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In commenting on the issues raised by Drake et al. the purpose of this paper is to discuss three areas of practice: assessing capacity in the presence of intransigence and/or rigid patterns of thinking and behaviour; understanding addiction in this context; and identifying “reasonable adjustments” in the way addiction and substance misuse services are provided to this client group.

As well as discussing the issues raised by Drake et al. the commentary refers to a serious case review exploring similar issues.

Both the case discussed by Drake et al. and the serious case review draw attention to the importance of identifying “reasonable adjustments” to current practice.

While the implications of the cases discussed are very significant, further work quantifying the scope of the problems identified would be very useful.

The 1995 Disability Discrimination Act (UK) requires public services to make “reasonable adjustments” in order for people with a range of disabilities to access their services on an equitable basis. This paper identifies what some of those areas of difficulty might be.

This is a relatively new area of work and expertise in both mainstream addiction and specialist intellectual disability and mental health services needs to be developed in order for them to provide more coherent and accessible programmes to individuals.

This paper reports the results of a study of the monitoring of adult protection referrals in 10 local authorities during six months in 1998. The issues are analysed at various levels. The information provides a useful window on the effectiveness of current policies and provides a baseline from which to anticipate the implications for workload and service planning of recent government guidance.

This paper considers the emergence of adult protection as a significant issue for health and welfare professionals. A range of definitions and dilemmas are considered alongside a comprehensive review of how abuse is manifested. A brief review of the latest research is followed by principles of good practice.

The registration and inspection of residential care services for vulnerable adults rests with local government but in 2002 responsibility passes to the new Commission for Care Standards. This paper looks at how inspection units understand and respond to adult protection issues, considers how they contribute to multi‐agency adult protection and speculates on how the planned changes will impact on policy and practice.

This article reports the results of a survey of local authorities, which asked about progress in responding to the Department of Health guidance, No Secrets. The findings of the survey suggest that the majority of local authorities are taking action in response to the guidance. However, there is variation in progress with the different components of the framework for the protection of vulnerable adults outlined in No Secrets.

This paper explores the links between the PGO and social services in relation to abuse and to local authority management of the finances of vulnerable people. It also reports a small‐scale study of adult protection co‐ordinators in social services departments, which explored the nature of and contact between the two agencies in the context of adult protection inquiries.