Search

Purpose: The purpose of this paper is to present findings from face-to-face interviews with three former care staff who were proven to have abused some of the older people living in the care and nursing homes in which they had once worked. The research sought to explore the intra-personal dynamics, personal characteristics and work experiences that led these staff to perpetrate abuse. Design/methodology/approach: Semi-structured interviews were undertaken with three former care and nursing home staff who had committed abusive acts and the data secured subjected to thematic narrative analysis. Findings: None of the three people interviewed had intended to become care staff and reported that the interview and induction processes they experienced did little to establish their suitability for the work they would be undertaking or to prepare them for its demands. Participants expressed their generally negative perceptions of older people, particularly those living with dementia, and told of how they also felt that they were under pressure to conform with the often abusive care home regimes that they had entered. They also recounted some specific abusive practices developed to allow them to manage the constant tension between the time available to complete all of the tasks required when "caring" for older people, and revealed their perceptions of external scrutiny of care home conduct and the behaviours developed to deflect the effectiveness of this oversight. Two interview participants also revealed their unfavourable attitudes to some of the people they were employed to care for that were based upon perceptions of ethnic differences, and of how this had contributed to the abuse they perpetrated. Research limitations/implications: Though the research draws upon the experiences of only three former care staff, the data reveal some of the intra-personal dimensions of individual staff who have engaged in abusive acts, and illuminates how the care home environment with which they interact can engender conditions under which abuse is more likely to occur. Originality/value: Unusually, the paper explores the characteristics, perceptions and experiences of care staff who have actually committed abusive acts against those entrusted to their care. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to summarize the work of the Court of Protection. Design/methodology/approach – The paper outlines the history and range of applications within the jurisdiction of the Court, drawing from the Mental Capacity Act and the Code of Practice. Reference is made to annual reports of the work of the court which profile its workload. Finally there is a review of a line of case law dealing with the question of media attendance and reporting of cases before the court. Findings – The Court in its current form was established under The Mental Capacity Act, 2005 and is a significant decision-making body in the UK within adult safeguarding practice concerning adults whose decision-making capacity is impaired. The implications of several specific cases are discussed. Originality/value – This paper provides a unique insight into the work of the Court of Protection and the implications of recent decisions by the Court for adult safeguarding. [ABSTRACT FROM AUTHOR]

