Emerald Group Publishing Limited
Article Type: Editorial From: The Journal of Adult Protection, Volume 17, Issue 1
Welcome to our first issue of 2015. We hope that readers have had a good New Year so far! Just a couple of recent new items for readers to consider, as follows ….
Recent media attention has been paid to the situation of people in solitary confinement. In 1972, Albert Woodfox was convicted of killing a prison guard. He is the longest serving solitary confinement prisoner in the USA, having been in isolation for 42 years. It is believed that his conviction was secured via racially discriminatory means – and his conviction has been overturned although he has not yet been released![1-2] Although the eighth amendment to the US Constitution prohibits cruel and unusual punishment, Albert Woodfox has been confined in a 6’×8’ cell for 23 hours a day and yes – he is subject to claustrophobia. One of the ways in which he has dealt with this is by closing his eyes and rocking.
Rocking – now which group of people do we associate rocking with? Here's a clue, an inquest at Hull Coroner's Court in late November 2014 established that Stephanie Bincliffe, a woman with severe learning disabilities who was sectioned under the Mental Health Act when she was 18, had been in the padded cell of an Assessment and Treatment Unit run by the Huntercombe Group, for almost seven years, and had not left the cell at all for over 18 months. When she died she was morbidly obese having gained ten stones in weight and yet she had no independent access to food. It's right that the term “Assessment and Treatment Unit” rings bells … Winterbourne View Hospital, or even the untimely death last year of Connor Sparrowhawk … There are more people with learning disabilities in such units now than before the closure of Winterbourne View three years ago. Not only have we not managed to put right the wrongs for those abused during that dreadful episode – some former patients are still in units over 200 miles away from their families and friends – but we seem incapable of closing unwanted services – despite polished press statements of management gobbledegook – and it goes on …
This issue contains a range of papers, which we hope will provide much food for thought for readers. Our first paper, by Michael Preston-Shoot and colleagues considers the somewhat contentious area of self-neglect. The paper is based on an analysis of 40 serious case reviews that have been undertaken in recent years in which issues relating to self-neglect featured. The analysis looked at the characteristics of the case and the review, the recommendations that were made and the themes that were derived. There is also a focus on the potential learning that might be relevant for service-level improvements – at the level of the individual adult and their context, the team of practitioners who worked with the adult (from different organisations where necessary), the organisations relating to the practitioners and the Local Safeguarding Board. In the absence of any national database of serious case reviews that are/have been undertaken, this level of analysis has been missing and the findings will be of use as we move in England to the world of Safeguarding Adults Reviews requirements introduced through the Care Act 2014, implemented from April 2015.
Staying with an emphasis on Local Safeguarding Boards, our second paper, by Jill Manthorpe and colleagues considers the issue of the inter-relationships between adult safeguarding and personalisation. The element of the study reported here relates to an analysis of the Annual Reports of Local Safeguarding Boards in order to establish what is reported concerning the personalisation agenda, specifically in relation to safeguarding. Despite variability between reports in relation to content relating to personalisation, some examples of changes at system or process levels were found in some areas. This may be an area of likely development in light of forthcoming legislative changes.
Learning from practice is also the theme for our third paper, a Viewpoint piece by Emma L. Stevens, which looks at the potential of written reflective assignments for professionals in training (in this case student nurses) to inform about safeguarding issues. From the review of work that took place, it was determined that local safeguarding policies and procedures were being followed in most of the placement areas that were considered; however, application of the Mental Capacity Act (MCA) appeared to be inconsistent. The work undertaken also included the development of an audit tool that can be used in relation to student work produced during (or following) placements.
The following paper by Chris Lennard concerns the Deprivation of Liberty Safeguards arrangements. The paper considers the factors that Best Interests Assessors take into account when undertaking assessments and examines some of the reasons that may result in the apparent under-use of the safeguards by professionals. The paper contains several case studies and explores the nature of difference between restriction and deprivation in a thought-provoking way.
Our fifth paper in this issue details a piece of research that took place in Northern Ireland, reporting an analysis of 50 case files relating to safeguarding cases over an 11-month period, together with findings from interviews with a number of Designated Officers, who have a responsibility to screen referrals and to co-ordinate investigations. The findings from the research were used in a review and redesign of the regional adult safeguarding documentation that was in use, together with a revision and update of the training that was provided for staff in that area of work.
The final paper of this issue is a legal piece by David Hewitt. The paper examines issues relating to the duty within mental health legislation (specifically the Mental Health Act 1983 and associated Code of Practice) for an Approved Mental Health Professional to undertake consultation with a person's nearest relative. The focus of the paper is to explain a recent decision made concerning this duty by the Court of Appeal and to set this in context by comparing it with an earlier decision. The implications of this recent decision are considered in relation to the potential for an individual's nearest relative to abuse their position and obtain information and/or access to the person.
As always if any reader is interested in writing and submitting to the journal but wish to discuss this or to seek advice, please do contact one of us in order to obtain relevant information and assistance. We look forward to your contributions and your support for the journal throughout this current volume.
www.amnestyusa.org/our-work/cases/usa-the-angola-3 (accessed 30 November 2011).
Bridget Penhale and Margaret Flynn