ISA

1
ISA
www.isa-gov.org.uk

• odonos01

2
Aims of sessionTo provide an update regarding
measures available to safeguard vulnerable adults
from abuse by staff with a duty of care to
protect them from harm

• Whistleblowing
• Cases of institutional abuse
• Care Council for Wales information
• NMC information
• POVA List
• Wilful neglect / ill treatment new criminal
  offences
• Cases prosecuted
• Independent Safeguarding Authority
• Implementation plan

3
Public interest disclosure /Whistleblowing

• In 2000, CHI reported on institutional abuse at
  North Lakeland NHS Trust, stating there was a
  systematic failure of management that allowed a
  culture of abuse to flourish.
• Patients with dementia were manhandled and denied
  a normal diet. One was tied to a commode others
  were fed whilst on the toilet two were left
  outside wearing inadequate clothing for the
  weather.
• Abuse was reported by student nurses. An internal
  investigation followed, but no disciplinary
  action was taken. Relatives later reported
  concerns directly to CHI.
• CHI reported that the Trust had ignored
  whistleblowers and implicitly condoned/excused
  abuse, allowing it to continue for 2 years. Its
  governance was felt to be seriously compromised
  and Trust managers were dismissed.
• In 1998 the Public Interest Disclosure Act
  became statute, requiring all statutory bodies to
  produce policies for confidential reporting, to
  ensure whistleblowers are protected from
  victimisation or dismissal. (See supplementary
  guidance - Appendix B of the Policy.)
• The VA1 abuse referral form allows it to be noted
  that the staff member who refers wishes to remain
  anonymous, however, professionals are bound by
  their Codes of Practice to support abuse
  investigations.

4
(No Transcript)
5
(No Transcript)
6
(No Transcript)
7
(No Transcript)
8
(No Transcript)
9
Care Council for Wales Register

• The Register of Social Care Workers opened in
  June 2003 with the registration of individuals
  with a Social Work qualification, followed by
  Social Work students in 2004 and Social Care
  Managers in 2005. 
• The Register is open to all Social Care Managers
  and Workers as described in the Care Standards
  Act 2000. The Register puts social care workers
  on a similar footing to other public service
  professions.
• It functions in the same way as the NMC Register
  and Social Workers who breach the Code of
  Practice for Social Care Workers could be removed
  from the Register.
• A major part of the drive for higher standards in
  social care services, registration will help give
  social care workers the recognition they deserve.
  It will also allow service users to be confident
  that they can depend on a trained and trusted
  workforce.

10
Care Council for Wales Register cont

• The number of social workers currently registered
  with the Care Council is 5277, as of March 2008.
• A Care Council for Wales Registration Committee
  has not refused registration to any applicant.
• In total 8 Conduct Committee Hearings have been
  held
• 2006 2
• 2007 6
• No Conduct Hearings have yet been held in 2008
  although 3 are scheduled.
• The Committees have removed 4 registrants,
  imposed a 1 year Suspension Order on a Registrant
  and Admonished 3 Registrants.

11
(No Transcript)
12
NMC Fitness to Practice Report 2004-5
13
POVA List

• From July 2004, a POVA List of staff within
  care homes/ domiciliary care agencies who abused,
  neglected or otherwise harmed vulnerable adults
  in their care was kept.
• The POVA List gave employers covered by the
  scheme a statutory responsibility to check staff
  against the list before they took up employment. 
  Access to a check was through the Criminal
  Records Bureau (CRB). Therefore, a POVA check
  also included an enhanced CRB check.
• Employers were required to refer staff to the
  list where staff have been sacked or suspended
  because of misconduct which harmed a vulnerable
  adult or placed them at risk of harm. To have
  been confirmed on the list, a person had to
  fulfil the criteria
• Their employment fell within the scheme
• Misconduct occurred which harmed or placed at
  risk of harm a vulnerable adult
• The misconduct resulted in the person being
  sacked or suspended
• The person was deemed unsuitable to work with
  vulnerable adults.
• Decisions were made on the balance of probability
  and are made by a senior official in WAG on
  behalf of the Secretary of State.

