Regulated activities are the activities that the DBS can bar people from doing. It is a criminal offence for a barred person to seek to work, or work in, activities from which they are barred. It is also a criminal offence for employers or voluntary organisations to knowingly employ a barred person in regulated activity.
The CQC provides guidance on which activities are considered regulated.
This is their quick reference guide, showing how regulated activities and service types are likely to link to each other. It is important to review the regulated activities
regulations, decide which regulated activities your service carries out, and then apply to register for those activities. If you carry on a regulated activity without being registered for it, you may be prosecuted and liable to a fine.
The Department of Health has also published information on the scope of regulated activity in relation to adults.
The debate about the care of vulnerable adults, in particular the elderly, is intensifying. A year-long inquiry by The Equality and Human Rights Commission into standards of care for the elderly at home has uncovered “appalling” evidence of pensioners being deprived of food and drink, handled roughly, humiliated and even robbed. Many incidents amounted to “abuses of human rights”, which left elderly people feeling profoundly depressed, in tears and even expressing “a desire to die”, the report said. Many care workers often spend just 15 minutes with an elderly person, ticking off pre-arranged “tasks” in an approach that displayed “chronic disregard” for their dignity.
In one case, an elderly blind man said two council carers were talking to each other over his head, leaving him feeling like “a lump of meat”. In another, a 76-year-old woman with advanced cancer was told her care worker could not prepare her a microwave meal because of “health and safety” rules. Baroness Greengross, the commissioner responsible for the report, told The Daily Telegraph that 250,000 vulnerable pensioners in England were receiving “poor or very poor” standards of care at home…but the true figure may be far higher because many are “too frightened to complain”, she said. Continue reading Equality and Human Rights Commission join debate about elderly care
A CQC report on 100 hospital inspections found that too many hospitals in England are falling short in the most basic care they are giving elderly patients. It carried out unannounced visits at 100 hospitals to assess dignity and nutrition standards, and identified concerns in 55 cases, describing the findings as “alarming”. Common areas of concern included a lack of support for those who needed help eating, poor hygiene and curtains not being closed properly.
Health Secretary Andrew Lansley said he would encourage whistle-blowers to highlight any concerns they had about the standard of hospital care for the elderly. He said: “We expect that staff across the NHS, if they see examples of poor care they blow the whistle on that, which is precisely why we have introduced changes to the staff contract.”
The inspections were ordered by Mr Lansley after several highly critical reports by campaigners, including the Patients Association.
In two cases – Sandwell General in West Bromwich and Alexandra Hospital in Worcestershire – the problems were judged to represent a major problem to patients. In the case of Sandwell, this led to the closure of the ward where there were the most problems, while a follow-up visit to the Alexandra showed measures had been put in place to rectify the issues. At another – James Paget in Great Yarmouth – moderate problems were identified, but when a return visit was made and the issues had not been resolved the hospital was issued with a warning notice, meaning if swift improvements are not made it could face sanctions including prosecution or closure of services. Continue reading the BBC story
Examples of poor care
- “The patient constantly called out for help and rattled the bedrail as staff passed by… 25 minutes passed before this patient received attention.”
- “We saw a staff member taking a female patient to the toilet. The patient’s clothing was above their knees and exposed their underwear.”
- “Nobody was routinely offered hand-washing before or after their meals and hand gel was not within easy reach.”
- “Two members of staff who were assisting people with their meals at the time were having a conversation between themselves.”
- “The person did not have any assistance and the food was left on their table for over half an hour before they were assisted to eat.”
- During the inspections, the regulator identified a series of common problems: These included call bells being placed out of the reach of patients, staff speaking in a condescending or dismissive way and curtains not being closed properly.
- In terms of nutrition, some people who were judged to need help eating were not getting it, while interruptions meant that not all meals were being finished by patients.
- The regulator also said that in too many cases patients were not able to clean their hands before meals.
Response to Report
CQC chair Dame Jo Williams said: “The fact that over half of hospitals were falling short to some degree in the basic care they provided to elderly people is truly alarming and deeply disappointing. This report must result in action.”
Michelle Mitchell, charity director of Age UK, agreed. “This shows shocking complacency on the part of those hospitals towards an essential part of good healthcare and there are no excuses.”
Janet Davies, of the Royal College of Nursing, accepted there could be “no excuse”, but added the squeeze in finances was making it harder to keep standards high on wards. “Evidence shows that patient safety and quality of care is improved when you have the right numbers and the right skills in place on wards,” she added.
A ‘Deaths in custody’ corporate manslaughter crime has been created so that Police and other authorities can now be prosecuted over deaths in custody in England, Scotland and Wales.
BBC News highlights that the new legislation of The Corporate Manslaughter and Homicide Act, which has now come into effect means police forces, the MoD, UK Border Agency and private firms managing people held in custody can be prosecuted for corporate manslaughter. Corporations can already be prosecuted for corporate manslaughter or for the equivalent offence (corporate homicide) in Scotland. The extension of these offences to public bodies involved in detention means they could be prosecuted if they failed to ensure the safety of someone in their care. Examples could include deaths during an immigration removal or when someone has been restrained using an unauthorised or badly taught body hold.
