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Purpose: Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area. Design/methodology/approach: A narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions. Findings: A range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective. Originality/value: This paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to interrogate and develop the conceptualisation of discriminatory abuse in safeguarding adults policy and practice beyond the current interpersonal definition. The paper draws on Safeguarding Adults Reviews (SARs) that refer to discriminatory abuse or safeguarding practice with adults who have care and support needs and protected characteristics. Design/methodology/approach: A search of the national network repository of SARs identified 27 published reviews for inclusion. The contents were thematically analysed to understand how discrimination was experienced in these cases. Fricker's "Epistemic Injustice" theory was adopted as a conceptual framework, informing the analysis of findings. Findings: Evidence from SARs provides a challenge to the interpersonal emphasis on language and behaviour in national policy. Although the reviews acknowledge that interpersonal abuse occurs, a close reading spotlights practitioner and institutional bias, and inattention to social, structural and contextual factors. The silence on these matters in policy provides a narrow frame for interpreting such abuse. This suggests significant potential for epistemic injustice and signals a need to acknowledge these social, structural and contextual factors in safeguarding practice. Originality/value: Discriminatory abuse is an under-researched and under-utilised category of abuse in safeguarding adults practice. The paper adopts Fricker's theory of "Epistemic Injustice" to highlight the silencing potential of current policy approaches to discriminatory abuse to suggest a more inclusive and structural framing for safeguarding practice with those targeted due to their protected characteristics. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) against women is a global phenomenon. IPV is a public health, social policy and human rights concern across the globe. It remains a serious issue in Indian context as well. This paper aims to identify the factors associated with IPV using India's nationally representative National Family Health Survey (NFHS) data. Design/methodology/approach: To identify the factors associated with IPV in India, the authors have used binary logistic regression to estimate two models. The outcome variables are women facing physical violence in the first model and sexual violence in the second. The explanatory variables are broadly socio-economic indicators related to the women and a few other indicators related to the characteristics of the household. Findings: The authors found that urban and working women face higher odds of violence. Alcohol consumption by the husband increases the risks of IPV, whereas risk decreases with women's autonomy. Even though the prevalence of physical and sexual violence has decreased by 6.8% and 3.9% from 2005–2006 to 2019–2021, the data shows that women across social, economic and regions still face violence from their partners. However, the physical violence increased from 2015–2016 to 2019–2021. Originality/value: To the best of the authors' knowledge, this study is a distinct attempt to use pooled data of the nationally representative sets NFHS-3 (2005–2006), NFHS-4 (2015–2016) and NFHS-5 (2019–2021) to study the factors associated with IPV in India. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to consider the role of the Mental Health Act (MHA) 1983 in safeguarding adults at risk of abuse and neglect. The author has undertaken a thematic review of Safeguarding Adults Reviews (SARs) commissioned in England and Adult Practice Reviews (APRs) commissioned in Wales where the MHA 1983 was a central aspect to the review. Design/methodology/approach: Reviews were included based on specific determinants, following analysis of SARs, APRs and executive summaries. This should not affect the credibility of the research, as themes were identified in conjunction with analysis of literature regarding use of the MHA in the context of adult safeguarding. Consequently, this review has been underpinned by evidence-based research in the area of study. Findings: The interaction between statutes, such as the MHA 1983 and Care Act 2014, signify challenges to professionals, with variable application of mental health legislation in practice. Research limitations/implications: Lack of a complete national repository for review reports means that it is likely that the data set analysis is incomplete. It was noted that limitations to this research include the fact that Safeguarding Adults Boards in England may not publish SAR reports or may choose to publish an executive summary or practice brief instead of the full SAR report, therefore limiting the scope of disseminating learning from SARs, as this is difficult to achieve where the full report has not been published. The author aimed to mitigate this by undertaking comprehensive searches of Local Authority and SAB websites, in addition to submitting Information requests to ensure that this research encompassed as many relevant review reports as possible. Originality/value: This is an important and timely topic for debate, given that the UK Government is proposing reform of the MHA 1983. In addition, existing thematic reviews of SARS tend to be generalised, rather than specifically focused on the MHA. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to review safeguarding adult reviews (SARs) pertaining to individuals with acquired brain injury (ABI) since 2014. This extended literature review also explores the lessons and recommendations from these reviews in relation to social work practice within the UK. Design/methodology/approach: The literature review reported and discussed findings across reviews and then used a thematic analysis to synthesise the findings and recommendations from the SARs reviews. Findings: This paper identified four main themes: a lack of awareness of the needs of those with ABI and their families and around the symptoms and nuances of brain injury, particularly executive impairment and mental capacity, among social workers; poor interdisciplinarity led to a lack of shared communication and decision-making with professionals with such knowledge; a poor understanding of aspects of the mental capacity legislation, particularly surrounding unwise decisions, led to inappropriate or absent mental capacity assessments; and a lack of professional curiosity led to a lack of action where intervention or assessment was required. Research limitations/implications: This review identifies significant shortcomings in social work practice, education and training within the UK with regards to ABI. Practical implications: This paper provides recommendations to current social work practice and highlights the need for significant improvements in pre-qualification and post-qualification training and supervision of social workers. Originality/value: To the best of the authors' knowledge, while there have been extensive reviews conducted on SARs, this is the only review that has focused solely on ABI. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to highlight devastating consequences when professionals misappropriate the presumption of capacity in s1 Mental Capacity Act 2005. Design/methodology/approach: This is the story of my vulnerable son's life and the failure of services to provide the professional help and support he needed in order to stay safe. I have flagged, with specific examples, how the law was perpetually misapplied in his case, with tragic consequences. Findings: The application of the statutory presumption of capacity is widely misunderstood. The presumption is frequently misappropriated by health and social care professionals as well as by legal professionals. Concerned families are being ignored or blocked out by professionals, many of whom seem unclear as to when evidence based mental capacity assessments, with rationale, are required. This is rendering the legislation in place for the protection of vulnerable adults ineffective and then allowing preventable deaths to evade appropriate scrutiny. Research limitations/implications: Some of the documents (e.g. police logs and records, some social care records) were withheld from the author or heavily redacted when the author requested them following her son's death. Practical implications: Vulnerable people can frequently suffer neglect and abuse in the community. Their deaths, following state agency failures, are not being investigated as they should be, preventing learning from mistakes. Social implications: We live in a society where, sadly, vulnerable people are often not appropriately supported by professional services. As a result, the police can be left to pick up the pieces following mental health service failures. Whilst there may now be a greater awareness of autism, this is not yet accompanied by a greater understanding of the condition. Originality/value: Christopher's story is unique, raising issues of serious concern across many different agencies. These appear to stem from a widespread lack of understanding of the vulnerability of adults with high functioning autism/Asperger's syndrome and a significant discrepancy between their intelligence and their life skills. [ABSTRACT FROM AUTHOR]

