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Purpose -- The purpose of this paper is to summarise findings of a review of service user and carer involvement in safeguarding and recommendations for good practice. Design/methodology/approach -- The study involved a review of selected literature and a consultation exercise with experts in the field of adult safeguarding and telephone interviews with 13 Adult Safeguarding Leads across England and Wales. Findings -- Service users value rights, independence, choice and support. Adult Safeguarding policy sets out an expectation of service user involvement in the process and expects agencies to balance rights to self-determination with properly managed risk. In practice, agencies tend to be risk-averse and service users often do not feel involved in their safeguarding processes. Processes such as collaborative risk enablement, training and capacity building, working with BME groups and evaluation of involvement help. Good practice examples of involvement in Safeguarding Boards or local forums, developing new methods of user feedback and community involvement were found. Recommendations include more involvement of service users in research, more effective forms of involvement of groups who may be more excluded, shared responsibility for risk, and more training in rights legislation. Practical implications -- The paper offers recommendations for good practice in improving involvement in adult safeguarding, which is a requirement and an essential component of delivering good services to vulnerable adults. Originality/value -- Service user involvement in health and social care is now widespread, but there is little knowledge of how to involve the most vulnerable service users who are in need of protection, or how to balance risk and empowerment. This paper addresses the dilemmas facing Adult Protection staff, summarises the experience of practitioners based on the first decade of adult safeguarding work and sets out guidance for improving practice. [ABSTRACT FROM AUTHOR]

Purpose -- The paper's aim is to explain the development of the concept of personalisation and its dependence upon prior innovations such as independent living, person-centred planning and individual budgets and explore its meaning, limitations and future prospects. Design/methodology/approach -- The paper takes the form of an analytical and historical review of ideas that have been important in the recent history of public policy for people with learning disabilities. Findings -- People with learning disabilities, along with other disabled people, have been engaged in a struggle to achieve full citizenship. The recent reforms that go by the name of "personalisation" may mark an important stage in the development of a fairer system, but on their own they will be insufficient to achieve that objective. Originality/value -- Personalisation is placed, with all its strengths and limitations, within the wider context of the development of policies for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to explore the potential impact on families of a greater emphasis on safeguarding for vulnerable adults, from both a legal and a lay perspective. Design/methodology/approach – Case examples are used to illustrate some of the issues and problems that can arise in safeguarding situations. Findings – In community settings there can be a tendency for Social Services to take an antagonistic rather than a conciliatory approach when communicating with families. In the setting of a care home, an example of the appropriate use of safeguarding is outlined. Practical implications – The authors argue that Social Services should take a more conciliatory approach and be prepared to work in partnership with families. Originality/value – The discursive format and narrative approach of this paper represents a useful and informative way of presenting important and topical insights. [ABSTRACT FROM AUTHOR]

Purpose -- The aim of this paper is to evaluate the effectiveness of the My Way transition programme. Design/methodology/approach -- The programme was evaluated over a two year period via interviews with a range of stakeholders. The evaluation focused on outcomes for young people, experience of the transition process, differences in the cost of care packages and an exploration of what was different about the My Way approach. Findings -- There were positive outcomes for young disabled people using the programme, and reduced costs to commissioners. The success of the My Way programme seemed to result from its focus on implementing actions and "doing" rather than just developing plans. Originality/value -- This study provides evidence for commissioners, providers and service users of the importance of providing person-centred facilitators who implement actions. It clearly demonstrates that when this happens savings can be made and good outcomes achieved. [ABSTRACT FROM AUTHOR]

Purpose - This paper's aim is to explore older peoples' decision making regarding complementary and alternative medicine (CAM) use and their perceptions and experiences of weft-being. Design/methodology/approach - Qualitative focus groups with 37 volunteers aged over 61 years exploring health and well-being decision making were held at a community centre in southwest London. Data were content analysed. Findings - Five themes emerged: physical well-being, impact on activity, emotional issues, community and health services, and keeping positive. A range of CAM was used, most commonly mind/body or physical therapies. The main reason for CAM use was to "keep going" and maintain well-being. Conventional medicine was perceived as central to weft-being, with CAM used to address its limitations. Decision making was rarely systematic; anecdotal information dominated, and disclosure to conventional practitioners was uncommon. "Keeping going" is important for older people and often promoted by CAM, including manipulative and exercise therapies. Concurrent CAM and conventional medication use, unreliable information and/or insufficient discussion with conventional providers may have safety implications. Healthcare providers should consider exploring CAM use with older people and facilitating access to CAM information. Practical implications - Asking older people about CAM use may be integral to providing holistic, safe care. CAM use may provide an opportunity for health promotion in older people by encouraging self-management and the taking of responsibility for their own health. Originality/value - Although up to half of older people in the UK may use CAM, there is little information on their decision-making processes. [ABSTRACT FROM AUTHOR]