The journey from first inspection to quality standards (1857-2016): are we there yet?
| Pages | 117-129 |
| Date | 12 June 2017 |
| DOI | https://doi.org/10.1108/JAP-10-2016-0024 |
| Published date | 12 June 2017 |
| Author | Martin Campbell |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
The journey from first inspection to quality
standards (1857-2016): are we there yet?
Martin Campbell
Abstract
Purpose –The purpose of this paper is to qualitatively analyse the inspection and regulation of care for
people with learning disabilities and mental health problems in Scotland, in two time periods.
Design/methodology/approach –The paper uses comparative historical research drawing on primary
sources from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy
for Scotland and associated papers, to compare inspection methods, quality standards and to identify
persistent challenges to effective inspection.
Findings –Political, clinical and public awareness led initially to criticisms of existing care and eventually to
the development of the “The Lunacy Act”of 1857. This Act resulted in the first attempts to set minimum
standards of care for individuals at risk, with enforceable regulation. Some factors recur as challenges to
effective practice in the inspection and regulation of care today.
Practical implications –There are problems of definition, reliable monitoring of quality standards and
adequate, independent inspection of services that respond to unacceptable standards of care. There is a
growing evidence base about best methods of inspection of services for people in care who are most at risk.
These methods attempt to strike a balance between evidence- and value-based judgments. Perspectives
from history may help focus resources.
Originality/value –This paper compares common and common challenges in two time periods to
investigate what can be learned about the development of policy and practice in inspection and regulation
of care.
Keywords Mental health, Safeguarding, Historical research, Inspection, Learning/intellectual disabilities,
Regulation of care
Paper type Conceptual paper
Introduction
There are some common themes in the principles underpinning legislation and care standards in
the 1850s and in the early part of this century, and there are also some recurring, persistent
challenges to effective inspection and regulation of services in both periods.
There is a well-detailed literature on the history of care in Scotland, (e.g. Campbell, 1932;
Anderson and Langa, 1997; Atkinson et al., 1997; Bartlett and Wright, 1999; Barfoot, 2009).
This paper is neith er an attempt to summ arise this work nor to comment on it. Inste ad, some
parallels will be drawn between inspection policy and practice around the time of the
introduction of The Lunacy Act in 1857 and now, with use of illustrative examples, in a
qualitative analy sis.
Common themes will be identified in this paper, but it is necessary at the outset to highlight some
fundamental differences in the context and the terminology used in the two periods. Many of the
terms used in the nineteenth century to classify individuals are today shocking and derogatory,
e.g. lunatic, imbecile, idiot, maniac, mad and insane person. This was the medical and political
terminology of the day and the classifications on which policy was based. A comparative
historical approach has been used in this paper. Although primary sources (1857-1862) have
been used, accessed in public archives and quoted where appropriate, the content and
emphasis in these sources will inevitably reflect the views of the original authors. So although the
Received 20 October 2016
Revised 15 March 2017
31 March 2017
Accepted 18 April 2017
This research was part funded by
the Carnegie Foundation in
Scotland.
Martin Campbell is a Senior
Lecturer at the School of
Psychology and Neuroscience,
University of St Andrews,
St Andrews, UK.
DOI 10.1108/JAP-10-2016-0024 VOL. 19 NO. 3 2017, pp. 117-129, © Emerald Publishing Limited, ISSN 1466-8203
j
THE JOURNAL OF ADULT PROTECTION
j
PAG E 117
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