Purpose: The issue of financial abuse is highlighted in the Care Act (2014). One category of financial abuse is consumer fraud or "scams." Evidence suggests that scams are becoming increasingly ubiquitous, yet how scams impact older adults remains under-researched. The purpose of this paper is to report data from 80 older adults' written responses to a Mass Observation Archive Directive, commissioned in autumn 2015, which focused on scams. Design/methodology/approach: A qualitative approach was used with data captured via written responses to a set of questions. There was no limit on the length of written accounts, and respondents remained anonymous. Data were analysed thematically, resulting in four key themes. Findings: The data indicated scams impact individuals in terms of health and well-being, irrespective of whether they have experienced financial loss, and trigger implementation of strategies intended to avoid being defrauded. There was also evidence of scam-related stigma with individuals who are defrauded being subject to derision and censure. Social implications: Individuals who have been victimised by fraudsters may need access to practical and emotional support. This requires the design of appropriate interventions and the stigma associated with being scammed to be addressed. Originality/value: This paper adopts an original approach to collecting rich, candid data about an under-researched topic. The authors highlight that anti-scam interventions should equip individuals to identify and avoid scams without inciting fear or anxiety; proposing this may be facilitated by drawing on health and safety risk assessment protocol when designing anti-scam interventions. [ABSTRACT FROM AUTHOR]

Purpose: Self-neglect is a public health concern that can manifest as failure to provide oneself adequate food, water, clothing, shelter, personal hygiene, medication or safety precautions. This paper sought to inform federal policy and research priorities regarding effective strategies to detect, prevent and address self-neglect. This study aims to inform federal policy and research priorities regarding effective strategies to detect, prevent, and address self-neglect. Design/methodology/approach: The authors conducted a rapid review of self-neglect literature and interviews with five national subject matter experts to inform federal policy and research priorities. Findings: This study identified gaps in the literature and several approaches and numerous challenges to preventing, identifying and addressing self-neglect. The lack of a nationally accepted definition of self-neglect, a dearth of longitudinal studies which has limited research on self-neglect etiology and trends, and limited development and validation of screening tools, are among the challenges. Research limitations/implications: Findings indicate that comparisons of self-neglect definitions, and longitudinal studies of self-neglect by subpopulations, are needed areas of future research. Issues for policy consideration include national self-neglect data collection and reporting requirements. Originality/value: This study synthesizes recent literature on self-neglect, highlights gaps in the literature on self-neglect and points toward federal policy priorities for advancing effective strategies to detect, prevent and address self-neglect. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine reform of mental health legislation in England and Wales. It covers the period from the introduction of the 1983 MHA to the proposed reforms outlined in the Wessley Review that was published in December 2018. Design/methodology/approach: This is a literature-based project. Findings: Reform of the mental health legislation reflects two potentially conflicting strands. One is the state's power to incarcerate the "mad", and the other is the move to protect the civil rights of those who are subject to such legislation. The failures to development adequately funded community-based mental health services and a series of inquiries in the 1990s led to the introduction of Community Treatment Orders in the 2007 reform of the MHA. Research limitations/implications: The development of mental health policy has seen a shift towards more coercive approaches in mental health. Practical implications: The successful reform of the MHA can only be accomplished alongside investment in community mental health services. Originality/value: The paper highlights the tensions between the factors that contribute to mental health legislation reform. [ABSTRACT FROM AUTHOR]

