UNIVERSITY OF SUNDERLAND

MENTAL HEALTH NURSING PRACTICE

NRS200

NAME: MARCUS MUABE NJUME

STUDENT NUMBER: 1113478276

TOPIC: ADULT SAFEGUARDING POLICY ANALYSIS

2037 words
Introduction.

 Adult safeguarding involves securing vulnerable people from neglect or abuse of

any form (Killeen et al., 2022). According to Chambers et al. (2021), safeguarding is

a term that encompasses diverse activities considered to protect adults at risk of

harm or abuse, including investigations and interventions into allegations of abuse,

and the approach to prevent abuse.

For consent and confidentiality, in accordance with the Code of Professional

Standards of Practice and Behaviour for Midwives Nurses, and Nursing Associates

published by the NMC (Nursing and Midwifery Council), (The NMC Code, 2018), this

report was created by examining an NHS local Trust policy on safeguarding adults. 

The Lead Professional for Safeguarding Adults created the policy, and the

Safeguarding Adult Board approved it in February 2022. The policy was selected for

this report because it is indispensable to safeguard the well-being, and human rights

of vulnerable adults and to offer additional help to those who are unable to defend

themselves against harm or abuse so they can live in safety from any form of abuse

or neglect (Killeen et al., 2022). This reinforces the value of the safeguarding

principles, which include empowerment, protection, accountability, proportionality,

prevention, and partnership, and is connected to the ethics of protecting adults

(Johnson and Bolland, 2019).

The policy document was designed to target a wider assemblage, including patients,

visitors, vulnerable adults, and healthcare workers, and obligated to collaborate with

local Safeguarding Adults Boards (Tieman and Lewis, 2021). The policy's guidelines

are simple and understandable (Chambers et al., 2021). This report would recognise

the implications and importance of evidence-based practice regarding person-

centred care and how it is relevant to the chosen policy and the relevance of service
users and caregivers' inclusion in the delivery and evaluation of research in

healthcare. Also, the student would critique a piece of research evidence that was

utilised in the formulation of the Trust policy. 

The Trust policy was formulated using sources from the Department of Health (DH),

the Mental Capacity Act, (2005), and the Royal College of Nursing (RCN) in addition

to a research article on adult safeguarding (Aspinwall-Roberts et al., 2022). These

sources sit at the bottom of the hierarchy of evidence pyramid because they consist

of background information and expert opinions, whereas the research article is at the

fifth position in the evidence pyramid, and qualitative research that aims to get a

deeper knowledge of social phenomena as it concentrates on the "why" as opposed

to the "what" of social occurrences (Kartz et al., 2019). The hierarchy of evidence is

pertinent to Evidence-Based Practice (EBP) because it helps identify the most

reliable research evidence that may be used to inform clinical practice (Ball and

Regan, 2019).

For nurses to make informed decisions about patient care, EBP must be used in a

fair, objective, and responsible manner to inform policy and incorporate the most

pertinent research, clinical knowledge, and patient preferences into clinical practice.

(Lund et al., 2021; Kumah et al., 2019).

According to Engle et al. (2019), the goal of EBP is to provide the patient with the

best outcomes possible while providing the most efficient care feasible while Duff et

al. (2020) reiterates that EBP offers patients the best effective course of treatment by

drawing on pertinent, reliable, and current research.

EBP informs the chosen policy by decreasing the likelihood of harm or abuse while

promoting quality, efficacy, and aids practitioners' ability to make clinical decisions,
by exploring the best and current research evidence (Lehane et al., 2019; Li et

al., 2019).

Lempp et al. (2017) in their study highlight the significance of caregivers' and service

users’ involvement in the delivery and evaluation of research in healthcare by

reporting that their involvement makes the research meaningful, resulting in higher-

quality research, and makes the process of knowledge transmission easier.

Moreover, caregivers may also gain from the process of research partnership by

learning new ways to interact with people who are living with mental health

(Berzins et al., 2018). Service users have acknowledged that their participation gives

them a voice and allows them to have an impact on research projects that may later

be of benefit to them (Gordon et al., 2018). 

The piece of research used for the formulation of the Trust policy was a user-led

exploratory research of mental health patients' experiences with targeted abuse and

violence, would be examined as the chosen policy evidence. The policy evidence

was published in 2019 and formulated by eight authors from different universities

across the United Kingdom and service users with mental health difficulties, adult

safeguarding and mental health professionals, and partner agencies were the target

audience for the policy evidence. (Carr et al., 2019). 

The policy evidence is chosen for this report because it encourages practitioners and

organisations involved in mental health and adult safeguarding to comprehend how

targeted abuse and violence affect the lives of mental health service users as well as

their behaviour when it comes to seeking treatment and preventing harm from

happening (Carr et al., 2019). In support Radell et al. (2021) highlight in their study

that targeted abuse in adulthood is frequently the primary cause of the onset of

depression, anxiety, and other mental health disorders while Troya et al. (2019)
reiterate that it can result in sleep difficulties, self-harm, attempted suicide, eating

disorders, and substance abuse.

The author's approach to the research methodology was appropriate because it

strives to share, discuss, validate, and make more universal the experiences that

different people bring (Aktar et al., 2020).

The nature of the policy evidence depicts a qualitative investigation of the

perceptions of targeted abuse and violence of service users with mental health

difficulties, and its methodology entails twenty-three adult participants over the age

of 18 living in England who self-defined as having mental health issues and had

mental ability to self-select, were interviewed for forty-three minutes to three hours.

