Saturday, 1 January 2011

There May Be Trouble Ahead...

The Independent Safeguarding Authority.

After the sad murders of Jessica Chapman and Holly Wells by school caretaker Ian Huntley in 2002, legislation was put in place to prevent this happening again.  All people working with vulnerable children and adults are required to take a CRB check as part of Vetting and Barring requirements, thus denying those with a questionable background having contact with these vulnerable groups.  The Independent Safeguarding Authority (ISA) is the child of this original legislation.

This protection of the vulnerable is laudable, but yet again good intentions have fallen victim to almost impenetrable layers of bureaucracy leading to such situations as this and  this where everyone is presumed guilty until proven innocent.

CRB checks operate at farcical levels - more often than not, taking up to three months before completion.  This puts care homes - whether private or council run - under great financial strain as they have to rely on agency staff during this period which is expensive.  Despite what you might think, care homes are not pots of gold and in fact, unless fully occupied, they are money pits.  Any break in the links of the chain can lead to this and this.  It is a sad fact that councils generally axe elderly services during periods of financial constraints.

The ISA, as well as protecting care home residents from dubious staff, also operates to protect residents who are vulnerable adults from other residents who are also vulnerable adults; this is where it gets a little crazy.

My home (my, as in where I work - I don't own it) is an end of the road home; it is where residents come when other pretty purpose built homes cannot manage their behaviours (where decor is more important than dementia); where resident come with complex problems; a home where social workers, psychiatrists and psychogeritricians know that hard to place Henry will be welcomed.

It is a wonderful place and you can rest assured your Henry will be well looked after.  Due to the nature of the resident group - friction occurs on a daily basis - whether it is physical or psychological abuse - it does happen.  Please be assured that this is the resident group and not staff v residents; that said, if your Henry thumps me, I don't take it personally!

Our resident group is made up of those with enduring (often complex) mental health problems and dementia's where aggression is a key presenting feature; saying that, my home is not in a constant state of war with staff and residents dropping like flies in an eternal, bloody bun fight!  But, during any twenty-four hour period at least one resident will become annoyed with another.

Tom and Dick will have a bust up and punches will be thrown; both Tom and Dick have dementia and appalling short and mid term memories.  Why Tom hit Dick we will never know; after a few minutes neither will Tom and he and Dick will pass each other in the corridor with absolutely no recollection of the incident.

Dutifully we fill in a Safeguarding Vulnerable Adults Referral Form, highlighting the vulnerability of both Tom and Dick and send it off to the powers that be.  Within a few days we are informed that the incident will not result in any further action taken.

Harry - one of our residents - is a thirty-six year old man with complex enduring mental health problems and in the past he has resorted to drink and drugs as a coping mechanism.  He has lived with us for nigh on four months and does not want to be here.  I can understand this - for as much as I love working in my home, I wouldn't want to live here either.  However, his history dictates that he must.  He poses a serious risk to himself and others.

Harry will sometimes request that we call the police as he feels that he is held as a prisoner against his will.  In a sense this is true.  But the reasons for this are manifold and as the saying goes - they are in his best interests.  We explain to Harry why we cannot call the police, and although he accepts this - he is not happy.

Harry, at times, responds to auditory hallucinations.  These voices tell him to do things and he does.  Outside of these times and indeed during these times, he retains full mental capacity.  He knows what he is doing - even when driven by auditory commands - and will apologise for verbal abuse afterwards.  As yet, he has only presented with verbal abuse  but has a long history of physical abuse.  Whether driven by auditory commands or not - a punch is a punch.

As his frustration grows, one day soon, Harry will punch a fellow resident and as Harry has mental capacity, the police will have to be involved for it is a requirement of the ISA.  Harry will then realise that for his wish to talk to the police to be granted, all he has to do is a punch a fellow (equally vulnerable) resident.

His co-residents will view the above and learn too that now they can throw a punch with impunity and that staff are have now been rendered impotent to halt this; whereas in the past staff would diffuse a situation, residents could now vent their anger (physically) and just receive a verbal smack on the hand.  The ability to manage a situation will have been removed from staff and a free for all could ensue.

We had an occasion early last year when police were requested to visit for a specific incident.  They didn't want to come for their hands are tied and a friendly, but firm little chat is all they can offer.  What else could they offer - a totally inappropriate night in the cells?

Thus, the very tool to safeguard the vulnerable from each other can be used as a cosh to hit each other with!  Safeguarding resident/resident adults from each other has not been properly thought through and residents will suffer because of it.

I see trouble ahead....

Anna :o]


ned ludd carer said...

For such a powerful organization, the ISA rules seem very poorly thought out. Our own experience is in preventing my son having a life by risk assessing out anything remotely interesting. I would have thought a better model would be some sort of independent advice/consultancy role we could invoke to get the best solution rather than just blanket rules that assume everyone guilty of the worst abuse - just in case - would be a better model. There's a place for abuse prevention, but it shouldn't be the only game in town - people can't live life at the lowest common denominator.

HyperCRYPTICal said...

Hi Ned,

ISA rules do appear to be poorly thought out. I do wonder if, that during its creation, consultations were held with the very people/organisations it would wield influence over - probably not, very unlikely. Safeguarding Vulnerable Adults illustrates this point only to well.

On a positive side, Acts such as Deprivation of Liberty, Mental Capacity and Best Interests have reaped benefits for those in care homes and hospitals - I am thinking of residents/patients here as they (the Acts) have given clarity to individual rights.

I am saddened that these same Acts have had absolutely the opposite effects on your son.

Anna :o]