Purpose: People with an intellectual disability are much more likely to be sexually violated and the violation is less likely to be reported. Despite this being high-lighted at least 3 decades ago and improvements in both safeguarding and national reporting processes, under-reporting remains a problem. This paper explored under-reporting alongside prevention possibilities using safeguarding alerts raised in a Community Learning Disability Team within a UK NHS trust. Design/methodology/approach: Using a combination of authentic but anonymised case vignettes and descriptive data drawn from the safeguarding team, under-reporting was examined through the lens of an ecological model. Safeguarding alerts raised in a particular year were compared with the number expected if all (estimated) cases of abuse were disclosed and reported. Findings: Only 4.4 per cent of expected abuse cases were reported to the team, which is lower than the reporting level the authors had expected from the literature. There is evidence in the literature of the under-reporting of sexual assault for all kinds of people. Arguably, the implications of under-reporting for PwID are even more traumatic. Research limitations/implications: Constraints included the lack of standardisation in data collection within the statutory services that report to the Birmingham Safeguarding Adults Board. One key recommendation is that the national provider of data for the NHS in the UK requires more complex and standardised audit information that would allow each local authority to benchmark their practice against a higher protection standard. Another recommendation is that compliance to quality standards sits within a comprehensive strategy. Originality/value: This paper explored the extent to which the previously documented under-reporting concern remains an issue. Certainly eye-balling safeguarding compliance data in the NHS organisation we worked in led us to a concern that reporting might be even lower than implied in the literature. This together with a renewed spot-light on sexual violence (e.g, NHS England, 2018) led us to decide that it was timely to re-examine the problem. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss the recent National Appropriate Adult Network (NAAN) report on the role of the appropriate adult. Design/methodology/approach: This paper is based on the NAAN report and a review of relevant policy and research literature. Findings: There to Help 2 highlights that there are still significant gaps in the provision of appropriate adult schemes across England and Wales. These gaps potentially place vulnerable adults at increased risk. Originality/value: This paper is a review of recent research. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to argue that the work of the American feminist political and legal philosopher, Martha Fineman can be the basis for a shift away from the proceduralism and managerialism that has come to dominate social work practice.Design/methodology/approach This paper's work is based on the application of Fineman's work to social welfare settings.Findings Fineman's work calls for a radical rethinking of our notions of autonomy and vulnerability.Originality/value This paper applies Fineman's work to this field. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to highlight concerns about recent CPS guidance on the prosecution of rape and sexual assault cases.Design/methodology/approach The paper places the CPS guidance in the wider policy context of concerns about sexual violence on mental health wards.Findings The paper concludes that the reported CPS guidance appears to run counter to other policy directives particularly the recent report from the CQC.Originality/value The paper is a first response to these issues. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine safeguarding adults reviews (SARs) that refer to mental health legislation in order to contribute to the review of English mental health law (2018).Design/methodology/approach Searches of a variety of sources were conducted to compile a list of relevant SARs. These are summarised and their contexts assessed for what they reveal about the use and coherence of mental health legislation.Findings The interaction of the statutes under consideration, in particular the Mental Health Act (MHA) 1983, the Mental Capacity Act (MCA) 2005, together with the Care Act 2014, presents challenges to practitioners and the efficacy of their application is variable.Research limitations/implications In light of the absence of a duty to report SARs to a national register, it is possible that relevant SARs were missed in the search phase of this research, meaning that the results do not present a complete picture.Practical implications Examining cases where use of legislative provisions in mental health has been found wanting or legislation may not be easily implemented may inform initiatives to increase understanding of the law in this area.Originality/value This paper's originality and value lie in its focus on mental health legislation as discussed in SARs at a time when both the MHA 1983 and the MCA 2005 are the focus of attention for reform. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to perform a review of the literature of empirical studies on elder mistreatment (EM) in South Asians, and to discuss key implications for policy, practice and research.Design/methodology/approach For this review, multiple electronic databases in the international health and social science were searched and supplemented by grey literature and cross-references. Quality of papers was assessed by two authors against the standard checklists.Findings In total, 16 studies met the inclusion criteria of this review, of which 11 were cross-sectional design, and only six of them used standard instruments to measure EM. The prevalence estimates of overall EM retrieved from general population-based studies ranged from 9.3 per cent in India to 49.1 per cent in Nepal. Age, gender, residential settings, socioeconomic status, health, education, and social structures and processes were key risk factors for EM in South Asian communities. Reporting and action taking were culturally rooted.Originality/value While the review is not systematic, there are limitations associated with the paper in covering the diverse range of databases and studies. However, this review provides a valuable synthesis of the empirical papers on the incidence, culturally specific risk factors and reporting trends of EM in South Asians. Additionally, the review presents the papers evaluated for a quality to ensure the validity of empirical data. Finally, the review includes several implications for policy, practice and future research on EM which may ultimately contribute in improving the health and wellbeing of elder South Asians. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report the findings of a scoping study that explored the extent of recorded sexual violence perpetrated on inpatients on mental health (MH) units.Design/methodology/approach A Freedom of Information Act (FOI) request was sent to 45 police forces. The FOI asked for the number of recorded offences of rape and sexual assault by penetration for the five years 2010-2015. Following the responses from the police, a similar FOI request was sent to MH trusts.Findings There were significant variations in the way that both police forces and MH trusts approached the recording of this information.Research limitations/implications The research highlights variation and inadequacy of current recording practices in relation to sexual offences committed against inpatients on MH units.Practical implications There needs to be more consistent systems of recording of allegations of sexual assault and responses to them by agencies. In the trust recording of these incidents, it is recommended that a specific category of sexual violence is created. On a national level, the Office for National Statistics should produce a national data set that records the number of rapes that are committed in MH inpatient units.Originality/value This paper highlights the “gap” of information in relation to recorded rape and may indicate that complainants with a history of mental illness are less likely to have their allegation recorded as a crime. [ABSTRACT FROM AUTHOR]

Purpose The paper reports on the findings of a survey of 115 (76 per cent) of English local authorities in 2016 which compared progress on the implementation of the Making Safeguarding Personal (MSP) approach in local authorities through their Adult Social Care departments and in relation to their area Safeguarding Adults Boards (SABs) and partner organisations. The purpose of this paper is to evaluate the survey in relation to personalised social care and its impact on organisations, their staff and service users, and conclude with wider implications and recommendations for further work.Design/methodology/approach A series of guided interviews were conducted with safeguarding leads from a sample comprising of 115 (76 per cent) of English local authorities during May and June 2016. The sample was randomly picked and balanced to give a fair representation of the different types of councils. The interviews were conducted by a team of five people. All interviewers had in-depth experience of adult safeguarding and were currently practicing independent chairs of SABs. The interviewers followed a prepared schedule consisting of a mixture of open and closed questions. All interviews were held over the phone and averaged one-hour duration.Findings The results pointed to the impression that the majority of local authorities had completed the first step of introducing MSP, i.e. they had trained their workers and modified their systems. Most local authorities were moving into the next phase of embedding user-focussed work into their practice and culture, and were at various points along that journey. However, most had still to engage partner organisations beyond a mere acceptance of MSP as “a good thing”.Research limitations/implications The research has wide ranging implications for organisations and their workers in the field of adult safeguarding based on its findings. Its limitations are that only organisational leaders and managers were interviewed, although reference is extensively made to initiatives that engage service users. The authors acknowledged the possible bias of interviewees when judging the performance of their own service and attempted to moderate their views in the final report.Practical implications The report references many practical implications to improve the practice of adult safeguarding in an attempt to make it more person-centred. Examples of good practice are given and recommendations are made to organisations.Social implications It is recognised that there are many people who may be at risk of harm through their environmental, personal, age or disability-related situations. In improving the way that services respond to their needs, they will be made to feel safer and their lives enhanced.Originality/value This original research follows up previous research in the preceding year. It is the widest ranging in its coverage of 76 per cent of English local authorities. Its value is that it measures progress towards full implementation of MSP; reports information and views from safeguarding leaders; and makes 20 recommendations to improve the implementation of MSP within local authorities, SABs and their partners. [ABSTRACT FROM AUTHOR]

Purpose: The prominence of the best interests principle in the Mental Capacity Act 2005 represented an important transition to a more resolutely patient-centred model regarding decision-making for incapable adults ("P"). This paper aims to examine the courts' consideration of P's values, wishes and beliefs in the context of medical treatment, reflect on whether this has resulted in a wide interpretation of the best interests standard and consider how this impacts clinical decision makers. Design/methodology/approach: A particular focus will be on case law from the Court of Protection of England and Wales and the Supreme Court of the UK. Cases have been selected for discussion on the basis of the significance of their judgements for the field, the range of issues they illustrate and the extent of commentary and attention they have received in the literature. They are presented as a narrative review and are non-exhaustive. Findings: With respect to values, wishes and beliefs, the best interests standard's interpretation in the courts has been widely varied. Opposing tensions and thematic conflicts have emerged from this case law and were analysed from the perspective of the clinical decision maker. Originality/value: This review illustrates the complexity and gravity of decisions of the clinical decision makers and the courts have considered in the context of best interests determinations for incapacitated adults undergoing medical treatment. Subsequent to the first such case before the Supreme Court of the UK, emerging case law trends relating to capacity legislation are considered. [ABSTRACT FROM AUTHOR]

