Forum Brief: Elder abuse
The Commons health select committee has called on the government to take action against abuse of elderly people by relatives and carers.
Government Response: Department of Health
Health minister Stephen Ladyman said: "We share the Committee's concerns about the abuse of older people and agree that more needs to be done to protect these vulnerable members of our society whether they are being cared for by a family member or professional carer. This government has worked hard to tackle the abuse of older people and has made it clear that there will be no hiding place in the care system for those who abuse vulnerable adults.
"We welcome this report and will be studying the recommendations. The government will publish a full response in the near future."
Party Response: Conservatives
Shadow health minister Simon Burns MP said: "For too long, elderly abuse has been the problem that dare not speak its name. It has been swept under the carpet as if it did not exist.
"It is imperative that action is taken in one area to avoid another Harold Shipman scenario – that is, where GPs own a care home and that GP is responsible for issuing death certificates. We cannot have the situation where GPs are judges and juries on issues as sensitive as this and action must be taken to avoid any future problems."
Forum Response: Carers UK
Imelda Redmond, chief executive of Carers UK, said: "Abuse should never be condoned and it is vital that we tackle this head on. It is essential that we ensure the dignity and human rights of all vulnerable people and this report offers a number of tangible recommendations that will help raise awareness of the issue and provide methods to directly identify and deal with abuse.
"When an elderly person uses paid homecare staff, residential respite care or they are considering permanent residential care, carers need the peace of mind and assurance that their relative is safe and that there are systems in place to identify and deal with abuse quickly.
"The report shows that although most abuse takes place in the home, it is less likely to be the main carer who is the perpetrator. In cases most people are looked after at home by loving relatives without any signs of abuse. It is important that we understand this if we are to tackle this serious issue effectively.
"Carers UK recognises that abuse sometimes occurs between carers and the relatives, partners or friends for whom they care. In most instances, it seems to occur because there are already problems within a relationship – one of the indicators illustrated by Action on Elder Abuse.
"In reporting on this issue, Carers UK said it was vital to be clear around the use of the term, 'carer'. This is because we need to be clear about the group of people that we are identifying in order to get the right response. It is one thing to be talking about a paid worker who has wilfully hurt an older person in the course of their paid employment and another about a domestic violence situation where a carer is abusing an older person. The situations might be equally serious, but demand different identification mechanisms."
CSCI chief inspector David Behan said: "The abuse of older people is completely unacceptable, and the social care commission has already made it a top priority to identify and drive out this abuse.
"We very much welcome this health select committee report into elder abuse. We are examining its recommendations in detail and are taking forward work to tackle this problem.
"No-one should have to live in fear of those people who should be caring for them.
"We have strong powers to tackle abuse whenever and wherever we find it. If we have any doubts about a care service, our inspectors will go in and investigate - and are doing this at any time of the day or night as required. Additionally in our assessment of council services we will ensure they are properly tackling elder abuse in their work.
"Where any evidence of abuse is found, we will take tough action and, where appropriate, we are working jointly on cases with other organisations, such as police, social services departments and the Healthcare Commission.
"Last year the regulator received 1,629 complaints of abuse - almost one in five of the 8,923 complaints received. These covered the full spectrum of abuse from physical and emotional abuse to financial abuse. The investigations following these complaints, and other inspection work, led to some care homes being closed, care managers being struck off and a significant amount of other enforcement activity to stop abuse in its tracks.
"The new commission will be taking on new functions in relation to complaints about council social services and we will be integrating this function with complaints about care homes, home care and other regulated services. This means that, for the first time, we will get the whole picture of care from commissioning to provision and follow cases through.
"Often abuse can be hidden and our inspectors are careful to look into a wider range of issues - such as staff attitudes, management supervision or the privacy given to residents - that can contribute directly or indirectly to abuse.
"The misuse of medication has been identified as a key area of concern and we will be carrying forward the work of the previous regulator. We will be working with care providers over the coming months to make sure there are proper clinical governance arrangements in place to prevent abuse through medication.
"In our work we will have a strong focus on the people who receive care and their experiences of that care. We will ensure that all our staff working in older people’s services have undergone training to build on their skills in recognising where abuse has occurred and ensuring that they continue to take swift and appropriate action .
"This year we will undertake a number of inspections of services for older people, ensuring that all these services have a clear action plan in place for safeguarding the protection of older people."
Forum Response: General Social Care Council
GSCC chief executive Lynne Berry said: "Abuse of older people or other service users by the people paid to care for them cannot be tolerated. To safeguard service users, we need to drive out untrained, unchecked and unsuitable people from holding a social care worker’s responsibilities.
"We are pleased the committee recognised registration as central to ensuring service users receive care from properly trained and checked workers, committed to high standards and accountable for their practice.
"The GSCC's own risk assessment found that service users in their own home or using outreach services were particularly vulnerable. This will be key to informing our approach to rolling out registration to other care workers."
Forum Response: Stroke Association
A spokesperson for the Stroke Association said: "Each year in England and Wales over 120,000 people over the age of 60 have a stroke. Stroke becomes much more common with advancing age and has a greater disability impact than any other condition. Many elderly people who have strokes will find their ability to communicate impaired, sometimes very severely, and therefore could be at a much higher risk of abuse from carers, relatives or even strangers.
"It is vital that the thousands of elderly people who receive care either in their own home or within a care home as a result of their stroke are safe and protected. The Stroke Association is very concerned by the health committee's report, which claims 500,000 older people are being abused by the very people employed to care and protect them.
"The Stroke Association therefore fully supports the call to make the protection of elderly people top of the government's agenda, and would like to see the introduction of guidelines that would protect all elderly people from any form of abuse."
Forum Response: Royal College of Psychiatrists
Dr Jane Garner, on behalf of the College's Faculty for Old Age Psychiatry, said: "People with dementia present particular challenges to their carers. Without adequate training they can often feel overwhelmed. Coping with repetitiveness, apparently aimless wandering, unpredictable behaviour, insomnia, agitation and occasional aggression requires particular personal skills and attributes. Older people with mental illness are especially vulnerable to abuse, and carers need to be skilful and imaginative.
"People with dementia are often unable to communicate effectively to report mistreatment, and may not even be aware of financial abuse, having lost the ability to manage their own affairs. They are disempowered. This report has important implications for older people with mental illness, who require particular safeguards and better training of care staff.
"Causes of abuse are deep-rooted personally and socially. A whole system, a whole society approach is needed to address them.
"The Commission for Health Improvement, in its recent report on abuse at Rowan Ward in Manchester, referred to old age mental health services as the 'Cinderella of Cinderellas', with attention focussed on access times and activity targets in the acute hospital sector.
"We welcome the increased level of interest in older people's mental health by the Department of Health and the National Directors for Older People and Mental Health.
"The subtleties and complexities of potential abuse need to be understood and they are unlikely to be resolved by regulation alone. Some abusive practice is conscientiously enacted. The majority is out of ignorance, unthinking and ageism - factors which may be addressed in training and sensitive supervision."
Forum Response: Counsel and Care
Martin Green chief executive of Counsel and Care told ePolitix.com: "The Select Committee Report on Elder Abuse highlights both the scandal of abuse and also the institutional ageism that exists within the system. If the government is serious about tackling the problem of abuse of vulnerable people they should require that the same protection that is available to children is applied to vulnerable adults. In particular they need to ensure that the same standards of checking on staff and reporting of abuse apply across all care groups"
Related News
- MPs attack DoH leadership
- MPs demand greater Nice independence
- MPs criticise NHS initiatives
- NHS staff planning a 'disastrous failure'
- NHS 'failing on financial management'
Discuss this article via video now
