englishlanguage literature on adult safeguarding governance, a survey of Safeguarding Adults Board documentation, and key informant interviews and workshops with professionals involved in adult protection.Findings -The effectiveness of adult safeguarding governance arrangements has not been subject to prior formal evaluation and thus the literature provided little research-led evidence of good practice. The survey and workshops, however, revealed a rich and complex pattern of arrangements spanning a number of dimensions -the goals and purpose of interagency working, the structures of boards, their membership, chairing and rules of engagement, their functions, and their accountabilities.Research limitations/implications -The research focus was England, and thus does not incorporate learning from other jurisdictions. Whilst the research scrutinised the extent to which Boards practise empowerment, service users and carers were not directly involved in the fieldwork aspects of this study. In view of the absence of outcomes evidence identified, there remains a need to investigate the impacts of different forms of governance.Practical implications -Drawing on this research and on governance frameworks in the context of related interagency fields, the article identifies standards to benchmark the approach to governance taken by Safeguarding Adult Boards.Value -The benchmarking framework will enable Safeguarding Adults Boards to audit, evaluate and further develop a range of robust governance arrangements.
Purpose -The research reported here aims to scope the concept of self-neglect as it is explored in the literature and interpreted in practice by professionals involved in adult safeguarding.Design/methodology/approach -The approach taken included a systematic search and thematic analysis of English-language literature on self-neglect, workshops with UK-based adult safeguarding leads and practitioners from social services, police and health services, and scrutiny of Safeguarding Adults Boards' documentation.Findings -The concept of self-neglect is complex with contrasting definitions and aetiology, accompanied by debates on the principles that guide intervention. Decision-making capacity is a key pivot upon which professional responses to self-neglect turn. Intervention in self-neglect requires careful exploration in the context of principles of personalisation, choice, control, and empowerment that underpin policy in adult social care and safeguarding.Research limitations/implications -As a conceptual scoping review, this study seeks to establish broad themes of use to practitioners working with self-neglect. It thus does not carry out a full quality review of the literature identified and discussed, but serves as a base for this to be done in future.Practical implications -Assessment in self-neglect should consider the influence of a number of possible causative factors, and intervention must balance respect for autonomy on the one hand and a perceived duty to preserve health and wellbeing on the other.Originality/value -This article summarises and critically analyses the emerging key features of evidence-informed practice in the challenging field of self-neglect.
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