Professional practice guidance for Safeguarding Adults during Covid-19 Pandemic

Published date 24 April 2020

A note on language

Terminology about safeguarding adults from abuse and neglect differs in different countries. This guidance talks about safeguarding adults. This means to support and protect adults from abuse and neglect. Other terminology around areas of safeguarding such as mental capacity/ incapacity also differs, along with names for bodies such as local multi-agency forums. This guidance aims to use language that can be understood across the UK.

Purpose and background

This guidance has been developed by the British Association of Social Workers (BASW) in consultation with practitioners, managers, academics and sector leaders to help social workers in any role or setting to safeguard adults.

The pandemic is putting pressure on safeguarding and is raising new safeguarding issues. This guidance anchors social workers by grounding their work in the purpose and ethics of social work, and by highlighting the support needed for social workers. This is generic guidance for all social workers across the UK.

The guidance acknowledges the lead role that social workers play in adult safeguarding, including within statutory services that undertake enquiries.  But it also recognises that safeguarding takes place in a multi-agency context.  Social workers may well be particularly anxious about some of the people they are trying to support at this time.  It may be very difficult to find ways of protecting them.  But social workers should not feel (or be made to feel) that they have sole responsibility for the safety of adults at risk of abuse.  Social work employers, partner organisations, and multi-agency oversight bodies also have a part to play.

The guidance aims to:

  • Reaffirm the purpose of safeguarding adults
  • Highlight some of the issues arising from the pandemic
  • Provide approaches to navigating these issues
  • Help social workers consider the specific support they may need.

Note: This guidance is on-line and will be reviewed and updated. Please use the online version to ensure you have the most recent version. It will be reviewed at least monthly during the Covid-19 emergency.

Other useful documents

All practice, ethics and policy advice is available on the BASW website coronavirus pages https://www.basw.co.uk/coronavirus-covid-19-basw-updates  

The guidance is grounded in BASW’s ethical guidance for the pandemic as set out in our Covid-19 pandemic ethical guidance https://www.basw.co.uk/covid-19-pandemic%E2%80%93-ethical-guidance-social-workers

Health and Safety Advice from our partner trade union is here: Social Workers Union health and safety advice during Covid-19 

Using the guidance

This is professional guidance based on best available evidence, latest public health guidance, practice experience and expertise.

We hope this guidance will support frontline practitioners and provide a framework to influence good practice within the workplace, as well as helping social workers to manage the ethical and emotional impact of their work.

The priority is to promote wellbeing for adults, carers and communities, and to promote the wellbeing of the workforce.

Please use the guidance to:

  • Guide and inform your practice
  • Request appropriate support and guidance from your employer
  • Raise professional concerns and questions about local practice or guidance with your employer, health and safety representative, trade union and BASW

This guidance does not:

  • Replace public health national (official) guidance 
  • Replace regulatory or employer guidance 
  • Advise on how to manage statutory duties – this is for statutory bodies to advise based on the law.

Understanding of health and safety throughout this pandemic is developing. Practitioners should continue to check and must follow public health guidance at https://www.gov.uk/coronavirus. This includes the latest information about selfisolating, shielding and what to do if you have symptoms.

 Practitioners should also be aware of the latest information from their government, regulator and their employer.

Personal, Protective Equipment (PPE)

There is no specific Public Health guidance for the use of PPE by social workers. However, there is guidance of relevance to social worker home visits particularly in the table of recommended PPE for primary, outpatient and community care settings (published 02 04 2020).

Social workers undertaking home visits are advised to review this table to match to their situation.  

It is likely that the section written for the setting of the Public Health guide ‘Individuals’ own home (current place of residence) – and foot notes 3 and 7 - will be particularly relevant (excluding ‘Home birth…).

In all circumstances, social workers should ensure they maintain social distancing (more than 2m away from any other person) throughout the visit and as a minimum follow the latest Public Health (PHE) guidance re recommended PPE for individual home settings.

BASW’s advice is that asymptomatic risk – whether from the social worker to person/s being visited or vice versa – during the pandemic is significant. Social distancing of at least 2m should be upheld and relevant and effective PPE (e.g. face masks; gloves, sanitiser) should be built into the infection prevention risk plan for all social work visits where maintaining social distance cannot be assured.

Overall updates on guidance for health and care workers in a variety of roles are available from Public Health here https://www.gov.uk/coronavirus 

The lack/insufficiency of PPE and training in its use for social workers is being raised with governments and public health in the four nations by BASW.

 

1.  Safeguarding adults

Purpose of safeguarding adults

The Code of Ethics for social workers in the UK https://www.basw.co.uk/about-basw/code-ethics says that:

Social work is based on respect for the inherent worth and dignity of all people as expressed in the United Nations Universal Declaration of Human Rights (1948) and other related UN declarations on rights and the conventions derived from those declarations.

One of the practice principles of the Code is:

Using authority in accordance with human rights principles: Social workers should use the authority of their role in a responsible, accountable and respectful manner. They should exercise authority appropriately to safeguard people with whom they work and to ensure people have as much control over their lives as is consistent with the rights of others.

