Pointers for Practice: Care and support or care and support, protection needs?

Practitioners encounter significant challenges when determining thresholds for intervention. It is impossible to reach universal agreement because we are dealing with individuals not objects, and each case has to be assessed based on the individual’s circumstances. This means practitioners must use their professional judgement when establishing whether an adult at risk has care and support, protection needs.

There are a number of barriers to consistent decision-making. These include:

• Subjective, inconsistent interpretations of abuse and neglect
• Variations between agencies when interpreting level of need
• Balancing the need to empower individuals with minimising risk
• Perceiving adults at risk as ‘vulnerable’ and the implications of this label
• Assessing mental capacity in relation to specific decisions
• Lack of clarity regarding role and responsibilities
• A risk averse society leading to a watch my back approach.

Moreover, despite the best will in the world individual practitioners hold their biases values and beliefs which will impact on their perception of the adult at risk and their situation.

Some commonly held perspectives are:

• dehumanising the individual by seeing the person as the problem or issue, for example, ‘the neglect case’;
• ageist views about the needs of older people. Similar views may be held about adults with learning disabilities;
• presuming that adults who have become highly dependent on carers or staff, for example, within a care home, cannot identify their own needs and desired outcomes;
• making presumptions about adults at risk from BAME communities. For example, South Asian families look after their older people.

It is important, therefore, that practitioners routinely ask of themselves ‘How are my views influencing my perception of this situation? It is important that supervisors recognise and challenge practitioner bias, values and beliefs if risk assessments are to be person-centred.