Response to Consultation: Protecting Vulnerable Adults – Securing their Safety

Alzheimer Scotland is a national charity representing the interests of Scotland’s estimated 63,000 people with dementia, and their carers. We aim to be the voice of and for people with dementia and their carers, to influence the improvement of public policies and to promote and provide high quality services for people with dementia and their carers.

We were happy to respond to the previous consultations and continue to be of the opinion that a specific Vulnerable Adults Bill for Scotland is required to fill gaps in the current legislative framework. We recognise the considerable advances in protection that have been made through the 2000 and 2003 Acts, and the measures intended to ensure that staff working with vulnerable adults have been properly vetted.

As a member of the Vulnerable Adults Alliance Scotland (VAAS) we join with other organisations in pressing for a firm statutory base for the protection of vulnerable adults, combined with robust local multi-agency procedures for detecting and investigating abuse and for ensuring that effective protective action is taken. Although there have been some years of exhortation, and some areas of the country have taken some steps to have proper protective procedures in place, we believe that there are still too many gaps in procedures, under-detection of abuse, and uncertainties among practitioners and the public about what effective action can be taken, leaving some of our most vulnerable citizens at considerable risk.

We therefore welcome this further consultation, and hope that this will lead rapidly to new and effective legislation.

Responses to consultation questions

Question 1: Do you agree with the revised definition of a vulnerable adult?No. We are concerned about the use of the words “significant harm” and “unable”.

Question 2: If you do not agree with the revised definition of a vulnerable adult, what changes do you think require to be made of it?

• Instead of unable, diminished / impaired ability would be better.
• The second criterion should read “disability of any kind, physical illness or mental illness”, as it reads as if restricted to mental ability.
• It needs to be clarified if these are tests that all have to be met.
• We question the use of age in criterion 2.
• The third criterion could read “impaired ability to care for themselves” or “have impaired ability to prevent self-neglect”.

Question 3: Do you agree with the definition of abuse?
No.

Question 4: If you do not agree with the definition of abuse, what changes do you think require to be made?
We are unhappy with the relationship being restrictive. It would be better to state “any relationship, formal or informal”. We are not comfortable with the expression “an expectation of trust”. The definition as it stands suggests awareness, yet some people being abused will not know they are being abused. The definition should be extended beyond “distress” as it is subjective and abuse may not be recognised by the adult as distressing. The effects of abuse may be “neglect, injury, distress or loss”. Some examples in a Code of Practice would be useful. The misuse of power should be emphasised.

Question 5: Do you agree that Adults Protection Committees should lead the investigation of abuse, including investigation of abuse in care settings?
Overall, we have no difficulty with the concept of the Adults Protection Committees; however, is there a statutory organisation in place at the moment that could perform this role? The group would have to be established with the clear purpose of protecting the adult. There should also be an arrangement for how the APC would work with other agencies with clear lines of communication. Some mention of advocacy should be made in the legislation. We have a concern about the expectation that the APC would lead investigations into regulated services – this or any delegation needs to be made clear. The Care Commission should be represented on the APC.

Question 6: If you do not agree what objections do you have and what alternatives do you consider possible or desirable?
No comment.

Question 7: Should the structure and powers of Adult Protection Committees be defined in statute or a statutory instrument or not?
Yes.

Question 8: When abuse of a vulnerable adult is proved, what risk assessment and management should take place?
Risk assessment should take place as soon as abuse is suspected as opposed to proved. The assessment and management should be the type needed according to circumstance. There could be one generic tool to identify risk. The job of the APC should be to oversee risk management strategies taking places and to be aware of how many case conferences there are. Risk assessment should take place as early as possible and care management should be used for risk reduction.

Question 9: Do you agree that mediation should be offered to all those who are subject to abuse? If you don’t agree, please state your key reservations.
The terms of this must be clarified. There may be occasions where this inappropriate; thus, it should be based on individual circumstances. In addition, the person would have to possess the mental capacity to engage with the mediation service and the parties would have to be on an equal footing.

Question 10: If mediation were to be offered, how could this be done?
We are unsure what is meant by mediation. Mediation in its strictest sense would be problematic due to the power balance. This needs to be clarified before we answer this question.

Questions 11 – 14
No comment on matters relating to learning disability.