The ethical purpose of safeguarding, therefore, is to uphold the inherent dignity and worth of all people, and to uphold their human rights.

This is echoed in legislation about protecting people from abuse and neglect, and in promoting wellbeing, as well as in the Human Rights Act 1998.

This fundamental purpose underpins the response of social workers to safeguarding issues in the pandemic. Social workers’ role is based on these two questions:

  • How can I uphold the inherent dignity and worth of all people?
  • How can I uphold human rights?

 

Issues with safeguarding adults during Covid-19

There are two main areas of pressure on safeguarding adults during the pandemic.

1. Additional concerns

Social workers report some specific concerns arising from Covid-19 and the public health response. These include:

  • New risks to physical and mental health from the pandemic
  • Difficulties of shielding or self-isolating and managing infection risk within shared homes
  • Risk of infection as key workers provide support to people at risk
  • Increase of physical, mental and emotional needs
  • Isolation of individuals who are not easily able to manage their own essential needs
  • Isolation of families or networks where abuse or neglect can increase due to proximity
  • Lack of community and social oversight leading to criminal or other exploitation
  • Fraud and scams based on Covid-19 themes
  • Increased rationing of support leading to biased or discriminatory decisions
  • Difficulty accessing appropriate care and support, for example safe discharge from hospital to home or to a placement that meets needs
  • The potential for crisis management to overrule human rights, for example discrimination in decision-making about access to medical treatment
  • Reduction of rights and protections that are or may be enacted due to changes in the law and statutory guidance during the pandemic
  • Lack of appropriate protection for adults who do not have capacity to make a decision
  • Difficulties upholding the human right to liberty as it is problematic to oversee any deprivations of liberty
  • Difficulties upholding human rights in mental health due to lack of resources including access to doctors, to appropriate placements and to tribunals
  • The inequality of impact of the pandemic due to pre-existing inequalities around all areas of life including physical and mental health, housing, income, social capital, community resources and voice
  • Lack of redress to complaints or issues raised about how statutory duties are met and services provided.

Please see BASW statements and guidance around ethical and human rights issues https://www.basw.co.uk/coronavirus-updates/how-basw-supporting-social-workers-during-coronavirus

There are particular issues around safeguarding adults who are in placements. These are raised here. BASW will address these in more detail in an addition to this guidance shortly.

 

2. Barriers to safeguarding adults

Social workers report some specific barriers arising from Covid-19 and the public health response to this. These include:

  • Reduced referrals and information due to issues arising from the pandemic, including reduced contact by networks and agencies
  • Very limited opportunities for face-to-face contact with adults at risk of abuse, family members, care staff etc.
  • Difficulties connecting with people who face barriers to communication and interaction, and to access to technology
  • Issues of trust arising from changes in relationships, communication and activity
  • Issues of trust arising from this situation echoing previous discrimination
  • The volume and complexity of new information about what social workers should do
  • Pressures of demand and shortages of staff in social work departments and health and social care providers
  • Difficulties accessing support from other agencies.

 

Approaches to safeguarding adults during Covid-19

The following approaches support social workers to undertake their safeguarding role in Covid-19.

1. Outcome-based work

Social workers can critically reflect on the fundamental questions in order to consider what their role is and how they can specifically act in a situation where there are safeguarding issues.

  • How can I uphold the inherent dignity and worth of all people?
  • How can I uphold human rights, including the right to life, the right to freedom from degrading treatment, the right to liberty, and the right to respect for family and private life?

 

2. Work in partnership with adults and those important to them

Social workers can take a lead in working in partnership, starting with adults and carers and their loved ones. In a complex and uncertain situation there can be a tendency to control or dictate what happens to people in their best interests. Social workers need to uphold the principles of:

  • Person-centred practice - Working with people to understand their individual outcomes and how best to achieve these.
  • Strengths-based work – Identifying the personal, social and cultural resources that people and their networks have to uphold their human dignity and human rights.
  • Following the Human Rights Act and the Equality Act – This includes not acting incompatibly with a Convention right, and acting to eliminate discrimination.
  • Following mental capacity principles and law for your country – This includes presumption of capacity, support to make decisions, not assuming lack of capacity because the decision seems unwise, acting in best interests and acting in the way that is least restrictive of people’s rights.
  • Understanding the potential impact on risk assessment and protection planning of public health protection regulations, and being able to access advice and support on this when necessary.
  • Rights to advocacy – Understanding and upholding people’s legal and ethical rights to advocacy.
  • Professional integrity – Acting with ethical purpose, being open and honest, making and showing clear judgements, recording and acting on decisions, keeping decisions under review.

