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

This research explores the implications of the Protection of Vulnerable Adults (POVA) List on safeguarding vulnerable adults and social work practice. It examines factors associated with decisions to list staff, contextual influences, and the synthesis of unsuitability. The study aims to inform developments in the operation of the POVA List.

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

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  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

  3. 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

  4. 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

  5. But, we’ve got a lot of lists… • POCA (children) list • List 99 (teachers) • POVA (adult social care) list Independent Safeguarding Authority 2009

  6. 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?

  7. Contextual influences Synthesising unsuitable people Referral Initial reaction Case investigation Reaction and judgement Evidence gathering Synthesis Harm Person Misconduct Not unsuitable Unsuitable

  8. 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 doesn’t care. • My view of it is that there are one or two traits here that I personally don’t like the sound of, and therefore I would not employ him and I wouldn’t advise anyone else to employ him but that’s a personal judgement and we are all down to personal judgements in these things

  9. Mitigation for the person Remorse Admission of guilt Previous good record The person Reaction Intentions Age of worker Ongoing stress/ mental health

  10. Victimisation Immediate stress Racism discrimination Misconduct Relationships with staff Staff shortages Working conditions Mitigation of misconduct Reaction to behaviour of service user

  11. Factors supporting unsuitable verdict • Types of misconduct It is very important, the worse ones like physical and sexual, I mean I just think you can’t afford to... if you have any sort of evidence there... I just don’t think you can afford to let that go. • Types of harm I am thinking of one particular case where users didn’t want any more assistance and this lady couldn’t 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.

  12. 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 Not unsuitable Unsuitable

  13. 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

  14. Contact details • Martin Stevens • e-mail martin.stevens@kcl.ac.uk; tel 020 7848 1860 • Jill Manthorpe • e-mail jill.manthorpe@kcl.ac.uk; tel 020 7848 1683 • Shereen Hussein • e-mail shereen.hussein@kcl.ac.uk; tel 020 7848 1669 • Joan Rapaport • e-mail Joan.Rapaport@kcl.ac.uk; tel 020 7848 1769 • Stephen Martineau • e-mail Stephen.martineau@kcl.ac.uk; tel 0207848 1694

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