Editorial

Citation

Penhale, B. (2011), "Editorial", The Journal of Adult Protection, Vol. 13 No. 3. https://doi.org/10.1108/jap.2011.54913caa.001

Editorial

Article Type: Editorial From: The Journal of Adult Protection, Volume 13, Issue 3

This issue of the journal continues the tradition of providing a varied menu of items relating to adult protection and safeguarding, which is always good to see.

Since the last issue of the journal, much has recently been happening in terms of developments in safeguarding and it is worth re-capping on some of these briefly for the benefit of readers as it appears that we are about to enter another phase in which there will be activity and policy changes. In early April, policy colleague Bonnerjea (2011) at the Department of Health (DH) (2011) circulated to stakeholders an update on adult safeguarding. The update covered a number of areas and served to inform people about various initiatives that were taking place, such as the possible amendment to the Domestic Violence, Crime and Victims Act (through a Private Member’s Bill) and an ongoing court case relating to the welfare, mental capacity and deprivation of liberty of an individual living in a care setting as well as a reminder about the recent introduction of DH guidance for health commissioners, managers and practitioners.

This update was followed in early May by a statement of DH policy concerning adult safeguarding, emphasising the core principles of: empowerment, protection, prevention, proportionality, partnership and accountability. These are stated as the key principles that should guide our work in adult safeguarding. Mention was also made in this statement that the government would be seeking to introduce legislation to provide a statutory basis for Safeguarding Adults Boards in local areas (this is perhaps an outcome of the inter-ministerial safeguarding group discussions referred to in the earlier update document). The issuing of the Law Commission (2011) Report on potential measures to reform Adult Social Care Law, which also appeared in May contained a chapter on issues relating to safeguarding. The report made a strong recommendation about the introduction of framework legislation covering this area of policy and practice, This would include making Safeguarding Adults Boards a statutory requirement. We are planning that future issues of the journal will contain papers by the Law Commission and legal colleagues concerning the report and related issues.

In late 31 May 2011, Panorama screened a shocking documentary about events that had been taking place in a privately run hospital for adults with learning disabilities in the Bristol area. The programme included footage taken through use of secret cameras and arose as a result of the BBC News (2011) being contacted by a senior nurse at the hospital. One expert in the programme (Prof Jim Mansell of the Tizard Centre) described many of the actions caught on film as tantamount to torture, and indeed many of those that were shown appeared to go beyond what might be commonly understood as “abuse”. More worrying still, perhaps, was information that the professional in question had contacted Care Quality Commission (CQC) three times in order to whistle-blow about the situation, with no resulting action by the regulator in relation to this (or any other) matter concerning the hospital, Winterbourne View. Perhaps, not surprisingly, high-level reaction was quick to appear. The CQC (Chair and Chief Executive) issued forthright apologies, admitting that they had “got this wrong” and announcing that an internal review would be held in order to ascertain what had/had not occurred, together with a programme of risk-based unannounced inspections of such provision, which the Minister had endorsed. Additionally, the Minister for Care Services, Paul Burstow, also expressed his concern about the situation and said that an investigation would be held to find out what had gone wrong and what lessons could be learned from this. It is not yet clear if there will be an independent inquiry into the situation or not, although it is hoped that an external review will be held and that this might achieve more than the (then) Commission for Social Care Inspection (CSCI) audits of learning disability provision that were held following the disclosure of abuse in NHS provision in Cornwall (CSCI and Healthcare Commission, 2006) and Sutton and Merton (Healthcare Commission, 2007). The investigations that were held following these scandals found that services were “old-fashioned” and not always of good standard, and that service users within such provision were still at risk of abuse. The current disgraceful situation that has been exposed in Bristol may well indicate that effectively not much has changed within learning disability provision since those investigations were completed.

Following the initial statements, the Minister also announced via the media (4 June 2011) that the government would shortly announce new measures to protect adults living in care homes. However, the linked statement by the Minister on the establishment of Safeguarding Adults Boards in every locality and putting these on a statutory footing as a response to the dreadful events that had taken place in Bristol (and very likely elsewhere across the country) may not convince everyone that this will result in satisfactory safeguards for those living in institutions.

