By Debbie le Quesne

Posts Tagged ‘safeguarding

Care homes . . . and dare we mention sex?

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I’m not one for deliberately grabbing the headlines, or in a knee-jerk way, responding to them. But I just can’t resist this BBC story pointed out to me by a colleague.

Headline: “The taboo of sex in care homes for older people.”

Hooked yet?

A recent study by the University of Manchester found that 54 per cent of men and 31 per cent of women over the age of 70 were still sexually active. Good of ‘em, I say.

The Beeb reported that it was the first nationally representative survey to include people over 80 in its sample, indicating both how attitudes are finally changing and how the sexuality of older people has been historically overlooked.

I find it interesting, though not surprising, that the subject still has an air of taboo, the findings of a study by the Royal College of Nursing a few years ago revealing that sex and relationships are not viewed as a priority in care homes.

“Human contact and sexual need are basic functions of the human being,” Dawne Garrett, older people’s adviser at the Royal College of Nursing, is quoted in the BBC report.

I understand that the subject can be a difficult one and observations in the report that “staff are generally not comfortable with the topic, and not knowledgeable about it either, thus they are powerless to help,” are probably true.

So how do we as care providers facilitate relationships?

I’d like to hear some answers or see a training brief, because sooner or later this is going to be a Human Right Act issue.

Lois Weaver, a performance artist who explores the subject of sex and ageing through her work, is quoted by the BBC: “We have a stigma about age.

“We don’t really treat people like elders. We treat [them] like people [who are] finished with life.”

Her groundbreaking show, What Tammy Needs to Know About Getting Old and Having Sex, seeks to break down the taboo of sex and ageing.

Anyone for a ticket?

Weaver is in her 60s, had been told that losing interest in sex was an inevitable part of getting older, but said she was not ready to accept that. “I was getting different urges and desires,” she was quoted as saying.

Her work is indeed interesting and those wishing to be challenged can find video links aplenty in a Google search. Her attempts to canvas opinion from residents in care homes, however, were generally met with failure which clearly underpins what she has coined the British “maternalistic” approach.

I really do feel I’m opening a proverbial can of worms here, especially as I consider what could happen sexually to dementia patients. We have to assume that homes seeking to have a more liberal approach to relationships sanction only consenting adults with capacity. Even then I suspect safeguarding issues would emerge.

Weaver, a professor of contemporary performance at Queen Mary University of London, a performance artist in her own right, writer, and director, is a seasoned campaigner. It will be interesting to see how she develops this one in the light of the Manchester study.

Guilty until proved innocent – how the law works with residential care

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The care industry is getting very twitchy over the new raft of regulatory demands and possible inspection outcomes that can now be deemed criminal offences.

High levels of corporate accountability that could end in the courts have racked up insurance policy bills and according to Caring Times editor Geoff Hodgson’s blog insurers seem to “rank care homes with paragliding and rodeo work.”

At odds with all of the UK justice system, the biggest problem is that provider are assumed guilty until they can prove their innocence.

Geoff point out, quite rightly, that we rarely hear much of lack of accountability of the public agencies involved in the investigation of safeguarding incidents.

Let me quote this incident he highlights in his blog: “In a letter published in the June issue of Caring Times, Paul Simic of the Lancashire Care Association recounts the sorry saga of Palatine Lodge in Burnley where a patient died in early 2012.

“The home had been cleared of any fault by the Coroner, the police, CQC and the local authority, but as a consequence of the safeguarding investigation, all the residents were moved and the proprietor of the home, its reputation in tatters, was compelled to sell the business at a substantial loss.

“In his letter Mr Simic asks: ‘How can it be that all this time on – with what happened to the other residents, to the proprietor, to the manager, to the staff, to any family and friends of Mrs A who also may have had to travel this unhappy road to the Coroner’s verdict – that no fault is found in a provider with an established good name, those who made such consequential judgments en route are subject to no independent review or scrutiny or consequence?

‘Where is the justice or fairness in this instance? Without the right checks and balances in place, the SME provider sector is too easily a secondary level victim.’”

I know too of another case where a male career was accused anonymously of sexual assault with a client in a nursing home. A massive, often hostile, police inquiry followed. The carer was suspended for months, his domestic life fell apart, the home’s manager was devastated and the owners distraught. Outcome: No case to answer – the letter believed to be sent by a former disgruntled employee.

Issues of a legal nature in safeguarding sometimes have catastrophic consequences, which, as these cases show, are not always fair.

