The Journal of Adult Protection

Emerald Group Publishing Limited
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Latest documents

  • Editorial
  • The demographics of forced marriage of people with learning disabilities: findings from a national database

    Purpose: The purpose of this study is to compare the UK demographics of forced marriage of people with learning disabilities and people without learning disabilities to inform effective safeguarding practice. Design/methodology/approach: An analysis of all cases of forced marriage reported to the UK Government’s Forced Marriage Unit (FMU) between 2009 and 2015. Findings: People with learning disabilities are at five times greater risk of forced marriage than people without learning disabilities. Men and women with learning disabilities are equally likely to be forced to marry, whereas amongst the general population, women are more likely than men to be forced to marry. Patterns of ethnicity, geographic location within the UK and reporters are the same for people with and without learning disabilities. Research limitations/implications: The analysis is based on cases reported to the FMU, and for some cases, data held was incomplete. More importantly, many cases go unreported and so the FMU data does not necessarily reflect all cases of forced marriage in the UK. Practical implications: Forced marriage of people with learning disabilities is a safeguarding issue. Practitioners across health, education, criminal justice and social care need to better understand the risk of forced marriage for people with learning disabilities. Links to practice resources developed as part of the wider project are provided. Originality/value: This is the first time that researchers have been given access to FMU data and the first time that a statistical analysis of cases of forced marriage involving someone with a learning disability have been analysed.

  • People with an intellectual disability: under-reporting sexual violence

    Purpose: People with an intellectual disability are much more likely to be sexually violated and the violation is less likely to be reported. Despite this being high-lighted at least 3 decades ago and improvements in both safeguarding and national reporting processes, under-reporting remains a problem. This paper explored under-reporting alongside prevention possibilities using safeguarding alerts raised in a Community Learning Disability Team within a UK NHS trust. Design/methodology/approach: Using a combination of authentic but anonymised case vignettes and descriptive data drawn from the safeguarding team, under-reporting was examined through the lens of an ecological model. Safeguarding alerts raised in a particular year were compared with the number expected if all (estimated) cases of abuse were disclosed and reported. Findings: Only 4.4 per cent of expected abuse cases were reported to the team, which is lower than the reporting level the authors had expected from the literature. There is evidence in the literature of the under-reporting of sexual assault for all kinds of people. Arguably, the implications of under-reporting for PwID are even more traumatic. Research limitations/implications: Constraints included the lack of standardisation in data collection within the statutory services that report to the Birmingham Safeguarding Adults Board. One key recommendation is that the national provider of data for the NHS in the UK requires more complex and standardised audit information that would allow each local authority to benchmark their practice against a higher protection standard. Another recommendation is that compliance to quality standards sits within a comprehensive strategy. Originality/value: This paper explored the extent to which the previously documented under-reporting concern remains an issue. Certainly eye-balling safeguarding compliance data in the NHS organisation we worked in led us to a concern that reporting might be even lower than implied in the literature. This together with a renewed spot-light on sexual violence (e.g, NHS England, 2018) led us to decide that it was timely to re-examine the problem.

  • Negotiating meaning within healthcare to improve suicide prevention

    Purpose: A framework for “negotiating meaning” was applied to a healthcare service to achieve a collaboratively developed suicide prevention clinical pathway. Design/methodology/approach: The framework was originally developed during a previous study that drew on the theory of philosophical hermeneutics to enable a researcher to better understand the experience of older people. This approach was then applied to a healthcare setting and the development of a suicide prevention clinical pathway. Clinical front-line staff engaged effectively and meaningfully with each other, consumers, family members and management to develop a clinical guideline that reflected best practice and improved care provision. An additional outcome involved establishing a supportive culture in which the shared meanings underpinning the experience of working with people expressing suicidality were explored. Findings: An evidence-based suicide prevention clinical pathway was developed collaboratively with clinicians taking the lead in the process, and leading to the agreement being reached on the final guideline and processes established. The negotiation process brought the perspectives of the different parties together enabling the sharing of underlying meaning inherent in the experience of losing a consumer tragically to suicide. A commitment to taking joint action to reduce the likelihood of further incidents occurring also grew from the shared understanding that developed. Originality/value: This paper describes the approach that was applied to facilitate engagement processes between clinicians and service management that also challenged the power differentials that usually exist within healthcare and led to positive engagement that supported the safety and quality agenda.

  • A strengths-based approach and safeguarding adults – are they compatible?

    Purpose: This paper aims to stimulate discussion. Design/methodology/approach: The paper is a personal reflection and is not a research paper; there is not therefore a design or methodology that was used in its writing. Findings: While it may initially appear that a strength-based approach is incompatible with safeguarding adults, it can be a valuable long-term tool in supporting adults who have been abused or self-neglected. Research limitations/implications: The piece is a personal reflection and therefore not based on research but it does highlight the need for further research to develop tools to facilitate the interface between safeguarding and a strengths-based approach. Practical implications: The need to recognise when a strengths-based approach is and is not appropriate in safeguarding adults. Originality/value: The author is not aware of a similar consideration of the interface between safeguarding adults practice and a strengths-based approach.

