Presentation - Office of the Public Advocate

Welcome to OPA
Interagency guideline for responding to the
abuse, exploitation and neglect of at-risk adults
5 October 2012
John Chesterman
Manager, Policy and Education
Plan for the morning
10.00 am
Is there a need for a guideline?
11.00 am
Morning tea
11.15 am
What form might a guideline take?
12.15 pm
Where to from here?
12.30 pm
Who’s here?
We are very pleased to have representatives from:
• Office of the Public Advocate (inc Community Visitors program)
• Melbourne Citymission, Wesley Mission, Yooralla, Scope, Karingal, National Disability Services
• Victims Support Agency, Victims of Crime helpline
• South Eastern Centre Against Sexual Assault, Domestic Violence Victoria, Making Rights Reality
• Dept of Families, Housing, Community Services and Indigenous Affairs
• Department of Human Services, Department of Health
• Vic Equal Opportunity and Human Rights Commission
• Office of the Disability Services Commissioner
• Carers Vic
• Valid, New Wave, Disability Advocacy Resource Unit
• MS Australia
• Victoria Legal Aid
• Vic Mental Illness Awareness Council, Vic Women and Mental Health Network
• Women with Disabilities Victoria
• Victorian Ombudsman
• Victoria Police
• University of Melbourne, La Trobe University
Is there a need for a guideline?
OPA, ‘Violence against people with
cognitive impairments’, 2010, p. 4.
‘The project examined 86 cases, involving 66 women and 20 men. This
report reveals that people of all ages with a range of cognitive impairments
are subjected to physical, sexual, psychological, emotional and
impairment-related violence, financial abuse and neglect.’
The report pointed to:
• A high rate of violence
• Inadequate support
Is there a need for a guideline?
Is there a need for a guideline?
Ombudsman Victoria, ‘Assault of a Disability Services
Client by Department of Human Services Staff’, March 2011
‘7. My investigation established that on 6 March 2008, two departmental
staff members … dragged the resident along a carpeted hallway in the
unit, causing him to sustain a serious carpet burn to his back …
15. The department’s response to the incident was inadequate and shows
a disregard for the resident’s human rights and the duty of care that the
department has a responsibility to exercise. It was also non-compliant with
departmental policies and procedures. This is particularly concerning as
the resident cannot speak for himself.
16. I consider that the assault on the resident was clearly a category one
incident, requiring the police and family of the victim to be notified.
However, as it was incorrectly classified, the department failed to notify the
Regional Director, police and family and commence an investigation ...’
A range of recommendations were supported by the department.
OPA, ‘Submission to the Inquiry into Access to and Interaction with the
Justice System by People with an Intellectual Disability
and their Families and Carers’, September 2011, par. 3.21.
‘[The] dismissal of the rights of people with cognitive disability is often
evident in flawed incident reporting systems. This was highlighted in the
Ombudsman’s report on the assault of a nonverbal man in supported
accommodation … The Public Advocate would like to commend Minister
Wooldridge for effecting a major cultural shift at DHS in response to such
“incidents”. Since the Ombudsman’s report, OPA has noticed a more
transparent and collaborative response from DHS and hopes this
continues into the future.’
Among OPA’s recommendations:
• Greater support for people to take claims through the criminal
justice system.
Is there a need for a guideline?
Is there a need for a guideline?
‘Yooralla incident poorly handled’, Nick McKenzie and Richard Baker
The Age, 21 August 2012
‘YOORALLA seriously mishandled internal complaints about a staff member
now facing charges of repeatedly raping or sexually abusing at least four
intellectually disabled people.
A confidential internal inquiry commissioned by the disability service has found
a team leader saw the male carer on a bed with a disabled client but failed to
report it. This was before residents alleged they had been raped by the carer.
The inquiry's report accused the team leader of "poor performance" and
recommended he should be disciplined for breaching rules requiring him to
report serious incidents.
The carer - who worked for Yooralla between 2009 and early this year - faces
rape and abuse charges involving several disabled residents of Yooralla
Detectives charged him in March. Investigations are continuing over whether he
abused disabled clients at other residential facilities.’
Is there a need for a guideline?
‘My son, and others, are owed an inquiry into Yooralla’,
Sandy Guy, The Age, 2 July 2012
‘Last Tuesday I received a phone call from a former Yooralla regional manager. She
said police were going to the home of my 31-year-old son, who is severely disabled, to
interview him and the other five residents of the house, which is run by Yooralla.
