Safeguarding people using services: who should be barred from providing care

1
Safeguarding people using services who should be
barred from providing care?

• Martin Stevens, Jill Manthorpe, Shereen Hussein,
  Stephen Martineau, Joan Rapaport, Jess Harris
• Social Care Workforce Research Unit

2
Introduction

• Background
• The POVA List
• The research
• Synthesising unsuitability
• Implications for vulnerability and risk and
  social work practice

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Background

• Increasing policy focus on safeguarding/protecting
  adults, particularly since the late 1990s
• No Secrets (2000) first dedicated Government
  policy
• Protection of Vulnerable Adults (POVA) List
  introduced in England in Care Standards Act
  (2000), implemented 2004
• Independent Safeguarding Authority introduced by
  the Safeguarding Vulnerable groups Act (2006)
• Risk as a backdrop (McLoughlin, 2007)
• Tension between safeguarding and personalisation

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The Protection of Vulnerable Adults (POVA) List

• It creates a list of people, held by the
  Secretary of State, who are considered unsuitable
  to work with vulnerable adults in England and
  Wales (DH Guidance, 2006)
• Mandatory to refer workers dismissed after having
  harmed or placed at risk of harm
• Mandatory to check if new employees have been
  barred (illegal to employ)
• Illegal to seek work with Vulnerable Adults
  when barred

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But, weve got a lot of lists

• POCA (children) list
• List 99 (teachers)
• POVA (adult social care) list
  

Independent Safeguarding Authority 2009
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POVA Research

• Purpose To inform developments in the operation
  of the POVA List
• What are the commonalities differences in a
  sample of referrals to the POVA list?
• What factors are associated with decisions to put
  staff onto the POVA list?
• How are decisions made about whether to put staff
  on the list?

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Synthesising unsuitable people
Referral
Initial reaction
Unsuitable
Not unsuitable
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Emotional reaction and moral judgement

• I just get the feel from the nature of the abuse
  and the sort of other incidents that he is
  somebody who doesnt care.
• My view of it is that there are one or two traits
  here that I personally dont like the sound of,
  and therefore I would not employ him and I
  wouldnt advise anyone else to employ him but
  thats a personal judgement and we are all down
  to personal judgements in these things

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Mitigation for the person
Remorse
Admission of guilt
Previous good record
The person
Reaction
Intentions
Age of worker
Ongoing stress/ mental health
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Mitigation of misconduct
Reaction to behaviour of service user
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Factors supporting unsuitable verdict

• Types of misconduct
• It is very important, the worse ones like
  physical and sexual, I mean I just think you
  cant afford to... if you have any sort of
  evidence there... I just dont think you can
  afford to let that go.
• Types of harm
• I am thinking of one particular case where users
  didnt want any more assistance and this lady
  couldnt manage by herself but her trust had been
  shattered by what had happened. So there are
  issues beyond the financial.
• Patterns of misconduct
• If we have got an individual with an odd spike
  here and there then we need to start looking to
  see if there is a pattern emerging here.

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Building a picture
Harm although he if you are an old lady being put
to bed and someone throws water at you and shouts
at you then I think that is emotional harm caused
there and I think physical
Person ...claims mitigating circumstances that
one of them nipped him,
Misconduct the fact that he Rob has shouted
and thrown water at a resident when helping them
to bed
Unsuitable
Not unsuitable
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Conclusion

• Unsuitability created as a relatively fixed
  trait, solidifying judgements of risk and
  vulnerability
• Ethical and evidence based decisions, which can
  be improved by a sound knowledge of
• service user and practice perspectives
• Policy and conceptual developments in social care
• Social workers involved in advising people using
  direct payments/individual budgets
• Good decision making promoting confidence
• Individual/collective focus

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Contact details

• Martin Stevens
• e-mail martin.stevens_at_kcl.ac.uk tel [phone]
  1860
• Jill Manthorpe
• e-mail jill.manthorpe_at_kcl.ac.uk tel [phone]
  1683
• Shereen Hussein
• e-mail shereen.hussein_at_kcl.ac.uk tel [phone]
  1669
• Joan Rapaport
• e-mail Joan.Rapaport_at_kcl.ac.uk tel [phone]
  
• Stephen Martineau
• e-mail Stephen.martineau_at_kcl.ac.uk tel [phone]
  1694