Purpose – The Mental Capacity Act (MCA) was implemented in 2007 as a piece of legislation to empower and protect adults who require support making decisions. Many older adults in residential care homes will be in this position due to developmental disabilities associated with functional impairments of the mind and brain. This paper aims to evaluate the impact of MCA training within older persons' care homes within an East-Midlands local authority. Design/methodology/approach – Semi structured interviews were conducted with key informants who had strategic responsibility for implementation of MCA training as well as a focus group conducted with managers/deputy managers of care homes within the local authority. Findings – With a primary focus on training, data revealed issues surrounding the delivery and content of training, and the organisational factors relating to both training and the subsequent implementation of the knowledge learned. Research limitations/implications – The key informants for this paper are limited to management perspectives. Interviews and a focus group were conducted with stakeholders who either had direct responsibility for service delivery or managerial oversight for training and development. Practical implications – The paper suggests methods of delivery with the Mental Capacity Act which offer a tailored, engaging and cost effective alternative to conventional "away day" training sessions. Originality/value – The paper challenges and critiques conventional approaches to training the social care workforce. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore the impact of domestic abuse on the health and lives of older women.Design/methodology/approach - A qualitative research design was used and data were collected using in-depth interviews with 16 older women who had experienced domestic abuse. The interviews varied between one and two hours in length and, with the participant's permission, all of the interviews were audio recorded and transcribed verbatim. Analysis was undertaken utilising an iterative approach. In the present study all data were manually indexed and coded.Findings - The findings of this study illustrate that the consequences of domestic abuse for older women are far reaching, impacting significantly on the long-term health and emotional wellbeing of those affected. This paper also highlights that there is currently little available data regarding older women and domestic abuse within the particular context of health. This is increasingly being recognised as a significant deficit in awareness and understanding within society as a whole and, more particularly, for those responsible for support and care provision. Existing policy in this field and the implications for service development are also considered.Research limitations/implications - This is a small scale study and therefore there are limitations in terms of generalisability.Originality/value - This paper discusses the specific issues that arise for older women who have experienced domestic abuse within the particular context of health. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to present findings from a review of hospital policies and practices in one NHS Trust in England. Design/methodology/approach – The focus of the review was hospital staff policy and practice in safeguarding the rights of vulnerable patients. A sample of staff was surveyed to investigate their knowledge of the Mental Capacity Act 2005 in 2010. Interviews, incorporating discussion of a vignette, were undertaken with a range of staff and findings were analysed thematically. These findings are contextualised by an analysis of Trust policies and the wider literature. The findings of this case study are used to develop recommendations for the hospital and healthcare sectors. Findings – Analysis of survey data and interviews revealed limited confidence and knowledge about the Mental Capacity Act 2005 and uncertainties about its relevance to clinical practice. In relation to safeguarding, there was limited realisation of the potential of the Act to uphold the rights of patients lacking capacity and staff responsibilities. MCA training had not made a great impression; hospital policies were inconsistent and lacked coherence. Research limitations/implications – This case study was conducted in one Trust and may not be generalisable. Other hospitals may have different training, policy and procedure systems. Practical implications – The findings of this case study may be applicable to other hospitals and to other providers of health and social care services. The relevance of the MCA could be highlighted and used on several induction and training programmes. The study identifies features of policy and practice that could be investigated in other organisations. Originality/value – Few studies have investigated the operationalisation of the MCA in hospital settings. This study reveals that there are opportunities to refresh MCA and safeguarding training strategies for hospital staff but these should be accompanied by changes to culture and attention to the coherence of different procedures. Audits of MCA and safeguarding compliance can be undertaken within hospitals and a systems approach could be adopted to address any issues identified and to sustain good practice. [ABSTRACT FROM AUTHOR]

Purpose – Commissioned as part of a Joseph Rowntree Foundation scoping programme, this consultation aims to explore the views of disabled people and service users about risk. Design/methodology/approach – The consultation reached nine individuals and one focus group, reaching a total of 17 disabled people and service users. Their views were supplemented by the literature. Findings – The landscape of risk and rights is highly complex. Disabled people and service users have quite different concerns about risk to those of the professionals and the regulatory bodies acting on their behalf. Many people talked of the fear of losing their independence, of asserting their rights and the fear of powerlessness in the face of bureaucracy and (sometimes) uncaring staff. Research limitations/implications – The profile of rights needs to be raised in an accessible and acceptable way: it is necessary to make the language of rights more commonplace. There is a particular need to reach into mental health and residential care services to find ways of enabling people to have their rights realised. The report has implications for risk assessment and risk management as well as for the regulatory bodies responsible in adult social care. Raising awareness among professionals and policy makers about the risks that service users themselves fear and experience should demonstrate just how important it is that the people whose risk is under consideration are involved in the process. Originality/value – This paper highlights the views of users of adult social care about risk; their views have rarely been documented. [ABSTRACT FROM AUTHOR]

