“His brain injury was missed, it led to his death”: brain injury case managers’ experience of safeguarding

Purpose Acquired brain injury (ABI) encompasses any injury to the brain that occurs after birth and impacts an estimated two million people in the UK. The invisible deficits associated with ABI can leave individuals at risk from a range of safeguarding issues including abuse, neglect and self-neglect. The purpose of this study is to investigate brain injury case managers (BICMs) experiences of raising safeguarding concerns about clients with ABI with local authority statutory services within the UK. Design/methodology/approach Sixty-one BICMs responded to a mixed-methods online survey about safeguarding concerns and practice, with a further seven BICMs being interviewed using a semi-structured approach. Qualitative data were combined across the two stages of study and analysed using thematic analysis. Quantitative data were analysed descriptively. Findings On average BICMs reported 17.72 safeguarding concerns raised about their clients with ABI within the 12-month period prior to data collection. All respondents stated that safeguarding concerns were directly linked to their clients’ cognitive and behavioural impairments. Safeguarding concerns related to psychological, emotional and financial factors. The qualitative data identified a “lack of understanding of ABI”, “absence of information sharing and communication”, “failure to assess mental capacity” and poor “safeguarding training” within statutory services led to inadequate response to safeguarding concerns. Addressing these factors could lead to “improved client outcomes”, such as improved wellbeing and reduced levels of abuse and/ or neglect. Originality/value This study adds to the increasing volume of literature highlighting the safeguarding issues associated with ABI but is the first to analyse service data pertaining to safeguarding concerns in this area.