  • Reframing financial abuse of parishioners: an analysis of a Church of England disciplinary tribunal hearing regarding Rev. Karl Wray

    Purpose: Traditional understandings of financial abuse are limited to particular situations and people who have close access to vulnerable adults. This paper aims to add to a debate that intends to push the boundaries of the understanding of financial abuse further. In particular, it seeks to add to the understanding of what financial abuse might look like and who the perpetrators of such abuse can be. In so doing, it seeks to offer greater protection to the vulnerable. Design/methodology/approach: Focusing on exploring the minutes of Church of England disciplinary tribunals, held to provide accountability for clergy, this paper considers how the church seeks to represent and construct the victims of financial abuse. Findings: The paper identifies that the victims of financial abuse are whitewashed out of the tribunal minutes and discovers that the disciplinary tribunal is solely concerned with the financial loss afforded by the church. This discovery offers a new context in which it is possible to explore the competing interest in, what has been regarded as, the “legitimate assets” of older parishioners. It provides an example of how organisations and individuals compete for them. Originality/value: This paper adds to the debate about the everyday nature of financial abuse and when and where it might take place. It provides an opportunity to reconsider potential offenders and the means by which abuse might be reduced. In exploring how the financial abuse of potentially vulnerable people can be reframed so that it is hidden by process and procedure, this paper offers an insight into the means by which it is possible to promote transparency and greater accountability.

  • Editorial
  • Safeguarding in Social Work Practice: A Lifespan Approach
  • The sound of silence: evidence of the continuing under reporting of abuse in care homes

    Purpose: The purpose of this paper is to present findings from two research projects undertaken between 2015 and 2019 that reveal continued underreporting and sometimes active concealment of abuse in private sector care homes for older people in England. Design/methodology/approach: An anonymously completed questionnaire was used among newly appointed staff in 11 newly opened care homes to elicit both quantitative and qualitative data relating to the reporting of occurrences of abuse within the care homes in which they had previously worked. In total, 391 questionnaires in total were returned, 285 of which indicated that respondents had witnessed the perpetration of abuse on at least one occasion. Findings: A significant number of respondents indicated their awareness of acts of abuse that had not been reported within the care home(s) in which they had worked, or externally to the appropriate authorities. Some respondents were aware that where occurrences of abuse had been reported within care homes no subsequent action was taken, or that external authorities were not always involved in responses to abuse. A significant number of respondents described strategies that had been used to deter reports of abuse to external agencies and to conceal its occurrence from the statutory regulator and service commissioners. Research limitations/implications: Though the research draws upon the experiences of only 285 questionnaire respondents who had witnessed episodes of abuse, data suggest that a significant proportion of abuse in care homes remains unreported. Originality/value: The research has revealed experiences of continued underreporting and concealment of abuse among staff in private sector care homes. Findings indicate that a strengthening of incentives and protections extended to the staff who should report abuse are essential, and that changes to current methods of external scrutiny to which care homes are subject are required.

  • The employment conditions of social care personal assistants in England

    Purpose: The purpose of this paper is to describe the employment conditions of social care personal assistants (PAs) in England. In England, disabled adults have been able to directly employ people to meet their care or support needs for a number of years, little is known about the employment conditions of people who are directly employed. Design/methodology/approach: PAs were recruited mainly through third sector and user led organisations. A total of 105 social care PAs took part in a semi-structured telephone interview, which on average was an hour long. Interviews were fully transcribed. Quantitative data were analysed using SPSS (v.24) and qualitative data by NVIVO software. Findings: The paper focuses on employment conditions: contracts, pay, pensions, national insurance, overtime, holiday and sick pay, etc. Access to training and support are also described. Though PAs enjoyed considerable job satisfaction, many did not enjoy good employment conditions. Though employer abuse was uncommon, many PAs could arguably be described as exploited. Occupational isolation and lack of support to resolve disputes was striking. Research limitations/implications: Though this may be currently the largest qualitative study of PAs in the UK, it is nonetheless relatively small and no claims for generalisability are made, though the geographical spread of the sample was wide and recruited from multiple sites. Practical implications: PAs are an effective way of establishing relationship-based care, and confer direct control to disabled employers. Many PAs experienced high job satisfaction. However, lack of regulation and oversight creates considerable potential for exploitation or abuse. This may make the role less attractive to potential PAs in the medium term. Social implications: Social care PAs may be a very effective means of achieving genuinely person-centred care or support for many people. However, PAs do not always appear to enjoy satisfactory conditions of employment and their role is largely unregulated. Growth and long-term sustainability of this emergent role may be jeopardised by these employment conditions. Originality/value: Little is known about PA working conditions. This study suggests that much more needs to be done to improve these.

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