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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 article updates a review submitted to the Department of Health (DH) in the light of the House of Commons Health Select Committee report on Elder Abuse. The review drew on recent research about elder abuse in the UK, including research published after the Select Committee's hearings, that made specific recommendations for areas of development in research and policy. The aim of this paper is to address specific questions posed by the Select Committee in light of developments up to mid 2005.

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 purpose of this paper is to explore and critique the conceptual and terminological shift – particularly from “vulnerability” to “adult at risk” – in adult safeguarding under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014.

The paper compares the notion of the vulnerable adult in safeguarding, with the notion of an adult at risk under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014 and questions to what extent such a shift addresses existing criticisms of “vulnerability”.

The paper criticises the notion of the “vulnerable adult” for perpetuating the stigma associated with an impairment or disability, and for the types of legal and policy responses deemed appropriate under such an understanding of vulnerability. While efforts to replace the term “vulnerable adult” with “adult at risk” are, to some extent, to be welcomed, “adult at risk” under the legislation relies on the same characteristics for which the “vulnerable adult” has been criticised. Nevertheless, the safeguarding provisions under the two Acts have made some strides forward in comparison to their legal and policy predecessors and the notion of the “vulnerable adult”.

This paper’s originality and value lie in its scrutiny of the notion of “vulnerability” in adult safeguarding, in comparison to the newer terminology of an “adult at risk”, whilst also suggesting that in important respects – in relation to the interventions deemed appropriate where an adult is perceived to be at risk – the two pieces of legislation are a marked improvement on their predecessors. It also offers some thoughts as to how criticisms of the new legislation may be overcome.

The safeguarding vulnerable groups bill aims to improve the system of checks on staff and volunteers who want to work in social care, health or education. However, it creates different levels of protection for children and for vulnerable adults. This article sets out the concerns expressed by a small coalition of disability charities that argued for improvements to the bill during its passage through Parliament. In particular, they wished to rectify the bill's failure to provide for mandatory checks on staff working privately for vulnerable adults who lack the capacity to manage their own affairs. These arguments were opposed by carers' organisations that wanted to avoid increasing the regulatory burden on carers. We critically examine these arguments, and ask whether there is a conflict of interests between carers and vulnerable adults.

Launched in the spring, No Secrets, the government's latest adult protection guidance is expected to have a major impact on all agencies involved and interested in adult abuse. Here, using a novel approach, Claudine McCreadie, one of the country's leading elder abuse researchers, looks at what No Secrets will involve for those charged with its implementation in local areas, while providing a range of useful insights and hints.

The current adult safeguarding system is failing people with mental health problems. Despite the introduction of the Department of Health's No Secrets guidance in 2000, abuse is still widespread in private homes, the community, and health and social care settings. New research from Mind demonstrates the urgent need for a shift in focus towards a prevention model of safeguarding, with service user involvement at its core. Currently, people feel disempowered by and frustrated with a paternalistic system that labels them ‘vulnerable’ and fails to take account of their preferences in making decisions about their safety. This has led to a real lack of faith among people with mental health problems in current procedures to ensure their safety, which undermines the entire safeguarding project. Mind conducted survey and focus group research that highlights three key areas where adult safeguarding is failing people with mental health problems: the system disempowers individuals and excludes them from participating in decisions about their level of risk; there is a systemic lack of engagement with safeguarding by the NHS, meaning institutional abuse is widespread and unchecked; and discrimination at the heart of the criminal justice system means that people with mental health problems are being denied equal access to justice, which poses a risk to their human rights. In light of these findings, Mind is calling for a wholesale revision of the current approach to adult safeguarding towards a rights‐based approach, which is underpinned by user involvement.

The purpose of this paper is to examine responses by police and Adult Social Care to honour based abuse (HBA) victims who have a diagnosed or perceived vulnerability, such as a physical disability or mental health issue. The aim is to improve professional practice in ensuring vulnerable victims are safeguarded.

Findings are drawn from 100 HBA investigations (2012-2014) derived from classified police electronic records and interviews with 15, predominantly specialist, public protection police officers in one UK force.

HBA against vulnerable adults is an obscure crime area. In cases of diagnosed vulnerability (3 per cent), police officers wrongly attributed “freewill” and choice to vulnerable adults who legally lacked the capacity to consent to marriage. Conversely, in 9 per cent of cases where victims were depressed and/or self-harming, perpetrators exaggerated the poor mental health of victims in order to discredit them to law enforcement. Professionals illogically latched onto perpetrator explanations and in turn undermined and problematised the victims.

There is limited access to data on vulnerable adult abuse, making this an under researched area of crime.

Failing to undertake risk assessments, or record whether the victim is legally vulnerable should lead to a review of police practice. An evaluation of joint working arrangements is necessary concerning which agency (police or Adult Social Care) should take primacy.

Vulnerable adult victims were retained in risk predicaments alongside perpetrating family members.

Police officers suggesting vulnerable adults can “consent” to marriage is a new concept, along with issues of goal displacement which illustrates avoidance behaviours by professionals and under protection by the state.

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.

Despite the introduction of Surrey‐wide vulnerable adults policies and procedures, monitoring figures from the Surrey Adult Protection Committee indicate that abuse is still being under‐reported for different service user groups. This study explored staff knowledge and attitudes towards abuse and the reporting procedure to further understand why abuse is not reported.