Long gone are the days when turning a blind eye to institutional abuse or blaming it on “one bad apple” was considered acceptable.
Those who work in healthcare have an ethical and legal obligation to make sure that those we care for are safe, but that does not mean that we all instinctively know how to.
In an age where the community ties of old have frayed, people like myself who work in healthcare are increasingly perceived, and expected to act as guardians of those members of our society who have complex needs.
However, you cannot expect dedicated professionals performing this important role to do so without the proper skills, knowledge and attitude.
“This new guidance is part of the continuing response”
We all know about the abuse scandals that have been uncovered in recent times – of which Winterbourne View is just one - and it is right and proper that they have been exposed and reforms made. This new guidance is part of the continuing response designed to counter such incidents of abuse, harm and neglect from re-occurring.
Adult Safeguarding: Roles and Competencies for Health Care Staff may have a slightly prosaic title but it is a watershed moment in adult healthcare and I am proud to have been its lead author.
It will greatly help organisations and the people who work in them to safeguard adults at risk from abuse, harm and neglect before it starts.
We are also seeing other equally dangerous types of exploitation emerging and this new set of roles and competencies is also a response to that.
Although hard statistics are in their infancy, a National Crime Agency report on county lines violence, exploitation and drug supply, published in November 2017 highlighted some of these illegal practices that are on the rise and affecting adults at risk.
They include “cuckooing”, where unscrupulous people take over the home of an adult at risk, and exploit them, even to the point of taking over the property; non-consensual online pornography involvement; and people trafficking and modern slavery.
As healthcare professionals, we know that working with people to help them safeguard their health and wellbeing is essential. It requires careful judgement, emotional labour and sound knowledge – and is not without risk.
Safeguarding activity is widely recognised as a core responsibility and is as much about prevention as intervention but when things are going wrong we need to act.
These new measures aim to safeguard anyone in the UK over the age of 18 at risk of abuse, harm or neglect because of their need for care and/or support, who are unable to safeguard themselves.
The role and competencies cover everyone from receptionists and porters to consultants and board members. There will be five levels, depending on the nature of a person’s role, and a mandatory training session is recommended to begin within the first six weeks of staff starting a new role within a healthcare organisation. Staff at every level will be required to refresh their skills within every three-year period.
It will cover staff working in everything from hospitals to care homes and those who help people to stay living in their own home. It is designed to counter all types of abuse.
Coming up with these new roles and competencies has been a highly complex piece of work. Officially, the Royal College of Nursing was asked by the NHS England to lead on it in January, and more than 30 other royal colleges and health organisations have contributed to it. However, its genesis stretches back longer than that.
“These new guidelines will help us all be better at what we do”
Much still needs to be done, such as the nuts and bolts of training and skills evaluation. However, what is certain is these new guidelines will help us all be better at what we do and ensure that the adults at risk who we safeguard are able to live without fear.
Dawne Garrett is professional lead for older people and dementia care at the Royal College of Nursing and lead author of Adult Safeguarding: Roles and Competencies for Health Care Staff