Case Study: Safeguarding Vulnerable Adults - Applied Social Studies

This case study, prepared by a student and available on Desklib, delves into the critical area of safeguarding vulnerable adults. It analyzes three distinct scenarios: a 42-year-old man with Down syndrome being exploited, an 85-year-old woman facing mobility challenges, and a 45-year-old woman with a learning disability who experienced childhood sexual abuse. The assignment applies safeguarding theories, particularly complexity theory, to identify main issues, indicators of concern, and the capacity of individuals to make choices under the Mental Capacity Act of 2005. It also examines other concerns, such as lack of support and family dysfunction, proposing solutions like increased support worker hours and caregiver assistance. The case study explores the roles of different professionals, including social workers and police, in safeguarding vulnerable individuals and provides detailed safeguarding plans for each scenario. It emphasizes the importance of understanding the individuals' environments and relationships to prevent abuse and ensure their safety and well-being, offering a comprehensive approach to managing and mitigating risks.

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SAFEGUARDING THE VULNERABLE
By
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Introduction
There is growing evidence that adults who are vulnerable face an increasing risk of abuse
when compared to the less vulnerable in society. Those most affected are older people, people
with mental conditions and those with learning disabilities (Northway and Jenkins, 2017, p.6).
While there is no formal definition of a vulnerable person, the UK Department of Health defines
a vulnerable person under the “No Secrets” policy as someone who is in need of community care
services because they suffer from a mental illness or disability and are unable to take care of and
protect themselves from harm, exploitation and abuse (2017, p. 27). The concept of safeguarding
refers to protecting the right to life of a person, free from abuse, harm and neglect. Individuals
are also supported so that they have control and make choices for themselves (NHS England,
2017). This assignment will analyze three scenarios while referring to the theory of safeguarding
by looking at the main issues in the scenario, indicators that cause concern, the capacity of the
individuals in the study to make personal choices.
Safeguarding Theory
The complexity theory is a model that is used by social workers in safeguarding adults
and children by providing an approach to understanding and evaluating outcomes. By using
complexity, social workers are able to develop their knowledge and skills to better understand
the client’s environment and its interconnectedness (Wolf-Branigin, 2013, p.142). This theory
looks at individuals as constitutive components of the various systems that they live or work in
and that the individual’s behavior has an impact on the whole system (Pycroft and Bartollas,
2014, p. 15). The complexity theory has concepts that are used to understand complex adaptive
systems which are characterized as being determined by order or chaos. These complex systems
lack equilibriums making them prone to abrupt changes (Stevens, 2008). Small changes in the
system might lead to large-scale changes that are unpredictable or no changes at all. People in
need of special care are exist within a complex system and caring for them leads to further
complexities (Stevens, 2008)
Main Issues Present
In the first scenario, Leo is a 42-year-old man with Down syndrome who has made
friends with a group of men from the local pub. The men are using him to deliver their packages

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and he thinks the contents are washing machine parts. It can be assumed that these men are using
Leo to deliver drugs or illegal products. His support workers are concerned and they have told
him to stop his interaction with these men but he has refused. The men are most likely taking
advantage of Leo’s intellectual deficits by using him to deliver their packages.
In the second case, Mrs. B is 85 years old and has been admitted to hospital following a
fall. She lives on her own but she receives help from her neighbors and her daughter who lives
50 miles away. The fall has created mobility issues and has affected her ability to take care of her
personal care needs independently. There is a suggestion to move her to a nursing home but Mrs.
B is against this idea and her daughter has stated she will not be able to support her if she lives at
home. There is a chance she can stay at home with assistance but she has not been assessed by a
social worker.
The third scenario deals with Susi, a 45-year-old female who has a moderate learning
disability but is highly independent. She was sexually abused as a child by older males in her
family which made her accept violence and unwanted sexual relationships as something normal.
She disclosed to her social worker that she was sending pictures of herself online to strangers.
Her family is dysfunctional and they are unable to provide protective care for her.
Indicators that Cause Concern
The indicators that cause concern in Leo’s case are that he is being used to deliver
suspicious packages by men he met at a pub. In the complexity theory, a concept known as self-
organization states that an individual’s behavior is a product of their interactions with other
people and their environment. It is during interactions that self-organization occurs within the
person’s environment, making it easy for them to be harmed by their complex environment or
relationships (Stevens, 2008). Leo’s social workers are concerned that his complex relationship
with the men might cause harm him at some point.
In Mrs. B’s case, the fall has affected her independence and she can no longer take care
of herself, therefore requiring full support. Jin (2018), notes that falls are the main cause of
injuries in people who are 65 years and older. The risk of falls in this age group is high because
of balance issues, fragility and weakness, poor vision, and cognitive problems (Jin, 2018). Mrs.
B’s situation falls under self-organization concept in the complexity theory because her behavior