 

3. Continually develop capabilities for safeguarding adults

Social workers should take positive action and be supported to develop specific capabilities to help them with safeguarding during the pandemic. Some of the most important capabilities are:

  • Acting lawfully – Social workers need to keep up to date with the law and the statutory guidance on safeguarding and human rights in their particular jurisdiction. This includes clarity about what has not changed. And knowledge of changes that have been made, for example how assessments on mental capacity to make a decision may be undertaken. BASW guidance and learning opportunities can support this.
  • Developing new ways of connecting to people – Social workers can use creative ways to connect with people where the risk of seeing them face-to-face is not reasonable. BASW’s work on digital capabilities for social workers can support this https://www.basw.co.uk/digital-capabilities-statement-social-workers/.
  • Understanding specific hazards that different people face – Social workers need to consider the impact of the pandemic on different groups, particularly how it interacts with existing oppression and lack of power. BASW capabilities for working with older people, adults with learning disabilities and adults with autism can support this https://www.basw.co.uk/social-work-training/professional-capabilities-framework-pcf.
  • Risk management - Social workers should identify those risks that will be difficult to address during the current emergency.  Social workers should be proactive in drawing these risks to the attention of managers and partners to explore creative solutions.
  • Risk assessment – Social workers need to understand hazards, and then carry out risk assessments setting out both the negatives and positives of the risks that people experience, based on the available information, so that they can make professional recommendations about how best to promote human dignity and human rights. 
  • Making ethical judgements – Social workers can use critical reflection tools and approaches with others to support them to consider the individual and contextual barriers to people being able to uphold their dignity and human rights. See 4. Below
  • Accountability – Social workers need to understand their responsibility and the limits to this in their role, see advice, record clearly and show decision making particularly where new approaches are being used.

 

4.  Employ capabilities through an Anti-Oppresive Practice framework

The pandemic is strengthening the impact of inequalities in society. Social workers can take a lead on using theory and research to understand why some people are more at risk, face barriers to staying safe, and/or receive less support and resource than others. The Anti-Oppressive Practice framework helps us understand this by highlighting how people face barriers at different levels. Social workers can identify and respond to:

  • The personal barriers to staying safe that people face – barriers associated with how individuals relate to them
  • The cultural barriers to staying safe that people face – barriers associated to how our society upholds dignity
  • The structural barriers to staying safe that people face – barriers associated with systems that create and perpetuate inequality

Responding to these levels is done both through individual practice and through collective action. Social workers can highlight cultural and structural issues to BASW through our survey https://www.basw.co.uk/media/news/2020/mar/social-work-during-coronavirus-covid-19-ongoing-survey.

Individual social workers who are members of BASW can contact our Advice and Representation team for professional advice and guidance on work or regulatory issues https://www.basw.co.uk/supporting-members-professional-advice-and-guidance-during-covid-19.

5.  Work in partnership with other agencies

Social workers can highlight ethical and practice principles in their work with other professions, agencies and organisations. Social workers need to be clear about their role and the limits of this, and the role of other partners. This is supported by clear outcomes, planning and assigning of actions.

 

2.  Organisational support for social workers

Social workers need support to enable them to undertake this work. Employers need to consider the specific support needs arising from safeguarding adults.  Local multi-agency forums that provide strategic leadership and decision making should also review the support being provided to social workers and other professionals.

Support for social workers to undertake safeguarding work should include the following:

  • Opportunities for critical reflection and supported decision making – For example, supervision, group supervision, critical reflective case discussions, multi-disciplinary meetings.
  • Support and containment for difficult work – Social workers need to have the chance to talk about the impact of their work. Different people will experience stress and trauma in different ways. Social workers may experience moral distress at not being able to support people in the way they would wish to. Employers should offer professional supervision and opportunities for peer support, and identify any other support needed including specialist help. BASW events and forums may support this https://www.basw.co.uk/events.
  • Managing risk – Social workers can only support others if their own health and safety is attended to. Employers should help with risk assessing the population, prioritising, advising on essential work, ensuring appropriate tools and equipment, and overseeing work. Employers must listen to and respond to social workers concerns about the reasonableness of the work they are asked to do.
  • Clear expectations and accountability – Employers must clarify lines of decision making, and ensure that social workers are able to make defensible decisions.
  • Support to work with partners – This includes strategic and operational ways of connecting, sharing information and working together during the pandemic.
  • Continuous learning – Employers need to find ways to share learning about good practice both within and between organisations.

 

3.  Additional support and resources for safeguarding adults

Human Rights Act 1998

http://www.legislation.gov.uk/ukpga/1998/42/contents

Equality Act 2010 Guidance

https://www.gov.uk/guidance/equality-act-2010-guidance

National safeguarding guidance

Advocacy

https://www.voiceability.org/for-professionals/

Coronavirus guidance

https://www.gov.uk/coronavirus

BASW information and guidance around Covid-19

https://www.basw.co.uk/coronaviruscovid-19-basw-updates   

You can direct questions or concerns to BASW by contacting us

https://www.basw.co.uk/contact   

BASW Survey for feedback on practice during Covid-19 https://www.basw.co.uk/media/news/2020/mar/social-work-during-coronavirus-covid-19ongoing-survey   

BASW virtual activities to provide peer support and learning can be found here https://www.basw.co.uk/events   

Professional practice guidance for Safeguarding Adults during Covid-19 Pandemic

BASW

Published date 24 April 2020