Stunned, I asked her what was going on. She replied that a Yooralla casual carer was
in police custody charged with alleged abuse. I asked her when the police were going
to my son's house. She said they were already there.
I live in Ballarat, so it was impossible for me to go to my son's home in Melbourne to
support him during this ordeal. My son, who is intellectually disabled, is largely nonverbal. No one knows how to communicate with him better than I do.
It was not until Wednesday morning that I learnt of the terrible details of the alleged
abuse - not from Yooralla, but from police. I learnt that the alleged offender had been
charged with rape in March; had appeared in court in June; and has been remanded
to face another court hearing in August. I learnt that the man had worked at least 40
shifts at my son's home.
Sickened, I tried to digest what is every parent's worst nightmare …’
Recent work at OPA on violence
• Sexual Assault in Supported Residential Services: Four
Case Studies. Departmental response and engagement
• Voices against Violence project, two-year project
examining violence against women with disabilities (with
Women with Disabilities Victoria)
Is there a need for a guideline?
Relevant Victorian agencies who have an investigation or complaint-based function:
• Victoria Police
• Victorian Ombudsman
• Office of the Public Advocate
• Victorian Equal Opportunity and Human Rights Commission
• Victorian Civil and Administrative Tribunal
• Office of the Disability Services Commissioner
• Health Services Commissioner
Office of the Disability Services Commissioner, ‘Learning from
Complaints’, Occasional Paper No. 1, 2012, p. 23.
‘Responding effectively to incidents and allegations of abuse
The literature on providing effective responses to abuse addresses the need for clear
policies and procedures for reporting, rigorous investigations of allegations of abuse, the
importance of recognising and responding to trauma, and enabling effective access to
justice. Links are also made between the quality of immediate responses to allegations or
incidents in terms of attending to client’s safety needs and impacts, justice outcomes and
recovery from abuse.’
Office of the Disability Services Commissioner, ‘Learning from Complaints’,
Occasional Paper No. 1, 2012, p. 29-30.
‘Responses to client wellbeing, health and safety:
• Were appropriate steps taken to address the client’s immediate safety…
Actions and support to clients following incidents and allegations:
• Have the client’s specific support needs been addressed …
• What steps were taken to proactively support the client in respect to the known
barriers and difficulties people with a disability can experience in relation to police and
investigation processes?
Addressing clients’ rights and outcomes:
• Has appropriate consideration been given to potential breaches under the Disability
Act 2006 and the Charter of Human Rights and Responsibilities Act 2006, and if so
has this been communicated to staff and appropriate acknowledgement and/or
apology given to the client?
• Have investigations been conducted with appropriate rigour, documentation and
independence, and enabled effective access to justice?
• Has feedback been sought from the client (and his/her family or significant others) on
the outcomes of responses to the allegations and incidents from their perspective?’
Is there a need for a guideline?
Some recent significant policy developments relevant to Victorians
Family violence 2010
Violence against women 2010
DHS Standards 2011
Aged care reforms 2012
Elder abuse 2012
Child protection (Cummins) inquiry report 2012
Review of guardianship legislation 2012
New supported residential services legislation and regulations operating from 2012
People with intellectual disability and the justice system inquiry report due 2012
National Disability Insurance Scheme (Barwon launch site 2013). Proposed
National Disability Insurance Agency to monitor. Productivity Commission
recommended Community Visitors be one monitoring mechanism.
• New mental health legislation coming 2013
Victorian Law Reform Commission,
Final Guardianship Report 2012
Recommendation 328. ‘Under new guardianship legislation, the Public
Advocate should have the function of receiving and investigating complaints
in relation to:
(a) the abuse, neglect or exploitation of people with impaired
decision-making ability due to a disability …’
Recommendation 329. ‘New guardianship legislation should provide that
where the Public Advocate believes that an investigation is warranted she
should be able to conduct an investigation on her own motion in relation to:
(a) the abuse, neglect or exploitation of people with impaired
decision-making ability due to a disability …’
Recommendation 305. ‘New guardianship legislation should provide that it is
unlawful for a person with responsibility to care for a person with impaired
decision-making ability because of a disability to abuse, neglect or exploit that
Is there a need for a guideline?
What other guidelines, resources, information exist in
relation to the abuse, neglect and exploitation of Victorians?
DHS departmental instruction, 2005.
DHS Ready Reckoner (2008),
based on departmental instruction
DHS Ready Reckoner ‘Responding to Physical and Sexual
Assault’ (2008), based on departmental instruction
‘Immediate steps to take when there is an allegation of assault are listed below:
• Re-establish a safe environment for clients and staff …
• Care for the victim and provide support and assistance.