(Carr et al., 2019). Richardson et al. (2018) assert that service users’ participation in

research is crucial for expanding knowledge of the topic and improving knowledge of

mental distress, social inclusion, and self-management, while Berzins et al. (2018)

identify that service users’ participation aids in guiding research practices away from

a propensity to conduct research on particular people or groups.

Conversely, Berry et al. (2019) argue that service users may encounter difficulties

during research interviews such as anxiety, doubts about the value of any

contribution, unfamiliarity with technical words, unclear roles, and a desire to avoid

appearing ignorant.

In addition, the data shows a small sample size, which can affect the reliability of the

findings as Gumpili and Das (2022) argue that a small sample size may undermine

the study’s significance, increase the error margin and make it difficult to extrapolate

the results and to tell whether a given outcome is a true finding.

The narratives of the interviews were scrutinised through an initial thematic analysis

as this makes it easier to comprehend participants' responses, understand what they

are saying, and analyse and summarise the overall research findings more

effectively (Rees et al., 2021). Montgomery et al. (2022) in their study suggest that

thematic analysis is adaptable and works remarkably well in 95% of feedback

scenarios because most people try to be explicit when they give feedback. On the

contrary Ahuja et al. (2022) dispute that this adaptability could lead to

inconsistencies and a lack of coherence when developing themes based on the

study's findings.

Informed by emancipatory research, the policy evidence enabled practice and policy

stakeholders to examine potential consequences for adult safeguarding in

connection to the implementation of the Care Act 2014, which establishes a

legitimate framework so that significant organisations and people with adult

safeguarding responsibilities can agree on how they must cooperate, and what roles

they must play to keep adults at risk safe (Johnson and Bolland, 2019). Additionally,

Shorrock and O’brien (2022) identified that without organisations and individuals

working cooperatively and recognising that safeguarding is everyone’s concern,

effective safeguarding cannot be attained.

The policy evidence went through an ethics committee and the Middlesex University

London Research Ethics Committee granted its ethical approval. Ethics committees

assess research proposals involving human participants and their data to ensure

they adhere to national and international ethical standards (O’Sullivan et al., 2020).

Therefore, the policy evidence must go through a research committee because it

safeguards study participants, and the public's perception of researchers' behaviour

and the worth, rights, security, and well-being of research participants is boosted as

a result as this will inspire more people to participate in research (Gordon, 2020).
Heerings et al. (2020) found that it is unethical to deny mental health service users’

access to meaningful participation in research and practice. Moreover, Muhorakeye

and Biracyaza (2021) suggest that the concepts of benefit and harm need to be

carefully considered when involving service users, as well as the knowledge that

discomfort when remembering upsetting or traumatic incidents is not always

tantamount to harm provided appropriate protocols and supports are in place and the

interviewer has the relevant expertise and training.

The findings of the policy evidence revealed that people with mental health

difficulties might not believe that adult safeguarding definitions apply to them, and

reduced services could put vulnerable people at risk to being subjected to targeted

violence and abuse. (Carr et al., 2019). In this regard, Chambers et al. (2021),

emphasised that vulnerable adults must be protected from abuse and neglect to

have the best outcomes, receive effective and safe care, and to live healthily without

the threat of abuse, harm or neglect. 

The findings further revealed service users’ experiences of feeling lost in their

vulnerability and inadequate service responses and the fear of speaking up.

Shorrock and O’brien (2022) in their study found that lack of a support system,

ignorance of the abuse, embarrassment or shame, or fear of the repercussions of

coming out were some of the reasons for not speaking up, while in another study

Hafford-Letchfield et al. (2018) identified that many disclosures were either not

acknowledged or understood, or they were brushed off, downplayed, or disregarded,

which resulted in no action being taken to help or protect the young person.

In terms of the strength and quality of the policy evidence, the study was based on a

focus group of mental health service users, its methodology was clear, and the style

of the interviews was created to help the authors achieve their objectives by having
participants answer questions about their experiences on the questions that were

asked (Carr et al., 2019). 

In addition, the research was conducted in compliance with research ethics as

Sivasubramaniam et al. (2021) noted that research ethics set guidelines for

behaviour among researchers while O’Sullivan et al. (2020) reiterate that these

guidelines make sure that researchers uphold moral principles including honesty,

objectivity, integrity, and accountability in their work while also protecting the rights

and dignity of research participants.

Moreover, primary research sources were utilised in the development of the policy

evidence, even though the relevance of these sources was not discussed in the

policy evidence, as discussing the relevance of these sources establishes the

accuracy of the information's source and its content, enhances the ability to

differentiate between pertinent and extraneous content as well as evaluating its

value as source material (Gordon, 2020).

The research evidence in one of its weaknesses highlights that since females made

up most of the interviewees, the findings mostly represent the ideas and experiences

of a varied range of females and that a fundamental weakness of the study is the

absence of experiences and viewpoints from males (Carr et al., 2019). Aktar et

al. (2020) identified that gender balance in research lends more credence to the

findings and enhances the strength and quality of the research.

In conclusion, this report has looked at the definition of safeguarding adults, utilised

a local Trust policy on the said topic, and explained how it was formulated and the

sources used. The report has examined the implications and relevance of EBP and

how the chosen policy informs EBP. The report has also examined and analysed the

nature, methodology, ethics, strengths, weakness and the findings of policy evidence
used in the formulation of the Trust policy which demonstrates service users’

perceptions of targeted abuse and violence and the necessity of multiagency

cooperation in protecting adults.

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