Key Principles in Adult Social Care Practice

1. General Principles

The Care and Support Statutory Guidance (Department of Health and Social Care) contains a number of key principles which services must have regard to when carrying out adult social care activities or functions. They include:

• Promoting Wellbeing – local authorities must promote wellbeing when carrying out any of their care and support functions in respect of an adult. This is often called the ‘wellbeing principle’ because it is a guiding principle that puts wellbeing at the heart of care and support.

It applies whenever a local authority is carrying out a care and support function (including providing information and advice) or making a decision. It applies to both adults and carers. Wellbeing includes:

• • personal dignity;
  • physical and mental health and emotional wellbeing;
  • protection from abuse and neglect;
  • adults having control over their day to day life;
  • participation in work, education and training;
  • social and economic wellbeing;
  • domestic, family and personal wellbeing;
  • suitability of living accommodation;
  • contributing to society.
• The importance of beginning with the assumption that the adult is best placed to judge their own wellbeing. Building on the principles of the Mental Capacity Act, staff should assume that the adult is the ‘expert in their own life’. They should be asked about their priorities and the outcomes they want to achieve. The local authority must not make assumptions as to what matters most to the adult.
• The adult’s views, wishes, feelings and beliefs. Considering the adult’s views and wishes is key to providing centred care and support. Where the adult has particular views, feelings or beliefs (including religious beliefs) which impact on the choices they may wish to make about their care, these should be taken into account. This is especially important where an adult has expressed views in the past, but no longer has mental capacity to make their own decisions.
• The importance of preventing or delaying the development of needs for care and support and the importance of reducing needs that already exist. At every interaction with an adult or carer, staff should consider whether or how their existing needs could be reduced or other needs could be prevented or delayed. Effective interventions at the right time can stop needs from escalating, and help adults maintain their independence for longer (see chapter on Preventing, Reducing or Delaying Needs).
• The need to ensure that decisions are made having regard to all the adult’s circumstances (and are not, for example, based only on their age or appearance, any condition they have, or any aspect of their behaviour which might lead others to make unjustified assumptions about their wellbeing). Staff should not make judgements based on preconceptions about the adult’s circumstances, but should in every case work to understand their individual needs and goals (see chapter on Assessment).
• The importance of the adult participating as fully as possible in decisions about them and being provided with the information and support necessary to enable this. Care and support should be personal, and people should be fully involved in decisions about their care (see chapters on Assessment and Independent Advocacy).
• The importance of achieving a balance between the adult’s wellbeing and that of any friends or relatives who are involved in caring for them. Adults should be considered in the context of their families and support networks. It is important to take into account the impact of the adult’s needs on those who support them (see chapter on Assessment).
• The need to protect adults from abuse and neglect. Ensuring adults are protected from abuse and neglect it a key part of promoting wellbeing (see the chapters on Adult Safeguarding and Assessing and Managing Risk).
• The need to ensure that any restriction on the adult’s rights or freedom of action are kept to the minimum necessary. Where action is taken which restrict an adult’s rights or freedoms, the course followed should always be the least restrictive necessary (see the chapter on Deprivation of Liberty Safeguards).

These principles must be considered in relation to every adult.  This will ensure an approach that looks at a their life holistically, considering their needs in the context of their skills, ambitions, and priorities – as well as the other people in their life and how they can support the adult in meeting the outcomes they want to achieve. The focus should be on supporting adults to live as independently as possible for as long as possible.

These principles will vary in their relevance to individual adults. For some adults, spiritual or religious beliefs will be of great significance, and should be taken into particular account. However, every person is different and what matters most to them will vary widely. See also chapter on Providing Culturally Appropriate Care.

2. Principles of Adult Safeguarding

See the chapter on Adult Safeguarding.

The following six key principles underpin all work to safeguard adults from abuse and neglect.

• Empowerment: People are supported and encouraged to make their own decisions and give informed consent. People must always be treated with dignity and respect, and practitioners should work alongside them to ensure they receive quality, person-centred care which ensures they are safe on their own terms.

“I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens.”

• Prevention: Prevention and early support are key to effective safeguarding. The principle of prevention recognises the importance of taking action before harm occurs and seeks to put mechanisms in place so they don’t recur.

“I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help.”

• Proportionality: This means deciding the least intrusive response appropriate to the risk presented.

“I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed.”

• Protection: This involves organising and delivering support and representation for those in greatest need who may not be able to do it themselves.

“I get help and support to report abuse and neglect. I get help so that I am able to take part in the safeguarding process to the extent to which I want.”

• Partnership: Effective safeguarding cannot be delivered in isolation and should involve other partners and systems that interact with or impact on a person. Local solutions are best achieved through services working with their communities, professionals and services as a whole.

“I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”

• Accountability: This recognises the importance of being open, clear and honest in the delivery of safeguarding and ensuring there are systems in place to hold practitioners, services and systems to account.

“I understand the role of everyone involved in my life and so do they.”

For more information see Revisiting Safeguarding Practice (Department of Health and Social Care).

3. Further Reading

3.1 Relevant chapters

Promoting Wellbeing

Preventing, Reducing or Delaying Needs