Safeguarding Vulnerable Adults - Essay Example

Safeguarding Vulnerable Adults Introduction The exploitation and abuse of vulnerable adults has increased in public awareness prominence in the recent times. Local initiatives and organisational priorities have led to more effective responses yielding various procedures and policies according to City of York Council (2012). The Human Rights Act 1998 has been crucial in protecting vulnerable adults across the UK. Even so, Wales reported a 5% increase in reported cases of vulnerable adults’ abuse from 2008 to 2009 (Healthcare Inspectorate Wales 2010). Northamptonshire Safeguarding Vulnerable Adults Board, NSVAB (2011) notes that safeguarding vulnerable adults would entail provision of conditions retaining independence, choice and well-being and allowing for access to human rights, free from abuse and neglect for those eligible for community care services. Social Services Directorate (2006) defines a vulnerable adult as that person aged 18 and above needing community care service or a continuing care facility resident with a disability, illness or aged or unable to take care of oneself or unable to protect oneself against significant exploitation or harm. To access community care services, such adults have their well-being and independence at risk if they lack appropriate social care and health support. These include adults with learning disabilities and sensory, physical and mental impairments. It could also encompass those paying for their personal care as well as friends and family providing free personal assistance to adults. Nordqvist (2011) lays the responsibility of protecting vulnerable adults in hospitals on assistant practitioners and doctors. Assistant practitioners would not only offer health services but also the needed social aid, thus they are important in protection of vulnerable adults. An assistant practitioner delivers social and health care for and to people. Such persons would be accountable to their employer, themselves and the people at large. Nonetheless, their tasks would normally be routine, a fact that could see them not pay individual unique attention to adult abuses bearing in mind the diversity in forms of abuses (Healthcare Inspectorate Wales 2010). As such, pharmacists, optometrists, dentists and particularly general practitioners have been cited as the most ideal persons to not only identify but also establish relationships with vulnerable adults due to their regular interactions. Unfortunately, this has not been consistent in practice across the UK. Types of abuse Abuse encompasses all acts leading to violation or denial of one’s civil or human rights by other persons. This could be single or repeated acts and could be physical, financial, psychological or verbal. The forms of abuse that vulnerable adults could be subjected to are usually not mutually exclusive as they would mostly involve several combinations of forms of abuse. All these forms of abuse would be perpetuated due to negligence, ignorance or deliberate intent. They take place in the public, day care centres, hospitals, nursing homes or education establishments (Nordqvist 2011). Its perpetrators include groups, organisations or individuals. Any form of abuse would result in significant harm or exploitation of the subject. According to NHS Northamptonshire (2011), an act would amount to abuse if it leads to deterioration in mental or physical health. Physical abuse would result from deliberately inflicting physical force resulting in impairment, pain or bodily injury which changes the victim’s physical state. Some of these include slapping, hitting, inappropriate sanctions or misusing invasive medication or procedure. Involvement in sexual activities or relationships by vulnerable adults without consent or without their ability to consent would amount to sexual abuse. It encompasses sexual involvements that violate one’s expressed religious and cultural preferences, family custom and sexual taboos. Some examples of this form of abuse include non-contact behaviour such as inappropriate looking, harassment and pornography and contact behaviour like touching genitals. Similarly, such persons could be subjected to psychological abuse, also referred to as emotional abuse which negatively affects the victim’s emotional development and health and includes denial of basic civil and human rights, dignity and privacy. It could also be a result of bullying, humiliation and other verbal conduct (Mandelstam 2008). NSVAB quotes Stein’s description of financial abuse as “unauthorised and improper use of funds, property or any resources belonging to an individual” (2011, p.38). The culprits of this form of abuse are the people holding positions of power, authority or trust or basically have the vulnerable adults’ confidence. They would use the income, property and assets of the vulnerable adults without seeking their informed consent or they would make financial transactions that such persons do not understand so as to take advantage of them. Local authorities provide Appointee and have