Search results

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

Scotland now has three key statutes that provide a legal framework for the support and protection of adults at risk of harm: Adults with Incapacity (Scotland) Act (2000), Mental Health (Care and Treatment) (Scotland) Act (2003) and Adult Support and Protection (Scotland) Act (2007). This article provides details of the 2007 act and highlights its interaction with the other two. The author argues that an effective adult support and protection strategy will need to address all three acts. A pyramid of intervention is used to explain the increasing levels of intervention that are now available in Scotland. The article also highlights how Scotland continues to diverge from the rest of the UK. It argues that comparative studies within the UK as well as the wider world, using tools such as the pyramid, could improve our understanding of this important and rapidly changing area of law.

This paper aims to explore the possible connections between self‐directed support and adult support and protection, both of which are important policy developments in Scotland.

The authors draw on findings from the national evaluation of the test sites or pilots of self‐directed support in Scotland and interviews at two time points with adult protection leads in the test sites. These interview data are set in the context of Scottish developments in adult support and protection.

Self‐directed support and adult protection had not been joined up initially. In the three Scottish test sites those responsible for adult safeguarding had not been engaged with the changes. They were unclear about the new systems and were concerned about the implications of reduced monitoring of risks. Shared training between those implementing self‐directed support and those carrying out adult protection work was viewed as a way of bridging these different areas of practice through enhancing mutual understanding and communication.

Policy and legislation have used the word support to provide reassurance of social protection for adults in need of care services. This paper provides new opportunities to consider the ways in which early enthusiasm for self‐directed support in Scotland may have neglected the support inherent to support and protection and the ways in which some adult support and protection stakeholders seemed to be acting as “bystanders” rather than influencing new systems of self‐directed support.

The Adult Support and Protection (Scotland) Act 2007 places a duty on Councils to investigate the circumstances of adults who, because of a disability, health condition or illness are unable to safeguard themselves from harm. Public partner agencies, including the NHS have a statutory obligation to bring to the attention of the Council those individuals who may be at risk of harm. Health professionals cooperate with adult protection investigations and participate in the development of adult support and protection plans, yet do not appear to be initiating adult protection referrals with the Council. Low reporting by health has also been recognised as a national issue. The purpose of this paper is to explore what promotes and what prohibits the identification and reporting of situations of abuse within the Scottish Legislative Framework. Understanding the decision-making processes of prospective reporters would potentially allow the barriers to be reduced and the supports to be strengthened.

The research strategy is based on a literature review, a web-based survey and semi-structured interviews with health professionals within community learning and community mental health teams.

The findings point to a number of inter-related factors which impinge upon the professional’s confidence to initiate adult protection referrals. Workers must first recognise harm as conduct which needs to be reported and addressed. They need to be familiar with referral procedures and be assured that their concerns will be dealt with appropriately. Health professionals are more likely to report if they are based in an environment which supports honest and open discussion regarding harm, without over-concern about agency reputation or resources. Access to multi-disciplinary consultation and support, particularly in relation to more ambiguous protection situations, was viewed as fundamental to reporting.

This small scale study adds to a developing bank of literature providing a Scottish perspective on protecting adults. It offers some insight into reporting decisions from the viewpoint of community health professionals.

This paper aims to describe the development and evaluation of a resource for use by practitioners to self‐evaluate their policy and practice in relation to the Adult Support and Protection (Scotland) Act 2007.

The self‐evaluation resource was developed in the context of multi‐agency adult protection policy and legislation to reflect key quality indicators relevant to stakeholders, the community, practitioners and their agencies.

The quality indicators were selectively piloted by 15 of the 28 multiagency partners in Scotland. The utility of the resource was demonstrated and in some cases the outcomes led to changes in policy and practice. The effect of resource restrictions was reported to have a bearing on the utility of the resource in some partnerships.

The quality indicators were not equally piloted with participants focusing on evaluation of case outcomes rather than wider structural and agency‐wide aspects of adult protection.

The adult protection, self‐evaluation resource has been identified as a potential means of enabling multi‐agency partnerships to establish the effectiveness of their own policy and practice and offers the potential for cross‐Scotland comparisons and bench marking.

The resource provides the basis for self‐evaluation and improvement in adult support and protection that will make the lives of adults at risk of harm safer.

An innovative approach is described to enable self‐evaluation by adult protection practitioners and policy makers to judge the effectiveness of their own performance and ensure improved performance.

The purpose of this paper is to report the findings from research into the outcomes of adult protection in Scotland, with particular focus on how service users, family members and service delivery professionals perceive the effectiveness of the protection orders in the Adult Support and Protection (Scotland) Act 2007.

The study comprised analysis of Adult Protection Committee biennial reports on implementation of the 2007 Act to the Scottish Government, key informant interviews and workshops with professionals involved in adult protection leadership and practice, and case study interviews with service users, family members and practitioners.

Concerns about the potential for paternalistic practice and excessive use of the protection orders within the 2007 Act have not materialised. The principle of proportionality appears to be firmly embedded in adult protection practice. Service delivery professionals, service users and family members remain acutely aware of the tensions between autonomy and protection but point to beneficial outcomes for adults at risk from the careful use of protection orders, especially banning orders.

Only ten case studies were able to be included in the study. However, the use of mixed methods enabled triangulation of the findings. Common themes emerge from across the data sources. The findings also resonate with conclusions drawn by other researchers.

