RSM june 19 2009

elder abuse: some implications for health professionals

Jill Manthorpe

King’s College London

RSM june 19 2009

Elder abuse, neglect and mistreatment and loss of dignity

1. Concern is unlikely to dissipate

2. Professional regulation – extensions

3. Legal developments

4. Review of No Secrets

5. Self-audit

6. Useful resources

RSM june 19 2009

Concerns abounding

• ‘Care home worker stole £20k from residents’ Caring Times, April 2008.

• ‘Conmen who earn a fortune by preying on the old’, Daily Telegraph, 29 October 2002

• ‘Family of elderly woman who was robbed on her deathbed face red tape nightmare to see crime investigated’, Mail Online 26 June 2008

• ‘Daughter’s pleas over mother’s care home death’, Mail Online, 14 July 2008

• ‘Half a million ‘forgotten’ elderly victims of crime’, Mail Online, 7 November 2007

• ‘Police probe six deaths of care home residents’, Daily Telegraph, 24 September 2008

RSM june 19 2009

The implications are

• Fear – huge under-reporting

• Anxious relatives

• Mistrust

• Staff shortages?

• ‘Managing’ with reduced quality of life

RSM june 19 2009

2. Professional regulation

• Lessons from POVA List (vetting and barring)

• Safeguarding Vulnerable Groups Act 2006 extending to Health

• Changes to social care through personalisation – registration of some but not all – fears about transferring of risk

RSM june 19 2009

The implications for health

• Employment and human resources work

• The importance of records

• Not stopping at checks

• Interface with professional regulation

RSM june 19 2009

3 Legal developments

• New offences under Mental Capacity Act 2005 of mistreatment and wilful neglect

• Role of IMCA and Mental Health Advocates

• Use of Lasting Powers of Attorney and Advance Decisions to refuse treatment

• DOLS - Deprivation of Liberty Safeguards

RSM june 19 2009

The implications for health

• Finding sources of support, information and advice

• Personal and professional indemnity

• Constructing thresholds

• Providing, seeking & challenging experts

• Working with colleagues

• Casting the law as obstructive or empowering

RSM june 19 2009

4. Review of No Secrets

• Key questions around organisational relationships and funding

• What are the interfaces with NHS systems?

• NB Review of law and adult social care

• Development of agreed outcomes

• Ministerial view awaited

RSM june 19 2009

Self-audit

• I know where the policies are on elder abuse in my organisation

• I know who to contact if I have a query

• I know what to do if I have suspicions

• I know how to support staff who are uncertain, distressed, under pressure

• I know how to communicate with an older person who is fearful.

RSM june 19 2009

resources

• Review of No Secrets DH

• Action on Elder Abuse

• Ministry of Justice (MCA & Code of Practice)

• DH DOLS Code of Practice

• Home Office (SVG, hate crime, distraction burglary, victim support)