Receivership procedure for vulnerable adults exposed to such form of abuse. Other than the 1998 Human Rights Act, the 2010 Equality Act and the 2003 Race Relations Act guide on discriminatory abuse among the vulnerable adults. Discriminatory abuse would be linked to all other abuses as it entails exploiting one’s vulnerability through unfair treatment or prejudice leading to exclusion of such persons from the opportunities in the society. Healthcare Inspectorate Wales (2010) gives some examples of discriminatory abuse as sexism, racism, ageism and religious discrimination. Vulnerable adults also face omission and act of neglect, but Northamptonshire Inter-Agency Safeguarding Adults Toolkit (2010) recognises the 2005 Mental Capacity Act which illegalises neglect or ill-treatment of incapacitated people such as the vulnerable adults. Other forms of abuse include domestic violence, professional abuse and institutional abuse. Domestic abuse encompasses sexual abuse, physical assault, financial exploitation and psychological abuse. Whereas professional abuse entails professionals abusing trust, institutional abuse considers an organisation’s collective failure to provide appropriate service to the vulnerable adults. Abusive behaviour could be a part of an organisational culture and custom. While some signs of abuse of vulnerable adults could be easy to notice, there are those that could be easy to miss. Common signs of vulnerable adults’ abuse include withdrawal from usual activities, self neglect, depression, bruises on genital area and physical conditions like burns, broken bones and bruises. Self neglect has been cited by Mandelstam (2009) as a common sign in vulnerable adults being abused in many cases. These people would not practice personal good care because of their declining health, memory impairment and social isolation among others. As such, they would not take medication as required, attempt suicide or have unclean living conditions. Legislation Offences against protection to vulnerable adults would be dealt with in civil and criminal courts. There are legislative mechanisms that serve to protect the vulnerable adults such as guardianship and power of attorney applications. These would prevent abuse and ensure that abusers face the law. Action against such abusers would arise mostly in criminal courts though civil action could be taken for damages. The 2010/2011 Safeguarding Annual Report reveals absence of coherent statutory framework on safeguarding vulnerable adults. Mandelstam (2009) argues that much effort has been dedicated towards child protection as opposed to adult protection. Statutory responsibilities would be a product of various statutes and NHS Northamptonshire (2011) proposes that local authorities be granted the duty to investigate related cases, establish boards responsible for adult protection and incorporate other strategic partners. Even so, there exist several pieces of law accompanied by various policies in UK which assist in recognising and preventing abuse of vulnerable adults. There were requirements passed in 2000 to ensure that all care providers in UK outside of NHS protect vulnerable adults under their care against risks and harm as stipulated in the 2000 Care Standards Act (Young 2011). The 2005 Mental Capacity Act plays a crucial role in ensuring that those considered to be mentally incapacitated do not suffer wilful neglect or mistreatment as it would amount to an offence. There are principles that enforce respect for the rights of this category of persons including privacy, dignity and respect, independence, choice, protection of law and to have their rights upheld without ethnic, sexuality, gender, religious, cultural or disability discrimination. According to SSD (2006), human rights considerations among vulnerable adults should be in tandem with Articles 2, 3 and 8 enforcing the Right to Life, Freedom from Torture and Right to Family Life respectively. In Scotland, the 2005 Mental Health Act and the 2000 Adults with Incapacity Act further ensure that vulnerable adults have their rights respected. Individually, a vulnerable adult should be accorded the same measure of respect and dignity as other adults by acknowledging their personal needs and uniqueness. They should be provided with information and knowledge that would enable them to make informed choices. The property and welfare of vulnerable adults would be protected through various techniques as provided in the respective legislation. If the vulnerable adult lacks the capacity and ability to make informed decisions, a guardian would be appointed by the court to deal with such person’s welfare. The Power of Guardian allows for regular amendments so as to meet the emerging needs over time. The Power of Attorney would be granted to a family member or close friend of a vulnerable adult if such a person loses the capacity to make decisions. The vulnerable adult should at the time of granting the powers have the capacity to comprehend the extent and nature of the Power of Attorney. This obviates the Power of Guardianship if