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 and standards which adult social care must have regard to when carrying out its activities or functions, as specified below.

• Promoting Wellbeing. This means actively seeking improvements in particular aspects of wellbeing at any stage of the process from the provision of information and advice to reviewing a care and support plan, including:
  • personal dignity;
  • physical and mental health and emotional wellbeing;
  • protection from abuse and neglect; control by the individual over their day to day life; participation in work, education and training;
  • social and economic wellbeing;
  • domestic, family and personal;
  • suitability of living accommodation;
  • the individual’s contribution to society.
• The importance of beginning with the assumption that the individual is best placed to judge the individual’s wellbeing. Building on the principles of the Mental Capacity Act, staff should assume that the person knows best about their own outcomes, goals and wellbeing, and should not make assumptions as to what matters most to a person.
• The individual’s views, wishes, feelings and beliefs. Considering the person’s views and wishes is critical to a person centred assessment and care and support system. Staff should not ignore or downplay the importance of a person’s own opinions in relation to their life and their care. Where particular views, feelings or beliefs (including religious beliefs) impact on the choices that a person may wish to make about their care, these should be taken into account. This is especially important where a person has expressed views in the past, but no longer has capacity to make decisions themselves.
• 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 a person, the staff should consider whether or how the person’s existing needs could be reduced or other needs could be delayed or prevented. Effective interventions at the right time can stop needs from escalating, and help people 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 individual’s circumstances (and are not 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 person’s circumstances, but should in every case work to understand their individual needs and goals (see chapter on Assessment).
• The importance of the individual participating as fully as possible in decisions about them and being provided with the information and support necessary to enable the individual to participate. Care and support should be personal, and people should be fully involved in decisions about their care.
• The importance of achieving a balance between the individual’s wellbeing and that of any friends or relatives who are involved in caring for the individual. People should be considered in the context of their families and support networks, not just as isolated individuals with needs. It is important to take into account the impact of an individual’s needs on those who support them, and take steps to help others access information or support (see chapter on Assessment).
• The need to protect people from abuse and neglect. Staff should ensure people are protected from abuse or neglect. This is not confined only to safeguarding issues, but should be a general principle applied in every case (see the chapters on Adult Safeguarding and Assessing and Managing Risk).
• The need to ensure that any restriction on the individual’s rights or freedom of action that is involved in the exercise of the function is kept to the minimum necessary for achieving the purpose for which the function is being exercised. Where action is taken which restricts rights or freedoms, they should always be the least restrictive necessary (see the chapter on Deprivation of Liberty Safeguards).

These principles must be considered in relation to every individual.  This will ensure an approach that looks at a person’s 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 person in meeting the outcomes they want to achieve. The focus should be on supporting people to live as independently as possible for as long as possible.

These principles will vary in their relevance and application to individuals. For some people, 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 to give informed consent. People must always be treated with dignity and respect, and staff 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 reoccur.

“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 providing 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 and services 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