On self-neglect and safeguarding adult reviews: diminishing returns or adding value?

Purpose: One purpose is to update the core data set of self-neglect serious case reviews and safeguarding adult reviews, and accompanying thematic analysis. A second purpose is to respond to the critique in the Wood Report of serious case reviews commissioned by Local Safeguarding Children Boards by exploring the degree to which the reviews scrutinised here can transform and improve the quality of adult safeguarding practice. Design/Methodology/approach: Further published reviews are added to the core data set from the web sites of Safeguarding Adults Boards and from contacts with SAB Independent Chairs and Business Managers. Thematic analysis is updated using the four domains employed previously. The findings are then further used to respond to the critique in the Wood Report of serious case reviews commissioned by Local Safeguarding Children Boards, with implications discussed for Safeguarding Adult Boards. Findings: Thematic analysis within and recommendations from reviews have tended to focus on the micro context, namely what takes place between individual practitioners, their teams and adults who self-neglect. This level of analysis enables an understanding of local geography. However, there are other wider systems that impact on and influence this work. If review findings and recommendations are to fully answer the question “why”, systemic analysis should appreciate the influence of national geography. Review findings and recommendations may also be used to contest the critique of reviews, namely that they fail to engage practitioners, are insufficiently systemic and of variable quality, and generate repetitive findings from which lessons are not learned. Research limitations/implications: There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here against the strands in the critique of serious case reviews enables conclusions to be reached about their potential to transform adult safeguarding policy and practice. Practical implications: Answering the question “why” is a significant challenge for safeguarding adult reviews. Different approaches have been recommended, some rooted in systems theory. The critique of serious case reviews challenges those now engaged in safeguarding adult reviews to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice. Social implications: Originality/value: The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of conducting safeguarding adult reviews by using the analysis of themes and recommendations within this data set to evaluate the critique that reviews are insufficiently systemic, fail to engage those involved in reviewed cases and in their repetitive conclusions demonstrate that lessons are not being learned

Role Models or Gateways to Resources?: Contemporary Confusions in Mentoring Practice

Mentoring has become increasingly popular in recent years in the criminal justice system, presented across the UK and internationally as a service that can address the specific ‘needs’ of women involved with the criminal justice system. This article draws on original qualitative research with mentors and mentees to explore their experiences and to establish the aims and processes of mentoring. The rhetoric of mentoring offered by mentors and staff suggested that mentoring was based on an individualistic approach that contained responsibilising strategies. In practice, however, mentors were helping women to resolve issues related to the welfare system and other services outwith the criminal justice system. If positive outcomes of mentoring are viewed by policy makers to be the result of an individualistic approach aimed at fostering ‘pro-social’ interventions, rather than the result of attempts to mitigate wider structural failures outwith the criminal justice system, then this takes responsibility away from the state and distracts from the deeper effects of criminalising processes

Examining the Psychopathology of Incarcerated Male Firesetters using the Millon Clinical Multiaxial Inventory-III

Research to date has been equivocal on the relationship between firesetting and psychopathology, and has been impeded by studies lacking adequate control samples. The present study examined psychopathology in a sample of incarcerated adult male firesetters (n = 112) and prison controls (n = 113) using the Millon Clinical Multiaxial Inventory-III. Firesetters demonstrated multiple elevated scores on personality and clinical syndrome scales. Logistic regression showed that the borderline personality scale was the strongest personality scale discriminator between firesetters and controls. Major depression and drug dependence were the strongest clinical syndrome scale predictors. However, both clinical syndrome scale predictors appeared to be mediated by borderline personality scores indicating that firesetters are best characterized by responding indicative of borderline personality traits rather than other psychopathological deficits. The results suggest that, relative to other offenders, firesetters face challenges with impulse control, affect regulation, stability of interpersonal relationships, and self-image

Australia's insurance crisis and the inequitable treatment of self-employed midwives

Based upon a review of articles published in Australia's major newspapers over the period January 2001 to December 2005, a case study approach has been used to investigate why, when compared with other small business operators, including medical specialists, Australian governments have appeared reluctant to protect the economic viability of the businesses of self-employed midwives. Theories of agenda setting and structuralism have been used to explore that inequity. What has emerged is a picture of the complex of factors that may have operated, and may be continuing to operate, to shape the policy agenda and thus prevent solutions to the insurance problems of self-employed midwives being found

Immaterial boys? A large-scale exploration of gender-based differences in child sexual exploitation service users

