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Action on Elder Abuse: Preventing and Addressing Elder Abuse in the UK

Action on Elder Abuse (AEA) is an organization focused on preventing and addressing issues of abuse, primarily elder abuse, in care homes, hospitals, and people’s own homes. They provide support services, conduct research, and advocate for legislation to protect older adults from abuse.

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Action on Elder Abuse: Preventing and Addressing Elder Abuse in the UK

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  1. Action on Elder Abuse

  2. AEA activities Formed in 1993, focuses exclusively on issues of abuse primarily elder abuse, care homes, hospital and people’s own homes. Independently funded. Helpline took 21,000 calls last year. 1,050 from Wales, 1,890 from Scotland and 630 from N. Ireland. Extending the reach and level of casework. Peer Support services in Lambeth, Southwark, Croydon and West Sussex, extended to Manchester and Essex this year and then the Celtic nations.

  3. AEA activities Staff in England, Wales, Northern Ireland and Scotland. Adult Safeguarding/Protection fora in Wales, Scotland and Northern Ireland, feeding into a UK wide stakeholder group developing good practice across the four nations Development of a Practitioner’s Network to facilitate the exchange of knowledge and information. Over 1200 members. Increased level of media activity around the issue of elder abuse and issues relating to adult protection.

  4. UK Study of Abuse and Neglect of Older People - 2007 8.6% The overall prevalence of abuse, defined by ‘expectation of trust’ in the year preceding the survey was This equates to over 500,000 people aged 66 and over. • Leicester population: 330,574 • Cardiff population: 292,150 • Belfast population: 276,459

  5. Data from the AEA Helpline 78% are over the age of 70 years; 16% over the age of 90 years. Over 67% are women; 11% have partners Most, 64%, live in their own home; with 23% in care homes 51% of abuse at home involves a spouse, 49% other family, 13% care worker, 5% friend 53% of victims live with their abuser

  6. Statistics released by the Health and Social Care Information Centre for 2014 - 2015 64% of victims are over 65 years; 29% are over 85 years 43% of abuse was in own home; 39% care home; 6% hospital. 30,000 cases did not know/not record capacity of victim

  7. AEA role in influencing and shaping the Care Act, etc

  8. AEA role Since 2004 AEA has been seeking legislation to underpin adult safeguarding. Our approach was developed as a consequence of our submission to the Health Select Committee Inquiry into elder abuse which was happening at that time. At the 2006 Action on Elder Abuse National Conference the WestminsterGovernment gave a clear commitment to examine the case for legislation, and this was repeated in 2007 When Ivan Lewis launched the Prevalence Study into community elder abuse.

  9. AEA role • In 2009 we made a 114 page submission to the consultation on No Secrets. This covered: • The Prevalence Study; Integration of Legislation; Serious Case Reviews and a centralised database; Learning from Domestic Abuse; Ethnicity and abuse; a focus on familial and community abuse; Citizenship and abuse; the need for national leadership; the need for national training, standards and monitoring of adult safeguarding; Integration of Safeguarding with the NHS; the need for prevention; funding; personalisation; Scotland; and powers of entry Many organisations quoted our submission but, for the first time ever, not one word found its way into the DH consultation response paper.

  10. AEA role In 2008 we met with PM Gordon Brown and in 2013 we met with PM David Cameron to pursue the case for robust legislation. During 2013 we produced multiple briefing papers, analyses of government proposals, drafted proposed amendments, wrote to both Norman Lamb and Jeremy Hunt, coordinated multiple presentations in the House of Lords, and gave evidence to the Joint Select Committee on the Care Bill (we were quoted extensively in this) Additionally, we hosted an Adult Safeguarding Alliance of the British Institute of Learning Disabilities, College of Social Work, Disabilities Trust, Mencap, Age UK, Equality and Human Rights Commission, Unison, Jewish Care, National Autistic Society, British Association of Social Workers and the English Community Care Association.

  11. AEA role Consideration of legislation needs to be based upon a strategic analysis of the value of legislation in comparison with guidance, and the lessons learned in other related fields. Legislation is not just about new laws, it is also about societal messages. This is often acknowledged by the Government. • a) Infrastructure • b) Duties of response c) Powers of intervention/access • d) Support for victims • Definitions • Offences g) Integration with existing legislation • Training, monitoring, national leadership • Funding

  12. Power of Entry – the Consultation

  13. An amendment that would authorise a power of access for confidential interview where: • there is reasonable cause to suspect a person is at risk of abuse or neglect; • access is not available through any other means; • ‘reasonable cause’ is tested via application to a justice of the peace; and • exercising the power will not result in the person being at greater risk of abuse or neglect

  14. The DH analysis of the Consultation The majority of the responses from local authorities and health were in favour (72% and 90% respectively). However, it ishighly significant that only 18% of members of the public who responded were in favour. We believe it is highly significant that members of the public were far more strongly against the proposal compared to health and social care professionals. There was some misunderstanding of what was proposed, with the third party element often omitted.

