Manna Santokhee Action on Elder Abuse

1
Manna SantokheeAction on Elder Abuse
2
Action on Elder Abuse
3
Manna Santokhee MA (Business and Fundraising
Manager) Background Experience
4
Action on Elder Abuse is a Four Nations
organisation based in London
It was established in 1993 by practitioners from
health and social care, academics and voluntary
sector representatives, and is now one of the key
Adult Protection agencies in the UK.
We are an ABUSE charity focusing upon the needs
of older people
5
a single or repeated act or lack of appropriate
action occurring within any relationship where
there is an expectation of trust, which causes
harm or distress to an older person.
6
A Vulnerable Adult is
An Adult at Risk is
a person who is (a) unable to safeguard his/her
own well-being, property, rights or other
interests, (b) is at risk of harm, and (c) is
affected by disability, mental disorder, illness
or physical or mental infirmity, and is therefore
more vulnerable to being harmed than adults who
are not so affected.
a person who is or may be in need of community
care services by reason of mental or other
disability, age or illness and who is or may be
unable to take care of him or herself, or unable
to protect him or herself against significant
harm or exploitation.
7
Five types of abuse
Time for Action (11 minutes DVD)
8
UK Study of Abuse and Neglect of Older People -
2007
The overall prevalence of abuse, defined by
expectation of trust in the year preceding the
survey was
4
This equates to 342,000 people aged 66 and over,
or 1 in every 25 of the population aged 66 and
over
9
UK Study of Abuse and Neglect of Older People -
2007
Nation Specific Prevalence
Percentage of all respondents who experienced
abuse
7
6
5
4
Percentages
3
2
1
0
England
Wales
Scotland
N Ireland
10
Age of victim
45
40
35
30
25
20
15
10
5
0
11
Gender of victim
12
UK Study of Abuse and Neglect of Older People -
2007
Percentage of all respondents who had experienced
abuse in the last year
The Perpetrators
40
35
30
25
Percentage
20
15
10
5
0
13
Where abuse occurs
70
60
50
40
30
20
10
0
14
Factors that may lead to elder abuse
Social Isolation
Poor quality long term relationships
Patterns of family violence
Dependency
Alcohol, drug and mental health problems
Minority status
15
Factors that may lead to elder abuse in
institutional settings
Poor staffing levels and working conditions
Lack of training, supervision and support
No procedures or policies on abuse
Poor communication
16
Reasons for the hidden nature of abuse

• Mis-diagnosis of abuse as something else

Family matters are private and should stay that
way
I have no one to turn to who can help.
The abuse is my fault.
The consequences of speaking up are worse than
keeping quiet.
I love my partner/son/daughter dont want them
criticised or punished for what they did
17
Reasons for the hidden nature of abuse
I am completely dependent on my abuser.
Im so ashamed and embarrassed that my own family
member could be behaving in an abusive or
neglectful way
Im afraid if I break the family secret, the
person hurting me will get back at me in a way
worse than what is happening now.
Long term conditioning by the abuser
Failings in the system.
18
Mrs Frances Hales
19
Mrs Frances Hales
Died from neglect
20
Visitors were encouraged to ring ahead when they
came to see relatives at the home in Oxford. It
gave the staff time to hide the stench of urine
and scrape faeces off the curtains
Not that they would ever see the 89 year old man
whose suppurating pressure sores had rotted the
flesh down to his bones. He was locked away
upstairs, in too much pain to move and too much
confusion to cry out.
For the last four months of his life Alec Taylor
saw no one except the owner, who cleaned his
wounds by hacking at the skin around the sores
with office scissors and ripping out his rotting
flesh, wearing gloves he had used to scoop faeces
off the sheets.
21
Adult Safeguarding
22
Adult Safeguarding and Adult Protection are
concepts that seem reasonably straightforward at
face value they involve protecting vulnerable
adults from harm or abuse. But they are in fact
complex and challenging constructs in reality -
both in terms of practical implementation but
also in terms of the ethical/moral dilemmas that
can be inherent within them.
23
Background
No Secrets was issued in 2000, as guidance under
section 7 of the Local Authority Social Services
Act 1970, to respond to a growing concern about
elder abuse in particular, and adult abuse in
general.
It was statutory guidance, and local authorities
were consequently required to follow it unless
they could demonstrate a clear reason why they
should not do so. It created, for the first time,
a framework for multi-agency action in response
to the risk of abuse or harm.
24
Process How it works
Alert
by anybody
Referral
Accepted into the system
Decision
Is it Safeguarding?
Assessment
Is it happening? What is it?
Plan
How to respond
Review
Is it working?
25
Whats going on
The consultation was eventually published 14
October 2008 and concluded on 31 January 2009.
In February 2010 the Government announced a
three-pronged approach legislation to address
the governance of Safeguarding Boards (but
without a commitment to what that meant or when
it would happen), an Inter-Ministerial Cross
Government Group on safeguarding adults, and an
updated version of No Secrets
26
Key points from the Law Commission