Purpose: A framework for "negotiating meaning" was applied to a healthcare service to achieve a collaboratively developed suicide prevention clinical pathway. Design/methodology/approach: The framework was originally developed during a previous study that drew on the theory of philosophical hermeneutics to enable a researcher to better understand the experience of older people. This approach was then applied to a healthcare setting and the development of a suicide prevention clinical pathway. Clinical front-line staff engaged effectively and meaningfully with each other, consumers, family members and management to develop a clinical guideline that reflected best practice and improved care provision. An additional outcome involved establishing a supportive culture in which the shared meanings underpinning the experience of working with people expressing suicidality were explored. Findings: An evidence-based suicide prevention clinical pathway was developed collaboratively with clinicians taking the lead in the process, and leading to the agreement being reached on the final guideline and processes established. The negotiation process brought the perspectives of the different parties together enabling the sharing of underlying meaning inherent in the experience of losing a consumer tragically to suicide. A commitment to taking joint action to reduce the likelihood of further incidents occurring also grew from the shared understanding that developed. Originality/value: This paper describes the approach that was applied to facilitate engagement processes between clinicians and service management that also challenged the power differentials that usually exist within healthcare and led to positive engagement that supported the safety and quality agenda. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to qualitatively analyse the inspection and regulation of care for people with learning disabilities and mental health problems in Scotland, in two time periods.Design/methodology/approach The paper uses comparative historical research drawing on primary sources from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy for Scotland and associated papers, to compare inspection methods, quality standards and to identify persistent challenges to effective inspection.Findings Political, clinical and public awareness led initially to criticisms of existing care and eventually to the development of the “The Lunacy Act” of 1857. This Act resulted in the first attempts to set minimum standards of care for individuals at risk, with enforceable regulation. Some factors recur as challenges to effective practice in the inspection and regulation of care today.Practical implications There are problems of definition, reliable monitoring of quality standards and adequate, independent inspection of services that respond to unacceptable standards of care. There is a growing evidence base about best methods of inspection of services for people in care who are most at risk. These methods attempt to strike a balance between evidence- and value-based judgments. Perspectives from history may help focus resources.Originality/value This paper compares common and common challenges in two time periods to investigate what can be learned about the development of policy and practice in inspection and regulation of care. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report on a study conducted for the purpose of learning more about the mindfulness experiences of college students and their teachers. To assist in developing a more inclusive approach to the teaching of mindfulness tailored to the individual needs of more vulnerable students and to inform teacher training and curriculum development.Design/methodology/approach This three-phase phenomenological study involved face-to-face and online contact with community college students and teachers involved in courses that incorporated mindfulness meditation. The findings from interviews with students in phase 1 were shared with teachers in phase 2 along with suggestions for safeguarding in phase 3 but initial results are promising as a number of safeguards have already been put into place.Findings This study found that mindfulness meditation is not necessarily a positive experience for vulnerable college students and their teachers and that there was a need for more teacher training, knowledge and ongoing support about the effects of some mindfulness meditations on some vulnerable students and how to adjust their intensity.Research limitations/implications While this is a small qualitative study, the majority of students interviewed reported unusual experiences. This this is not well known in the literature on mindfulness in higher education, and a search of the clinical literature supports the findings that significant safeguards and adjustments are needed for mindfulness meditation for vulnerable students in educational, non-clinical settings. Further research is needed.Practical implications An implication of this study is that mindfulness meditation in its current form is likely to be unsuitable for vulnerable students. Practical recommendations for safeguarding mindfulness in higher education are already being trialed, as mentioned in this paper and will be the subject of more extensive exploration in another paper.Social implications There are significant implications in these findings that the potential harmful effects of mindfulness may be overlooked and may be more commonly experienced than is currently realized especially for individuals with a history of trauma, with addictions, mental health difficulties or self-harm.Originality/value An innovation in this study is its methodology which drew out students’ and teachers’ own experience of mindfulness meditation in their own words when most mindfulness studies are quantitative and tend to focus on outcomes before understanding. In addition, the findings were presented directly to teachers making it possible to see how little they knew about their students’ experiences. This created an opening and a willingness to adopt safeguarding recommendations. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to review the care management of a man with a traumatic brain injury (TBI) from a family member’s perspective.Design/methodology/approach The paper provides a case history of “Tom” both prior to his TBI and after.Findings Tom was the subject of a safeguarding adults case review in Somerset following his death in 2014. Ultimately the paper highlights the shortcomings and failures in the care Tom received by various organisations which ultimately contributed to his suicide.Practical implications The paper highlights the need for more effective communication between professionals managing the care of those with TBI. Furthermore, professionals need training in the need for mental capacity assessments and improved safeguarding and risk assessments with adults with TBI.Originality/value This paper provides insight into the needs of an adult with TBI from the perspective of a family member who is also a trained psychologist. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to "read across" a sample of domestic homicide reviews (DHRs), mental health homicide reviews (MHHRs) and adult practice reviews (APR) to identify the cross-cutting themes.Design/methodology/approach The study involved a qualitative comparative analysis of 20 Welsh reviews: 10 DHRs, 6 APRs and 4 MHHRs. Each review was triple coded by a multi-disciplinary team of researchers (representing criminology, social work and law).Findings Five overarching themes were identified from this diverse sample of cases: crossing boundaries, including transitions between services and geographical boundaries; hoodwinking, where there was manipulation of the presentation of self; faulty assessment, which was not always holistic and only based on certain aspects of behaviour; tunnel vision, resulting from the initial underpinning narrative rarely being challenged; and knowledge, with certain types being privileged over others, especially professional over that of families and para-professionals.Research limitations/implications Further research into death reviews should adopt a comparative, multi-disciplinary approach.Practical implications The research highlights the possibility for duplication across the different types of reviews. Further, it suggests that review processes could be streamlined.Originality/value Five cross-cutting themes have been developed through the very first study "reading across" three types of reviews (DHRs, APRs and MHHRs). Findings suggest the need for streamlining review processes and highlight the importance of adopting a multi-disciplinary perspective when researching death reviews. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to compare recent developments in adult protection legislation, policy and practice in Scotland in 2015 with the first attempts at protection of adults at risk of harm, in 1857-1862, with a particular focus on people with learning disabilities. Design/methodology/approach – The paper uses comparative historical research, drawing on primary archive material from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy for Scotland and associated papers. Findings – Growing public awareness of the extent of neglect and abuse, and the need for overarching legislation were common factors in the development of both the “The Lunacy Act” of 1857 and the Adult Support and Protection (Scotland) Act of 2007. Both pieces of legislation also had the common aim of “asylum”, and shared some other objectives. Practical implications – Total prevention of abuse of vulnerable adults is an aspiration in law and in policy. There is an evidence base of effectiveness, however, in protecting adults at risk of harm from abuse. Some ecological factors recur as challenges to effective safeguarding activity. These include problems of definition, uncovering abuse, enforcing legislation, evaluating impact and protection of people who are not a risk of harm to others. Originality/value – This paper compares common themes and common challenges in two separate time periods to investigate what can be learned about the development of legislation and practice in adult protection. [ABSTRACT FROM AUTHOR]

