Action on Elder Abuse damns Welsh adult protection system

Action on Elder Abuse today issued a damning indictment of the Welsh system for protecting vulnerable adults in a report on the case of a former social services manager with Alzheimer’s disease.

The charity’s report into the case of Derek Parker, who died last November, includes stinging attacks on regulator the Care and Social Services Inspectorate Wales, adult protection services in the Vale of Glamorgan Council and the Older People’s Commissioner for Wales.

Parker previously managed care services in Wakefield and for ten years was a senior lecturer in Cyncoed College’s social work department in Cardiff.

Failure to respond

It claimed they failed to respond adequately to concerns about Parker’s care at Waverley Care Home, Penarth, that were raised by his family and, subsequently on their behalf, by Action on Elder Abuse from July 2008 onwards.

These included that:-

• He was receiving drugs licensed to treat depression and epilepsy, but not Alzheimer’s, as well as antipsychotic drugs with potentially adverse side effects, apparently to make him more “manageable” for the home.
• Residents’ hearing aids were gathered together at 6.30pm each day into a collective jar.
• Residents were found not wearing their own clothes.
• Residents were lined up at dinner time and then waited up to 40 minutes for food, while other residents were compulsorily toileted.

Widow was social work tutor

Concerns were raised by the family in July 2008 but following an investigation by the home, the allegations were rejected and Parker given 28 days to leave the home. He died in another home, where his care was of a high quality, according to widow Mair Parker, a former tutor in social work and specialist dementia teacher.

AEA chief executive Gary FitzGerald said: “The [Welsh government] has established a range of agencies and systems over the last decade to ensure protection for adults at risk of abuse. And yet this report suggests a chaotic approach by those very agencies, with unnecessary delays, confusion, failures to understand their respective roles and a position by the Commissioner for Older People which is highly questionable.”

Criticisms of Vale of Glamorgan adult protection system

AEA said the Vale of Glamorgan Council’s adult protection team initially claimed that the concerns did not meet the threshold for an adult protection inquiry, when contacted by the charity in September 2008.

Two months later, it reversed this view in the light of the advice of the council’s legal department; however, AEA criticised the subsequent investigation.

It said four multi-agency strategy meetings had been held since December 2008, which AEA dismissed as “an administrative process” because they did not lead to intervention in the home.

Council’s response

The council said enquiries under its adult protection process were still ongoing but that South Wales Police had now sent a file to the Crown Prosecution Service for consideration. This is believed to refer to allegations around the use of medication.

It said that the Vale’s adult protection committee would meet following the CPS’s decision to look at the case and assess whether due process had been followed.

A spokesperson added: “We very much regret any additional distress caused to Mrs Parker and her family by fact that thorough investigation of their concerns has taken such a long time. We can reassure people that action was taken promptly to ensure that other residents of the home were not placed at risk.”

Criticisms of CSSIW

Action on Elder Abuse criticised CSSIW, which was contacted by a family friend of Parker’s in July 2008 and by AEA in September 2008, for failing to take “immediate, effective and robust action”.

This was despite some of the concerns involving potential breaches of regulations under the Care Standards Act 2000 or failures to meet national minimum standards.

AEA said the inspectorate did not adequately address the concerns raised on Parker’s behalf until an inspection report published in June 2009, but said even then a number were left un-addressed, including around the use of medication. 

AEA said the inspectorate had referred this issue to the local health board despite the charity claiming it had a duty to investigate.

This was because Care Standards Act regulations state that homes “should make proper provision for the health and welfare of service users”, and “unnecessary risks to the health or safety of service users are identified and so far as possible, eliminated”.

Criticisms of older people’s commissioner

The charity criticised older people’s commissioner Ruth Marks for deciding in November 2008, almost two months after being contacted by AEA, that it was not appropriate for her to intervene in the case but without saying why.

It said it contacted her office again in June this year to find the reasons for her lack of intervention, through a Freedom of Information request. The charity said it was told that the information could not be supplied unless AEA could prove it was acting on behalf of Parker’s family, something it claimed it did in October last year.

Welsh government response

The Welsh government said it could not comment on individual cases but a spokesperson said it was “satisfied that CSSIW and the Commissioner for Older People take allegations of abuse of any older person very seriously”.

The spokesperson added: “It is important where people have concerns about the care of an elderly relative or friend that they are able to raise these with the relevant authorities, which include local authorities, CSSIW and the police, who will investigate or take action where required.”

CSSIW has not responded separately.

Commissioner’s response

Ruth Marks said her “full sympathy” was with Parker’s family and said tackling elder abuse was a top priority.

But she added: “As commissioner I have significant powers to promote the interests of older people and I must ensure I work within my legal remit.  There is an ongoing investigation by other bodies and when this is complete I will carefully consider the outcome.
 
“Since Autumn 2008 I have made two offers to meet the organisation Action on Elder Abuse, neither of which have been responded to.”

Waverley Care Home’s response

Waverley Care Home was not available for comment but AEA’s report said that a reponse to the allegations, made in August 2008, said:-

• Parker was prescribed Amisulperide – an antidepressant and antipsychotic drug – because of his aggression and resistance to nurse interventions.
• Service users never waited 40 minutes before meals.
• Hearing aids were placed in a communal jar but this practice had ceased.

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