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This month finally sees the introduction of the government's latest safeguard to protect vulnerable adults from care workers who may abuse or harm them.

From 26 July it will become a statutory requirement for registered care providers in England and Wales to check whether a care worker is on the Protection of Vulnerable Adults (Pova) list before employing them. The list is a centrally held register containing the details of care workers known to have harmed, or placed at risk of harm, a vulnerable adult in their care.

As laid out in the Care Standards Act 2000 (see panel), the Pova list will be operated on behalf of the Department of Health by the Department for Education and Skills. The DfES already runs a similar scheme, List 99, which bars unsuitable people from working with children in education settings.

A potential employer requests a Pova check by ticking a new box on the Criminal Records Bureau (CRB) forms that all social care staff must complete before taking up a post.

Many in social care have campaigned for the introduction of a Pova-like initiative to curb the abuse of vulnerable adults, who are often older, have mental health problems or learning difficulties. Children have long had this protection through the Protection of Children Act list that bans unsuitable staff from working in children's services.

Registered care homes and domiciliary care agencies have waited a long time for the Pova list, which was supposed to be up and running in June this year. The government response to the health committee's inquiry into elder abuse admitted the hold-up was because it was waiting for the CRB to modify the way it dealt with its disclosure forms.

The government is committed to preventing abuse, but is the Pova list worth the wait?

Sally Hughes, social care policy officer at mental health charity Mind, believes so. She says that as the health and social care sectors are large employers with mobile workforces "it is reasonable to have a fair amount of control over bad employees". For Hughes the Pova list is another quality control mechanism employers can use when recruiting staff to work with vulnerable people.

Gary FitzGerald, chief executive of campaigning charity Action on Elder Abuse, is equally supportive of a measure that will catch some employees who currently may evade detection. "Our helplines repeatedly hear about individuals who have resigned after being accused of abusing clients," he says.

But will it end the abuse that makes shocking headlines? No, says FitzGerald: "There's a small group of serial abusers and Pova will never catch them because they know how to play the system. We can't afford to rely on registration alone."

This view is echoed by Stephen Lowe, policy officer at Age Concern England. He has heard anecdotal evidence that paedophile websites encourage abusers to target older people because of the lack of protection for them. "Abuse is about power, and people who misuse power over children will misuse power over adults," he says.

Establishing the Pova list sends a clear message that protecting vulnerable adults is as important as protecting children. Kathryn Stone, director of Voice UK which works with people with learning difficulties who have been abused, says: "It is a very important step but will only be as effective as the people who use it and the people who enforce it."

So are employers geared up to meeting Pova's requirements? Stone says many residential care providers still do not fully know about it. "The information that has been put out about Pova has not been far-reaching or clear enough." She urges the Department of Health to work with service commissioners, providers and advocacy and support groups on how they can use Pova effectively.

About three-quarters of the 25,000 care homes in England are not members of any national association and therefore unlikely to have a main source of information for Pova. Registered Nursing Home Association chief executive Frank Ursell believes such providers need further clarification on when to invoke the list. He asks if institutions should notify Pova when they suspend a member of staff because abuse is suspected or only once an employee has been found guilty.


"Home owners are between a rock and hard place as the Care Standards Act says they have to report people almost before finding them guilty, but the Human Rights Act and employment legislation says you have to treat them fairly," he adds.

One hindrance to Pova's success is that it relies on job applicants declaring all the names they have used. If a candidate withholds this information there is very little that can be done. The Pova list is not retrospective and employers are obliged to report staff only for incidents of abuse occurring after 26 July, so it may be months before names start appearing on the Pova list.

One concern that arose during the consultation on Pova, which ended last March, was the cost of an initial Pova check. This will now be free. A PovaFirst, as it is known, enables employers to check the list to see if a person is recorded on it. If they aren't, they can be employed while the full CRB check goes ahead.

While the government has listened to some fears, it has ignored others. The most controversial decision is the Pova list's phased introduction. Initially, Pova will not apply to staff working with vulnerable adults in the NHS or independent hospitals, clinics or other facilities, or through independent medical agencies.

Mind strongly disagrees with this decision. According to Hughes, people with mental health problems overwhelmingly use NHS services, and as NHSstaff will not be subject to Pova, users will continue to be put at risk. She adds: "Pova should be introduced as parliament intended: across the board."

A Department of Health spokesperson defended the government's position, saying that most abuse of adults takes place in their own homes and points out that the scheme will eventually cover the NHS but not until next year at the earliest.

So will the Pova list do the job? The last word goes to a Department of Health spokesperson: "Pova is not going to replace what should already be happening in social care - good employment practices and picking up on undesirable people in the recruitment process."

Care Standards Act 2000

The Protection of Vulnerable Adults (Pova) duty is laid down in section 80 of the Care Standards Act 2000. Residential care home providers and domiciliary care agencies are obliged to refer a care worker to the Pova list if they are suspended, dismissed or transferred to a non-care role because they are thought to have harmed, or placed at risk of harm, a vulnerable adult in their care. They must also check against the list before offering anyone employment in care work, and may not employ anyone on the list.

Care workers are first placed provisionally on the list and can appeal to the secretary of state and then to the Care Standards Tribunal (CST) to have their name removed. Unless an appeal succeeds, names remain on the list indefinitely. After 10 years, they can ask the CST to review their case. If they were under 18 when they were listed they can request a review after five years.

It is a criminal offence for anyone confirmed on the Pova list to seek employment in a care position. If found guilty in a magistrate's court, they can be fined and imprisoned for up to six months - or up to five years if convicted in a crown court.