My Lords, I shall speak to several amendments in this group. I strongly welcome the clauses in the Care Bill that relate to adult safeguarding. It is right that the abuse of vulnerable adults should be placed on a statutory footing, alongside domestic abuse and child abuse. However, these clauses primarily address a minimum safeguarding infrastructure, and in the main seek to meet the requirements of professionals. My proposed amendments focus on the needs of victims.
The prevalence study into elder abuse, funded in part by the Department of Health and published in 2007, indicated that at least 500,000 older people experience abuse at home; abuse that is, sadly, often perpetrated by family members and others whom the victim should be able to trust. Research by the charity Action on Elder Abuse—I declare an interest as one of its founders—indicates that fewer than 10% of the victims come to the attention of adult safeguarding systems. We clearly must do better than that. However, we must also recognise that there are more victims than just the older person. No matter what the circumstances, when someone's mother or father or sister or brother is abused or neglected, it is not unusual for relatives to blame themselves—to feel that somehow they should have known or should have done something. Even when they could not have done so, there are many more victims of elder abuse than just the older person. We know that many victims of
elder abuse are elderly people who are attacked by their son or daughter, perhaps because of a long history of domestic violence. However, they are very reluctant to call the attention of the police or anyone to those crimes because they see themselves as having failed as parents.
The amendments go to the heart of what is most cruel about elder abuse. Too many older people are locked away in back rooms, imprisoned by those who choose to exploit them, and unable to seek assistance. Theirs is a silent scream that we must hear, and to which we must respond. We cannot allow abusers the right to deny access to their victims. We must ensure that we do everything possible to find and support the 90% of older victims who currently are unsupported, and we must encourage agencies to work together, as the noble Baroness, Lady Hollins, has said, to report their concerns about possible victims. We must also ensure that those who ill treat or neglect vulnerable people are held to account, because victims and their families deserve to know that elder abuse will not be tolerated and that abusers will be held to account.
Amendment 92ZFC deals with the need for a power of access for confidential interview, to occur only when the reasonable suspicion of a social worker or other practitioner is tested by application to a court, which would consider whether or not to authorise such access. As we have heard, such access is available under the Scottish Act and is proposed in the Welsh Bill through application to a justice of the peace.
Amendment 92ZFD relates to safeguarding adults at risk of abuse and neglect and introduces a duty to report adults at risk of abuse. There is currently no duty on agencies to notify a local authority if they believe an adult may be at risk of abuse. A local authority cannot be expected to identify all abuse by itself. It has to rely on the good will of others to make referrals. There is a need to underline the responsibility of all agencies to report if they have a reasonable belief that an adult is at risk.
As we have heard, the Welsh Bill proposes:
“If a relevant partner of a local authority has reasonable cause to suspect that a person is an adult at risk and appears to be within the authority’s area, it must inform the local authority of that fact”.
A relevant partner is proposed to be the police, another local authority, the probation service, a local health board, an NHS trust, Ministers, or anyone else that regulations may specify.
Amendment 92ZFE is proposed because there is currently no specific offence to protect adults with capacity who are the subject of neglect or abuse but who are not covered by the Mental Health Act or the Mental Capacity Act. The view is that, in such circumstances, they can be covered by the inherent jurisdiction of the courts only, which is time-consuming, costly and not widely used in such circumstances. The Law Commission report noted the gap in the law relating to protecting adults at risk who were being ill treated or neglected but who were not subject to the powers of the Mental Health Act or the Mental Capacity Act. Police officers had suggested that prosecutions were being dropped in practice because doctors could not confirm, or had not documented, that a person lacked capacity.
Additionally, the extent of abuse and neglect uncovered in hospitals and care homes has caused anxiety and outrage throughout the UK. Current systems and law have been insufficient to deter abuse, and too often the few perpetrators who reach the courts have sentences that the public consider far too lenient.
Amendments 92ZFF and 92ZJ are about safeguarding adults at risk of abuse and neglect. I welcome the proposals in the Bill to put safeguarding adults boards on a statutory footing. However, along with the College of Social Work, I believe that the Bill should ensure that social workers are appointed to supervise safeguarding inquiries because they alone have the theoretical, legal and policy knowledge to undertake complex, politically charged and sensitive pieces of safeguarding investigative work that may require co-operation and co-ordination with other professionals and organisations.
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The Bill should also stipulate that the local authority representative on safeguarding adults boards must be a social worker or have a social work qualification. This would ensure practice-based and evidence-led influence on boards by practitioners involved in active work with clients. Safeguarding adults review teams should also include a social worker with substantial experience of safeguarding work. Where there is not someone of sufficient seniority and experience, representation on SABs and review teams should be a role for the principal social workers now being appointed in many local authority adult social services departments.
Amendment 92ZK is about the statutory duty of candour. I very much welcome its introduction in the health service but we feel that it should be extended to local authorities, apply to any contract that a local authority awards to a community-based service and should extend to instances of abuse or neglect. I have a concern that social workers who whistleblow on bad practice within their organisations are not always properly protected. The Public Interest Disclosure Act 1998 sets out the minimal requirements on employers and offers protection to staff making a protected disclosure. However, even these minimal requirements on employers are often poorly enforced, thereby making it hard to expose malpractice and putting people at risk of harm.
I would like the Bill to extend the PIDA requirements on employers by introducing a duty of candour for employers in health and social care, in keeping with the Francis report’s recommendations. The provisions should ensure the existence of a clear presumption of disclosure where the behaviour of employees gives rise to concerns. All staff must have a professional duty to whistleblow if they identify practice that they believe puts people they are supporting at risk of harm. Organisations must have clear whistleblowing procedures in place for when practice that puts people at risk of harm has been identified. These should stipulate that if a social worker or another care worker identifies abuse, mistreatment or neglect in any care setting, or has questions about treatment affecting anyone, whether they are supporting them directly or encounter them in the course of their work, they have a duty to draw this to the attention of managers, commissioners and
managers of any provider organisation, and follow up to see if their concern has been acted upon. This would amount to a duty of candour.