the vulnerable adult loses capacity in future. Part III of the 2000 Adults with Incapacity Act provides for application to the Public Guardian for authority to withdraw money from the account of the vulnerable adult by the carer for daily upkeep. The policy of No Secrets in England gives a framework where local agencies, led by the local authorities would develop strategies for tackling abuse. In 2008/2009, NHS Northamptonshire (2011) recorded a review of the guidelines on this policy to enable the society empower its vulnerable adults so as to protect them from harm. It included consideration for a new legislation. Among the major gaps considered in current legislation in the UK there is the lack of statutory duty on vulnerable adult protection agencies to work together (Young 2011). There has been major debate on whether to place requirements on protecting vulnerable adults under the same statutory requirements as those for safeguarding children. Ethical dilemma In enforcing the legislation involved in safeguarding vulnerable adults, varied ethical dilemmas arise. Normally, the principle of confidentiality dictates that information should be passed on to authorities with service user consent (SSD 2006). However, in some circumstances, it could be necessary to share this confidential information so as to protect vulnerable adults. The vulnerable adults or their carers should therefore be informed in advance that there could be circumstances where they would have information shared for their protection or investigation of suspected criminal offence. Even so, for any information to be shared there should be consultation with the police or social service providers and other relevant authorities. Public or media enquiries should be handled after briefing all staff and volunteers and subsequent appointment of the rightful spokesperson. A key challenge when dealing with vulnerable adults involves consent and capacity when considering the action to be taken on a suspected abuse. The question to be answered is whether the vulnerable adults consented to the relationship, situation or act that constituted the alleged abuse. Similarly, it would be important to understand whether the person gives meaningful consent to a preventable investigation, report or action. The legislation in England and Wales provides principles in Good Practice in Consent with regard to mental incapacity in order to determine one’s ability and capacity to consent. These include a principle that assumes everyone has the ability to make decisions unless all possible practical steps that would help them do so have been exhausted without success (SSD 2006). The Common Law Duty of Confidentiality dictates situations where information on a vulnerable adult could be shared without seeking the consent. Examples of such situations include when such disclosure has been requested by a court, for crime prevention or when in public interest. Duty of Care also bounds each person to report any abuse on a vulnerable adult to the relevant authorities with or without the consent of such adults. Conclusion There are a myriad of forms of abuse that face vulnerable adults. Unlike child protection, safeguarding vulnerable adults has not been strongly implemented. Local authorities should be given the necessary authority, together with empowerment of the people to ensure that vulnerable adults have their basic human rights through appropriate legislations. Nonetheless, the existing legislations play an important role in the UK in ensuring that the rights of vulnerable adults have been observed to the latter. Everyone has the duty of ensuring that vulnerable adults do not suffer abuses that could cause them harm. References City of York Council 2012, ‘Keeping Safe and Protecting Vulnerable Adults from Harm and Abuse’, viewed 22 March 2012 from www.york.gov.uk Galloway, J 2011, ‘Dignity, Values, Attitudes and Person-Centred Care’, viewed 22 March 2012 www.oup.com/uk/orc Healthcare Inspectorate Wales 2010, Safeguarding and Protecting Vulnerable Adults in Wales: A Review of the Arrangements in Place across the Welsh National Health Service, Crown Ltd, Caerphilly. Mandelstam, M 2009, Safeguarding Vulnerable Adults and the Law, Jessica Kingsley Publishers, London, UK. NHS Northamptonshire 2011, ‘Safeguarding Annual Report 2010/2011’, viewed 22 March 2012 www.northamptonshire.nhs.uk Nordqvist, C 2011, ‘Protecting Vulnerable Adults, New Guidance for Doctors, UK’, Medical News Today, July 28, viewed 22 March, 2012 www.medicalnewstoday.com Northamptonshire Inter-Agency Safeguarding Adults Toolkit 2010, Reference Guidance for Professionals, vol. 1, no. 4 Northamptonshire Safeguarding Vulnerable Adults Board 2011, Safeguarding Vulnerable Adults from Abuse, 3(0). Social Services Directorate 2006, Safeguarding Vulnerable Adults: Regional Adults Protection Policy & Procedural Guidance, vol. 2. Young, A 2011, No Secrets: Guidance on Developing and Implementing Multi-Agency Policies and Procedures to Protect Vulnerable Adults from Abuse, Department of Health Publication, London. Read More