Preventing abuse of adults in hospitals (ppt, 860 KB)

Prevention of abuse
Jill Manthorpe
Social Care Workforce Research Unit
King’s College London
Email: [email protected]
Rings of prevention
• ‘Primary intervention’ aims to prevent
abuse occurring in the first instance
• ‘Secondary intervention’ aims to identify
and respond directly to allegations of
potential abuse
• ‘Tertiary intervention’ aims to remedy any
negative and harmful consequences of the
abuse, and put in place measures to
prevent future occurrences
Primary prevention
• Social
– Zero tolerance and
targeted approaches
(research based)
– Public and peer education
• Legal
– Crime & Disorder Act 1998
– Trading Standards
• Welfare
– Advice and Information
– Mental Capacity Act 2005 –
Lasting Powers of Attorney
Emerging areas of prevention
• Human trafficking
[Olympics 2012]
[Children & Vulnerable Adults
exploited as commodities].
• Trafficking Toolkit
• National Referral
Mechanism [NRM]
[Adults and/or children
deemed to be trafficked]
Also e-abuse generally
The Scope for Safeguarding Adults
Safer communities
Service planning
for ‘vulnerable’
responses to
support individuals
and groups
person centred
Investigation and
protection planning
Risk assessment
and enablement
Secondary prevention
• Social
– Changes in Human Rights
• Legal
– New status eg MCA, new
crimes, victim rights
• Welfare
– Policies and procedures,
investigations, inquiries
Example of prevention
• In Hospital X all grade
3 or 4 pressure sores
that occur on the
ward or are observed
on admission are
notified to the Police
who visit the ward in
uniform to investigate
Tertiary prevention
• Social
– Compensation,
• Legal
– Redress, confinement,
banning, injunctions
• Welfare
– learning the lessons,
SUI, SCR, therapy,
perpetrator assistance,
peer support
“Ill-treatment” & “wilful neglect”
Mental Capacity Act 2005 section 44
defines “ill-treatment” and “wilful neglect”
– Criminalises neglect and abuse
occurring in a relationship of trust
Can include professionals and family
The offender indulges in behaviour
believing the person lacks capacity
Serious departures from required
standards of treatment that they were
aware they were under duty to perform
If reported and prosecuted, penalty for
criminal offences may be fine and/or a
prison sentence for up to five years
Balancing prevention
• Recent judgments under MCA
– ‘physical health and safety can sometimes be bought
at too high a price in happiness and emotional
welfare. The emphasis must be on sensible risk
appraisal, not striving to avoid all risk, whatever the
price, but instead seeking a proper balance and being
willing to tolerate manageable or acceptable risks as
the price appropriately paid in order to achieve some
other good…What good is it to make someone safe if
it merely makes them miserable?’ (Re MM 2007)
Some conclusions
• Little evidence on
prevention but emerging
• Role in collecting
• Need for common
• What are we trying to
• And what are desired
This presentation presents independent research
commissioned by the National Institute for Health
Research (NIHR) under its Programme Grants for
Applied Research scheme (RP-PG-0606-1005). The
views expressed in this publication are those of the
author(s) and not necessarily those of the NHS, the
NIHR or the Department of Health.