Adult protection legislation risks leaving people unprotected by setting too high a threshold for intervention, a safeguarding expert has warned.
Lower-level incidents risk being missed by government plans to provide statutory protection to people who may need care, are unable to safeguard themselves and are at risk of “significant harm”, as opposed to “harm”, said Shirley Williams.
Williams, a consultant and independent chair of Blackburn with Darwen Safeguarding Adults Board, was speaking at a Community Care adult safeguarding conference yesterday. Earlier, Department of Health official Robert Parsons had revealed that forthcoming legislation was likely to set a significant harm threshold for adult protection proceedings – in line with child protection and the current No Secrets guidance on safeguarding adults.
Parsons, the DH’s policy lead on safeguarding legislation, stressed the plan was provisional and subject to further discussions around the government’s forthcoming adult social care White Paper, which would itself be subject to consultation before a parliamentary bill is published.
Were it to go with a “significant harm” threshold, it would reject the recommendations of the Law Commission, which proposed a threshold of “harm” in its review of adult social care law, which reported last year and is supposed to form the basis of the government’s own legislation.
It would also leave England with a technically higher threshold for adult protection than Scotland, whose 2007 law defines an “adult at risk” as someone at risk of “harm”, unable to safeguard themselves and affected by mental disorder, illness or disability. The Welsh government has also proposed a “harm” threshold for adult safeguarding in its consultation on a Social Services (Wales) Bill.
Williams said the evidence suggested that socially excluded people with lower-level disabilities were at particular risk of abuse, but were often screened out of services.
“What concerned me is the use of ‘significant harm’,” she said. “If we set the threshold too high we will miss small incidents [that indicate risk].”
The Law Commission initially proposed a “significant harm” threshold in consultation, and while some respondents felt this would help keep safeguarding workloads manageable for councils, others warned that it would undermine preventive work and imply that some levels of abuse were acceptable.
Action on Elder Abuse chief executive Gary FitzGerald reiterated this concern, in the light of Parsons’ comments. “What level of harm does a victim have to endure before it is considered significant,” he asked. “Or, perhaps more precisely, what level of harm is society willing to ignore before allowing intervention? Are we not in effect authorising perpetrators to commit a certain level of abuse?”
Though the commission removed “significant” from its final proposals, it stressed that the other criteria – that the person was unable to safeguard themselves and had health and social care needs – “would do the main work” of defining who was at risk.
Parsons also said that the government did not plan to bring self-neglect under safeguarding procedures, again contrary to the Law Commission’s proposals.
He said the planned Care and Support Bill would be likely to give local authorities powers to make enquiries where abuse was suspected.
Safeguarding adults boards would be put on a statutory footing, convened by councils with mandatory membership from the relevant police force and NHS clinical commissioning groups, said Parsons.
Their role would be to produce a strategic plan setting out outcomes, an annual report setting out progress against the plan and to commission serious case reviews. He said the legislation would set out that the purpose of SCRs was to learn lessons, not apportion blame.
Parsons said the DH wanted to allow boards the flexibility to adapt arrangements to local circumstances, and also to widen their remit to take in self-neglect and other issues if they so wished.