Exploring professional decision making in relation to safeguarding: a grounded theory study of social workers and community nurses in community learning (intellectual) disability teams in Wales

Background: People with intellectual disabilities are at increased risk of abuse which may not always be responded to appropriately. This study therefore sought to explore how nurses and social workers make decisions when safeguarding adults with intellectual disabilities.
Method: A situational analysis grounded theory study. Semi-structured interviews were undertaken with social workers (n=16) and community nurses (n=9) working in Community Learning (Intellectual) Disability Teams in Wales. Data were transcribed and analysed thematically and cartographically in keeping with situational analysis.
Results: Four key themes emerged: The official line; Expectation and perception; Non-vulnerable adult process options; Confidence and competence. Sites of silence were also identified: not making a decision, not asking further questions, preserving family relationships and the individual with intellectual disabilities.
Conclusion: Decision making in relation to safeguarding adults with intellectual disabilities is a complex process, influenced by many factors and in which discretion is exercised by professionals.