APPENDIX 10
Memorandum by Pete Morgan, Adult Protection
Co-ordinator with Coventry City Council Social Services Department
(EA13)
The post of Adult Protection Co-ordinator was
implemented as a direct response to "No Secrets"
but was only recruited to in July 2003. Coventry's multi-agency
Vulnerable Adult Protection Policy, Procedures and Good Practice
Guide were launched on 10 November 2003, though they were implemented
on 1 November 2003. As yet, therefore, the implementation hasn't
generated any data as to the nature or quantity of abuse within
the city. A system for the recording and monitoring of the implementation
of the Procedures in individual cases has been established and
will generate such data in the future.
1. Within the context of "No Secrets",
"Elder Abuse" doesn't exist as a concept. Indeed, such
a concept can be seen as "ageist" by its very nature,
and local authorities are required to ensure that their policies
and procedures are not ageist.
2. People are not abused because they are
"elders", but because they are unable to effectively
protect themselves. In order to distinguish between "crime"
and "abuse", it is necessary to introduce an element
of responsibility into the relationship between the abused and
the abuser. "No Secrets" achieves this by restricting
its remit to those who are eligible for, though not necessarily
receiving, community care services.
3. The above requires the use of the concept
of "vulnerability" in relation to adults who are deemed
to be autonomous individuals, able to protect themselves, as opposed
to children who are deemed to be "vulnerable" by definition.
4. Any examination of the abuse of adults
should therefore be targeted at vulnerable adults, as defined
by "No Secrets", rather than an arbitrary sub-division
of adults, such as `the elderly', which is bound to discriminatory.
5. At present, there isn't adequate research
data as to the extent of vulnerable adult abuse because, amongst
other reasons, definitions of "abuse" are loose and
not agreed between agencies and recording is inconsistent both
between and within authorities.
6. Practitioners and service users tend
to deal with the symptoms of vulnerable adult abuse rather than
the causes for a number of reasons, including the limited options
for practitioners, compared to child protection, to ensure the
safety of abused vulnerable adults and the nature of the relationship
between an abused vulnerable adult and their abuser being one
that will have an increasing level of dependency, unlike that
between and a child and their abuser, which will tend to be one
of lessening dependency.
7. The above mean that the prevalence of
vulnerable adult abuse is not known, the details as to the most
common types of abuse, their causes, who abuses etc are unclear
either, though some patterns may be beginning to appear.
8. "Empowerment" is a key issue
within the concept of vulnerable adult protection, not just the
empowerment of the vulnerable adult, but also those health and
social care staff and their managers working in this area. These
staff, working in multi-agency and multi-professional settings,
need to be empowered, by the policies and procedures they work
to, to make judgements based on their professional expertise and
experience, to best protect their patients/service users. There
is a danger of policies and procedures becoming "straight-jackets"
that fail to enable staff to protect vulnerable adults by disempowering
them through undermining their ability to make professional judgements.
9. A large percentage of current health
and social care provision can be seen as "preventative"
either by supporting informal carers via respite etc or by undertaking
care tasks instead of informal carers.
10. It is necessary to acknowledge that
no system is going to prevent abuse taking place, but different
procedures can better protect vulnerable adults by respecting
their autonomy as far as possible.
11. It is necessary to acknowledge that
it is not possible to eradicate abuse of vulnerable adults anymore
than it is possible to eradicate child abuse. This is partially
due to the fact that a small percentage of society appears to
enjoy the misuse of power to the detriment of others but also
to the fact that society merely lowers the threshold of what it
considers "abuse" overtime as particular forms of abuse
are reduced in prevalence.
12. "No Secrets" was defined
by the Department of Health as being "cost neutral"
in its implications for local authorities. To a degree, this is
understandable, as very few health or social care workers will
have walked away from a case of actual or possible vulnerable
adult abuse. They most likely will have dealt with its symptoms
rather than its causes, however. This does reduce the amount of
additional work that implementing "No Secrets"
is likely to cause local authorities in the short term, as work
will be accurately recorded as being with vulnerable adults who
have, or are at risk of being abused. In the longer term, however,
raising public awareness of the nature of vulnerable adult abuse
is bound to lead to increased referral rates.
13. If the Government is seriously committed
to tackling vulnerable adult abuse, not elder abuse, then this
will require additional resources for the statutory and voluntary
and independent sectors. This is partially to meet the increased
staff costs of employing appropriately qualified and experienced
staff and providing on-going staff development and support opportunities
for them, but also in recognition of the longer term increase
in work that will occur.
14. The Government could demonstrate its
commitment by establishing Performance Indicators for this area
of work and monitoring the implementation of "No Secrets",
neither of which it has done to date.
15. Given that "abuse" will never
be eradicated from society, it is necessary for equal emphasis
to be given to empowering vulnerable adults and the care staff,
health, social and informal who work with them, to reduce the
need to implement Protection Policies and Procedures, rather than
concentrate on the system required once abuse has taken place.
16. Within the West Midlands, there is a
Group of Vulnerable Adult Protection Co-ordinators who have developed
a benchmarking mechanism that is starting to produce data that
may be of interest to the Committee. This Group is making a separate
submission to the Committee.
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