  15. The DH analysis of the Consultation Was there any research undertaken to determine the number of people affected by a failure to gain entry? No, an AEA FOI request identified 25 people within the previous year, while 46% of respondents to a College of Social Work survey indicated that they would have used such a power 1-5 times in the last three years. 83 members of the public responded to the consultation (39% of total respondents), with 63 opposed to a power of entry (29% of total respondents). At least 90% had ‘misunderstood what was proposed’ i.e. they failed to understand the Third Party issue and the involvement of Magistrates.

  16. The DH analysis of the Consultation What was actually said, in full: The state is already too much like a police state, and it (The state) never should have the power or right to force entry into a law abiding person's home under any circumstances even if someone "thinks someone is at risk". This is a recipe for Fascism.

  17. The DH analysis of the Consultation The same contributor also said: Stalin used Article 58 of Lenin's Criminal Code to justify his Stasi's invasion of people's homes, because they 'thought the residents were enemies of the state', and dragged them off against their will to the Gulags. Now you are proposing to bring in measures which would be almost identical, with the prescribed woolly wording to justify home invasion and detention of fully compus mentis (sic) human beings, without giving them a choice in the matter, saying it is for their own good!

  18. The DH analysis of the Consultation “This is draconiancontrol of the people. And it is Treason (illicit subversion of the nation by removal of the people’s freedoms and liberty in an underhand manner to usurp power over the people). It must never come into force. It is State control of people’s freedom and liberty for State purposes.” No more gestapo powers for the festering cesspool of incompetence that is local government.

  19. The DH analysis of the Consultation “We are not talking about those with limited mental capacity. If this law is passed then any council employee without recourse to a court can forcibly enter my home and tell me that I shouldn’t be putting full fat milk on my cornflakes because that individual’s opinion is that full fat milk is harmful to me, irrespective of my own mental capacity and fitness to make such a decision. That may be an extreme example but the principle is thesame.”

  20. The DH analysis of the Consultation We believe it is highly significant that members of the public were far more strongly against the proposal compared to health and social care professionals. Department of Health ‘These views have been used to completely invalidate the opinions of everyone else, and the views of everyone else were not given an equal weight, and were in fact given a lesser weight.’ Paul Burstow M.P, former Minister for Social Care.

  21. Power of Entry – the Law

  22. Norman Lamb, Minister for Social Care, February 2014 “it is my view that there is no gap in powers that would prevent care or other professionals from accessing those in urgent need of assistance. I am not alone in that view. The Association of Chief Police Officers says:‘Powers of entry are provided to us under both common law and PACE and I am satisfied that these would afford us access to premises where vulnerable individuals are considered to be at risk.’ In its press release responding to the new clause tabled by my right hon. Friend the Member for Sutton and Cheam, Action on Elder Abuse talked about the need to interview people  “being imprisoned in their own homes by their abusers.”That is precisely the sort of situation for which powers are available under PACE to take necessary action where appropriate.”. 

  23. Alex Ruck Keene and Gary FitzGerald, February 2014 on PACE DH, SCIE guidance, October 2014 This power clearly allows the police to enter premises. However, it is with the express purpose of arresting a person. This would seem to mean the police must already have detailed information about an indictable offence being committed and by whom. Therefore, section 17(1)(b)cannot be used simply to gain access to a dwelling in order to allow the police to find out what is going on. The use of the Police and Criminal Evidence Act 1984 (PACE) 17(1)(b) which enables the Police to enter and search premises without a warrant to effect arrest for an indictable offence …could not apply to the extent that there is no established evidence that an indictable crime has been committed etc.

  24. Alex Ruck Keene and Gary FitzGerald, February 2014 on PACE DH, SCIE guidance, October 2014 The use of PACE Section 17(1)(e) provides the Police with the power to enter premises for the purposes of “saving life or limb or preventing serious damage to property”… but there are two relevant cases that restrict its use.These raise the threshold for what can be considered ‘life or limb’ justification for enforced entry, and make clear that general welfare concerns are insufficient. Section 17(1)(e) of the Police and Criminal Evidence Act 1984 gives the police a power to enter and search premises without a warrant, in order to save life or limb or prevent serious damage to property.However, it is not enough that the police should have a general welfare concern about somebody, in order to use this power of entry. Concern for welfare is not sufficient to justify entry.

