Weak adult safeguards and data vacuum must be addressed

Ronald Roberts killed his 56-year-old partner, Angela Titley, with the Swiss Army knife she had given him so they could carve their initials into a tree.

The 72 year old had heard voices in his head telling him the woman he had met at a private mental health unit in Surrey was two-timing him.

Roberts was sentenced to life imprisonment at the Old Bailey this month (news, 12 January) after admitting manslaughter by reason of diminished responsibility.

But the judge criticised the “numerous and alarming” shortcomings in the care given to both Roberts and his victim.

Roberts had a history of violence against women and was repeatedly diagnosed as suffering from a severe personality disorder. In 1990, a psychiatrist decided he was a severe and continuing danger to women.

But in 2004 it was decided that Roberts was safe to live in the mixed-sex, low-security Shrewsbury Court ward at Whitepost Health Care Centre in Redhill. Later that year, three days after failing to receive an anti-psychotic injection he was supposed to get every three weeks, he killed Titley.

An external investigation into the care and treatment of both Roberts and Titley has just been commissioned by South West London and Kent and Medway strategic health authorities, who placed the pair.

But a serious case review is almost complete and is set to recommend that adult protection, currently governed by guidance, be given the same statutory weight as that afforded to children.

Surrey’s adult protection manager, Louise Lamb, believes the incident reveals the lack of strong multi-agency strategies to promote information-sharing about vulnerable adults.

Local information-sharing protocols were not designed for adult protection and are not always appropriate, she says.

Lamb says there are no clear requirements for sharing information with police when someone such as Roberts is placed in an area. And neither are there requirements for information about vulnerable adults to be shared between a private hospital such as Shrewsbury Court and local health and social care bodies.

The No Secrets guidance, issued by the Department of Health and Home Office in 2000, encourages local authorities to take a lead role in the implementation of multi-agency codes of practice aimed at preventing and tackling abuse.

But Lamb believes there should be a universal information-sharing protocol for vulnerable adults.

A framework was provided by the Association of Directors of Social Services in its 2005 Safeguarding Adults document, which includes procedures for alert, referral and assessment, and Lamb would like to see this become a requirement rather than a suggestion.

Action on Elder Abuse chief executive Gary FitzGerald suggests England might look towards Scotland, where a draft Vulnerable Adults Bill is currently being considered. The bill would give local authorities a duty to look into cases of potential abuse as well as powers to visit the home of vulnerable adults or exclude suspected abusers.

The English Safeguarding Vulnerable Groups Bill, which is due to implement a vetting scheme for people working with children and vulnerable adults, following the Bichard inquiry, is unlikely to contain such measures.

But David Congdon, head of policy and campaigns at Mencap, believes the problem lies more in people’s attitudes than in the lack of a statutory framework.

“Our experience in general has been that the issue of abuse gets ignored too often because people don’t look for it. As a general statement the framework is broadly OK but the crucial thing is all the agencies taking it seriously.”

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