• If required, call for immediate medical assistance such as an ambulance.
• Listen carefully to and reassure the victim. Advise them that Police will be called …
• Call Police. The most senior staff member in the relevant work area present at the
time the allegation is made is responsible for reporting the allegation of assault to
Police. If an immediate response is required, call 000 …
• If the victim or perpetrator has a cognitive disability, advise Police of this and the need
for an Independent Third Person (ITP) …
• In alleged sexual assault, if the victim consents, contact the local Centre against
Sexual Assault ...
• The Police may suggest a forensic medical examination and will arrange this.’
Is there a need for a guideline?
Do people wonder, or are you questioned about: what should
we do when there is a suspicion or allegation that abuse,
neglect or exploitation has occurred?
Do other agencies have useful resources to guide responses?
Do we need an interagency guideline? What do people here
think? Straw poll?
Is there a need for a guideline?
Morning Tea
What form might a guideline take?
Brief exploration of some resources that exist elsewhere
Social Care Institute for Excellence, ‘Protecting adults at risk:
London multi-agency policy and procedures to safeguard adults from abuse’
What to do if you suspect abuse
‘Everyone with a duty of care to an adult at risk should:
• act to protect the adult at risk
• deal with immediate needs and ensure the person is, as far as possible, central to the
decision making process
• report the abuse to an appropriate person or service (e.g. your line manager)
• if a crime has or may have been committed, contact the police to discuss or report it
• record the events.
A concern may be a direct disclosure by the adult at risk, or a concern raised by staff
or volunteers, others using the service, a carer or member of the public, or an
observation of the behaviour of the adult at risk, or the behaviour of another.’
What form might a guideline take?
Important considerations
• Whose guideline is it?
» those agencies which wish to adopt it
• Who would be covered?
» ‘at-risk adults’,
» ‘vulnerable adults’
» ‘people with cognitive impairments or mental illness’
• What would be covered?
» ‘abuse’ would include physical abuse and sexual assault but would it
extend to financial abuse, emotional abuse? The guideline will be of
limited use if the definition is too broad or if it is too narrow.
» ‘neglect’
» ‘exploitation’
• In what situations would the guideline operate?
» disability accommodation
» supported residential services
» mental health facilities
» rooming houses
What form might a guideline take?
Important considerations
I’d suggest that we should err on the side of creating something that has
broad useability.
Particular agencies and settings will require particular responses. E.g. some
agencies will have particular policies on these matters that will determine
reporting practices. Abuse and neglect in some settings will require
particular responses (e.g. mental health facilities, supported residential
Are we right to aim for broad coverage?
What form might a guideline take?
Other considerations
• There is underreporting, so reporting needs to be made relatively simple
• Equal rights (we don’t want one law for some people and another law for
others – so referrals to police will be important)
• Safety and well-being of the person in question is paramount
• Privacy and confidentiality
• Right of family members and carers to know
• Rights of alleged offender
Victorian Law Reform Commission,
Final Guardianship Report 2012
Recommendation 309. ‘The term “abuse” could be defined to mean any intentional conduct involving injury
to or maltreatment of a person with impaired decision-making ability and can include:
(a) physical abuse, such as causing physical harm to the person
(b) sexual abuse, such as engaging in sexual activity with the person without their valid
(c) financial abuse, such as taking the person’s money without their valid consent.’
Recommendation 310. ‘The term “neglect” could be defined to mean any intentional or negligent conduct
that amounts to failure to perform duties owed to the person and can include:
(a) physical neglect, such as not providing the person with adequate food or attention to
physical needs
(b) financial or property neglect, such as not taking adequate care of the person’s
finances or property.’
Recommendation 311. ‘The term “exploitation” could be defined to mean taking advantage of the person for
one’s own benefit or gain, and can include:
(a) financial exploitation, such as the use of another person’s finances principally for
one’s own benefit
(b) sexual exploitation, such as allowing a person, or images of a person, to be used in a
sexual manner for one’s own financial gain or benefit.’
A name for the guideline?
Interagency Guideline on the Abuse and Neglect of At-risk Adults
Where to from here?
We will work on a draft guideline. Please communicate any
thoughts to Lois or me:
[email protected]
[email protected]
We will circulate a draft guideline in early February with a
view to discussing it at a second forum here on Friday 15
February 2013, 10am to 12.30pm.
Please discuss this with your organisation to find out what it
would take for your organisation to adopt a guideline of this
The End (for now)
Thank you
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