Purpose – In his recent report, Lord Adebowale (2013) described mental health issues as “core police business”. The recent retrenchment in mental health and wider public services mean that the demands on the police in this area are likely to increase. Mental health triage is a concept that has been adapted from general and mental health nursing for use in a policing context. The overall aim of triage is to ensure more effective health outcomes and the more effective use of resources. The purpose of this paper is to examine the current policy and practice in this area. It then goes on to explore the models of mental health triage that have been developed to try and improve working between mental health services and the police. Design/methodology/approach – The paper outlines the main themes in the research literature regarding mental illness and policing, including a brief overview of section 136 MHA. It then examines recently developed models of triage as applied in these settings. Findings – The models of triage that have been examined here have developed in response to local organisational, demographic and other factors. The approaches have two key features – the improved training for officers and improved liaison with mental health services. Practical implications – Wider mental health training for officers and improved liaison with community-based services are the key to improving police contacts. Social implications – The current pressure on mental health services has increased the role that the police have in responding to these sorts of emergencies. This situation is unlikely to change in the short term. Originality/value – This paper contributes to the wider debate about policing and mental illness. It highlights the fact that section 136 MHA use has tended to dominate debates in this area to the detriment of a broader discussion of the police role. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to outline how questions relating to capacity arise in the context of safeguarding, and when applications to the Court of Protection are required in relation to those who may lack capacity. It also seeks to provide guidance as to how applications to the Court of Protection should be made so as to ensure that they are determined effectively and in a proportionate fashion. Design/methodology/approach – The paper draws on the practical experience of practising barristers appearing before the Court of Protection, and on the experience of a social worker who is an MCA/DOLS lead at a London local authority. The paper proceeds by way of a review of the relevant statutory provisions, an overview of the Court of Protection and then to a practical analysis of when and how applications to the Court need to be made. Findings – When to go to the Court of Protection in the safeguarding context is poorly understood, and there has not been proper recognition of the fact that proceedings for “adult care orders” have a strong forensic analogy with applications for care orders in relation to children. It is only by recognising these forensic similarities that local authorities can properly make use of the Court of Protection in the discharge of their obligations to vulnerable adults in their area. Practical implications – The paper should lead to a recognition that there is a specialist “adult protection court” within the Court of Protection, and that applications for adult care orders to that court require specific and careful preparation and presentation. It will therefore lead to better use of the Court of Protection in the safeguarding context and – ultimately – a better balance between empowerment and protection of vulnerable adults who may lack capacity. Originality/value – The paper is original in combining both legal and social work expertise to reach practical conclusions as to why such poor use has been made of the Court of Protection in safeguarding context. Its value lies in the deployment of that expertise to suggest how better use can be made in the future. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to give a brief background to the Deprivation of Liberty Safeguards (DoLS), and studies which factors Best Interests Assessors consider when making a judgement on Deprivation of Liberty. It examines some of the reasons why professionals may be under-using DoLS, including lack of knowledge, complex processes and paperwork, and the pejorative nature of the word "deprivation", and looks at a possible way forward. Design/methodology/approach -- The paper looks at the evidence to the House of Commons and House of Lords Committees on the Mental Health Act and Mental Capacity Act, as well as previous and current research papers. It examines the nuances of difference between restriction and deprivation, and the cumulative impact of several restrictions, which may, in fact, amount to a deprivation, illustrated by case studies from the author's own practice. Findings -- It makes the case that health and social care professionals should err on the side of caution, by making precautionary DoLS applications, arguing that MCA DoLS is a forerunner of good practice, and that good care planning allied to judicious application of the MCA leads to better, more robust and more defensible decision making. Originality/value -- And it points the way to a possible future, citing the recommendations of the Select Committee on the MCA for a clearer link between DoLS and the principles underpinning the MCA, and for simplifying and clarifying the legislative provisions and the associated paperwork. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report on the aspects of an exploratory investigation into the scale and nature of the financial abuse of adults lacking mental capacity.Design/methodology/approach It uses mixed-methods study which comprises of: a review of safeguarding adults’ statistics; analysis of court case findings; classification of types of financial abuse, victims and perpetrators; qualitative exploration of professional views of the nature of financial abuse of those lacking mental capacity; and a consideration of policy implications.Findings It demonstrates the significance of financial abuse within the spectrum of abuse experienced by adults at risk; the wide range of both victims lacking capacity being abused and type of financial abuse; its often hidden nature embedded within the family; and the limitations of processes designed to protect.Research limitations/implications The investigation reveals the paucity of statistical data available on the nature of financial abuse and the outcomes of official investigations into reported cases, both of which limit analysis and understanding of the phenomenon.Practical implications It demonstrates the need for greater transparency and consistency in the reporting of safeguarding and legal processes to enable practitioners and policymakers to fully understand the nature and significance of this abuse for both victims and society.Social implications It questions the extent to which existing protective processes are sufficient in terms of safeguarding victims and deterring perpetrators.Originality/value It involves original research that brings together data from a range of sources involved in the protection of a particular hard-to-reach group of individuals (those lacking capacity) from a particular type of risk (financial abuse) of increasing social significance. [ABSTRACT FROM AUTHOR]

