Safeguarding vulnerable adults; research

The Safeguarding Vulnerable Adults Act 2006 protects vulnerable people aged over 18 in care settings in England and Wales. At the centre of the act is the Protection of Vulnerable Adults (Pova) list. Care workers who have harmed or risked harm to vulnerable adults and are deemed unfit to work with them are placed on this list. It is an offence for people confirmed on the list to knowingly apply for or accept any work covered by the scheme.

Employers have two duties with regard to the list: they are obliged to check any potential employees who may work with vulnerable adults against it and they are required to refer care workers or adult placement carers reasonably considered guilty of causing harm to a vulnerable person or of placing them at risk of harm.

Referral to the POVA list

Referrals to the Pova list are made to the Independent Safeguarding Authority (ISA), which formally begins work in October. The ISA will be responsible for evaluating individual cases and making a recommendation to the health secretary. Three groups are able to refer an individual to the Pova list:

● Employers or managers of registered care homes, domiciliary care agencies and placement schemes.

● Regulators: the Commission for Social Care Inspection (from April 2009 the Care Quality Commission)/Care and Social Services Inspectorate Wales (CSSIW).

● The secretary of state for health.

The Pova scheme uses the term “work” in a broad sense and the scheme covers individuals working with vulnerable adults on a formal, informal and voluntary basis.

The ISA will consider including on the Pova list any individual named in a relevant inquiry, which are defined in section 85(7) of the Care Standards Act 2000 as:

● An inquiry held under:

(i) section 10 of the Act

(ii) section 35 of the Government of Wales Act 1998

(iii) section 81 of the Children Act 1989

(iv) section 84 of the National Health Service Act 1977 and

(v) section 7C of the Local Authority Social Services Act 1970.

● An inquiry to which the Tribunals of Inquiry (Evidence) Act 1921 applies.

● Any other inquiry or hearing designated for the purposes of [section 85(7)] by an order made by the health secretary.

Referral criteria

Before referral, the employer will usually have determined if the care worker is guilty of misconduct during regular disciplinary proceedings. A referral should be made when a care worker has been suspended where the misconduct has harmed a vulnerable adult or placed them at risk of harm, or where the suspension is pending consideration of dismissal or transfer after a finding of misconduct.

Employers will have also determined the severity of the misconduct. This takes into consideration the frequency of incidents, the degree of harm, and whether or not it was in breach of policies, a matter of poor clinical judgement or deliberate abuse. They must also consider any mitigating factors put forward by staff members.

Carers in adult placements are approved rather than employed so any investigation into misconduct by a carer will usually be led by the local adult social services adult protection staff. The carer is not sacked but has their approval removed.

Referral to the Pova list follows on from these internal disciplinary procedures. It occurs once the individual has been moved to a non-care position, suspended, dismissed, or has left the post before such action could have been taken. Referral can also be made retrospectively about former employees.

Preparing for POVA referral

Employers should be prepared to make a Pova referral. An employer should:

● Know their statutory responsibilities for working with the Pova scheme.

● Be familiar with the requirements for making referrals.

● Put in place the necessary employment policies to ensure effective referrals can be made when necessary. This includes disciplinary and dismissal procedures and effective recording of information.

● Inform its staff about the responsibilities of the scheme.

● Increase staff awareness to help make the process transparent and effective.

● Be familiar with local procedures and policies for protecting vulnerable adults and be in contact with key local people and agencies.

These relationships can be an important source of information, advice and support during a Pova referral process.

Making the referral

Before a referral is made, the employer should ensure they can have carried out the following tasks:

● Completed a Pova list referral form. The official form should be used with clear cross-referencing to any attached documents.

● Gathered all the required information. Clear and factual information accompanied by formal statements and supporting evidence should be provided. The ISA does not investigate the case it reviews the information provided. This means accurate record keeping is essential for a successful Pova list referral.

● Documents should be clearly signed and dated and copies should also be made available.

● The employer should inform all relevant parties of the referral. This includes witnesses and local adult protection staff.

Officials will also consider whether the individual should be placed on the Poca (Protection of Children Act) list as well as the Pova list.

Witnesses and whistleblowers should be fully protected and supported when disclosing instances of abuse. If there are concerns about the safety of witnesses, statements can be made anonymous although this will be reversed should the referral proceed to an appeal to the first-tier – the Care Standards Tribunal.

Appeals

The appeals process differs depending on whether the referral was made before or after 20 January 2009. Individuals confirmed on the Pova list before 20 January have the right of appeal to to the Care Standards Tribunal. From 20 January 2009, all appeals against inclusion on the list can be made only on points of fact or law to the Upper (Care Standards) Tribunal.

Practice points: how the Pova list works

● Referrals are made to the Pova list when care workers or adult placement carers are reasonably considered guilty of causing harm to a vulnerable person or placing them at risk of harm.

● The referral can be made by employers or managers of registered care homes, domiciliary care agencies and placement schemes, regulators or the health secretary.

● The employer will determine whether the employee is guilty of misconduct during the regular disciplinary proceedings.

● When an employee is found guilty and the individual has been moved to a non-care position, suspended, dismissed, or has left the post, the Pova list referral is made.

● The referral is made to the Independent Safeguarding Authority (ISA) which evaluates the evidence and makes a recommendation to the health secretary.

● Employers are legally obliged to check any potential employees who will work with vulnerable adults against the Pova list and refer any carer considered guilty of misconduct to the ISA for inclusion on the list.

Further information

● Scie Guide 12: Making Referrals to the Protection of Vulnerable Adults Pova list – update from www.scie.org.uk

● Commission for Social Care Inspection

● Independent Safeguarding Authority

● General Social Care Council

 ● Care Standards Tribunal

● More on the four UK countries’ regulatory authorities

Research abstracts

Author PARSONS Gillian

Title Setting the scene for protection of vulnerable adults investigations

Reference Journal of Adult Protection, 8(2), August 2006, pp.39-45

Abstract This article suggests social services as the lead agency to co-ordinate investigations and referrals of allegations of abuse. An analysis is provided of three alternative organisational models for dealing with referrals and investigations. The discussion also proposes different sets of arrangements for achieving effective multi-agency working. The article focuses on England and Wales

.

Author STEVENS Martin, MANTHORPE Jill

Title Barring ‘inappropriate people’? The operation of a barring list of social care workers: an analysis of the first referrals to the Protection of Vulnerable Adults list

Publisher Health and Social Care in the Community, 15(4), July 2007, pp.285-294

Abstract The Department of Health commissioned the authors to analyse the first 100 referrals to the Pova list. Key findings include the over-representation of males and care home staff compared with national figures and the tendency for male staff to be involved in more physical misconduct. While it is argued that the list is a positive development, it is also emphasised that more general measures to improve the quality of services may be at least as important a means of protecting vulnerable adults. Furthermore, the article argues for public debate on the proper balance between the rights of staff and the protection of vulnerable people.