Transcript Manna Santokhee Action on Elder Abuse

Manna Santokhee
Action on Elder Abuse
Action on Elder Abuse
Manna Santokhee MA
(Business and Fundraising Manager)
Background $ Experience
Action on Elder Abuse is a ‘Four Nations’
organisation based in London
It was established in 1993 by practitioners from health
and social care, academics and voluntary sector
representatives, and is now one of the key Adult
Protection agencies in the UK.
We are an ABUSE charity focusing upon the needs of
older people
‘a single or repeated
act or lack of
appropriate action
occurring within
any relationship
where there is an
expectation of trust,
which causes harm
or distress to an
older person….
A Vulnerable Adult is …
An Adult at Risk is …
a person who is or may be in
need of community care
services by reason
of mental or other disability,
age or illness; and who is or
may be unable to take care of
him or herself, or unable to
protect him or herself against
significant harm
or exploitation.
a person who is (a) unable to
safeguard his/her own wellbeing, property, rights or
other interests, (b) is at risk of
harm, and (c) is affected by
disability, mental disorder,
illness or physical or mental
infirmity, and is therefore
more vulnerable to being
harmed than adults who are
not so affected.
Five types of abuse
Time for Action
(11 minutes DVD)
UK Study of Abuse and Neglect of
Older People - 2007
The overall prevalence of abuse,
defined by ‘expectation of trust’ in the
year preceding the survey was
4%
This equates to 342,000 people aged 66 and over,
or 1 in every 25 of the population aged 66 and over
UK Study of Abuse and Neglect of
Older People - 2007
Nation Specific Prevalence
Percentage of all
respondents who
experienced abuse
7
6
6
Percentages
5
4
4.3
3.9
3
3
2
1
0
England
Wales
Scotland
N Ireland
England
Wales
Scotland
N Ireland
Source: Hidden Voices
Age of victim
78% of abuse occurs after the
age of 70 years
45
40
40
35
30
22
25
18
20
16
15
10
5
4
0
55-64
65-69
70-79
80-89
90+
55-64
65-69
70-79
80-89
90+
Source: Hidden Voices
Gender of victim
Men
11
Women
22
67
Both
UK Study of Abuse and Neglect of
Older People - 2007
Percentage of all
respondents who had
The Perpetrators
experienced abuse in
the last year
40
35
35
33
33
Percentage
30
25
20
15
9
10
3
5
0
Partner
Other family
Home Help
Friend
Neighbours and
Acquaintances
Source: Hidden Voices
Where abuse occurs
70
64
60
50
Other
40
Hospital
30
20
10
0
Sheltered
housing
23
4
4
5
Care Home
At home
Factors that may lead to
elder abuse:
Social Isolation
Poor quality long term relationships
Patterns of family violence
Dependency
Alcohol, drug and mental health problems
Minority status
Factors that may lead to
elder abuse in
institutional settings:
Poor staffing levels and working conditions
Lack of training, supervision and support
No procedures or policies on abuse
Poor communication
Reasons for the hidden nature of
abuse
Mis-diagnosis of abuse as something else
Family matters are private and should stay that way
I have no one to turn to who can help.
The abuse is my fault.
The consequences of speaking up are worse than keeping quiet.
I love my partner/son/daughter don’t want them criticised or
punished for what they did
Reasons for the hidden nature of
abuse
I am completely dependent on my abuser.
I’m so ashamed and embarrassed that my own family member
could be behaving in an abusive or neglectful way
I’m afraid if I break the “family secret,” the person hurting me will
get back at me in a way worse than what is happening now.
Long term conditioning by the abuser
Failings in the system.
Mrs Frances
Hales
Mrs Frances
Hales
Died from
neglect
Visitors were encouraged to ring
ahead when they came to see
relatives at the home in Oxford. It
gave the staff time to hide the
stench of urine and scrape faeces
off the curtains
Not that they would ever see the 89 year old man whose
suppurating pressure sores had rotted the flesh down to
his bones. He was locked away upstairs, in too much
pain to move and too much confusion to cry out.
For the last four months of his life Alec Taylor saw no one
except the owner, who cleaned his wounds by hacking at
the skin around the sores with office scissors and ripping
out his rotting flesh, wearing gloves he had used to
scoop faeces off the sheets.
Adult Safeguarding
Adult Safeguarding and Adult Protection are concepts that seem
reasonably straightforward at face value; they involve protecting
vulnerable adults from harm or abuse. But they are in fact
complex and challenging constructs in reality - both in terms of
practical implementation but also in terms of the ethical/moral
dilemmas that can be inherent within them.
