What is Making Safeguarding Personal?
Chapter 14 Care and Support Statutory Guidance sets out the following:
“Making safeguarding personal means [safeguarding] should be person-led and outcome-focused. It engages the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety”.
As Making Safeguarding Personal is set out in statutory guidance, you must adhere to it and should you depart of the statutory guidance you must have a rationale for doing so, which should be clearly documented.
Making Safeguarding Personal (MSP) moves away from paternalistic approaches and means we place adults at the centre of decision making regarding their lives, which means safeguarding is done with a person not to them. MSP is relevant to all aspects of safeguarding activity, across all agencies, and is not only relevant in formal enquiries.
MSP means we need to ask the person what they would like to happen and how. This might differ from your professional opinion! Choice and consent are important, meaning that you should seek consent for any actions you take for the person, taking account of mental capacity. MSP does not mean that refusal of help should not be taken at face value, but it requires proactive engagement work to help people make sense of their situations and make informed and considered choices. MSP does not give us an excuse to do nothing if the person does not want to take any action, there are still actions we can take to support the person such as giving advice and providing information, and in certain circumstances we do need to take actions that are contrary to Making Safeguarding Personal for that person.
MSP requires you to be professionally curious, for example, if a patient declines any safeguarding support, be curious to the reasons why and work with the individual to overcome any obstacles in seeking support. People may not know any other options to their situation and the abuse and/or neglect could be normalised.
When you identify a safeguarding concern, you should:
- Ask the person what their desired outcome is, which should be recorded, and this should guide any action or intervention.
- You should support them to understand and consider the risks they face; this often requires more than one conversation.
Examples of outcomes could be that they want to move homes, end a relationship, someone else to manage their finances etc.
Remember that MSP does not mean eliminating every risk and that we need to work in a strength-based and person-centred way with people we support. Judge Munby once said about risk appraisals: “What good is it making someone safer if it merely makes them miserable?” (§ 120 Local Authority X v MM & Anor (No. 1) (2007)) which is a good guide for your safeguarding practice as it emphasises the person at the centre.
Principles of Safeguarding Adults
In addition to the principle of Making Safeguarding Personal, the Statutory Guidance sets out the following principles of Safeguarding Adults practice:
- Empowerment
- Prevention
- Protection
- Partnership
- Proportionality
- Accountability
As you can see, engaging with the adult is the key and the ethos of safeguarding adults’ practice.
When would you raise a concern even if it goes against Making Safeguarding Personal?
The principle of Making Safeguarding Personal is not without its dilemmas. There are several situations where we may need to act contrary to someone’s wishes. Prior to action it is important to discuss a concern with the adult directly, MSP requires careful balancing of consent against safety. Before deciding the next steps ensure you seek information held by other professionals or informal supports. There are situations in which action should be taken without consent even where the person has mental capacity:
- Emergency or life-threatening situations
- Other people are, or may be, at risk, including children. This could mean concerns about a care home/provider that impact other residents
- A serious crime has been or might be committed.
- If the risk appears to you unreasonably high
- If someone in a position of trust is implicated (PiPoT)
An example of a situation that can cause dilemmas regarding MSP are hoarding situations. The person who are hoarding may not wish to take any actions in regard to this, for you as a practitioner it is essential to understand the backstory to the self-neglect hoarding and can only be achieved through communicating with the person. The challenge lies in that hoarding can cause significant harm to others through fires, vermin and diseases and each local authority will have a Hoarding Policy/Protocol which they adhere to and when hoarding is at a certain level, actions may be taken against the wishes of the person, such as enforced deep clean.
Another situation which may cause a dilemma is that a person discloses a serious crime to a practitioner, but do not wish to take any actions, however, we may still have a duty to report this despite the wishes of the person. The reasons could be public interest or children being at risk.
Making Safeguarding Personal and Mental Capacity -
MCA, BIA and DoLs - Mersey Care
MSP is for everyone, even if they lack mental capacity regarding the safeguarding concern. Lack of capacity does not mean that someone’s desired outcomes cannot be established, which can be done via representation by family/friends or an advocate. As an example, a person may lack capacity regarding financial decisions, but this does not automatically mean they can’t make decisions about the care they are receiving. We must work according to the principles of the Mental Capacity Act 2005 and make a best-interests decision in terms of specific safeguarding risks.