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will affect whether she will receive assistance with her care in a nursing home or she will place a
significant burden on her daughter (Stevens, 2008).
Indicators of concern for Susi are that she engages in unwanted sexual relationships,
sends pictures of herself to strangers online and she has a tolerance for violence. Her moderate
learning capability has made it hard for her to differentiate between a normal and violent
relationship. According to the Social Care Institute for Excellence (2018), people with special
care needs are more likely to be abused because they are an easy target, are not aware they are
being abused and are less likely to report abusive situations. In the complexity theory, her abuse
is seen as an occurrence of events that will occur with certainty because of her complex
environment/dysfunctional family (Stevens, 2008).
Capacity of Individuals to Make Choices
The Mental Capacity Act of 2005 states that, anyone 16 years and above with mental
impairments can make informed decisions on their own as long as they have all the relevant
information to make a decision (Brown, Barber and Martin, 2015). This information should be
easy to understand and can be in the form of diagrams, symbols, videos or a verbal conversation
(Down’s Syndrome Association, 2018). Under the Act, Leo has the capacity to make decisions
for himself because he receives support decision making from his social workers.
In the scenario, Mrs. B gets confused at times which might affect her cognitive functions
and ability to make sound decisions. According to Mitoku and Shimanouchi (2014), older people
want to make decisions on their own despite the fact they need assistance with care. They need
support in decision making but when their cognitive functions are impaired, it becomes difficult
for them to do it on their own. Mrs. B does not have severe cognitive impairment so she can still
make decisions for herself but her daughter might be required to speak for her especially when
she becomes confused.
People with moderate learning disabilities have a degree of independence and might
require support in some areas to achieve this independence. They can make decisions on their
own as long as they have enough time to consider all aspects that are needed in reaching a
decision. In England, there are policies that support people with learning disabilities by making
provisions for their rights, independence and capacity to choose. These policies give guidance to

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the patient and the practitioner when it comes to decision making (Atherton and Crickmore,
2011, p.77). Susi can make decisions on her own based on the Mental Health Act of 2005
because she is a highly independent person.
Other Concerns about the Situation and Solutions
In Leo’s situation, he does not receive support from social services during the evenings
and night. This has created an avenue for him to engage with the men at the bar because there is
no one to monitor his activities during this time. To mitigate this problem, two support workers
should be hired for the evening and night shift to monitor him and report concerning activities to
the team manager. For Mrs. B, her daughter lives 50 miles away, making it difficult to take care
of her mother on a frequent basis. It can be assumed the daughter has caregiver stress because of
the burden of taking care of her elderly mother (Del-Pino-Casado et al. 2018). To address this
concern, an aide can be hired part-time to take care of Mrs. B so that her daughter can have some
time to rest.
In Susi’s case, she has no contact with her child who has been placed in permanent care.
According to the attachment theory, parents or caregivers need to be present and accessible for
the children to form a bond with them (Howard et al. 2011). A child assesses attachment as
having a mother or father who is physically accessible to the child. If the parent is not available,
there is a disruption to the family unit and the child might experience emotional distress,
instability and a lower cognitive functioning. This is a cause of concern in Susi’s case because
her child might be negatively affected by this mother-child separation (Howard et al., 2011).
Steps can be taken by social support for her to visit the child as long as it’s deemed suitable for
both her and the child.
People Involved in Safeguarding
In their study, Graham et al. (2016) developed three models which can be used to address
safeguarding concerns. The first model known as the dispersed-generic-model involves social
workers who perform investigations, senior social workers who conduct complex investigations
and provide supervision, team managers who coordinate and chair meetings (Graham et al.,
2016, p.10). In the dispersed-specialist model, social workers specialized in safeguarding
coordinate high risk investigations while local social workers perform the low-risk investigations

