Protecting our adults: ‘Why England should follow Scottish lead on adult safeguarding’

“Scotland is the only country that has this adult protection legislation at the moment. England should follow suit,” says Kate Fennell, lead officer for adult protection at Edinburgh Council.

Fennell is referring to the Adult Support and Protection (Scotland) Act (ASPA), legislation passed by the Scottish Parliament in 2007 that promised to give adults at risk more protection than their counterparts in England, Wales and Northern Ireland.

The Act enables social workers to enter any place as part of adult protection inquiries and, with court approval, to remove an adult at risk for an assessment, remove them from a place of risk for seven days, and ban alleged perpetrators from a specified place for up to six months.

While these orders should be made with the vulnerable adults’ consent, this can be overridden if the victim is under “undue influence” from the perpetrator.

Six years on, with the government in England having rejected giving social workers powers of entry, how have Fennell and her social workers in Edinburgh found working with the much stronger powers brought in with the Scottish Act?

Sharing responsibility

“For social workers there was almost a sense of relief when the legislation came in, because a lot of this was work they were doing anyway,” says Fennell. “These people were coming to social workers’ attention and often they were left on their own to deal with it but now there is a sharing of responsibility with other agencies.”

This shared responsibility has been boosted by the fact the Act hands other agencies a duty to cooperate with social services’ adult safeguarding inquiries. At a time of scarce resources across health, social care and police forces, having a statutory lever to get people “round the table” to attend safeguarding meetings has been key.

“That’s the bit that the people working in English social services would love. We can say to the police, the GP, the health professionals ‘you have to cooperate’, you have to come to this meeting,” Fennell says. (The Care Bill currently going through parliament in England contains a similar duty.)

“It’s not just ‘let’s dump it on social work’, ‘let’s dump it on the police’ or ‘let’s dump it on health’ anymore. Once that happens, you find you can cut down your own work because so much of it was duplication. It can still be difficult in practice, but having the legislation has helped I think.”

Help in tricky cases

The powers of intervention have also given social workers “a little bit more weight” and a slightly more formalised role around adult safeguarding. Fennell says that the fact social workers can tell clients “I’m really sorry, you might not want me here, but I have a duty to investigate this” can help in tricky safeguarding cases.

How does she respond to the criticism that the ASPA infringes someone’s human rights? At the time of its introduction critics were concerned that the legislation gave social workers powers of intervention even when that wasn’t what the suspected victim wanted.

“We always have to be ECHR [European Courts of Human Rights] compliant, we have to weigh up the balance of someone’s right to choose with our duty to protect. That is tricky, but we always have to use the least restrictive options,” she says.

Fennell points to the fact that when the Act was coming in, “people were worried we were going to be intrusive and banning people left, right and centre.” Yet in six years of implementing the Act, and around 900 referrals per year, Edinburgh has had about 10 cases where banning orders – one of the Act’s most restrictive orders – have been used.

Fennell describes the ASPA as a “gateway act”. The local authority has an overarching duty to inquire in cases of suspected abuse. If needed, they initiate an interagency referral discussion (an ‘IRD’) where police, social services and health will discuss the case, and then make a decision on what action, if any, to take.

Non-restrictive options

There are a range of options available to the local authority that don’t involve any of the restrictive powers – such as banning orders – that critics of the ASPA have focused on. No action may be taken, a support worker might be put in to work with the person, or another type of legislation – the Mental Health Act or Adults with Incapacity Act – may be deemed more appropriate.

“The Act gives you a framework. You get to case conference and then you think of all the options, including the full range of legislation, available and think about what might best meet someone’s needs,” says Fennell.

In Edinburgh, ASPA work is shared across social work teams rather than being the sole responsibility of a dedicated safeguarding unit. The statutory underpinning to adult safeguarding has allowed social workers to tell managers “this is a duty, we have to do it”, says Fennell, but she acknowledges that can bring its own pressures for management.

“Because this work is resource intensive I think it’s harder for them because they are not going to get the same level of throughput. That is hard,” she says.

Fennell is responsible for ensuring professionals are aware of their duties under the legislation, but this extends beyond social services departments. She is working with colleagues in police, health, voluntary sector and private sector agencies.

Supporting care providers

A major priority at the moment is raising awareness of adult safeguarding responsibilities among care home staff and providers, she explains. A lot of care sector staff are underpaid and may have skills and levels of practice that are outdated and, possibly, illegal.

“Winterbourne View could happen anywhere, we’re very much aware of that,” she says.  

“We need to get this right, it’s a national issue not just in Edinburgh. We need to work out how to support care providers. Many of them are getting it right and it’s a blooming hard job, but if we have concerns we need to get around, involve the care inspectorate, and look at what we can to do help them.”

Tackling the financial exploitation of adults at risk has been another key area of work. Cases where people with learning disabilities or mental health issues have had their bank accounts emptied by relatives who have hit on tough financial times are not uncommon, Fennell says.

“Take a case where a woman had no food in her cupboard, had no heating, her phone had been cut off,” she says. “She was a widow who should have had a very significant amount of income. It was only when her hairdresser realised how distressed this woman was about having no money in her account. It turned out a relative had decided the woman ‘would have wanted them’ to have her money.”

Police and social services have also been working with bank staff to be wary of a “bogus workman” scam that has seen vulnerable people duped into handing over £3,000 to scammers who claim their guttering needs fixed urgently. E-mail phishing scams, luring web users to hand over their bank details, are another constant problem.

Impetus to investigate

The ASPA legislation doesn’t provide “any additional answers” to these issues, admits Fennell. People are still going to make lifestyle choices that could harm them, whether it’s drug and alcohol related or being in destructive relationships where they are financially, or physically, exploited. But it offers a framework and impetus for social workers to investigate where people might be at significant risk.

She says the toughest part of adult safeguarding is that, despite the ASPA legislation, it can be “tough to do things immediately” in emergency situations. But she feels that, overall, social workers are on-board with the legislation which, in some ways, offers a chance for frontline staff to engage in more community-based social work.

“In a lot of health and social care we’ve become brokers and community care agents and we’ve moved away from the traditional relationship-based counselling case work stuff,” says Fennell. “But I think adult protection is harking back to that. You have to get to know and understand someone and build a relationship. Social workers like that. That’s what you go into social work to do. It can be scary, but it’s interesting.”