Child sexual exploitation is increasingly recognised nationally and internationally as a pressing child protection, crime prevention and public health issue. In the UK, for example, a recent series of high-profile cases has fuelled pressure on policy-makers and practitioners to improve responses. Yet, prevailing discourse, research and interventions around child sexual exploitation have focused overwhelmingly on female victims. This study was designed to help redress fundamental knowledge gaps around boys affected by sexual exploitation. This was achieved through rigorous quantitative analysis of individual-level data for 9,042 users of child sexual exploitation services in the UK. One third of the sample was male and gender was associated with statistically significant differences on many variables. The results of this exploratory study highlight the need for further targeted research and more nuanced and inclusive counter-strategies

Women, resettlement and desistance

With the numbers of women imprisoned increasing across Western jurisdictions over the last 15 or so years, so too have the numbers of women returning to the community following a period in custody. Despite increasing policy attention in the UK and elsewhere to prisoner resettlement, women’s experiences on release from prison have received limited empirical and policy attention. Drawing upon interviews with women leaving prison in Victoria, Australia, this article discusses the resettlement challenges faced by the women and highlights their similarity to the experiences of women leaving prison in other jurisdictions. Women had mixed (and predominantly negative) experiences and views of accessing services and supports following release, though experiences of parole supervision by community corrections officers were often positive, especially if women felt valued and supported by workers who demonstrated genuine concern. Analysis of factors associated with further offending and with desistance, points to the critical role of flexible, tailored and women-centred post-release support building, and, where possible, upon relationships established with women while they are still in prison

The Big Society and the Conjunction of Crises: Justifying Welfare Reform and Undermining Social Housing

The idea of the “Big Society” can be seen as culmination of a long-standing debate about the regulation of welfare. Situating the concept within governance theory, the article considers how the UK coalition government has justified a radical restructuring of welfare provision, and considers its implications for housing provision. Although drawing on earlier modernization processes, the article contends that the genesis for welfare reform was based on an analysis that the government was forced to respond to a unique conjunction of crises: in morality, the state, ideology and economics. The government has therefore embarked upon a programme, which has served to undermine the legitimacy of the social housing sector (most notably in England), with detrimental consequences for residents and raising significant dilemmas for those working in the housing sector

Conspicuous by their abstinence: the limited engagement of heroin users in English and Welsh Drug Recovery Wings

Background In recent years, an abstinence-focused, ‘recovery’ agenda has emerged in UK drug policy, largely in response to the perception that many opioid users had been ‘parked indefinitely’ on Opioid Substitution Therapy (OST). The introduction of ten pilot ‘Drug Recovery Wings’ (DRWs) in 2011 represents the application of this recovery agenda to prisons. This paper describes the DRWs’ operational models, the place of opiate dependent prisoners within them, and the challenges of delivering ‘recovery’ in prison. Methods In 2013, the implementation and operational models of all ten pilot DRWs were rapidly assessed. Up to three days were spent in each DRW, undertaking semi-structured interviews with a sample of 94 DRW staff and 102 DRW residents. Interviews were fully transcribed, and coded using grounded theory. Findings from the nine adult prisons are presented here. Results Four types of DRW were identified, distinguished by their size and selection criteria. Strikingly, no mid- or large-sized units regularly supported OST recipients through detoxification. Type A were large units whose residents were mostly on OST with long criminal records and few social or personal resources. Detoxification was rare, and medication reduction slow. Type B's mid-sized DRW was developed as a psychosocial support service for OST clients seeking detoxification. However, staff struggled to find such prisoners, and detoxification again proved rare. Type C DRWs focused on abstinence from all drugs, including OST. Though OST clients were not intentionally excluded, very few applied to these wings. Only Type D DRWs, offering intensive treatment on very small wings, regularly recruited OST recipients into abstinence-focused interventions. Conclusion Prison units wishing to support OST recipients in making greater progress towards abstinence may need to be small, intensive and take a stepped approach based on preparatory motivational work and extensive preparation for release. However, concerns about post-release deaths will remain

The ombudsman, tribunals and administrative justice section: a 2020 vision for the ombudsman sector

This article analyses the growing role for ombudsman schemes in the UK administrative justice system following the Government reforms post 2010. It argues that the ombudsman institution is perhaps the one example of an administrative justice body that looks set to emerge stronger over the period. But the ombudsman sector needs to guard against complacency, as the demands, expectations and publicity placed upon it are all likely to increase