Transcript Risk and participation in adult support and protection

IRISS SEMINAR
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Risk is about “the possibility of positive beneficial
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Participation is about the how of practitioners’
and harmful outcomes and the likelihood of their
occurrence in a stated timescale” (Alberg 1996:9)
work with people:
◦ to fully hear their views
◦ to gain a shared understanding
◦ to ensure that people are involved as fully as
possible in any decision-making.
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Interactive!
Hope to hear your voices as much as ours
Co- researchers will move around tables to
join in discussion rather than lead them
Photo exercise
◦ Select a photo from those on the table that best
speaks to you about trust
A Joint Research Project into
Supporting and Protecting Adults
Presenter on behalf of research
team : Kathryn Mackay
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East Dunbartonshire Council: Claire McLaughlan,
Sylvia Rossi
Falkirk Council: Justin McNicholl
Perth and Kinross Council: Diane Fraser, Mary
Notman
Stirling University: Kathryn Mackay
Aim:
To explore the assessment, decision making and
intervention from the perspective of the practitioner and
the person
Method:
Semi-structured qualitative interviews -October 2010
and May 2011
Sample:
29 practitioners , 6 adults defined as at risk of harm
(adults AROH) and 1 proxy/relative
Ethical approval:
University and agencies
Many excellent examples of working with risk alongside
the person, however key messages for today are :
 Being subject to ASP intervention is scary
 Building and maintaining relationships are essential AND
take time
 Working with uncertainty requires confidence and
support
 Use of words still the chief communication approach
 Case conferences: a low point in participation.
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First contact
Well, in a way it was good. Although I was
scared…… I was hoping they could help me. It was
what I wanted, somebody to help me. But it was
fear….
Person 1
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Professional power
One of the big things for (person) was they thought
that we had the power to (put them in care) and that
was always a fear ..So we continually reassured (the
person) that we would set up supports in the
community.
Practitioner 10
He did have his ups and downs and his
place did deteriorate again……….….He is
quite an able person as well, and it’s
looking at that and saying, well he’s lived
like that and he’s managed to stay out of
the criminal justice system and manage his
own mental health at times…. and not to
actually storm in and take that all away
from him.
Practitioner 15
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Why should a person have confidence in you
or your advice?
This takes time: more of a process not an
event or outcome
Practitioners talked of:
◦ having something to practical offer to demonstrate
usefulness
◦ ‘chipping away’, going the person’s pace
◦ being given more time, like being a social worker
than care manager
◦ Having ‘frank conversations’
We would never be able to stop that, she would
choose when not to and when to drink and
that’s what she did. But I mean her quality of
life improved as well because things like
getting things done in the house like she had
her living room decorated, new carpet that
sort of thing. If we hadn’t been involved she
would have had none of that Practitioner 1
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Some risks will never go away
Practitioners need support too>
To be confident with and within uncertain
situations
Being realistic about what change might be
possible
Responsibility ( limits to it) has to openly
shared with person, management etc.
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Whilst feeling safer there was often a sense of loss
about changed relationship where harmer was a relative.
I think that’s the time …he put his hand up,
but it wasn’t a bad, you know what I mean. But it’s
the
thought; aye, your boy doing that to you, he
couldn’t have done anything worse… and I miss him
terrible.
Person 5
Importance of acknowledging
Consideration of how addressed
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Practitioners referred on to experts
◦ learning disability nurses, psychologists
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When there were questions
◦ Of capacity
◦ Or challenges in communication e.g. autism- how people
interpreted the world and relationships
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One example of talking mats but again an ‘expert’
undertook work
Practitioners therefore relied on the spoken word a lot of
the time
…cos I’ve never been in before so it was really,
really bad. But (name of practitioner), she was
marvellous….And I wasn’t really picking up
everything. But…like (name of practitioner) would
explain anything I wanted. I didnae know anybody
so…I’d say who was that…and she would tell me
who it was. My daughter went with me for support.
Person 1
Working with the adult at risk of harm:
 Continued support for relationship- based work
 Recognise losses as well as gains for the person
 Promote choice and self-determination as the adult
grows in confidence and skills
 Consideration of different forms of case conferences
 Exploration of alternative methods of communication to
help people to verbalise their thoughts and feelings.
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To what extent do the research findings
match your experience?
What are the challenges / reasons behind
people not fully participating?
What might be some of the solutions?