Posted by Marcia White on 10 April 2012
I welcome the publication of the Care Quality Commission’s recent report on the operation of the Deprivation of Liberty Safeguards in England.
Though the CQC clearly states the next stages, there is also a depth of implication for health and social care professions to embark on a full review of existing practices, policies and guidance.
The overview gives me much concern and I recommend that all managers, commissioners of service, and Safeguarding Adults Boards digest the implications of this report.
This would be especially useful for their own resources, staff and service users in order to arrive quickly at an updated strategy to further protect very vulnerable people.
Sadly some of the issues raised, or which are implicit, in this report are not new and without being addressed at an early point will be to the detriment of vulnerable adults.
Appropriate safeguarding training
My views are that:
- The full review of the commissioning policy within local authorities – care homes without policies and good practice evidence, within a specified timescale, should not be used as a placement resource.
- Similarly there must be evidence available by the provider that all staff are appropriately trained in all aspects of safeguarding – a lack of evidence must therefore negate a placement possibility. That only one third of staff is trained is entirely unacceptable.
- The reasons that applications were not granted gives me real concern that managers and other staff are so confused and lacking knowledge. Training on Deprivation of Liberty should be mandatory for all staff and this lead should come from Safeguarding Adults Boards. It is clear that such applications should not have been made – more, that multi-agency safeguarding reviews should have been called and that refreshed care plans and protection plans should have been established.
- There is evidence of “gaps in information” which indicate poor record keeping.
- There is evidence of restriction without “proper” assessment, which infers a lack of multi- disciplinary working.
- There is a lack of leadership in the direct management of some care homes and from the commissioners in respect of ensuring that care staff are adequately trained to undertake their caring task, and especially in ensuring that all are accessing fully their legal entitlement of liberty and all other human rights.
- I would recommend that this topic is placed on the agenda of all PCT and social care management at an early stage to ensure that this cannot become “just another report”. Providers’ meetings must also be tasked to report back on the effectiveness and legality of their care provision. Above all, opportunities must be afforded at all levels to learn from good professional practice examples.
- It is clear that this issue is “Everybody’s Business” and responsibility for which we must be accountable.
Safeguarding practice needs significant improvement
I would like to think that a future report will describe a significant improvement in all areas of practice, policy, guidance and training levels relating to adult safeguarding.
Without promoting the need to achieve this would be to render the safeguarding of very vulnerable people as unimportant. It could also point to illegal practice.
For my part I will be raising awareness on both the existence of this report and its contents. A partnership approach to achieving these targets is the most effective way forward. There is a need to act now!
Alan Lambert is an independent Safeguarding Consultant & Trainer
Deprivation of Liberty Safeguards in England – Care Quality Commission