Editorial

Citation

Penhale, B. (2012), "Editorial", The Journal of Adult Protection, Vol. 14 No. 5. https://doi.org/10.1108/jap.2012.54914eaa.001

Editorial

Article Type: Editorial From: The Journal of Adult Protection, Volume 14, Issue 5

Welcome to this issue, our fifth of volume 14. We are already most of the way through the publication year for the journal, which seems strange given that we are in still in July, but that is the way of schedules, publishers and so forth! As seen in previous issues, here is a selection of recent news items relating to safeguarding, that readers may wish to consider further.

Slightly earlier in the summer (a term somewhat loosely applied given the weather at that point!) the Committee for Healthcare Regulatory Excellence (CHRE) published its annual performance review of the professional regulators within health. The report shows that eight of the regulators either do not meet one or more of the standards or that CHRE has concerns about the consistency of their performance of these regulators against one or more of the required standards. This relates in particular to performance in education and training, registration and fitness to practice, which is surely some cause for concern. This publication was followed by media attention on the Nursing and Midwifery Council (NMC) as the CHRE report drew attention to the NMC’s long-standing problems including the confusion about its regulatory purpose, weak governance, poor planning, unreliable management information, and inadequate information technology. In general terms, this leaves the public with little confidence and nurses annoyed that they should be the ones paying the price, as the NMC has recently proposed to increase registrant fees for nurses. And as many readers will no doubt be aware, from the end of July the General Social Care Council (GSCC) will cease to exist as it will be amalgamated into the Health Professions Council; the final Annual Report for the GSCC was issued in early July which may be of interest to those who might wish to see a summary of the work undertaken, including in relation to fitness to practice issues. Responsibility for the social care Code of Practice will rest with Skills for Care from the beginning of August.

A reminder (if any was needed) that the legal ban on age discrimination in public services will come into effect (in England and Wales) in October this year. This will mean, inter alia that it will be illegal for healthcare professionals (managers or clinical team members) to deny older people treatment simply on the basis of age. It will be interesting to see how this requirement will be embedded in practice over time. And linked to this, the report from the Commission on Improving Dignity in Care, Delivering Dignity was published in June, with a focus on how to deal with the underlying causes of poor care in hospitals and care settings (Local Government Association, NHS Confederation and Age UK, 2012). The report is also clear that a major cultural shift is needed in order to deal with such issues effectively.

Also in June, the Department of Health (DoH) (2012b) issued an interim report relating to Winterbourne View. This report contained new proposals to improve the quality and safety of services for vulnerable people with learning disability, but not a great deal about safeguarding. The final report of the Serious Case Review is due to be published later in the year and we hope to be able to provide fuller coverage of this in a future issue.

The Social Care draft Bill and White Paper, Caring for Our Futures was issued in early July and contains a small section relating to safeguarding (DoH, 2012a). There is discussion of the statutory requirement for their to be Adult Safeguarding Boards in each locality and mention also of a consultation exercise relating to whether legal powers of entry are needed in relation to adult safeguarding. The consultation period ran over the summer period, but hopefully a number of readers will have been able to respond to the call for responses. Information was also highlighted about the extension from this year of the whistleblower’s helpline for health and social care staff (see also Care Quality Commission (CQC) item below).

Finally, a few CQC snippets, which may be of interest to some readers. The learning disability provision inspections that were largely initiated following the Winterbourne View exposé last summer have now been completed and results of the inspections can be found on the CQC web site. Perhaps not too surprisingly, one of the standards that formed part of the inspection related to safeguarding and people being kept safe and examination of the findings of the inspections concerning this standard makes for interesting reading. The new Chief Executive of the CQC has been announced as David Behan, previously head of Social Care with the DoH; it is too early yet to see what impact this change may have on the functioning of the former organisation (CQC). A further piece of information from the CQC is a report that almost 4.5 thousand calls have been made to them over the past 16 months by people wishing to complain about the treatment of older people and those with disabilities who are in receipt of care services; some of these are from whistle-blowers, whilst others are from relatives and other members of the public. The number of such complaints rose from 22 per month in December 2010 to 556 per month by March 2012 (BBC News, 2012).