  25. Alex Ruck Keene and Gary FitzGerald, February 2014 on Common Law • Only a sufficiently real and present threat to the peace justified depriving a citizen, not at the time acting unlawfully, of his liberty: • * The threat must come from the person to be arrested; • The conduct must clearly interfere with the rights of others and its • natural consequence must be "not wholly unreasonable violence" • from a third party: and • * The conduct of the person to be arrested must be unreasonable: • In the circumstances it seems unlikely that uncorroborated anxiety or concern by a next door neighbour would meet such a criteria or be legal justification for enforced entry under Breach of the Peace.

  26. On Common Law DH, SCIE guidance, October 2014 • The courts have set a high threshold of justification for entering domestic premises to prevent a breach of the peace. • The purpose of the power is to deal essentially with emergencies. • Only in exceptional circumstances will it be justifiable to enter into • private premises to deal with or prevent a further breach of the peace • The officer must, before he enters, be satisfied that there is a real • and imminent risk of a breach of the peace. • Where the original breach has not occurred in the police officer‘s • presence, the further breach must be immediate or about to occur. • * The threat to the peace must be sufficiently real and present • So, just as in the case of section 17(1)(e) of the Police and Criminal Evidence Act 1984, a general “welfare visit” would obviously not satisfy this test.

  27. Does the Care Act meet expectations?

  28. The Care Act No

  29. The Care Act: what’s good Safeguarding Adults Reviews: in addition to the circumstances in which you would expect to hold a SAR, SAB's are free to arrange for one in other situations where it believes there may be value in doing so. These should be about learning but evidence to date suggests SCRs are not having that impact. There is no central library from which to access them, and no legal requirement to learn from them. A system that provides centralized monitoring and support e.g. a central library of Serious Case Reviews is needed, with consistent analysis and reporting to allow monitoring of trends etc.

  30. The Care Act: what’s good Advocacy: There is a requirement to arrange, where appropriate, for an independent advocate to represent and support an adult who is the subject of a safeguarding enquiry or Safeguarding Adult Review (SAR). Only 2.1% of cases had such an advocate in first six months against a target of 7%. The two barriers appear to be a lack of funding and an insufficient supply of advocates. If something is going to be a legal requirement then it needs to be adequately funded and supported. If there is evidence it is not happening then the causes need to be explored and addressed.

  31. The Care Act: what’s good Enquires: There is now a legal requirement for a local authority to make enquiries, or ensure others do so where someone ‘needs care or support', be experiencing or be at risk of abuse or neglect, and be unable to protect themselves because of their care or support needs’. Linking abuse scenarios to ‘care or support needs’ is unhelpful and misses the reality of many domiciliary and financial abuse circumstances. The system really needs to focus on the fact that someone is being abused and, for whatever reason, needs outside help to stop it and/or control it..

  32. The Care Act: what’s not so good Under No Secrets Safeguarding was a non-statutory policy directive, and functioned through the use of other legislation, such as the Community Care Act, the Mental Capacity Act, the Mental Health Act, and the Human Rights Act. This remains the case with the Care Act, as it has provided no new Powers of Intervention. Powers of intervention that are proportionately applied by suitably qualified staff, that allow access to potential victims, and that learn from Scotland and Domestic Abuse, in terms of barring and managing abusers.

  33. The Care Act: what’s not so good Safeguarding Adults Boards: The Act confirms into law the existing arrangements for Adult Safeguarding Boards but makes them exclusively locally accountable. It's definitely good that they are now statutorily required, but the issue is about how effective they can be given their limited defined role. There needs to consistency across Local Authority boundaries, in terms of what type of response can be expected, the level and quality of training provided to those who are intervening, the maximum length of time an investigation should normally take, and which has national expectations and standards.

  34. The Care Act: what’s not so good Definitions: The Act explicitly states that “Abuse” includes financial abuse but all other forms of abuse are addressed through the statutory guidance. The rationale that everyone understands what abuse is flawed. We need to comprehensively defines abuse in legislation, with criminal intervention genuinely available, with consequences that do not belittle the victims experience by offering suspended sentences, and community service etc in place of real deterrence.

  35. Measurement • Infrastructure • Duties of response • Powers of intervention/access • Support for victims • Definitions • Offences • Integration with existing legislation • Training, monitoring, national leadership • Funding Okay Open to interpretation. Insufficient Non-existent Okay Open to interpretation. Insufficient Non-existent Non-existent Non-existent Non-existent

  36. Elder Abuse Helpline 080 8808 8141 Admin telephone: 020 8835 9280 Email: garyfitzgerald@elderabuse.org.uk WEBSITE: WWW.ELDERABUSE.ORG.UK

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