So, after months of hiatus and not much at all on the horizon, we appear to be set for another flurry of high-level activity and perhaps, at least for a while, an increased pace of change. This is somewhat reminiscent of the old adage about buses and waiting for a long time with nothing happening for three then to appear all at once! But the message attached to this is also: watch this space and to try and assure readers that the journal will endeavour to keep up with the changes that are taking place and reflect what is happening in the coming months.

This issue of the journal contains a number of papers that will be of particular interest to practitioners. The research-based paper by Carr (2010) of Social Care Institute for Excellence (SCIE) is concerned with current issues in adult social care relating to personalisation and safeguarding and provides some useful pointers for our consideration. The paper presents an informative synopsis of the main discussion and findings from a recent SCIE report on risk enablement and safeguarding in the context of self-directed support and personal budgets. It explores how the personalisation agenda and adult safeguarding might work together in both policy and practice terms and also addresses some of the frontline concerns about empowerment and duty of care in this complex area of work.

The paper by Helen Thacker reporting work undertaken as part of the JIP programme on Adult Safeguarding in the Eastern region reports the findings of a survey of all local authorities in that region and discusses some of the issues raised, such as those concerning referral rates and patterns. The survey showed wide differences in a number of areas, including thresholds, eligibility, definitions and accuracy of recording across the authorities, which took part. These differences appear to contribute to conceal real differences in underlying processes. The paper also focuses on some of the implications raised by the survey (not just for the eastern region but also more widely).

The following paper by Diane Galpin of Bournemouth University and her colleague Dorena Hughes of Bournemouth Borough Council considers the issue of multi-agency and partnership working from practitioner perspectives. It also introduces a framework, which practitioners can use in order to develop a partnership approach to multi-agency decision-making. Usefully, the authors have drawn on the direct experiences of social work practitioners currently involved in safeguarding activity and qualified social workers undertaking post qualifying social work education.

The policy and practice section of this issue comprises a paper from the Office of the Public Guardian (OPG). The paper details the work of this organisation, with a particular focus on issues relating to adult safeguarding. The paper considers the work of the investigations team concerning safeguarding issues that come to their attention and includes some interesting case study material, which provides a useful flavour of the work that OPG are undertaking in this area. An outline of current and likely future work by OPG is also provided.

Monica Dennis and her colleague Judith Allen have provided the final paper for this issue. Regular readers may recall the organisational profile that appeared in an issue last year concerning the organisation, A Dignified Revolution, which Monica and colleagues established (Dennis, 2010). This paper is based on information and comments sent to the organisation about the issues of nutrition and hydration, particularly relating to the care of older adults in acute hospital settings. We know that matters of food and drink are a long-standing concern for many hospital patients, perhaps, particularly those who are elderly and that the issue is still being reported on a regular basis, most recently in the CQC reports about nutrition and dignity in acute hospital provision for older adults. What is less clear is why this should still be the case (why has the problem not been satisfactorily dealt with by now). This paper provides some useful perspectives, especially in considering the human rights aspects of such failings in care.

Many of you will be aware of the annual 6th World Elder Abuse Awareness Day, held on 15 June 2011. Previous years have been a great success across the UK and we know that many of you held awareness-raising events for this year’s day. Please remember, however, to send details of your events (and photos, reports, etc. after the event) to Maggie Evans at Action on Elder Abuse, who continues to collate information about what is happening in the UK and to post this on their web site. In addition, the principal world event took place in Europe this year in London and we hope to provide a report about this in a future issue this year. It is hoped that as many of you as possible were able to participate in this one day event, in London on 17 June 2011.

Finally, those of you who are eagle-eyed may have spotted a change in the journal cover in recent issues. As the journal is now fully part of Emerald Publishing Group Ltd this is reflected in the change of cover to include a pictorial design, in keeping with the style of the rest of the Emerald health and social care collection. Additionally, as indicated in previous issues, we would be pleased to hear from our readership and encourage you to make contact with the editors if there are issues that you wish to raise, comments that you want to make about the journal or papers that you want to submit for consideration! In the meantime, we hope that you enjoy reading this issue of the journal.

Bridget Penhale