14
POVA List 1st year data research

• By the end of June 2005, 155 people had been
  permanently barred from working with vulnerable
  adults and 559 people were provisionally on the
  POVA list pending further clarification of their
  cases, equalling a total of 714.
• An audit of the first 100 referrals, commissioned
  from King's College London by the DoH, which
  introduced the scheme, found that
• Just over a third of referrals concerned male
  workers involved in physical abuse, despite them
  forming only 5-15 of the workforce
• The vast majority (87) of referrals were of
  front line workers, care assistants and support
  workers, including 8 who were registered nurses
• The top three reasons for referral concerned
  neglect, physical or financial abuse
• Neglect and physical abuse were more likely to be
  found in residential settings, and financial
  abuse in domiciliary care
• 81 of referrals came from residential services,
  despite the fact that in England and Wales 80 of
  service users receive community-based services
• The Police were involved in 40 of referrals 7
  staff were convicted of offences
• Many workers were referred for more than one type
  of abuse. 

15
POVA List 1st year report cont.

• A total of 2,124 referrals were made in the first
  year, at the rate of approximately 200 a month,
  and cases involving violence or sexual abuse were
  prioritised.  
• The researchers at Kings concluded there was a
  need for a wider examination on the quality of
  social care employment practice, more information
  on ethnicity of service users and staff, and more
  guidance about the roles of adult protections
  teams.
• There were clear implications for the
  workforce 
• males were over represented and more likely to be
  involved in direct forms of harm
• female staff were more likely to be involved in
  neglect or financial abuse 
• staff were inadequately equipped to deal with
  challenging behaviour 

16
Problems with the POVA List

• The POVA List was always seen as being flawed, as
  it only applied to staff working within the
  social care sector. What about staff who
  perpetrate abuse within voluntary sector services
  and the NHS?
• The gap allowed staff who abused within other
  sectors to be re-employed within social care
  after they had been dismissed (or resigned before
  dismissal) for abuse of vulnerable adults.
  (People could move between care sectors or
  geographically, perhaps obtaining references from
  earlier employment.)
• The POVA List was also successfully challenged in
  the High Court, by several nurses working in care
  homes who had been placed on the provisional
  list and had been subject to loss of earnings.
• Thus the POVA List was replaced by the
  Independent Safeguarding Authority Vetting and
  Barring Service in January 09 and will be
  extended to the NHS and other sectors on 12th
  October 09.

17
New criminal offence

• The Mental Capacity Act 2005 introduced new
  criminal offences of ill treatment and wilful
  neglect of a mentally incapacitated adult.
  Penalties range from a fine to a sentence of
  imprisonment of up to 5 years, or both.
• 14.25 For a person (or authority) to be found
  guilty of ill treatment, they must either
• Have deliberately ill-treated the person, or
• Be reckless in the way they were ill-treating the
  person or not.
• It does not matter whether the behaviour was
  likely to cause, or actually caused, harm to the
  persons health.
• 14.26 The meaning of willful neglect varies
  depending on the circumstances, but will usually
  mean that a person has deliberately failed to
  carry out an act they knew they had a duty to do.

18
(No Transcript)
19
(No Transcript)
20
(No Transcript)
21
Independent Safeguarding Authority

• The new Independent Safeguarding Authority
  (www.isa-gov.org.uk) will have an important and
  lasting impact on our work with vulnerable
  adults, especially in terms of recruitment and
  disciplinary processes.
• The ISA was established after the Safeguarding
  Vulnerable Groups Act 2006 passed into statute.
  The Act was developed as an outcome of the
  Bichard Inquiry which investigated the tragic
  murders of Holly Wells and Jessica Chapman in
  Soham in 2002.
• Recommendation 19 of the Bichard Inquiry stated,
  "New arrangements should be introduced requiring
  those who wish to work with children or
  vulnerable adults to be registered. The register
  would confirm that there is no known reason why
  an individual should not work with these
  clients.
• Such a register would have prevented Ian Huntley
  from being appointed as a school caretaker
  despite known previous concerns.

22
ISA Scheme cont.

• The ISA will establish Barred Lists for Children
  and Vulnerable Adults, which will replace the
  existing POCA List, List 99 and the POVA List, as
  well as Disqualification Orders.
• The new Barring List - Vulnerable Adults, will
  extend the existing POVA List scheme from social
  care to cover all sectors, including health and
  voluntary services (from 12th October 2009).
• All those working in 'Regulated activity' have
  to be 'Vetted' (registered) to work with
  vulnerable adults. Thus a Vetting Service is
  established.
• 'Regulated activity' is defined as being, "any
  activity of a specified nature that involves
  contact with children or vulnerable adults
  frequently, intensively or overnight.
• Any person applying to work with vulnerable
  adults must first apply to the ISA Vetting
  Service via the CRB, who will check whether there
  is any relevant information from the Police or
  any referred information from previous employers
  or professional bodies that states that the
  person has been dismissed (or resigned) because
  they harmed, or put at risk of harm, a vulnerable
  adult.

