Dr Sheila Fish, Senior Research Analyst at the Social Care Institute for Excellence (SCIE) spoke with us about the ethical and human rights issues that the pandemic has brought into focus and how it is important to tackle this head-on.

The Pandemic’s Impact on Safeguarding Adult Reviews (SARs)

From the beginning of the pandemic, SARs that had already been agreed were being delayed. The purpose of a SAR is to help identify what is hindering safeguarding work from being carried out effectively.[1]

The backlog caused by the delay of SARs being carried out diminished the relevancy and potency of the learnings available, which was coupled with the new and unique issues that the pandemic was causing.

Instances where carers and/or families of those in care had a reluctance to let professionals into their homes due to worries about contracting Covid-19, is an example of a pandemic-specific issue.

Trying to deal with new issues before they became overwhelming created a sense of urgency to identify cases such as these and share the learnings quickly.

The pandemic also provided further logistical challenges, with all those working in partnership with SCIE tackling issues such as setting up staff to be able to work from home effectively.

Balancing the statutory requirement to conduct SARs whilst also understanding the challenges to those carrying them out proved challenging during the first lockdown.

Rapidly Responding to Pandemic-Related Problems

In order to handle these issues promptly, SCIE began looking into the flexibility that The Care Act (2014) [2] affords regarding the format of SARs.

While providing a robust mandate on the obligations on SCIE and their partners to conduct SARs, it also gives Safeguarding Adult Boards (SABs) the freedom to be creative to generate the most useful findings.

In that context, part of the Department for Health and Social Care’s (DHSC) Covid-19 Action Plan for Social Care [3] was to fund SCIE to produce a new ‘Rapid Review’ of safeguarding processes and tools, as well as guidance for the social care sector.

This included the production of templates and frameworks to follow to fit with the new SARs in Rapid Time process, as well as supporting familiarisation with webinars and remote support.

SARs in Rapid Time

The new model of SARs in Rapid Time has been distributed to SABs across the country.

Dr Fish highlights that the new model is not a one-size-fits-all solution, an imposition or a requirement, or a remedy for all of the problems and challenges that exist when it comes to progressing the learning process.

The model is to be an additional tool for SABs to use to improve learning outcomes while being a pared-back option in terms of capacity, resource requirements, and turnaround time.

The key principle is to build on the knowledge base about effective approaches to learning, which are anchored in the SAR Quality Markers.

SAR Quality Markers provide a consistent and robust approach to carrying out SARs, which are predominately based on:

“established principles of effective reviews, experience, expertise, and ethical considerations.”[4]

However, within these principles and the broader understanding of the Social Care Act, the flexibility available to SABs allows them to prepare strategically rather than reactively.

Commissioning SARs proactively and with strong strategic planning can help alleviate some of the pressures, that became particularly prevalent when Covid-19 hit.

With better planning, SARs can generate deep analysis that moves from descriptive language about a case, to identifying more systemic problems.

The new model has also been designed to be compatible with the evolving National SAR Library.

The focus of this has been to give a qualitative understanding of enablers and barriers to adult safeguarding.

Testing and Refining the New Model

SAR in Rapid Time Sequencing[1]

The hypothesis being tested at the start was whether or not a SAR could be carried out in 15 days.

By the end of the testing phase, the conclusion was that this was probably a bit too fast and left little time to make a decision and carry out each part thoroughly.

The solution to this was to embed the quicker model in each respective SABs process.

This would allow the SAB to carry out their own referrals, initial decision-making, and inform the person and/or their family before step 1 of the new model, setting up the meeting.

After producing the systems findings report, the SAB would also have time to do their own governance and improvement actions.

SCIE took the learnings from their initial testing and pared back the model some more, to try and make it as rapid as possible whilst still meeting the capacity requirements of a SAR.

Capacity Requirements for a SAR[1]

Learning Outcomes

The most radical part of the new model is not the speed at which it is carried out, but the production of a systems finding report.

The reason there is a greater emphasis being put on this part of the process is that there is a need to give the SARs process “a window on the system.”[1]

It allows three key questions to be asked:

  • What is supporting good quality work?
  • What organisational factors make it more likely that anyone in a similar position would make similar poor decisions?
  • What is making it harder to do a good job?

The reports can help find systemic vulnerabilities and highlight whether there have been unintended consequences of recent changes and developments.

The majority of the feedback from the SABs involved in testing this new model has been positive, with emphasis on its concise approach, an easy-to-follow chronology, and the shared learning that comes from it.

Learnings can now be pooled, enabling better sharing, comparing, and collaborating across SABs.

[1] Fish, Dr Sheila. 2021. Head of Learning Together. SCIE. Safeguarding Adults in Response to the Covid-19 Pandemic

[2] Legislation.gov.uk. 2021. Care Act 2014

[3] Gov.UK. 2021. Coronavirus (COVID-19): adult social care action plan

[4] Mertonsab.org.uk. 2021. Safeguarding Adult Review Quality Markers Checklist

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From the beginning of the pandemic, Safeguarding Adult Reviews were already being delayed. In this article we’ll look at the challenges posed by Covid-19 when safeguarding adults.

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