Purpose The issue of mental health and policing is a subject that has been debated from a number of different perspectives. The purpose of this paper is to report on the findings of a case study that explored mental health difficulties and vulnerability within police custody.Design/methodology/approach The design of the study was qualitative, and it utilised telephone, semi-structured interviews with all levels of the custody staff. This approach was taken because the aim of the study was to explore how people in different roles within the organisation worked to safeguard vulnerable people in custody.Findings The findings from this study identified a number of interesting themes that could be explored further in later studies. Overall, the respondents expressed frustration that vulnerable people find themselves in police custody for low-level crime, when it could have been avoided with improved mental health services in the community. Additionally, the findings demonstrated that despite the processes that are designed to safeguard the detainee, tensions still exist including, timely access to mental health assessments, appropriate training and support for staff and the use of appropriate adults.Research limitations/implications Although the study was small in scale, the custody facility delivered detainee facilities for about 5,000 individuals per year. The research and information obtained supported the police lead for mental health to identify opportunities for improving the customer journey, as well as recognising the need for further research to identify how officers and staff relate to vulnerable individuals in contact with the police service.Originality/value Despite the limitations of the study, the findings have captured interesting data from a range of professionals working in one police custody suite, and therefore it presents a holistic overview of some key issues around mental health, vulnerability and safeguarding within the context of police custody. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine differences in the experience of somatic symptoms by domain (exhaustion, musculoskeletal, gastrointestinal, heart distress) between psychologically abused and non-abused older persons, and to scrutinize associations between abuse and somatic symptoms while considering other factors (e.g. social support). Design/methodology/approach – The design was cross-sectional. The participants were 4,467 women/men aged 60-84 years living in seven European cities. The data were analysed using bivariate/multivariate methods. Findings – Psychologically abused participants scored higher on all somatic symptom domains than non-abused, and thus were more affected by the symptoms. The regressions confirmed a positive association between psychological abuse and most somatic symptom domains, but other factors (e.g. depression, anxiety) were more salient. Demographics/socio-economics were positively (e.g. marriage/cohabitation) or negatively (e.g. education) associated with somatic symptoms depending on the domain. Social support and family structure “protected” the experience of somatic symptoms. Research limitations/implications – The research focused on psychological abuse. It did not incorporate other abuse types calling for further research on the effects of other abuse types on somatic symptoms. Nevertheless, the findings indicate that psychological abuse is linked to somatic symptoms, but the role of other factors (e.g. depression, anxiety, social support) is also important. Practical implications – Improvements in the older person's situation regarding somatic symptoms need to consider psychological abuse, co-morbidities, social support and living conditions. Originality/value – The paper reports data from the ABUEL Survey, which collected population-based data on elder abuse. [ABSTRACT FROM AUTHOR]

Purpose -- This paper concerns the fall-out from a TV programme which exposed the arbitrariness of cruelty at a private hospital that purported to provide assessment, treatment and rehabilitation to adults with learning disabilities, autism and mental health problems. The paper seeks to address the issues involved. Design/methodology/approach -- It describes the principal findings of a Serious Case Review which was commissioned after the TV broadcast, and outlines some of the activities designed to reduce the likelihood of such abuses recurring. Findings -- From policy, commissioning, regulation, management, service design and practice perspectives, events at Winterbourne View Hospital highlight a gulf between professionals, professionals and their organisations, and leadership shortcomings. Originality/value -- The English government responded promptly and encouragingly to the wretched circumstances of patients at Winterbourne View Hospital with a "Timetable of Actions". The Serious Case Review which was commissioned after the TV broadcast contributed to the growing scepticism of "out of sight, out of mind" placements. It covered wide-ranging territory. [ABSTRACT FROM AUTHOR]

Purpose – There have been increased concerns about disciplinary procedures in relation to adult safeguarding. The purpose of this paper is to argue that the personal "boundary attitude" of workers is a strong component of their response to issues that have a safeguarding dimension. Design/methodology/approach – This study reports an analysis of questionnaire responses and data generated from interactive training events. Findings – The data suggest most workers adopt a personal stance or "boundary attitude" that drives their response to many of the diverse circumstances they face at the interface of their professional and personal life. Research limitations/implications – The particular profession, stage in career development or work environment may affect staff responses and this needs further exploration. Practical implications – There are implications for how services identify the most effective workers and their least effective colleagues, as well as for staff selection and training. Improving our understanding of boundary attitude will help to protect vulnerable people from abuse whilst supporting them to have a full life. Social implications – A better understanding of whether staff who maintain rigid boundaries deliver better outcomes than their colleagues who exercise substantial flexibility will help in recruitment, supervision and safeguarding activities. Originality/value – The paper explores an under-recognised issue in adult safeguarding, the personal "boundary attitudes" of staff, and their impact on judgements that affect a range of professional decisions they take. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide a brief overview of the Law Commission's final report and recommendations on the reform of the deprivation of liberty safeguards under the Mental Capacity Act. Design/methodology/approach: Summary of main report. Findings: The proposals contained in the Law Commision Review and proposals for law reform are outlined. Originality/value: This is a summary. [ABSTRACT FROM AUTHOR]

Purpose To reflect on the particular case from a professional’s perspective to provide, in conjunction with the original article, a more holistic overview of some of its implications for safeguarding practice and, by definition, for the provision of health and social care support services to individuals with a traumatic brain injury and their families. The paper aims to discuss these issues.Design/methodology/approach A response to an already published article.Findings That a lack of “professional curiosity” on the part of practitioners across a range of professions and agencies led to a failure to initiate safeguarding processes and procedures appropriately, resulting in avoidable damage to the subject of the article, the author’s partner and their families.Practical implications There is a need for a greater awareness and understanding of the implications of traumatic brain injuries across health and social care services: that hospital discharge planning and community support services need to be more flexible in identifying and meeting the needs of patients with traumatic brain injury, that there is no substitute for “professional curiosity” in ensuring that assessments are holistic, and that services are appropriate and multi-agency working is effective.Originality/value This is a response to an existing publication. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to summarize the work of the Court of Protection. Design/methodology/approach – The paper outlines the history and range of applications within the jurisdiction of the Court, drawing from the Mental Capacity Act and the Code of Practice. Reference is made to annual reports of the work of the court which profile its workload. Finally there is a review of a line of case law dealing with the question of media attendance and reporting of cases before the court. Findings – The Court in its current form was established under The Mental Capacity Act, 2005 and is a significant decision-making body in the UK within adult safeguarding practice concerning adults whose decision-making capacity is impaired. The implications of several specific cases are discussed. Originality/value – This paper provides a unique insight into the work of the Court of Protection and the implications of recent decisions by the Court for adult safeguarding. [ABSTRACT FROM AUTHOR]

