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.
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.
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.
South Lanarkshire Council has joinedwith 13 other councils to produce a TV campaign that they hope will offer hope to thousands of Scottish adults who suffer verbal, physical, sexual and financial abuse every day. It follows research carried out by Mencap, the charity for people with learning disabilities and their families, which found that 90per cent of people with learning disabilities reported being bullied in the last year.
Charity Action on Elder Abuse, recently revealed that property and cash worth nearly £8million, including 31 homes, had been stolen from UK pensioners in just one 12 month period. The figures were generated from 471 calls to the charity’s helpline. Continue reading TV campaign about vulnerable adult abuse
Details of the new Criminal Records regime will be announced today as part of the all encompassing Protection of Freedoms Bill. Points that are likely to emerge when it is published are:
- The need for checks to be drastically reduced to ‘common sense’ levels -now it will only apply to those who have the most close and regular contact with children or vulnerable adults, such as professional childcare workers or teachers. The total number who will need to undergo background checks will halve to around 4.5million, although who this includes does not appear to have been defined judging from the interview given by Nick Clegg his morning on BBC.
- Continual updating and portability will be enabled so that teachers and care home workers who do require checks will have their records constantly updated. This is seen as a key benefit and was already planned in by CRB.
- The content of CRBs will be reviewed – for instance the changes will also drastically cut the use of ‘soft intelligence’ when examining a person’s history. Unproven allegations will only be placed on a person’s record if a Chief Constable believes they are true.
Checks that are unnecessary and which breach an employee’s privacy could be referred to the data protection watchdog, the Information Commissioner, and any employer found knowingly to have requested an unlawful check could face fines running to thousands of pounds. This will prevent the over zealous use of CRBs such as the school in Warrington that would not be allowed into the premises to see their children.
- the Independent Safeguarding Authority will be merged with the Criminal Records Bureau. Continue reading Reduced CRB regime announced
The London Safeguarding Children Board has launched a new set of guidance and tools to help social workers, teachers, police, health workers and other agencies identify and support children who have been trafficked. These children can be subjected to sexual exploitation, enforced labour or drug dealing, sold or forced to commit crime by the organised gangs or individuals who have brought them into the country or trafficked them between cities within the UK. Continue reading New guidance to tackle child trafficking
On BBC News, Mark Williams-Thomas a ex-policeman and specialist in child safeguarding gave the following interview:
Click to play
See also our page tracking stakeholder comments
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
An article in the Telegraph pre-empts the announcement about the results of the criminal records regime review by Sunita Mason and the parallel one into the Vetting & Barring Scheme. Headline: “An anti-paedophile vetting scheme that would have involved nine million adults will be ripped up next week in a major reworking of how background checks are conducted.” Continue reading CRB & ISA to merge into new body
The interim report on child protection by Eileen Munro has been published today. It signals a new approach which will focus on helping children rather than on regulations, inspections and procedures. The areas for reform in the interim report include: