If you always do what you have always done, you will always get what you have always got: commissioning and regulating care homes to prevent abuse

Pages418-430
Published date11 December 2017
DOIhttps://doi.org/10.1108/JAP-04-2017-0018
Date11 December 2017
AuthorSteve Moore
Subject MatterHealth & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse
If you always do what you have always
done, you will always get what you have
always got: commissioning and regulating
care homes to prevent abuse
Steve Moore
Abstract
Purpose The purpose of this paper is to present a review of some of the fundamental theoretical and
contextual components of commissioning and regulatory processes as applied to care home services,
revisiting and examining how they impact on the potential prevention of abuse.
Design/methodology/approach By revisiting a number of the theoretical bases of commissioning
activity, some of which may also be applied to regulatory functions, the reasons for the apparent limited
impact on the prevention of the abuse that occurs in care homes by these agencies are analysed.
Findings The paper demonstrates how the application of commissioning and regulatory theory may be
applied to the oversight of care homes to inform proposed preventative strategies.
Practical implications The paper offers strategies to improve the prevention of abuse in care homes
for older people.
Originality/value A factual and back to basicsapproach is taken to demonstrate why current strategies
that should contribute to tackling abuse in care homes are of limited efficacy.
Keywords Regulation, Commissioning, Care homes, Practice and policy, Preventing abuse,
Psychometrics and surveillance
Paper type Technical paper
Introducing a perennial question?
The assertionsof the Joint Committee on Human Rights(2007), Garner and Evans (2000,p. 6) and
Glendenning (1997, p. 15) that abuse is a common and often routine part of institutional life,
and that older peopleliving in care homes are more likelyto be at risk of abuse than those living in
the community have been borne out more recently by statisticsprovided by the NHS Information
Centre andits successor the Health and SocialCare Information Centre.These figures identify that
for four consecutiveannual periods, 36 per cent of all safeguarding referrals haveemanated from
within care and nursinghome settings (The NHS Information Centre,2013; The Health and Social
Care Information Centre, 2014a,b, 2015), though only some 5 per cent of the population aged
over 65 years live inthem at any time (Office for National Statistics, 2014). Of these referrals, over
40 per cent were found to be substantiated or partially substantiated in each of the four years,
confirming thatabuse of some kind had definitely taken place. These figures, along with recurring
televised imagesof abuse in care homes obtainedusing hidden cameras, and the recentresearch
of Moore (2016a) that revealed some of theabusive realities of care home life, allserve to confirm
the earlier avowals of thosereferred to above, and suggest that abuse in care homes occurswith
notable frequency and remarkable tenacity.
Notwithstanding the concern that of the 36 per cent of referrals emanating from care homes, only
between 3 and 4 per cent were classed as institutional abuse in each of the four periods from
Received 12 April 2017
Revised 26 July 2017
5 September 2017
Accepted 18 September 2017
Steve Moore is an Independent
Researcher and Consultant
based in Dudley, UK.
PAGE418
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THE JOURNAL OF ADULT PROTECTION
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VOL. 19 NO. 6 2017, pp. 418-430, © Emerald Publishing Limited, ISSN 1466-8203 DOI 10.1108/JAP-04-2017-0018

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