National Institute for Health and Clinical Excellence (NICE)
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Feeling safe and being heard in residential care is crucial

Dorothy Hodgkinson from Finding Perspectives discusses the importance of safeguarding adults in care homes

Dorothy Hodgkinson, independent advocate and practitioner at Finding Perspectives

Often when an adult transitions to living in residential care, there’s an understanding that this may well be their final home. It becomes the imperative of the facility and its staff to create an environment of comfort, safety, and a place where residents feel they have retained some autonomy. 

Key to this is ensuring there are ways in which residents and their families or carers can flag concerns when things appear to be going, or have gone wrong, without fear of retribution.

When we feel unsafe, or even just less safe than usual, one of the first things we lose is our voice. The confidence to speak up, to tell someone that something isn’t quite right, just disappears. 

I have been an independent advocate in the care sector for the best part of a decade, working with people in a wide variety of settings and across many different issues. I have seen the fear of an individual at the thought of speaking out about an organisation or staff member when they feel unsafe, discriminated against, or unheard.

The NICE guideline on safeguarding adults in care homes has been designed to address this. By bringing together lived experience and professional awareness across all areas of the care sector, the new recommendations provide information and advice that could help enhance the safety of individuals in care, and better enable their voices to be heard.

My role has always been to help individuals voice what they need others to hear and understand about their situation, and to work to their instruction alone. As a member of the guideline committee, I was given the opportunity to bring some of these voices and experiences to the fore, alongside a range of other health and care practitioners.

Members of the public who have had direct experience of safeguarding procedures were also a part of the process, which makes me confident that the guideline is a true representation of those who may be impacted by safeguarding concerns and investigations.

The person-centred approach is central to the legislation concerning safeguarding and has played an essential role in the development of the new guideline. The guidance draws upon legislation, research and lived experience, and was constantly reviewed to ensure that the needs of the care home resident were kept central to the focus.

I have valued my involvement in the development of the safeguarding adults in care homes guideline, and have high hopes that it will make a real impact.


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