Talk by Simon Duffy of the Centre for Welfare Reform for Norfolk County Council on safeguarding, social care and personalisation.

1. Safety for Citizens
Talk for Norfolk: March 2010
© Simon Duffy. Rights Reserved. The author must be cited if images or slides are used

2. Activating our collective citizenship is the
key to promoting safety

3. Citizenship is vital to safety
1. Self-determination - I am at greater risk of
abuse if I cannot direct my life, if I cannot
communicate and if I am not listened to.
2. Direction - I am at greater risk of abuse if my
life does not suit my preferences or character
and if I am perceived by others as lacking
social value.
3. Money - I am at greater risk of abuse if I lack
money or if I cannot control my own money.
4. Home - I am at greater risk of abuse if I
cannot control who I live with, who comes into
my home and if I cannot protect my privacy.
5. Support - I am at greater risk of abuse if I’ve
no one to help me and if I cannot control who
helps me.
6. Community life - I am at greater risk of abuse
if I am not part of my community, if people do
not know me and I have no chance to
contribute to it.
7. Rights - I am at greater risk of abuse if there

4. Institutions are very unsafe
1. Diminished self-determination - it is very hard
to be heard when you have no authority
2. Devalued lives - self-expression and personal
development threaten institutional thinking
3. Impoverishment - economic power is nullified
4. Sheltered, but homeless - a home is more than a
roof - vital to control privacy and security
5. ‘Care’ not support - the paradigm of ‘care’
already assumes the passivity and relative lower
value of the person ‘in care’.
6. Disconnected from community- it is mostly other
citizens who report abuse and it is structures of
power within institutions that make it hard for
people to not collude within institutions
7. Rightless - the shift to focusing on abuse not
crime is a symptom of institutional thinking

5. Self-directed Support improves
safety
1. Good risk management
demands personalisation
2. Self-Directed Support is
consistent with Health & Safety
Law and the Mental Capacity
Act
3. Shifting the primary locus of
decision-making closer to the
person improves the quality of

6. Self-Directed Support is risk
1. management
First Contact - Initial
support, direction and
possibility to spot risks
2. Assessment - Finding
out about the risks that
the person faces and
defining an indicative
entitlement
3. Capacity Test - Making
sure the person can be in
control, has the right
support and
representation where
necessary
4. Support Planning -
Enabling the person to
develop their own plan,
with support if necessary
5. Plan Review and Sign-
Off - Checking plans,
offering advice and
ensuring risk is well-
managed
6. Outcomes Review -
Checking outcomes and
if necessary changing
resources, supports or

8. 30
25
20
15
10
5
0
Positive Support Choice and Plan Maintain Active part Right Help to Your own Staying Managing Allocating
difference tailored to Control over creatively support in their amount of people in a skills and motivated in Risks resources
to lives individual. lives networks community. help to timely way knowledge work fairly
people
Helped Same Worse

10. 10
Hidden Voices:
Hidden Voices: Older People’s Experience of Abuse
7.5 Older People’s Experience of Abuse
An analysis of calls to the Action on Elder Abuse helpline.
Written by Action on Elder Abuse and published by Help the Aged
5
Help the Aged Action on Elder Abuse
Action on Elder Abuse Data (2004)
2.5
Home
Sheltered Housing
Hospital
Care Home
0
Relative Risk

11. Service Area % failing
User focused services 22%
Personal care 26%
Protection 29%
Managers and staff 33%
Organisation and running of the 23%
business
Standard % failing
The needs, wishes, preferences and personal goals for each user are 48%
recorded in a personal service user plan
Staff are supervised and appraised 43%
Safe procedures for medication, with users keeping 42%
control where possible
Rigorous recruitment and selection procedures 39%
The risk of accidents for users and staff is minimised 37%
CSCI Report - State of Social Care - 2005-2006 - Failure to meet minimal
standards in domiciliary care agencies

12. Challenges ahead
1. Institutional assumptions about
how best to reduce risk are still
powerful and seem ‘intuitive’
2. Incoherent legislation under-pins
social care and safeguarding
duties are not clearly defined
3. Public understanding is weak on
these issues - perverted by partial
news coverage and the
vulnerability of the social work
profession
The way to resolve these issues is to radically reform
the welfare state in order to enhance, rather than
undermine, citizenship.

13. 1% 6% 6%
Who keeps
9% citizens safe?
3%
3% People recieving ASC
Paid Social Care Staff
Family Carers
54% Self Funders in Regulated Services
18%
Other Connections (x6)
Self Funders in Non-Regulated Servic
1% People recieving NHS
Paid NHS Staff
Non-eligible but Vulnerable
Only citizens can keep other
citizens safe

14. Contact Details
Simon Duffy
Centre for Welfare Reform
The Quadrant,
99 Parkway Avenue, Parkway Business Park
Sheffield, S9 4WG
T +44 114 251 1790
M +44 7729 7729 41
admin@centreforwelfarereform.org
www.centreforwelfarereform.org