• a duty on social services to investigate or
  cause an investigation
• into adult protection cases and a duty on
  Government to
• prescribe the process for such
  investigations

• a new definition of people at risk of abuse
  and of harm in order
• to ensure those in need receive adequate
  protection

• a statutory basis for adult safeguarding
  boards which should as
• a minimum comprise local social services,
  police and health

• the legal requirement to establish serious
  case reviews and an
• enhanced duty to cooperate between relevant
  organisations.

27
Government response

• Safeguarding Boards will be made statutory. 

• A statement of principles for use by Local
  Authority Social
• Services and housing, health, the police and
  other agencies for
• both developing and assessing the
  effectiveness of their local
• safeguarding arrangements.

• Principles Empowerment, Protection,
  Prevention,
• Proportionality, Partnership, and
  Accountability

• The outcomes for adult safeguarding, for both
  individuals and
• agencies

28
Thinking about Outcomes Lord Justice Munby
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 to be paid in order to achieve some
other good in particular to achieve the vital
good of the elderly or vulnerable persons
happiness. What good is it making someone safer
if it merely makes them miserable .
29
Thinking about Outcomes Lord Justice Munby
Intervention which is proportionate to the harm,
or real possibility of future harm, and which has
the overall effect (outcome) of improving the
life of the adult, including their safety,
happiness and mental well-being.
If the State is to justify removing vulnerable
adults from their relatives, partners, friends or
carers it can only be on the basis that the State
is going to provide a better quality of care than
that which they have hitherto been receiving
30
Key Issues
31
Key issues
There is a poor level of co-ordination across all
organisations/capable guardians within the public
and private sectors, leading to inconsistent
delivery of appropriate advice, support and
intervention.
Those organisations/capable guardians, who come
into contact with vulnerable adults exhibiting
high levels of independence, may not recognise
their vulnerability.
32
Key issues
Where organisations see no immediate threat to a
persons well-being, they may fail to consider
the long-term impact of victimisation. This lack
of realisation or sense of urgency can lead to
safeguarding procedures not being invoked, or
organisations choosing not to share data.
The social care element of the No Secrets
definition has the potential to limit the
response of Adult Social Care, leaving a group of
people, who are unable to safeguard themselves
against harm or exploitation, excluded from the
provision of protection.
33
Key issues
ACPO found a lack of consistent understanding of
financial crime across police services and
several examples of victims being turned away at
police front desks. This may be due to a lack of
understanding of financial crime, or an
assumption that the loss of monies or assets is
of less importance than other forms of abuse or
crime. There is also evidence that police
officers are, on occasion, making their own
judgements about capacity, in circumstances where
referring the adult for an assessment may be more
appropriate.
34
Key issues
Despite high levels of contact, GPs appear to
generate disproportionately low numbers of
referrals. The role of GPs is considered crucial
to safeguarding, as they are In an ideal
position to identify safeguarding concerns with
their knowledge of patients, their families and
situations. These low volumes of referral could
be due to a lack of ability to identify
safeguarding problems, or a concern over
breaching confidentiality.
35
Elder Abuse Helpline 080 8808 8141
Admin telephone [phone]
Email manna_at_elderabuse.org.uk
WEBSITE WWW.ELDERABUSE.ORG.UK
36

• All Our Tomorrows Yfory Pawb
• Conference Sponsors Noddwyr y
  Gynhadledd
• Thank you Diolch yn Fawr