The paper identifies outcomes and challenges in respect of protecting adults at risk in Scotland. Strengths and limitations of the 2007 Act are identified.

The paper offers a formal evaluation of the outcome of protection orders for adults at risk in Scotland. The findings are of wider policy relevance given the debates on how to legislate for adult safeguarding in England and Wales.

This paper's aim is to evaluate understanding and knowledge of the Adult Support and Protection (Scotland) Act 2007 in a sample of community nurses working in learning disability services in Scotland.

Ten community nurses who worked in learning disability services in one NHS area were tested at two time points, four months apart using a questionnaire designed for this study by researchers and practitioners. Level of previous national training in the Adult Support and Protection Act and length of time working with people with learning disabilities were recorded. Three domains of adult protection were included in the questionnaire: Principles of the Act and definitions; Adults at risk of harm; Protection, assessment, removal and banning orders.

Questionnaire scores varied widely overall and across the three domains. There was no correlation between individual scores and training or length of work experience. The level of knowledge was below what might have been expected for this group, given the level of training and experience. Carefully designed verification of the impact of nationally approved adult support and protection training is needed.

There is an absence of research in evaluating the impact of the approved Scottish Government training materials on staff knowledge and understanding of the 2007 Act, with staff attendance being taken as the main measure of training compliance. This was a small scale pilot study and recommendations are made for the scope and methods of evaluation.

The Adult Support and Protection (Scotland) Act 2007 (ASP Act) mandates public bodies to investigate situations of harm and to support and protect adults at risk. One of the fundamental principles of the legislation is to involve the person in the adult protection process. Older people are highly represented among those defined as adults at risk and have the right to participate in decisions about their lives. However, contextual factors can impact participatory parity, and participation can be tokenistic. Drawing on the author’s practice experience, this paper aims to explore the supports and barriers to meaningful participation in adult protection.

Based on practice during the first decade of the ASP Act, this paper uses amalgamated scenarios involving older adults at risk to illustrate some of the key themes emanating from literature.

Despite Human Rights Conventions and law promoting participatory principles, research evidence and practice experience suggests that ethical principles do not always translate to practice. Within adult protection case conferences (APCCs), participation is nuanced and multifaceted, involving individual and structural facilitators and impediments. APCCs can be inhospitable environments for the adult at risk. But they also have the potential to be collaborative and supportive spaces, promoting the person’s self esteem and agency. The author plans to conduct research with service users and practitioners exploring the extent to which APCCs can facilitate meaningful participation.

This paper contributes to the wider debate about the participatory rights of service users and the value of experiential knowledge.

Frequent attendance at emergency departments (ED) has been identified in adult protection reviews as a potential warning sign of the escalation of someone’s vulnerability. Concern has been expressed about the engagement of the National Health Service (NHS) in adult protection and the small number of NHS adult protection referrals. More specifically ED departments have been identified as an area of high patient through put where there has been little evidence around how well adult support and protection (ASP) was being delivered. The paper aims to discuss these issues.

A series of audits were undertaken in three different hospitals across a large Scottish Health Board accessing ED at different times of day on different days of the week to test out whether NHS staff working in EDs are identifying adults who meet the criteria of “an adult at risk”.

The audits identified a total of 11 patients from a total sample of 552 records examined who may have met the criteria to be considered an adult at risk, although further information would have been required to make a fully informed decision.

The main study limitation is that the hospitals are all within a single Health Board. The EDs have a large number of admissions and it is possible that a less pressurised area, might have a lower threshold of “risk” than the practitioners involved in the audits. The decision as to whether an adult was considered to meet the three-point test by the three people undertaking the audit was dependent on the quality of information recorded on the patients’ electronic hospital record.

It is essential that NHS Boards proactively support practice in ED settings so staff are able to identify adults at risk of harm under the ASP legislation so that ED staff are responsive to ASP needs.

The research evidence around adult protection in the UK is still emerging. The development of good practice based on the Scottish Government’s ASP legislation is still being shaped. In England and Wales, the principles of identification and multi-agency working underpinning the safeguarding of vulnerable individuals are broadly similar to Scotland. These audits add to the literature by challenging the assumption that patients who would benefit from local authority investigation and possible support are not being identified within EDs.

The purpose of this paper is to outline the duties and powers of the Adult Support and Protection (Scotland) Act (ASPSA) 2007 and place them in the wider Scottish adult protection legislative framework. It considers the potential value of a standalone adult safeguarding statute.

The authors draw upon their research and practice expertise to consider the merits of the ASPSA 2007. They take a case study approach to explore its implementation in one particular Scottish local authority, drawing on the qualitative and quantitative data contained in its annual reports.

Skilled, knowledgeable and well-supported practitioners are key to effective screening, investigations and intervention. Protection orders are being used as intended for a very small number of cases.

The lack of national statistical reports means that there is limited scope for comparison between the local and national data.

Adult support and protection requires ongoing investment of time and leadership in councils and other local agencies to instigate and maintain good practice. Aspects that require further attention are self-neglect; capacity and consent and residents in care homes who pose potential risks to other residents and staff.

ASPSA 2007 has helped to raise awareness of adults at risk of harm within the local communities and as social issue more generally.

The authors provide a critical appraisal of the implementation of Scottish adult safeguarding legislation over the last six years. They consider similar developments in England and Wales and argue for comparative research to test these out. Finally, they signpost future directions for bridging separate policy streams.