Developmental steps in building a toolkit to challenge wilful neglect and ill-treatment

1. Developmental steps in building a toolkit to challenge wilful neglect and ill-treatment under the Mental Capacity Act Jill Manthorpe and Kritika Samsi, Social Care Workforce Research Unit, King’s College London • Ill-treatment & wilful neglect under • Mental Capacity Act 2005 • Section 44 defines “ill-treatment” and “wilful neglect” occurring in a relationship of trust with person lacking capacity • Covers professionals and family carers • The offender indulges in behaviour believing the person lacks capacity • Both offences include serious departure from required standards of treatment that they were aware they were under duty to perform • If reported and prosecuted, penalty for criminal offences may be fine and/or a prison sentence for up to five years • What’s new? • Applies to professionals, plus family and friends • Does not rely on victim’s evidence (hard to get) or complaint • Criminal convinction of “ill-treatment” and “neglect” can prevent re-employment in the health and care sector Example: Care home nurse conviction for neglect under Mental Capacity Act makes legal history Ms Ramona Dublas, aged 41, was found guilty of taking a photo of a 92-year-old semi-naked woman after being convicted of ill-treatment and wilful neglect under section 44 of the 2005 Act. Inner London Crown Court heard that Dublas worked as a nurse at the private X Nursing Centre. A member of staff at XX Council's Safeguarding Team, which helps vulnerable adults, became aware a photo was in circulation of one of the residents. She managed to obtain a copy and the picture showed the elderly dementia sufferer being held up by her wrists and naked from the waist up. In court Dublas claimed she wanted to take the photo to show the woman was "happy". The resident died three weeks later, although this was not related to the offence. Dublas was sentenced to nine months' imprisonment, suspended for a year, 200 hours community service and banned from working with children and vulnerable adults in the future. http://cms.met.police.uk/news/convictions/nurse_conviction_makes_legal_history • Our research • EviDEM study: funded by National Institute for Health Research • Exploring practitioners’ experiences, knowledge & expectations of the Mental Capacity Act • End date: mid 2012         EviDEM www.evidem.org.uk Participants (N=115) • Findings 1: What do practitioners know about the new offences? • Basic, rather than specific, concepts understood • Fuzzy understandings of definitions of ‘wilful neglect’ and ‘ill-treatment’ • Some, but not all, fairly knowledgeable • Thresholds (when is it wilful?) not clear • Uncertain how to collect evidence Adult safeguarding coordinators = 13 (+12 +15) Social workers = 10 (+9) Specialist dementia nurses = 15 (+15) Age Concern = 10 Alzheimer’s Society staff = 9 Difficult to sometimes differentiate between those two, I am sure there will be clear legal definitions which separates them but they are very similar you know it’s – no there is a difference. Wilful neglect is where somebody doesn’t do something, and ill-treatment is where they do something that they shouldn’t, so giving people the wrong medication, erm, injuring somebody when they don’t follow handling procedures that type of thing. [Safeguarding Adult Coordinator] Care home workers & managers = 43 Carers’ groups & other voluntary associations = 15 • Findings 2: Developing an Educational Prescription • To cover: • Knowledge of the Act • Ways of working with the Police • Tailor information to context and role • Stories and case studies helpful • Make product appropriate to setting, e.g. posters for care homes, details on websites for older people, pamphlets in GP surgeries, information sheets for advisers… • Results of a nominal group discussion of practitioners, including policewoman, Adult Safeguarding Lead, former carer, day centre worker and GP trainers This report/article presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0606-1005). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. For further information, please contact: Jill Manthorpe (jill.manthorpe@kcl.ac.uk) or Kritika Samsi (kritika.1.samsi@kcl.ac.uk) .