Purpose – The Mental Capacity Act (MCA) was implemented in 2007 as a piece of legislation to empower and protect adults who require support making decisions. Many older adults in residential care homes will be in this position due to developmental disabilities associated with functional impairments of the mind and brain. This paper aims to evaluate the impact of MCA training within older persons' care homes within an East-Midlands local authority. Design/methodology/approach – Semi structured interviews were conducted with key informants who had strategic responsibility for implementation of MCA training as well as a focus group conducted with managers/deputy managers of care homes within the local authority. Findings – With a primary focus on training, data revealed issues surrounding the delivery and content of training, and the organisational factors relating to both training and the subsequent implementation of the knowledge learned. Research limitations/implications – The key informants for this paper are limited to management perspectives. Interviews and a focus group were conducted with stakeholders who either had direct responsibility for service delivery or managerial oversight for training and development. Practical implications – The paper suggests methods of delivery with the Mental Capacity Act which offer a tailored, engaging and cost effective alternative to conventional "away day" training sessions. Originality/value – The paper challenges and critiques conventional approaches to training the social care workforce. [ABSTRACT FROM AUTHOR]

Purpose -- This paper seeks to consider the Deprivation of Liberty Safeguards (DoLS) and, in particular, the extent to which the functions of supervisory bodies can, or should be, performed as part of wider "safeguarding" responsibilities. Design/methodology/approach -- The paper reports the views of practitioners, given in response to comments made by the Care Quality Commission. Findings -- Some practitioners believe that DoLS and safeguarding functions should be consolidated, and some, that they should remain discrete; most, however, accept that the two functions should work closely together, and also that an understanding of the Mental Capacity Act is important for each; there is a suspicion that DoLS-activity is greatest where the two functions are kept discrete (and, it is assumed, DoLS practitioners therefore have more to prove); there is also concern about financing, particularly within discrete DoLS services, and, furthermore, some suspicion about the whole business of "safeguarding"; the Neary case continues to cast a long shadow. Originality/value -- This is believed to be the first time practitioners' views have been sought or at least published on this question. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to summarise the findings of a desk-based international review investigating the checking of staff and volunteers working with adults who are vulnerable or at risk (or similarly defined) receiving social care in their own homes, or in day centres or residential care. Design/methodology/approach – In England, as part of the government’s attempts to prevent harm to vulnerable people, employers must check if their staff or volunteers are barred from working with vulnerable adults in the health and care sectors or if they have a relevant criminal record. This review sought to explore practices elsewhere, with a view to informing policy and practice debates. The review was undertaken in winter 2014-2015. It mainly involved a search of internet-based material and databases. This was further informed by communications with experts and practitioners from different countries. Findings – The review found a variety of practices, ranging from no checks to substantial checks involving fingerprinting. Reasons for checks identified in different national contexts extend from efforts to stop fraudulent use of government subsidies to minimising the risk of harm to vulnerable adults, and more positively to enhance user and public trust in care providers. A small number of countries place particular emphasis on the rights of individuals to privacy and rehabilitation and this moral imperative overrides other policy goals. This review highlighted a lack of clarity in publicly available documents about the potentially multiple policy goals of different schemes and suggests that there may be advantages to clarifying the options available from other countries. Research limitations/implications – This review was confined to English language material and to material located through internet searching. Some material may not have been updated on internet sites. Originality/value – The details of the processes have not previously been collated to the best of the authors’ knowledge. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to increase understanding of elder abuse in Ethiopia by considering the perspectives of abused elders. Design/methodology/approach - A phenomenological study was conducted to investigate the lived experience of 15 elders (six men, nine women) in Ethiopia who experienced domestic abuse. Data were collected using unstructured interviews and were analyzed using interpretive phenomenological analysis. The results described here focus on Ethiopian elders' perceptions of factors contributing to abuse. Findings - Themes identified in elders' statements about the factors contributing to elder abuse included: declining respect for elders, conflicts of interest, poor health, mutual dependency and other economic issues, and loss of support providers. Abject poverty was evident as an underlying influence contributing to abuse. One elder stated, “Life is meaningless without food and without a caregiver. I am ready to welcome death.” Research limitations/implications - Documentation of elder abuse is needed to bring recognition to abuse as a problem deserving public attention and response. Practical implications - Given the apparent influence of poverty-related factors on the occurrence of elder abuse among the study's participants, policy initiatives are needed to enhance the economic well-being of older adults in Ethiopia. Originality/value - Since elder abuse is generally not viewed as a societal problem in Ethiopia, there have been very few studies documenting its existence. Research on elder abuse in Ethiopia and other developing nations can help to bring the issue to the attention of communities and authorities. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explain a decision of the Court of Appeal about the duty an Approved Mental Health Professional (AMHP) will sometimes have to consult a patient's nearest relative, and to set that decision in the context of an earlier one. Design/methodology/approach -- Each decision is examined in detail and one is compared with the other . Reference is made to the Mental Health Act 1983 Code of Practice. Findings -- It will be harder for an AMHP to establish that consultation is not reasonably practicable, and it will be correspondingly easier, in some cases, for a nearest relative to obtain information about a patient or achieve proximity to her . Originality/value -- This is thought to be the first time the two cases have been considered together or in their true context. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to look at safeguarding documentation in relation to 50 adult safeguarding files for the period April 2010 to March 2011. This was followed up with semi-structured interviews with a small number of Designated Officers whose role it is to screen referrals and coordinate investigations. Findings from the research were used to redesign regional adult safeguarding documentation to ensure Designated Officers have access to the information necessary to assist them in reaching decisions. Designated and Investigating Officer training was also updated to reflect learning from the research thereby reducing the potential for variation in practice. Design/methodology/approach -- A file tool was developed which examined the recorded information in safeguarding documentation contained within 50 service user files. The review tool looked at the personal characteristics of the vulnerable adult, the nature of the alleged abuse and the decisions/outcomes reached by staff acting as safeguarding Designated Officers. A semi-structured interview schedule asked Designated Offices to comment on the training and understanding of the process as well as the factors they believed were central to the decision making process. Their responses were compared to data obtained from the file review. Findings -- A key finding in the research was that while factors such as type of abuse, the vulnerable adults' consent to cooperate with proceedings, identity of the referrer, etc. did influence decisions taken there was a lack of clarity on the part of Designated Officers in relation to their roles and responsibilities and of the process to be followed. Research limitations/implications -- The research was limited to one Health & Social Care Trust area and had a small sample size (n=50). Practical implications -- The findings of the research led to a revamping of existing safeguarding documentation which had failed to keep pace with developments and was no longer fit for purpose. Adult safeguarding training courses within the Trust were redesigned to bring greater focus to the role and responsibilities of designated and Investigating Officers and the stages in the safeguarding process. Adult Safeguarding leads were established within programmes of care and professional support mechanisms put in place for staff engaged in this area of work. Social implications -- Better trained and supported staff alongside more efficient safeguarding systems should lead to better outcomes in the protection of vulnerable people from abuse and harm. Originality/value -- The research built on existing albeit limited research into what potentially influences staff involved in critical decision-making processes within adult safeguarding. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explore US Chinese older adults' views regarding elder abuse interventions in order to understand barriers and facilitators of help-seeking behaviors. Design/methodology/approach -- The study design was qualitative, using a grounded theory approach to data collection and analysis. Community-based participatory research approach was implemented to partner with the Chicago Chinese community. A total of 37 community-dwelling Chinese older adults (age 60+) participated in focus group discussions. Findings -- Participants viewed many benefits of intervention programs. Perceived barriers were categorized under cultural, social, and structural barriers. Facilitators to implement interventions included increasing education and public health awareness, integrating social support with existing community social services, as well as setting an interdisciplinary team. Perpetrators intervention strategies were also discussed. Originality/value -- This study has wide policy and practice implications for designing and deploying interventions with respect to elder abuse outcome. Modifying the cultural, social, and structural barriers that affect health behavior of Chinese older adults contribute to the salience of elder abuse interventions in this under-served. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to inform readers about the Law Commission's review of hate crime offences and provide information on key stages. At the time of writing the review is at consultation stage and people are being invited to participate in this process. Design/methodology/approach – The paper is structured in a question and answer format and provides an overview of existing hate crime offences and the stages of the Law Commission's review. Findings – The consultation will consider the effect of the Law Commission's review of hate crime law on people with disabilities. Originality/value – The author is a member of the Law Commission's criminal law team and answers questions on what's involved in the consultation process. The Law Commission wants to make sure that people who could be affected by any changes to the law on hate crime have their say. [ABSTRACT FROM AUTHOR]