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(2016, p.11). The centralized operational model involves specialist teams that investigate and
coordinate high risk investigations (Graham et al., 2011, p.14).
If a concern is deemed to be low-risk, senior social workers within the local teams
coordinate the investigations while the high-risk investigations are done by the specialist teams
(2011, p.14). In Leo’s case, it can be considered high-risk because of the interactions he has with
the men from the pub. Therefore, the people involved will be centralized specialist social
workers in the local team to coordinate and conduct investigations. The local police will also be
involved to investigate the men.
In Mrs. B’s case, the people involved will fall under the dispersed-generic model where a
social worker within the local team will address safeguarding concerns especially related to
home care (Graham et al., 2011, p. 10). Her daughter should also be involved especially in the
assessment so that she can be involved in decision making. Susi’s situation is high-risk because
of her tolerance to violence, unwanted relationships and past sexual abuse. The people concerned
with her case will be specialist social workers who can coordinate and investigate safeguarding
concerns under the dispersed specialist model (2011, p.14).
What to do and Why (Safeguarding Plan)
A safeguarding plan is a set of actions that have been agreed on to manage ongoing cases
of negligence or abuse involving special care adults (Gloucestershire.gov, 2018). The tables
below represent the safeguarding plans for Leo, Mrs. B and Susi. There is a comprehensive
safeguarding plan in the appendix.
Leo’s Safeguarding Plan (Western Care, 2016)
What are you trying to do? Determine what kind of business Leo has with the men at the
pub, if it is legal or illegal, if they are taking advantage of his intellectual disability.
What safeguarding actions will be done: Carry out an investigation of Leo’s activities
and involve the local police to investigate the men’s business activities
People responsible: Specialized social worker, local police, team manager/coordinator
Completion date: The investigation will be done in three months to effectively monitor
Leo and the men
Review date: In four months’ time

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Status/update (initial review should be within six months): Green
RAG: Red- unable to complete action/significant delay, Amber-difficulty achieving, Green-
Action complete or will be complete within timescale
Name of Safeguarding Co-ordinator: Date of Initial Safeguarding Plan:
Date of Review of Safeguarding plan:
Mrs. B’s Safeguarding Plan (Western Care, 2016)
What are you trying to do? Perform a home care assessment to determine if Mrs. B
should live at home with assistance or be moved to a nursing home
What safeguarding actions will be done: Observe how she performs her activities of daily
living (independently, with minimal, moderate or full support)
People responsible: Social worker within the local team
Completion date: One month
Review date: Eight weeks
Status/update (initial review should be within six months): Green
RAG: Red- unable to complete action/significant delay, Amber-difficulty achieving, Green-
Action complete or will be complete within timescale
Name of Safeguarding Co-ordinator: Date of Initial Safeguarding Plan:
Date of Review of Safeguarding plan:
Susi’s Safeguarding Plan (Western Care, 2016)
What are you trying to do? Find out if she is in a relationship that is coerced or violent
What safeguarding actions will be done: Provide support and engagement in activities to
increase her self-esteem, seek counselling services and encourage her to attend a
survivors group for abused women.
People responsible: Specialist social workers
Completion date: Two months
Review date: Three months
Status/update (initial review should be within six months): Green
RAG: Red- unable to complete action/significant delay, Amber-difficulty achieving, Green-
Action complete or will be complete within timescale
Name of Safeguarding Co-ordinator: Date of Initial Safeguarding Plan:
Date of Review of Safeguarding plan:
References

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Atherton, H.L. and Crickmore, D.J. (2011). Learning disabilities: toward inclusion. Churchill
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id=T5PzwMYPkbYC&pg=PA87&dq=can+people+with+moderate+learning+disabilities+make+
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page&q=can%20people%20with%20moderate%20learning%20disabilities%20make
%20decisions&f=false
[accessed 28 November 2018]
Brown, R.A., Barber, P. and Martin, D. (2015). The Mental Capacity Act 2005: a guide for
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id=bRJiCgAAQBAJ&printsec=frontcover&dq=mental+capacity+act+2005&hl=en&sa=X&ved=
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Del-Pino-Casado, R., Frias-Osuna, A., Palomino-Moral, P.A., Ruzafa-Martinez, M. and Ramos-
Morcillo, A.J. (2018). Social support and subjective burden in caregivers of adults and older
adults: a meta-analysis. Plos One, [online], available: https://journals.plos.org/plosone/article?
id=10.1371/journal.pone.0189874
Down’s Syndrome Association. (2018). For families and carers: making everyday decisions
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everyday-decisions-post-16/ [accessed 28 November 2018]
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_section_11_safeguarding_plansc41e.pdf [accessed 28 November 2018)

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Graham, K., Stevens, M., Norrie, C., Manthorpe, J., Moriarty, J. and Hussein, S. (2016). Models
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Appendix

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1. Details of Safeguarding Report
1. Summary of the investigation
2. Needs or risks identified (are there ongoing support services during the formulation
of a safeguarding plan)
3. Is the Vulnerable person aware there is a safeguarding?
Yes  No 
What are their opinions about the plan?
4. Detail and outcome of any Strategy Meeting or Case Conference if held:
5. Safeguarding Plan to deal with current and/or any future safeguarding problems:
6. Category of concern(s)/suspected abuse where reasonable grounds have been
established and formal safeguarding plan has being formulated:
Sexual abuse
Financial abuse
Physical abuse
Neglect
Psychological abuse
Discrimination
7. Additional information: