Emerging from out of the shadows? Service user and carer involvement in systematic reviews

The systematic review methodology literature refers to the importance of involving stakeholders, including service users and carers, in the research. However, compared with other aspects of the methodology, this aspect of conducting systematic reviews is under-developed and the practice of involvement appears highly variable. This article draws on the experience of working with service users and carers in one systematic review to review the barriers to participation and the components of effective involvement. It suggests that quality standards can be identified for service user and carer involvement in systematic reviews, which will benefit policy and practice development

Carers as partners in social work education

This report explores the extent and nature of participation by caregivers in the education of social work students in England. A national survey gave rise to a series of telephone interviews with education providers; regional workshops then brought together for discussion representives of carers' organisations, individual caregivers and educators. The study identified the ways in which caregivers are involved in educating social work students, the challenges experienced, the factors that facilitate positive involvement, and the outcomes experienced by those involved. The report makes a series of recommendations designed to facilitate good practice in caregiver participation in social work education

Self-neglect and adult safeguarding: findings from research

This report was commissioned by the Department of Health (DH) and examines the concept of self-neglect. The relationship between self-neglect and safeguarding in the UK is a difficult one, partly because the current definition of abuse specifies harmful actions by someone other than the individual at risk. Safeguarding Adults Boards’ policies and procedures commonly contain no reference to self-neglect; occasionally they explicitly exclude it or set criteria for its inclusion The perceptions of people who neglect themselves have not been extensively researched, but where they have, emerging themes are pride in self-sufficiency, connectedness to place and possessions and behaviour that attempts to preserve continuity of identity and control. Traumatic histories and life-changing effects are also present in individuals’ own accounts of their situation. Self-neglect is reported mainly as occurring in older people, although it is also associated with mental ill health. Differentiation between inability and unwillingness to care for oneself, and capacity to understand the consequences of one’s actions, are crucial determinants of response. Professional tolerance of self-neglect as lifestyle choice is higher than when it accompanies physical/mental impairment. Professionals express uncertainty about causation and intervention

Law Learning in Action: An Action Learning Project to Evaluate Processes and Outcomes of using Law E-learning Objects in Social Work Education

This document reports on a research project funded by the Social Care Institute for Excellence to evaluate the processes and outcomes (for social work students and educators) of using a suite of e-learning objects within law teaching on social work degree programmes. The e-learning objects in question were published by SCIE in 2007, and those involved in their development were keen to explore how they were being used, and what their impact might be. The research, which started in 2008 and reached completion in 2010, has tracked a group of educators in 6 universities as they have engaged in a process of collaborative capacity building, through participation in a learning set designed to support their own engagement with e-learning and to develop skills in evaluating their outcomes for students. A full list of the SCIE law e-learning objects and their associated learning outcomes is given at Appendix 1

Broadening the vision: law teaching, social work and civil society

In the context of debates about social work’s relationship with individuals, the state and civil society, educators face a challenge. How best to ensure that professional education prepares practitioners to engage with the task of promoting social justice and human rights? This article draws on a systematic knowledge review of learning, teaching and assessment of one key subject area in social work education - that of law - to explore the contribution legal knowledge and skills can make to social work’s engagement with its vision of empowerment and liberation

Learning lessons about self-neglect? An analysis of serious case reviews

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

A scoping review of workforce development for self-neglect work

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Autonomy and protection in self-neglect work: the ethical complexity of decision-making

Self-neglect, in which an individual does not attend to their hygiene, health or home surroundings, is one of the most challenging aspects of adult social care practice. In England, its inclusion within the remit of adult safeguarding, as a result of changes in adult social care law introduced under the Care Act 2014, has thrown into relief the ethical dilemmas arising from tensions between respect for autonomy on the one hand and the exercise of a protective duty of care on the other. This paper draws on serious case reviews and safeguarding adult reviews in self-neglect cases, along with findings from adult safeguarding research, to propose that an appropriate balance between these two moral imperatives is not always achieved in self-neglect practice. It considers why autonomy appears to be privileged over other considerations, illustrating the complex interplay between law and ethics that gives autonomy pre-eminence. It then considers how a more nuanced, situated and relational approach to autonomy can enable practitioners to move away from dichotomous interpretations of the moral imperatives present in self-neglect work, and can support more nuanced understandings of the ethics of professional decision-making. Finally it considers the personal and organisational implications of this enhanced ethical literacy

Self-neglect policy and practice: building an evidence base for adult social care

This research, commissioned by the Department of Health (DH), set out to identify what could be learned about current policy and practice in self-neglect, experienced as a highly challenging aspect of contemporary adult social care. A national (England) survey investigated current strategic and policy initiatives, with responses from 53 out of 152 local authorities (34.9 per cent). A series of in-depth interviews undertaken with 20 managers, 42 practitioners and 29 people who use services across 10 authorities identified approaches that have produced positive outcomes from the perspectives of those involved

On Systematic Reviews in Social Work: Observations from Teaching, Learning and Assessment of Law in Social Work Education

This paper draws on the experience of completing a systematic review of teaching, learning and assessment of law in social work education. It reviews core elements of the process and questions whether systematic reviews as currently conceived for social work education and practice can realise the claims advanced on their behalf. The paper considers questions of evidence, quality, knowledge, dissemination and research use, and offers observations on the potential of systematic review to provide knowledge for policy-makers, practitioners, researchers and academic tutors