The law does not cover incidents abroad, such as where someone dies in the custody of British forces. However, British nationals can be convicted of causing a death through gross negligence, even if the fatality occurred overseas. The provisions are not retrospective, meaning the law could not apply to cases such as Jimmy Mubenga, an Angolan man who died during his deportation in October 2010.
Under the Safeguarding Vulnerable Groups Act of 2006, priosoners were included as ‘vulnerable adults’. However the Protection of Freedoms Bill will remove this status when it becomes law.
Continue reading ‘Death in Custody’ crime created
There will be a review of vulnerable adult protection in Northern Ireland.
Edwin Poots,The Northern Ireland Health Minister is looking into creating new policy to ensure the protection of vulnerable adults in care. His announcement of a review of the system came after the number of people alleging abuse against vulnerable adults was revealed to be 1,184 referrals to health trusts in 2009-2010, the last year for which there is accurate data. Of these 1,184 referrals almost two-thirds, 750, were considered serious enough for a protection plan to be put in place.
Responsibility for child protection falls to the department of health and the five health and social care trusts who are individually responsible for providing residential care services to children and young people within their areas.
There were also 1,271 child protection referrals for the quarter ending 31 March 2011, which was almost 20% higher compared with both the previous quarter and the same quarter in 2010. Continue reading Review of vulnerable adult protection in NI
A FORMER Cwmbran senior support worker has been jailed after admitting stealing £5,670 from vulnerable adults in her care. Karen Moore, 40, of Brendon Hill, Somerset, appeared in Newport Crown Court after pleading guilty to three theft charges relating to her time working at CPI Care’s supported accomodation on Roll’s Close, Cwmbran.
Moore was a senior support worker at the facility between 2005 and 2008, where she helped four adults with learning difficulties, controlling their financial affairs, taking money out of their accounts and paying outgoings.
It was after Moore had left the position and moved to Somerset that the deception came to light in June 2010 and she was arrested and interviewed by police in Minehead. Prosecutor Hywel Hughes said CPI Care found unexplained cash deposits made by Moore, with the overall loss greater than £5,670, but this is the amount that was provable.
In interview, Moore told officers she struggles with figures and made up sheets to make cash tally, while Mr Hughes said she made withdrawals to pay off her own debts.
Judge David Morris called it a “tragedy” that someone of Moore’s intelligence and background was in front of him for him for such offences. He said she had breached a position of trust repeatedly and gave her concurrent terms of 14 months for each offence. DC Sarah Garland of Gwent Police’s protection of vulnerable adults team said: “She had a position of trust helping people live independent lives. She abused this position, so a custodial sentence is fair.
The British Medical Association (BMA) has issued new guidance for doctors regarding the treatment of vulnerable patients, stating that healthcare professionals have a duty to flag up any suggestion of abuse. It also explains the procedures if they suspect that physical and mental abuse of vulnerable adults by NHS staff or carers is being covered up.
The Guidance was commissioned by the Department of Health, and highlights the legislation in place to protect people if they choose to speak out about possible neglect. Dr Tony Calland, chairman of the BMA’s Medical Ethics Committee, noted that the guidance is there to support doctors and understand which adults have the capacity to protect their own interests. “The way doctors deal with these possible situations demonstrates how complex caring for vulnerable adults can be. There is no ‘one size fits all’ solution,” he added.
GPs should be alert to identifying abusers, spotting systemic healthcare failures and recognising signs of neglect, ranging from physical and mental abuse to financial exploitation. Whistle-blowing may involve providing information to the media or MPs. and the individual is protected as long as it is reasonable, not made for gain and meets the following conditions:
- Whistle-blowers reasonably believe they would be victimised if they raised the matter internally or with a prescribed regulator
- They believe a cover-up is likely and there is no prescribed regulator
- They have already raised the matter internally or with a prescribed regulator.’
A poll of 290 GPs, carried out by Pulse in July 2011, found that 41% believe one or more of their patients has been subjected to abuse.
The scandal of vulnerable adults being abused at Winterbourne House highlights safeguarding gaps following the Panorama expose. The National Autistic Society (NAS) has submitted a 10,000 strong petition to Parliament asking for urgent action to address the failings in the current system of inspection of adult care services. John Pugh, MP for Stockport and Co. Chair of the Liberal Democrat Committee on Health and Social Care, presented the petition calling upon the Government to review the inspection process for vulnerable adults living in residential care. It asks for the following points to be addressed:
- All organisations must create working cultures where abuse is unacceptable and clear polices and procedures are in place to report abuse and wrongdoing.
- It is vital that individuals working in adult social care have the right attitude to work with vulnerable adults and that they are trained in safeguarding and managing challenging behaviour
- Robust and rigorous recruitment procedures are essential.
- Specific on-the-job training should be regularly assessed and refreshed.
- Staff must have relevant and specific knowledge of the disabilities they are dealing with to help support individuals appropriately.