Purpose -- This article aims to outline simple measures which, by making better use of existing legislation and provision, could change the day-to-day experience of individuals with learning disabilities currently in long stay hospitals, whilst phased local provision is being sourced for them. The proposals will also promote the safety and dignity of the minority of patients who ultimately cannot be settled successfully within their own community Further, these measures may help ensure that any individual undergoing assessment and treatment at such a unit, for whatever period, and for whatever reason, will receive care in an environment where abuse cannot go unnoticed or unchecked. Design/methodology/approach -- The paper provides a review of the potential to use current legislation and provision to better effect, highlighted by case studies. Findings - Commissioners contracting with providers could include measures to promote the safety and protection of adults with learning disabilities from abuse at little or no cost to the commissioning authority. Originality/value -- This is an original piece of work - developed from a short opinion/comment piece (750 words) originally prepared for the benefit of mental health lawyers in the Law Society Gazette. It is primarily of value, however, to social workers, care providers, adult safeguarding teams, advocacy services and commissioners of services. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to present findings from a review of hospital policies and practices in one NHS Trust in England. Design/methodology/approach – The focus of the review was hospital staff policy and practice in safeguarding the rights of vulnerable patients. A sample of staff was surveyed to investigate their knowledge of the Mental Capacity Act 2005 in 2010. Interviews, incorporating discussion of a vignette, were undertaken with a range of staff and findings were analysed thematically. These findings are contextualised by an analysis of Trust policies and the wider literature. The findings of this case study are used to develop recommendations for the hospital and healthcare sectors. Findings – Analysis of survey data and interviews revealed limited confidence and knowledge about the Mental Capacity Act 2005 and uncertainties about its relevance to clinical practice. In relation to safeguarding, there was limited realisation of the potential of the Act to uphold the rights of patients lacking capacity and staff responsibilities. MCA training had not made a great impression; hospital policies were inconsistent and lacked coherence. Research limitations/implications – This case study was conducted in one Trust and may not be generalisable. Other hospitals may have different training, policy and procedure systems. Practical implications – The findings of this case study may be applicable to other hospitals and to other providers of health and social care services. The relevance of the MCA could be highlighted and used on several induction and training programmes. The study identifies features of policy and practice that could be investigated in other organisations. Originality/value – Few studies have investigated the operationalisation of the MCA in hospital settings. This study reveals that there are opportunities to refresh MCA and safeguarding training strategies for hospital staff but these should be accompanied by changes to culture and attention to the coherence of different procedures. Audits of MCA and safeguarding compliance can be undertaken within hospitals and a systems approach could be adopted to address any issues identified and to sustain good practice. [ABSTRACT FROM AUTHOR]

This paper highlights the case of David Cooper, a vulnerable adult who was financially abused. It discusses the indicators that may have alerted individuals and services to the risk of financial abuse, and the measures taken by those aware of David's potential vulnerability. [ABSTRACT FROM AUTHOR]

The draft Mental Health Bill 2004 proposes transfer of the main monitoring functions of the Mental Health Act Commission (MHAC) to the Healthcare Commission (or in practice whatever body succeeds the Healthcare Commission) with the abolition of the MHAC on implementation of the Bill when enacted. This paper describes the present role and remit of the Mental Health Act Commission, outlines the government's strategy on inspection and regulation and identifies the importance of protecting the rights of vulnerable adults and children with mental disorders. The reasons for retaining independent scrutiny and inspection of mental health services are explored and structures and mechanisms that might assist in achieving an effective regulatory environment are proposed. [ABSTRACT FROM AUTHOR]

Tackling the problem of aggression and violence in health care is high on the agenda for healthcare professionals. In an endeavour to protect both patients and staff alike when managing aggressive behaviour, the use of physical restraint is under scrutiny, particularly as a result of the reported deaths of a number of patients whilst being restrained. The challenges of employing this type of intervention, implications for safe and effective practices and the need for the suitable training of staff are explored in this paper. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to summarise the Making Safeguarding Personal (MSP) programme in 2014/2015. Design/methodology/approach – Review of Council contacts in relation to MSP 2014/2015. Findings – Councils participated at varying levels in the MSP programme during 2014/2015. Research limitations/implications – An independent evaluation of the 2014/2015 Making Safeguarding work has been commissioned and will be published later in 2015. Practical implications – MSP requires cultural, practice, workforce and technical changes. A range of challenges have been identified in taking forward the changes, which Councils are responding to in different ways. Social implications – A person-centred outcome-focused approach to safeguarding adults can benefit people who are at risk of or experience harm or abuse. Originality/value – MSP is a LGA-commissioned programme. [ABSTRACT FROM AUTHOR]