The final piece of information that has been reported by CQC is that up to one-fifth (20 percent) of nursing and residential homes in England are failing to give residents their prescribed medication or to meet required professional standards in relation to the administration of medication, which may potentially have major consequences for residents (Daily Telegraph, 2012). It is also clearly an issue for those involved in safeguarding, including those at Board level in local areas.

In Wales, the Board of Community Health Councils has recently published its report on the activity of the Complaints Advocacy Service (the Complaints Advocacy Service Report 2010-2012). It has also produced a recent report on the use of electroconvulsive therapy by health boards across Wales. Both of these reports are available from the web site for the Board of Community Health Councils, Wales (www.wales.nhs.uk/sitesplus/899/home). In addition, the Healthcare Inspectorate Wales has published reports concerning unannounced inspections relating to dignity and essential care, including spot checks on cleanliness and hygiene concerning several areas and trusts in mid Wales (Powys). It is disappointing to find that improvements that one hospital (Brecon War Memorial hospital) was required to make following checks in October 2009 have not been implemented, but information about what action will be taken in relation to this matter have not yet been wholly confirmed. Please see the Inspectorate’s web site: www.hiw.org.uk/page.cfm?orgid=477&pid=33035 for further details of the inspection, including the audit tool used and reports from the individual inspections that were undertaken.

This issue of the journal contains a number of thought provoking and interesting papers. The first paper is one that is very much related to practice situations and has been jointly written by Cate Searle, who has a legal background and by Thurstine Basset who provides a welcome caregiver perspective. In the first section of the paper, the legal perspective, Cate Searle looks at the complex issues (particularly legally) that can occur when procedures relating to safeguarding are used. She also explores the possible impacts that can arise from an increased emphasis on safeguarding if local authorities do not work with service users and their families. In the second part of the paper, Thurstine Bassett provides his experience of how a safeguarding situation, concerning his family was dealt with and resolved. The final section of the paper explores some of the issues raised in the paper further and the authors make some useful recommendations for developing practice in this area.

The second paper in the issue has been provided by Diane Galpin, and is a conceptual paper, which aims to further our understanding of the ways in which elder abuse might increase within health and social care organisations in the UK given the current circumstances which such organisations find themselves in. She explores and discusses such issues in some depth, considering the potential roles of social defences and consumerism in perpetuating poor and even abusive practice. A strong argument for reform at individual and structural levels of society, based on human rights and equality-based concepts is provided in the paper.

The third paper is from Tim Spencer-Lane of the Law Commission and introduces the current work being undertaken by the commission in relation to the potential for reform of the regulatory systems that currently govern the health and social care professions. Tim provides the context in which this work has developed and discusses the consultation process that the Commission have been involved in over recent months (in the spring and early summer of this year) and which some readers have no doubt contributed to. We are fortunate that we have already secured agreement for a further paper to be submitted once the outcome of the consultation process is known and future directions are somewhat clearer.

As our final paper in this issue, we are fortunate to be able to provide another paper in our series of occasional papers relating to adult safeguarding from the Social Care Institute for Excellence (SCIE), in this instance provided by Elaine Cass of the Institute. This paper relates to some recent work that SCIE undertook concerning commissioning systems and safeguarding and introduces two reports that have recently been published by SCIE in relation to this area. We are also pleased to let you know that further papers from SCIE are likely to appear in issues for the next volume, during 2013.

Finally we include a review of some recently produced training material published by Pavilion publishing, which has been provided by Paul Cambridge of the Tizard Centre, University of Kent. The resource concerns training for those involved in safeguarding in what should ideally happen after detection, reporting and investigation of abusive situations, in an attempt to improve the likelihood that equitable responses can be provided. It is clear that the training material is based on a thorough understanding of policy, theory and the available evidence that can be derived from experiences gained from both management and practice, which provides for a detailed and useful resource.

As ever, we are always interested in receiving material submitted by individuals for consideration for publication and are happy to discuss potential ideas for articles. We are also looking to increase the number and range of reviewers for both submitted papers and for books and training material, so if you think that you might be interested please do get in touch with one of the editors to discuss further. Although we are not able to pay for the latter type of reviews, it is generally possible for reviewers to keep copies of books and/or training resources once the review has been submitted. Finally, we hope that this issue of the journal continues to provide readers with some useful and thought-provoking material for further consideration and reflection concerning developments in adult safeguarding.

Bridget Penhale