Purpose – The protection of vulnerable adults from abuse is paramount for those working in adult protection. However, staff supporting vulnerable adults who are alleged to have abused them can feel very vulnerable and their needs must also be taken into account. The purpose of this paper is to consider the impact of adult protection investigations from the experiences of people who have been identified as alleged perpetrators in adult protection cases in order to identify improvements in practice. Design/methodology/approach – This limited study used qualitative semi-structured interviews to collect data that reflected views of the issues and experiences of participants. Findings – This study shows that expectations set out in the Wales Interim Policy and Procedures document under “support for alleged perpetrators” do not match with the experience of those who took part in this study. The experience of some alleged perpetrators is that the investigation process can be protracted, they may be left isolated with little or no information and feel very vulnerable. Research limitations/implications – A limitation of this study was the small number of participants who were interviewed and the selection and bias. Participation was on a voluntary basis and the participants were self-selecting. The participants were all paid staff. Vulnerable adults who had been identified as alleged abusers were excluded from the study on the premise that their experiences were likely to be quite different. Practical implications – It is vital that alleged perpetrators are not themselves abused by the process. The findings from this study should be used to develop recommendations to improve practice. Originality/value – The effects on staff who have been investigated as alleged abusers under adult protection policy and procedures has been under-researched. This study will make a contribution to addressing this. [ABSTRACT FROM AUTHOR]

Purpose – This paper's aim is to consider three ways in which, recently, the English courts have sought to define deprivation of liberty (and, maybe, limit the effect of safeguards against it). Design/methodology/approach – Two significant decisions of the Court of Appeal were considered, together with one each of the House of Lords and the European Court of Human Rights. Consideration was also given to the context of those decisions, as disclosed in official policy documents and at least one piece of academic research. Findings – The decisions in question have limited the circumstances that will amount to deprivation of liberty and thereby reduced the scope of the Deprivation of Liberty Safeguards (DoLS). The English courts' understanding of false imprisonment is diverging from their understanding of deprivation of liberty. The English courts differ from the European Court of Human Rights in their understanding of the relevance of "purpose" to the question of deprivation of liberty. If the former are correct, the DoLS – and maybe even the Mental Health Act – are redundant. Originality/value – This is the first time these cases, and this subject, have been analysed in this way; and that these findings have been published together. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to clarify the relationship between safeguarding adults training, staff knowledge and confidence.Design/methodology/approach - A total of 647 responses from a cross sectional postal sample survey of the health and social care sector in Cornwall, were analysed.Findings - Differences in knowledge and confidence around safeguarding were observed between staff groups and agencies. Training contributed to an approximately 20 per cent increase in knowledge and a ceiling effect was noted. Confidence linked knowledge and action. More confident staff offered more sophisticated responses regarding improving safeguarding processes.Research limitations/implications - Low response rates and the specific context limit generalisability. Knowledge and confidence measures were simplistic. Further research is needed on the mechanism of action by which safeguarding adults training is effective.Practical implications - Safeguarding adults training and a targeted approach to the analysis of learning needs should be debated in the context of training transfer. Training should be evaluated to ascertain its effectiveness.Originality/value - This is the first major multi-agency UK survey of its kind. Findings provide a baseline for further research. [ABSTRACT FROM AUTHOR]

Purpose - The research reported here aims to scope the concept of self-neglect as it is explored in the literature and interpreted in practice by professionals involved in adult safeguarding.Design/methodology/approach - The approach taken included a systematic search and thematic analysis of English-language literature on self-neglect, workshops with UK-based adult safeguarding leads and practitioners from social services, police and health services, and scrutiny of Safeguarding Adults Boards' documentation.Findings - The concept of self-neglect is complex with contrasting definitions and aetiology, accompanied by debates on the principles that guide intervention. Decision-making capacity is a key pivot upon which professional responses to self-neglect turn. Intervention in self-neglect requires careful exploration in the context of principles of personalisation, choice, control, and empowerment that underpin policy in adult social care and safeguarding.Research limitations/implications - As a conceptual scoping review, this study seeks to establish broad themes of use to practitioners working with self-neglect. It thus does not carry out a full quality review of the literature identified and discussed, but serves as a base for this to be done in future.Practical implications - Assessment in self-neglect should consider the influence of a number of possible causative factors, and intervention must balance respect for autonomy on the one hand and a perceived duty to preserve health and wellbeing on the other.Originality/value - This article summarises and critically analyses the emerging key features of evidence-informed practice in the challenging field of self-neglect. [ABSTRACT FROM AUTHOR]