Safeguarding and reviews in NHS continuing healthcare: keeping people safe

On Friday 25^th November, CHS Healthcare held the eighth installation of our continuing healthcare (CHC) webinar series – Safeguarding and reviews in NHS continuing healthcare: keeping people safe. Marking the end of this year’s adult safeguarding week,  we were joined by Kenny Gibson, Deputy Director for NHS Safeguarding at NHS England and Jonathan Senker, Chief Executive of patient advocacy charity VoiceAbility.

The webinar was an important discussion on the role of clinical reviews in safeguarding and why independent advocates need to continuously monitor for risks and prevent issues from arising in the first place. The following discussion points were addressed:

• The vital role CHC plays in the safeguarding of vulnerable people
• The importance of empathy and understanding when working with vulnerable people
• How robust review processes can support effective safeguarding
• How issues can be prevented by organisations conducting thorough clinical reviews
• How a focus on patient safety can act as an economic approach to NHS continuing healthcare

You can watch the full webinar here.

Our key takeaways from the discussion:

Looking at the whole person and their journey

The people we see for CHC assessments are a product of their living situation, their neighbourhood and community, the circumstances that led them to needing CHC support, as well as their individual emotions and aspirations.

It is critical to keep in mind that the situation in which we are assessing someone isn’t the full picture. We can get a lot of value from speaking to others, including neighbours, families, pharmacists, GPs, and district nurses. There are so many touchpoints that allow us to paint a complete picture of the individual and understand what the world looks like for them. This is of extreme importance especially in situations where the person lacks mental capacity. By having this holistic view, we can better identify potential safeguarding concerns.

Kenny Gibson shared the methods reviewers can use themselves to keep people safe, including challenging unconscious biases about cognitive impairment, family dynamics and domestic abuse.

Kenny also suggested being mindful of the language we use and the traumatic effects that safeguarding concerns can have – for example ‘cuckooing’ is a commonly used safeguarding term, but from the perspective of the person who experienced it, it’s a home invasion.

Advocacy should become a mainstream part of services

Jonathan Senker highlighted that all examples of safeguarding concerns and abuse are examples of a voice that hasn’t been heard.

Independent advocates can provide a voice for people who may otherwise struggle to express theirs. Jonathan shared how it’s currently unusual for people to have independent advocacy through the CHC process and it isn’t happening as often as it should. We need to highlight the legal right to advocacy in CHC assessments. The new NICE guidelines published on the 9^th November this year about providing advocacy to adults with health and social care needs, is a step in the right direction to help prevent safeguarding issues in the first place.

Importance of training

The panel also touched on the importance of cultivating the skills required for effective CHC assessments early on, through ongoing CHC training and shadowing. This will support the future CHC workforce, for which it is currently challenging to recruit in to and instil into future nurses and social workers the complexity of assessments and safeguarding concerns to be aware of.

CHS Healthcare prefer the term ‘CHC education’, rather than training, as it is an ongoing process rather than something that can be taught through a single training course. At CHS Healthcare we pride ourselves on being one of the first organisations to offer a full eight-week placement for students in continuing healthcare.

Looking to the future

The discussion finished by reminding attendees that there is far more excellence than there is incidents, and there is much to learn from examples of best practice. Changes in the organisational culture are necessary to improve safeguarding culture.

Leaders need to demonstrate compassionate leadership, use trauma informed approaches, and build on both their emotional intelligence and data intelligence. We encourage staff to exercise professional curiosity around the situation and feel encouraged to speak out without fear of being wrong – and this begins with the leadership culture.

To learn more about how CHS Healthcare can support your teams with safeguarding and keeping people safe within continuing healthcare, contact Will Johnson, william.johnson@chshealthcare.co.uk and Tom Morgan-Lee, tom.morgan-lee@broadcare.co.uk