PROTECTING VULNERABLE ADULTS - SECURING THEIR SAFETY

UNISON Scotland's response to the Third Consultation Paper on the Protection of Vulnerable Adults and Related Matters

September 2005

Executive Summary

• UNISON Scotland is pleased to comment on the Scottish Executive's Third Consultation Paper on the Protection of Vulnerable Adults.
• UNISON believes that there is a pressing need for additional training to be carried out across the Health and Social Care Workforce in an attempt to eradicate abuse of vulnerable adults.
• We believe that additional resources will need to be invested in such training.
• We support the creation of Adult Protection Committees which should be defined in either statute or a statutory instrument. However, we do not believe they should lead the investigations of abuse, which should be carried out by the relevant organisations with findings presented to the Committees to determine whether intervention is necessary.
• Mediation is seen as appropriate in some circumstances, but with safeguards built in.
• We believe there is a place for Guardianship, but again with safeguards built in.
• UNISON believes that there should be a different provision made for people with learning disability.
• We also believe that training for carers of vulnerable adults, who may have difficulties themselves, should be introduced.

Introduction

UNISON is Scotland's largest trade union representing over 150,000 members working in the public sector. UNISON Scotland represents workers from the NHS and social services throughout Scotland, many of whom work with vulnerable adults.

Most of our social services workers are employed by Local Authorities, which we believe is the most appropriate vehicle for delivery of social care services. We also represent a substantial number of staff who work in the private and voluntary sector.

UNISON Scotland welcomes the opportunity to comment on the Third Consultation Paper on the Protection of Vulnerable Adults and Related Matters

Response

General

UNISON Scotland supports the principle of seeking to protect vulnerable adults in all settings and is generally in favour of the proposals the Scottish Executive has put forward in the two previous consultations. We acknowledge the difficulty in attempting to create the correct balance between protecting the vulnerable and at the same time, allowing them to lead independent lives wherever possible. We are also very concerned that the rights of those staff who may be investigated are upheld as much as those of the service user.

In this connection we believe that the issue of training for staff and other people who are involved with vulnerable adults should be taken into account in this consultation, as we feel this is a key element in attempting to protect vulnerable adults from abuse.

The Scottish Executive must guarantee that sufficient additional resources are invested in this training, which will be required across the whole health and social services workforce and in the community.

We are pleased to note that a fair appeals system against exclusion from the list of those allowed to work with vulnerable adults will be incorporated into any proposed Bill.

Question 1: Do you agree with the revised definition of a vulnerable adult?

Part of the protection of vulnerable adults is included in the Adults with Incapacity (Scotland) Act 2000. Although this definition of Vulnerable Adult is supported, it should be remembered that many adults under this heading are vulnerable due to the lack of training afforded to carers re their specific difficulty, e.g. Autism. Training should be provided to both family members and employees of individuals and volunteers who work with those individuals classed as vulnerable, on, for example, challenging behaviour and how to deal with violent incidents or sexualised behaviour and how to deal with it appropriately.

Question 3: Do you agree with the definition of abuse?

In part

Question 4: If you do not agree with the definition of abuse, what changes do you think require to be made?

There should be reference clearly made that abuse includes verbal, emotional, mental and physical acts, as many individuals only view the physical act as a term of abuse.

Question 5: Do you agree that Adult Protection Committees should lead the investigation of abuse, including investigations of abuse in regulated care services?

The initial investigation of abuse should be carried out by the organisations involved with all findings passed to the Adult Protection Committee. The investigatory department should present their case to the Committee with a decision then being taken to decide whether their intervention is required. A familiar face should also be available to the individual who is allegedly being abused to prevent further stress and unnecessary distress being placed upon them.

Question 7: Should the structure and powers of Adult Protection Committees be defined in statute or a statutory instrument or not?

If the proposed changes from 2.22 to 2.27 are put in place in full, it should be agreed that Adult Protection Committees should be defined in statute or a statutory instrument

In 2.27 the level of abuse should be ascertained. An individual assessment should be carried out in each case to ensure that this would be in the best interests of the vulnerable adult and that the perpetrator is fully aware of their actions and the reasons behind the exclusion. It should also be ascertained what assistance there was for the individual dealing with the vulnerable adult, what resources were available to them in dealing with the individual and whether these resources were provided (Carers Act, 1995). The perpetrator may in fact turn out to be in just as vulnerable a position as the individual defined as being vulnerable (elderly parent, sibling, etc.)