23
ISA Scheme cont

• It will be a criminal offence for employers to
  appoint someone to work in a regulated activity
  without first checking their status under the
  Vetting Service and/or to allow a Barred
  individual to work in such activity. (It will
  also be an offence for a Barred individual to
  seek such employment.)
• If there is no information held on record, the
  CRB will inform the applicant that they are
  Vetted. If there is information, the CRB will
  pass it on to the ISA, which will make the
  decision to place the person on the Barred List.
• Those working within 'Controlled activity', i.e.
  support work which involves indirect contact with
  vulnerable adults, such as cleaners and catering
  staff, will also need to be Vetted. However, a
  Barred person may be permitted to work in
  controlled activity, providing effective
  safeguards are put in place.
• The ISA will make independent discretionary
  Barring decisions based on clear criteria and
  evidence. Individuals placed on the Barred List
  will be able to appeal against the decision via a
  Care Standards Tribunal, except when they have
  committed a serious offence.

24
Implementation

• The Barred List will be more current than the
  Enhanced CRB Check, as it will be reactive and
  maintained with rigour by the ISA. (CRB Checks
  are merely a 'snapshot' of information, only
  valid on the day of issue.)
• Employers will be able to undertake a 'live'
  on-line check of prospective employers' status on
  the Vetted Register and Barred List.
• Registration will cost individuals a one off fee
  of 64, as once on the Vetted Register the ISA
  will maintain the Vetted Register and Barred List
  on a regular basis.
• Referrals to the ISA will be made by the Trust
  once a disciplinary process is concluded (the
  process for this is yet to be defined, but it is
  likely that referrals will be co-ordinated via
  multi-agency Adult Protection Case Conferences
  (POVA), as the case file for the ISA will need to
  be prepared.
• There will be a legal duty to refer (criminal
  offence not to refer) when a worker has been
  dismissed (or resigned before dismissal) for
  causing harm to a vulnerable adult or placing
  them at risk of harm.

25
Updates ISA ROADSHOWS JULY 2009

• The CRB will be maintaining the Barred Lists
  (vulnerable adults and children) and providing
  information to the ISA from 12th Oct 2009.
• From 12th Oct 2009 all enhanced CRB checks will
  include an ISA Barred List check. Enhanced CRB
  check will reveal the new Barred List information
  decisions may take up to 28 days. It will be an
  offence to employ anyone before satisfactory
  checks are available.
• From 26th July, 2010 the ISA on-line service
  will be available, where employers can check a
  persons ISA status Vetted or Barred. However,
  prospective employees will have to consent to
  their status being checked and will need to
  supply their ISA registration number and date of
  birth.
• The system will be constantly monitored and any
  new information supplied to the CRB via the
  Police National Computer or from the ISA will be
  included.
• - Employers will be able to subscribe to the
  on-line checking system, so that all individuals
  within the organization can be monitored. E-mails
  will be sent to the employer automatically if
  there any changes in the status of individuals.

26
Phasing In

• - YEAR 1 - From November 2010 it will be
  mandatory for all new entrants and job movers to
  seek ISA registration, before they commence work
  in a new post and a legal requirement for all
  employees to check individuals status.
• Year 2, 2011-12 - all those who have never had a
  CRB check including existing employees must be
  enhanced CRB checked/ISA vetted
• Year 3, 2012-13 - all those whose CRB checks are
  over three years old
• Year 4, 2013-14 - those with more recent checks
  will need to be re-checked Year 5 (in 2015) - all
  remaining workers, including those who work in
  controlled activity will need to be enhanced CRB
  checked and ISA vetted.
• ISA registration is fully portable and travels
  with the employee to any new posts. There will
  be a one-off fee of 64 for the ISA
  registration.
• Further information, including a FAQ Booklet,
  can be obtained form the ISA website
  www.isa-gov.org.uk