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Behaviour that is in fact adult abuse may be reported through a number of different frameworks (for example complaints procedures and incident reporting procedures) without it being realised that adult protection procedures need to be activated as well. This paper will examine how adult abuse can be reported through the disciplinary framework, and therefore how adult protection and the disciplinary process need to be joined.

In adult protection many of the concerns that are highlighted about possible abuse relate to non‐criminal situations in which neglect may have occured. Designated lead managers, often social services team managers, act as gatekeepers. In conjunction with police, health and inspectorate colleagues they have to determine if allegations and referrals should be dealt with either as possible abuse or as poor practice, triggering different mechanisms. A tool has been developed in Wales to promote and support consistency in decision‐making in ‘grey areas’. Also, the Welsh Assembly Government(2009) has published helpful guidance on the management of escalating concerns in care homes, which helpfully informs arrangements for adult protection and provider performance to be managed in tandem.

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.

This limited study used qualitative semi-structured interviews to collect data that reflected views of the issues and experiences of participants.

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.

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.

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.

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.

Kent was one of the first social services departments to develop a specific adult protection policy in 1987. This paper charts the development of policy and references key landmarks on this journey from the perspective of the policy manager's role. Opportunities are also taken to identify the key learning from this experience and the main challenges for the newly emerging safeguarding agendas.

Adult protection has been a relatively recent concept for staff working within the health economy. Priorities have focused on raising awareness, developing an understanding of safeguarding responsibilities, challenging established practices and attitudes and embedding the concept within the culture of NHS organizations and the daily work of staff at all levels. Although social services have the lead for safeguarding activities (Department of Health, 2000), statutory health bodies have now begun to integrate their adult protection activities more effectively and positively with social services and the police. This paper reviews the journey undertaken by the three primary care trusts (PCTs) in Kent and Medway in developing adult protection expertise and sharing multi‐agency adult protection practice with both social services and the police. The three safeguarding vulnerable adults leads from the PCTs have joined together to look at how far we have come and what we still need to achieve.

This paper describes the development of a multi‐agency model for adult protection training in Kent and Medway and sets this in the context of the evolution of wider adult protection policy and competence. The rationale for the planning and development of the model is outlined and the content and coverage of the different levels of training are described. Key issues include the progression of staff and managers and the implementation and operation of the model. These are explored in relation to the different demands on the safeguarding activities in Kent and Medway and the different agency and professional interests at stake. Future developments are also briefly mapped and discussed.

The Mental Capacity Act 2005 introduced the role of the independent mental capacity advocate (IMCA). This is essentially a new safeguard for adults when they lack the capacity to make critical health and welfare decisions, particularly those without family or friends to represent them. IMCAs can have a statutory role in adult protection cases that is detailed in this paper. Advocacy Partners (AP) was one of seven organisations piloting this service in England before the service was introduced nationally in April 2007. AP is now commissioned to provide the IMCA service in 10 local authorities in the South East. Of the 270 cases referred to Advocacy Partners that have met the criteria for an IMCA since the Act was implemented, 38 were referred as part of adult protection proceedings. This early experience of IMCA involvement in adult protection cases is discussed.

Although there has been a commitment to develop a policy framework to support vulnerable adults at risk of abuse, there remains concern around its lack of use within National Health Service inpatient settings and mental health services in particular. A gap between policy and practice appears to have developed, which leaves inpatients vulnerable to inadequate responses to allegations of adult abuse. This article will provide a critical overview of the policy and practice issues that affect the use of adult protection procedures.

This paper argues for a case management rationale in adult protection management and practice, drawing insights from a series of linked training initiatives and an evaluation of the role of the specialist adult protection co‐ordinator. An explicit case managed approach contrasts with much current practice for adult protection, where responsibilities often vary widely within, between and across agencies and professional and worker roles.

The purpose of this paper is to measure nurses’ knowledge about Adult Support and Protection (Scotland) Act 2007 before and after a one-day training course using participants’ favoured methods of training activities.

A repeated measures design was used to evaluate the impact of a one-day Adult Support and Protection training on pre-training knowledge of community nurses across one NHS area. Participants’ favoured methods of training activities were used in the training. Participants were community nurses working in learning disability, mental health, older people's services, acute services, substance misuse, and accident and emergency. All completed a training needs analysis and training preferences study. Individual and group scores on an Adult Support and Protection knowledge questionnaire were analysed pre- and post-training.

There was a statistically significant increase in scores post-training (Wilcoxon's signed-ranks test). Individual increases ranged from 2.5 to 27.5 per cent, with a mean score of 15 per cent. Evaluation of the impact of nationally approved Adult Support and Protection training is needed and training should take account of participants’ existing knowledge and preferred methods of training delivery to improve the transfer of learning into practice.

Participants were self-selecting. Existing knowledge was not controlled for in the sample. No longitudinal follow up to measure retention of any improvements in knowledge. No control group. Training methods used were based on the expressed preferences of 40 nursing staff, but only 18 of these staff participated in the training day.

There is a dearth of research in evaluating the impact of the adult protection training on staff knowledge and understanding. Designing training activities and content to take account of participant preferences, and areas where knowledge is weakest may enhance the effectiveness of training in this area. This research was funded as a Queens Nursing Institute Community Project. It builds on a pilot project