02 May 2014

Abuse and older people: more personal accountability required

In May 2011, the nation was shocked by images of people with learning disabilities being abused by their carers at the Winterbourne View Care home near Bristol. Wednesday’s BBC Panorama programme showing more images of abuse and humiliation of elderly people in care homes only serve to reinforce fears that the current system of accountability in the care sector is not working.

Our view has always been that there needs to be a system of personal accountability in place to address poor care. In the programme, the company who run one of the care homes defended their business by saying that the incidents only involved "a small number of staff." Employers we have spoken to over the last two years say the same. Surely this points to the need for a more robust and responsive system for dealing with "the small number of staff" who should not be working in the care sector.

At the moment, there is no statutory code of conduct to hold care workers to account. We recognise that the majority of care workers, with the right support and supervision, do an excellent job in challenging circumstances.  However, there are too many reports of staff delivering poor care. The judge in the Winterbourne view case was told by one of the carers - "I wasn't trained in this. His response was - "you don't need to be trained to act humanely."  We also know from the sector that there are individuals who abuse elderly and vulnerable people, are dismissed from one employer and then employed in another setting. These serial offenders must be stopped. It is time to reinforce this message through legislative change.

So what is the solution?

Certainly, there are encouraging signs of change following the Cavendish Report, which advocated standardisation of training and supervision for support workers, and greater responsibilities on employers. The CQC is strengthening its inspection regime and is identifying poor care. Celebrating excellent care and promoting good recruitment processes are also part of change and improvement. We fully support and welcome all these initiatives, but they are not enough.

We believe our proposals would address specific failures by ‘the small number of staff’ whose behaviour and care is unacceptable.  Three elements - a statutory code that articulates the requirements for honesty, integrity and respect, together with an adjudication process that can hold individuals to account, and public access to a register of those not fit to work as carers, would make a difference. These changes would be proportionate, cost effective and stronger than the current system.

There needs to be greater personal accountability, backed by legislation. I am very encouraged that our proposals for such a system have been incorporated into the Law Commissions’ draft Bill currently being considered by the government. Decisive legislative action is needed so we can deliver more effective protection for the elderly and most vulnerable members of our society.

Anna van der Gaag
Health and Care Professions Council

Further reading
Full details of the HCPC's proposals are set out in our policy statement - see section 4.8 http://www.hcpc-uk.org/assets/documents/10003F1AHCPCpolicystatement-RegulatingadultsocialcareworkersinEngland.pdfhttp://www.hcpc-uk.org/assets/documents/10003F1AHCPCpolicystatement-RegulatingadultsocialcareworkersinEngland.pdf

The Law Commissions’ final report and draft legislation sets out the recommendation and proposals to introduce barring schemes - see p66 and p359 (part7) http://lawcommission.justice.gov.uk/publications/Healthcare-professions.htmhttp://lawcommission.justice.gov.uk/publications/Healthcare-professions.htm