Commenting, Carol Povey, Director of NAS Centre for Autism, said: “It is completely unacceptable that any form of abuse by support staff takes place in any care service. It is deeply distressing that these vulnerable adults have been treated so diabolically and the strength of support for urgent action is palpable. In less than two weeks the NAS received over 10,000 signatures to the petition.
The new Police National Database ((PND) will be launched nationally on 23 June 2011. The information held on the PND is not new information but comes from existing force systems that support force intelligence, crime, domestic abuse, child abuse and custody business areas. The PND now offers forces direct access to that information, and details of intelligence about vehicles, locations and events.
A case study demonstrating the benefits for police users working in child protection is available here.
Only Enhanced Disclosures will contain reference to any ‘relevant and proportional information’ held by local police forces, so employers will need to utilise safer recruitment and other HR policies to ensure that people working on the periphery of Regulated Activity are appropriate to do so. Continue reading Launch of Police National Database
31 May – BBC Panorama’s Undercover Care: The Abuse Exposed The BBC filmed abuse of patients with learning difficulties at Winterbourne View residential hospital in Bristol. During five weeks spent filming undercover, BBC Panorama’s reporter captured footage of some of the hospital’s most vulnerable patients being repeatedly pinned down, slapped, dragged into showers while fully clothed, taunted and teased.
The case has been condemned as “shocking” by the government and Care Services Minister Paul Burstow said he was determined to strengthen safeguards for vulnerable adults. He has already ordered a thorough examination of the roles of the government regulator, the Care Quality Commission (CQC), and the local authorities. CQC chairman Dame Jo Williams admitted that the failure to follow up the reports of a whistleblower – a senior nurse at the home – had been an “unforgivable error of judgement”. Avon and Somerset police confirmed three men – aged 42, 30 and 25 – and a 24-year-old woman were arrested as part of their investigation into the hospital. The hospital’s owners, Castlebeck, have apologised and suspended 13 employees. It has launched an internal investigation into its whistle-blower procedures and is reviewing the records of all 580 patients in 56 facilities. Winterbourne View can accommodate 24 patients and is taxpayer-funded, charging the state an average of £3,500 per patient per week.
The programme was broadcast on BBC One on Tuesday 31 May at 2100 BST and is available to view in the UK on the BBC iPlayer.
A Bill to promote awareness of abuse of elderly people entitled ‘Support and Protection for Elderly People and Adults at Risk of Abuse Bill 2010-11’ has been introduced under the Ten Minute Rule motion by Nigel Dodd MP.
It is expected to scheduled to have its Second Reading debate on 21 October 2011. It’s objectives are:
- to promote awareness of abuse of elderly people and adults at risk,
- to promote training on how to recognise and respond to such abuse amongst those who are likely to encounter abuse in the course of their work,
- to promote greater awareness and understanding of the rights of victims of abuse amongst agencies with responsibilities for providing, arranging, commissioning, monitoring and inspecting care services,
- to promote the development of local strategies for preventing abuse of elderly people and adults at risk and for ensuring that victims are assisted in recovering from the effects of abuse’
The Protection of Freedoms Bill is the first time that a new element called a “Public Reading Stage” will be introduced. It means that members of the public can comment directly on clauses of the Bill. These comments should contribute to the points made by MPs across all parties during the debates and committee stages – so it is an important opportunity.
The website can be found here – http://publicreadingstage.cabinetoffice.gov.uk – do add your perspectives with practical examples from your sector as this a very complex area which has been subject to sweeping misrepresentation in the media. Since only very low level stakeholder engagement is likely this is the best opportunity to amend some aspects of the legislation such as the availability of disclosures, scope of regulated activity and the level of guidance available.
Also register with us so that you receive our briefing papers on each of these topics and more.
The Children’s Rights Alliance for England (Crae) has applied for a judicial review of the refusal by the justice secretary, Ken Clarke, to identify and contact children who may have been unlawfully restrained in privately run secure training centres.
Under the Safeguarding Vulnerable Groups Act, all prison and probation officers would have been checked and monitored for their ongoing suitablity for the role as prisoners and people on probation would have been considered as being ‘vulnerable adults’. It remains to be clarified whether this promised level of protection will be compromised under the halving of the numbers defined as doing ‘regulated activity’ under the Protection of Freedoms Bill. Continue reading Judicial review of unlawful child restraint
The NHS is failing to treat elderly patients in England with care, dignity and respect, an official report says. Of nearly 9,000 complaints made to the Health Ombudsman last year, 18% were about the care of older people. In total, it accepted 226 cases for investigation – twice as many as for all the other age groups combined. Continue reading NHS fails elderly vulnerable adults
Volunteering England, Fair play for Children, NACRO, NSPCC and Barnados are among those who have commented about the impact of the new disclosure and vetting laws on volunteering. Continue reading Mixed response from voluntary sector
About 500 people a month are being referred to Leicestershire police’s newly formed specialist adult referral unit. It was created to ensure vulnerable adults do not slip through the net following criticism after the death of Fiona Pilkington and her daughter in October 2007. Ms Pilkington killed herself and her daughter Francecca after years of torment from yobs. Continue reading 500 referrals to Pilkington unit each month