Background:
No Secrets was issued in 2000, as guidance under section 7 of
the Local Authority Social Services Act 1970, to respond to a
growing concern about elder abuse in particular, and adult abuse
in general.
It was statutory guidance, and local authorities were
consequently required to follow it unless they could demonstrate
a clear reason why they should not do so. It created, for the first
time, a framework for multi-agency action in response to the risk
of abuse or harm.
Process: How it works
Alert:
by anybody
Referral:
Accepted into the system
Decision:
Is it Safeguarding?
Assessment:
Is it happening? What is it?
Plan:
How to respond
Review:
Is it working?
What’s going on:
On 15 June 2007 the Minister of State for Care Services, Ivan Lewis,
promised a review of No Secrets, with particular regard to the need
for legislation.
The consultation was eventually published 14 October 2008 and
concluded on 31 January 2009.
In February 2010 the Government announced a three-pronged
approach: legislation to address the governance of Safeguarding
Boards (but without a commitment to what that meant or when it
would happen), an Inter-Ministerial Cross Government Group on
safeguarding adults, and an updated version of No Secrets
Key points from the Law
Commission:
• a duty on social services to investigate or cause an investigation
into adult protection cases; and a duty on Government to
prescribe the process for such investigations;
•
a new definition of people at risk of abuse and of harm in order
to ensure those in need receive adequate protection;
• a statutory basis for adult safeguarding boards which should as
a minimum comprise local social services, police and health;
• the legal requirement to establish serious case reviews; and an
enhanced duty to cooperate between relevant organisations.
Government response:
• Safeguarding Boards will be made statutory.
• A statement of principles for use by Local Authority Social
Services and housing, health, the police and other agencies for
both developing and assessing the effectiveness of their local
safeguarding arrangements.
• Principles: Empowerment, Protection, Prevention,
Proportionality, Partnership, and Accountability
• The outcomes for adult safeguarding, for both individuals and
agencies
Thinking about Outcomes:
Lord Justice Munby
Physical health and safety can sometimes be bought at too high a
price in happiness and emotional welfare. The emphasis must be on
sensible risk appraisal, not striving to avoid all risk, whatever the
price, but instead seeking a proper balance and being willing to
tolerate manageable or acceptable risks as the price appropriately
to be paid in order to achieve some other good – in particular to
achieve the vital good of the elderly or vulnerable person’s
happiness. What good is it making someone safer if it merely
makes them miserable .
Thinking about Outcomes:
Lord Justice Munby
Intervention which is proportionate to the harm, or real possibility
of future harm, and which has the overall effect (outcome) of
improving the life of the adult, including their safety, happiness and
mental well-being.
“If the State is to justify removing vulnerable adults from their
relatives, partners, friends or carers it can only be on the basis that
the State is going to provide a better quality of care than that
which they have hitherto been receiving
Key Issues
Key issues:
There is a poor level of co-ordination across all
organisations/capable guardians within the public and private
sectors, leading to inconsistent delivery of appropriate advice,
support and intervention.
Those organisations/capable guardians, who come into
contact with vulnerable adults exhibiting high levels of
independence, may not recognise their vulnerability.
Key issues:
Where organisations see no immediate threat to a person’s
well-being, they may fail to consider the long-term impact of
victimisation. This lack of realisation or sense of urgency can
lead to safeguarding procedures not being invoked, or
organisations choosing not to share data.
The social care element of the No Secrets definition has the
potential to limit the response of Adult Social Care, leaving a
group of people, who are unable to safeguard themselves
against harm or exploitation, excluded from the provision of
protection.
Key issues:
ACPO found a lack of consistent understanding of financial
crime across police services and several examples of victims
being turned away at police front desks. This may be due to a
lack of understanding of financial crime, or an assumption that
the loss of monies or assets is of less importance than other
forms of abuse or crime. There is also evidence that police
officers are, on occasion, making their own judgements about
capacity, in circumstances where referring the adult for an
assessment may be more appropriate.
Key issues:
Despite high levels of contact, GPs appear to generate
disproportionately low numbers of referrals. The role of GPs is
considered crucial to safeguarding, as they are:
“In an ideal position to identify safeguarding concerns with
their knowledge of patients, their families and situations.”
These low volumes of referral could be due to a lack of ability
to identify safeguarding problems, or a concern over breaching
confidentiality.
Elder Abuse Helpline
080 8808 8141
Admin telephone:
020 8835 9280
Email:
[email protected]
WEBSITE:
WWW.ELDERABUSE.ORG.UK
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