Geoff quotes 
“All are punished,” – the Duke in Romeo and Juliet after the lovers’ joint demise’ and notes well it’s not so in the safeguarding scenario. I have a quote to add here too: “The law is an ass” – Charles Dickens (Oliver Twist).

Ahead of Panorama: Secret abuse that must be rooted out

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Understandably, the care sector is a little twitchier than usual today as it braces itself for tonight’s shocking report by Panorama.

HC–One, which features in the ‘Behind Closed Doors: Elderly Care Exposed’ report have already gone public by responding with the announcement of introducing a camera-watch system in its homes.

The Care Quality Commission also has a response on its website which has been picked up by a number of publications.

Clearly, we still need the Panorama approach to expose rotten care, but it makes me feel ashamed that we still have not cracked an effective screening to ensure rogue employees are kept well away from the care business.

This evening’s Panorama investigates what life can be like inside the world of elderly residential care homes and asks if parts of the system are letting down our elderly.

Secret filming uncovers what can happen away from the eyes of relatives and Commission inspectors and shows the lives of some elderly and vulnerable people blighted by poor care.

I read that since the episode care workers have been suspended and others convicted of assault.

We struggle so hard over years to present all of the good care that hundreds of homes deliver and in a brief hour all of good work is undermined. I am not for one moment suggesting that such abuse is silenced or ignored by the media, but hope the public understands that all care is not bad. Sadly, I feel this morning that such wishes are just a dream.

On it’s website, the CQC posted: “CQC carries out an unannounced inspection of every care and nursing home in England every year – more often if we believe people may be at risk. This system of regulation can and does identify poor care which CQC then takes action to tackle.

“However, what it cannot do is to identify and stamp out deliberately concealed abuse. By its very nature, concealed abuse takes place away from the eyes of managers and inspectors and can even take place, as in this case, in a well-run care home. Abuse of vulnerable people is a criminal matter, and is rightly handled by the police and the courts.

“CQC has taken action against a number of providers where a current risk to people has been identified. In this case, the risk had been dealt with by the removal of the care staff involved by the home. CQC’s role was to make sure residents were protected once police and social services had acted to deal with the abuse shown in the hidden camera footage. CQC acted quickly and appropriately in this regard.”

My sympathy is extended to the people affected in this case and I have no words to express my anger that fellow human beings can do such cruel things to vulnerable people. Yes, I know that there have always been ‘bad eggs’ and that some have no conscious about wrongdoing. I guess I want the culprits to understand the full extend of the damage they do, firstly to their victims and the victims’ families . . . and then the wider care arena.

Get ready to man the phones Debbie!

Safeguarding high on the agenda as associations meet

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The misuse of safeguarding procedures was again high on the agenda when representatives from 24 local associations met in London.

The meeting at the Skills for Care offices seized the opportunity to establish a monitoring ‘tool’ to assess what is happening with safeguarding in various regions and what, if any, the shortcomings are.

It’s a positive approach to a problem that is not going away. Too often, safeguarding is being used as a mechanism to overcome inertia on decision-making and as a complaints procedure.

Eight safeguarding boards will be scrutinised and if specific areas are deemed critical, a national approach will be made to address them.

The national lead for safeguarding has been contacted and made aware of our on-going investigations.

Safeguarding: A new way of sharing information

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I have long said that the Welsh know a thing or two – I seem to spend a lot of time in Wales doing family stuff.

So I’m not in the least surprised that Caerphilly council’s Protection of Vulnerable Adults (POVA) team have come up with a new tool in the way we protect vulnerable adults.

The mechanics of sourcing information and, in particular information exchange with other agencies, has been a problem for decades.

Accurate assessment of risk is critical. However, there is a “lack of consistency” when it comes to information sharing between agencies, The Guardian reminded us recently.

It is no longer acceptable for agencies to keep information pertinent to risk to themselves. Risk management is a multi-agency approach.

This question has formed the premise for a new piece of work, which has led to the development of a new tool – the adult safeguarding chronology, a timeline initially based on social services’ records and added to at strategy meetings by agency partners.

The Welsh Social Services Improvement Agency – a group aimed at equipping leaders to improve practice – has supported the scheme.

Up until now no clear means to document complex history of acts of abuse existed. The Guardian says.

The people at Caerphilly are piloting the new model and I’m sure this initiative will empower all concerned. It will be nothing short of comprehensive, including actual referrals and concerns that have not met the threshold for a referral.

I applaud the idea: Signposting for other organisations is critical and this certainly ticks the boxes. Information really is power in often-difficult safeguarding circumstances.