Question 8: When abuse of a vulnerable adult is proved, what risk assessment and management should take place?

When abuse of a vulnerable adult has been established, an assessment should provide the following:

• Whether contact between both parties appropriate and if so how should this take place, i.e. supervised, in an identified building, how often, how long;
• the vulnerable adult should be assessed for a package of care. This would include living environment, social, emotional, physical needs and most importantly, where possible, the individual's own views, expectations and aspirations.
• Identified workers should be provided to give continuity and stability to the individual
• If further intervention is necessary for the vulnerable adult the environment and sensitivity of the intervention should be considered, i.e. doctors, hospitals, police, change of location re living. The individual should not be taken away from all that is familiar to them. This could be seen as a punishment for being abused, if not handled carefully, i.e. familiar landmarks and social activities, the church, day care, local amenities, etc

Question 9: Do you agree that mediation should be offered to all those who are subject to abuse? If you do not agree, please state your key reservations.

Question 10: If mediation were to be offered, how could this be done?

If mediation is offered it should be because the individual who has been abused wants it. Prior to any mediation, strict ground rules and guidelines should be put in place (on an individual basis). These should include:

• Where mediation is to take place
• For how long
• Purpose of mediation should be clarified
• What can or cannot be discussed
• Reassessment after each meeting

An advocate for the individual who has been abused should be provided in order to provide support, encouragement and reassurance.

Mediatation can be stopped if it is creating further difficulties for the individual who has been abused. An evaluation of the effectiveness of mediation should be put in place.

Question 11: Do you agree that guardianship is the most appropriate method to protect and control some people with a learning disability who may also exhibit challenging behaviours?

Question 12: If you do not agree, what alternative methods could be provided other than detention under the 2003 Act?

UNISON agrees, with reservations. If applying for guardianship the individual who would be overseeing the life of the individual with a learning disability should have it made clear in some form of documentation that guardianship does not mean total control over the rights of the individual. For example, regardless of an individual's disability, if they are able to communicate through actions, words or any other form of communication distinct to themselves regarding their needs or wants then the guardian should provide them with this opportunity, if within the law, i.e. in relationships, living arrangements, social experiences. In our experience, in some instances guardians imposes their own values and lifestyle on the individual, rather than take what the individual may want into consideration. This includes issues that could be seen as trivial to others, e.g. attending funerals, weddings or other social activities or not wanting to take part in their guardian's choice of lifestyle, e.g. religion, remaining in the family home, medical arrangements, form of dress, etc. Informed choice, based on the level of understanding of the individual should also be provided.

Question 13: Is it preferable to make a different provision for the compulsory care of people with a learning disability outwith the 2003 Act?

Question 14: What would the implications of change be in practice?

UNISON believes that it is preferable to make a different provision for the compulsory care of people with a learning disability. Individuals with a learning disability have been denied equal rights to those who do not have a learning disability in all areas of life.

Many individuals do not appreciate the restrictions put in place by law as many have never been given the opportunity to be governed or realise the effects of law/legislation. Many individuals have been institutionalised since birth or in their youth, either in hospitals, care homes or even within their family's care. They have been in a sense, ‘protected' from society and its rules.

New legislation is then introduced through care in the community and in order to satisfy their own statistics individuals are forced, too quickly, into the wider community without having the broader understanding or knowledge of the wider society. Whether it is right or wrong, many individuals view these institutions as their home and their existence is based around its boundaries.

To then expect individuals to behave in a manner than is seen as acceptable to others is a breach of their human rights. What is learned in a lifetime for others should not be expected to fall into place in a matter of months, or even years, for those individuals who have been denied the right to the opportunities afforded by our society.

Therefore a different provision for the compulsory care of people with a learning disability should be sought outwith the 2003 Act or the Act should be amended to include the needs and rights of these individuals. People who have been institutionalised by what society previously saw as a means of their or our protection should not be punished because society has changed or moved the rules.

For Further Information Please Contact:

Matt Smith, Scottish Secretary
UNISONScotland
UNISON House
14, West Campbell Street,
Glasgow G2 6RX

Tel 0845 355 0845 Fax 0141 342 2835

e-mail matt.smith@unison.co.uk