It will be interesting to see if this records model is rolled out nationally. For sure, if it wins high praise in Wales it ought to be given an airing in England.

Tragic Daniel: Please tell me why society failed him?

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Deceptive, manipulative and cruel beyond imagining – the mother and her partner who murdered a lovely little boy.

The news has been full of the chilling facts of how four-year-old Daniel Pelka met his death.

Starved, poisoned with salt, beaten, locked in a small room, Daniel finally died from a head injury.

Like many of my friends and colleagues I have watched the news unfold with a tear in my eye.  Phrases like an “absolutely wretched existence”, “incomprehensible cruelty”, “likened to a concentration camp victim” and “skeletal emaciation” have described the poor boy’s life so graphically.

At the time of death, he weighed just 1st 7lb.

Birmingham Crown Court is due to sentence Mariusz Krezolek and Magdelena Luczak today for the crime, which police said, was “pre-planned and premeditated.”

How could this happen? Like countless others I find myself asking this question over and over.

His screams were heard by a neighbour – she thought he was having nightmares.

A teaching assistant told the court: “We watched him walk up to the bin, look to see if anyone was looking and pick out either the core of an apple or a pear and he started to eat it.”

The school raised concerns about his weight and the deputy head teacher rang Daniel’s GP, who examined him and put him on a course of nutritional tablets.

Staff at his school had likened him to a little boy with leukaemia.

Daniel’s stepdad “broke his arm in a game” and the catalogue of abuse just goes on and on.

Clearly the school trued to intervene, but the course of action failed.

I cannot follow this story without questioning how so many people failed to break the cruel inertia that trapped Daniel in a living hell when evidence of abuse was so clear.

MP Geoffrey Robinson appears to blame Colin Green, the director if children’s services in Coventry, and demands his resignation, but the serious case review on the matter has only just begun.

What would such a resignation achieve?

Not a lot I suspect, except to pander to a baying media to lay blame at someone’s door.

Clearly, blame lies somewhere, but let’s wait and see what the outcomes of the review are before seeing heads roll.

In the meantime it’s worth considering the recent Action on Elder Abuse challenges to the Care Bill in an attempt to stop abusers imprisoning their victims in their homes.

And to the movers, shakers and policy-makers: Whatever you to in the way of response to the Daniel tragedy, please do it speedily.

Written by debbielq

August 2, 2013 at 8:04 am

Safeguarding: A need to open doors

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Action on Elder Abuse is campaigning for sweeping changes in the Care Bill – with safeguarding issues grabbing the headlines.

The pressure group is also defining a course of action rank and file care sector workers can take to help place existing infrastructure of adult protection onto a statutory basis.

In 2007, following publication of the Prevalence Study into the extent of elder abuse within the community, the Government committed to a refresh of the No Secrets guidance on safeguarding vulnerable adults, with particular reference to the legislation underpinning adult protection policy. This review was finally concluded in 2009. A large number of issues were identified by that review, the majority of which are not addressed by the current Care Bill.

Simply, AEA is saying the current clauses are not stiff enough to protect those who cannot protect themselves.

So what’s AEA looking to achieve?

Powers to stop abusers imprisoning victims in their own homes.

Some 40 per cent of referrals are regarding victims in their own homes. The law needs to allow, through a court process, entry into the homes of potential victims. All too often that access is dependent upon the co-operation of the abuser.

A duty on agencies to notify the Local Authority if they believe an adult may be at risk of abuse. There is a need to underline the responsibility of all agencies to report if they have reasonable belief that an adult is at risk.

Adequate Funding:

The greatest number of referrals to adult safeguarding is older people and, referrals are increasing year on year by at least 11 per cent. At the same time local authorities are making significant cuts in services, with a significant proportion affecting older people’s services. Funding limitations must not dictate whether an abused adult receives intervention.

There must be a minimum expectation of what we will collectively consider financially acceptable to invest in these activities, and this must be reflected in our financial priorities.

Clearly, given the gravitas of AEA and its robust response, something is wrong. Our most vulnerable it appears are still vulnerable.

What can you do?

  • Write to peers indicating your support for Baroness Greengross’ amendments. She is supporting the AEA proposed amendments.
  • Encourage others to get involved
  • If you work in this area, send examples to the AEA enquiries@elderabuse.org.uk of where a power of access would have been necessary

Already on deck pushing for powers of access are Mencap, the College of Social Work, the Equalities and Human Rights Commission and Age UK.