Editorial

Bridget Penhale (School of Health Sciences, University of East Anglia, Norwich, UK)

The Journal of Adult Protection

ISSN: 1466-8203

Article publication date: 9 April 2018

307

Citation

Penhale, B. and Flynn, M. (2018), "Editorial", The Journal of Adult Protection, Vol. 20 No. 2, pp. 73-77. https://doi.org/10.1108/JAP-03-2018-0004

Publisher

:

Emerald Publishing Limited

Copyright © 2018, Emerald Publishing Limited


Welcome to our second issue of this year. As always, there are lots of events to snag the attention of safeguarding students – violence in all its manifestations, belated convictions, the bonuses of the overpaid and organisations caught in the headlights because they did not protect children and young people and adults with support needs. There are too many trials being described as “the biggest […] abuse scandal”. So, we will begin with a rare account of a successful and concerted initiative, to reduce knife crime. “No knives, better lives[1]” was part of the Scottish Government’s response to Scotland’s significant knife crime problem. The Strathclyde Police set up a specifically funded Violence Reduction Unit, which has adopted a public health approach to knife crime, that is, the police undertake focussed work with the health, education and the social work services. From stop and searches, hard-hitting campaigns, increasing sentences for carrying knives in Scotland and hearing victims and their relatives describe the impacts of knife crimes on them, in court – Scotland has significantly reduced the numbers of children and teenagers killed.

Another programme of work merits consideration. Two years ago, the Mersey Care Trust set itself the goals of reducing re-admissions for self-harm and eliminating suicides[2]. Mental health patients’ social media posts are scanned by an artificial intelligence app for signs and cues that they may be contemplating harm or suicide and it alerts services when they visit suicide hotspots. While perhaps not as exhilarating as the precision and miniaturisation of robot-assisted remote surgery, for example, the outcomes are just as valued.

Back to the usual fare, we begin with the trial of Larry Nassar, a world-renowned Sports Physician, who has just begun his 175-year sentence for decades of sexually abusing girls and young women who aspired to be Olympian athletes. More than 150 women made impact statements[3]. Complaints about him were dismissed. He convinced parents that their children were lying. It is inexplicable that his night time “pelvic exams” in hotels and dormitories went unchallenged. USA Gymnastics, Michigan State University and the US Olympics Committee took no action.

Onto football and one junior football coach, youth scout and predatory paedophile’s legacy will not be forgotten at Chelsea, Crewe Alexandra and Manchester City. Since Barry Bennell was also associated with junior teams in Derbyshire, Staffordshire, Cheshire and Greater Manchester and “soccer camps” in the USA, the reach of his crimes is unknown[4]. A series of convictions in the USA and UK did not halt his crimes. A “star maker” – it is not only the patriarchy of filmmakers who deploy sexual aggression to selectively advance the careers of chosen victims. Just as #MeToo revealed the courage required by young women in a single industry to reveal the dark underbelly of criminal assaults and threats, children and young boys did not asked to be raped. Bennell has been jailed for 31 years.

Bijan Ebrahini was a disabled Iranian refugee who will not be quickly forgotten by Avon and Somerset Police and Bristol City Council[5]. They treated him as a nuisance and troublemaker rather than a complainant reporting multiple crimes committed against him. He was arrested on 15 occasions and yet was never prosecuted. He was kicked to death and a neighbour, Lee James, who had believed Ebrahini was a paedophile, set his body on fire. The failures of the police and council resulted in the findings of police racism at both officer and institutional levels. He was “treated differently to his detriment and without objective reason”. Four police officers were dismissed, two of whom received jail sentences – two decades after the publication of the MacPherson report concerning the racist murder of Stephen Lawrence and the institutional racism that was prevalent at that time.

Meanwhile, the festival of greed persists uninterrupted with chief executives immune to embarrassment. For example, the taxpayer-backed help-to-buy scheme has made some builders very rich[6]. The Chief Executive of Housebuilder Persimmon has received a “bonus” of £100 m – linked to stock market performance, which was boosted by the taxpayer-backed scheme.

The Community Security Trust reported an increase of 3 per cent in anti-Semitic incidents during 2017[7]. The total of 1,382 incidents is attributed, inter alia, to the “rise in all forms of hate crime following the referendum to leave the European Union in June 2016”. The most common form of incident was randomly directed verbal abuse in public. The theme for Holocaust Memorial Day 2018 was “The power of words”.

We know that mistakes, trial and error are vehicles to learning. However, doctors are threatening to cease recording their errors in the wake of Hadiza Bawa-Garba’s conviction of manslaughter by gross negligence[8]. The conviction hinged on the death of six-year-old Jack Adcock in 2011. Jack had Down’s syndrome. Bawa-Garba did not diagnose sepsis, or escalate his deterioration to a consultant. She mistakenly halted his resuscitation. There is, however, a view that the doctor is a scapegoat for systemic failings and possible racism.

However, mistakes, trial and error may not always be effective vehicles to learning. Some readers will have been following the torturous tale of Connor Sparrowhawk, who died in a bath in an Assessment and Treatment unit in July 2013, as a result of an epileptic fit. The Consultant Psychiatrist in the Unit, Dr Valerie Murphy, who is currently working in Ireland, has been subject to a GMC hearing into her fitness to practice, which was finally drawn to a conclusion in mid-February. Some of the delay in hearings and outcomes has been due to deliberations by the GMC concerning Dr Murphy’s apparent failure to acknowledge her role and level of responsibility for what happened to Connor and her absence of insight about both the situation and her role in it. The final determination by the GMC, issued in mid-February is that Dr Murphy has been suspended from the GMC register for a period of 12 months from late March this year, with a further review at the end of this time to determine if she can be re-admitted to the register. Readers will have seen a book review (by Margaret Flynn) of Justice for Laughing Boy, written by Connor’s mother, Sara Ryan in the previous issue of the journal and be aware of the ongoing stress and distress that the family face. This outcome may not serve to alleviate the distress that much.

Belated justice was realised during January 2018 when harpist Danielle Perrett and her ex-partner were found guilty of sexually assaulting a 14-year-old boy more than 30 years ago[9]. Richard Barton Wood was the boy’s Teacher and he had assaulted the boy on several occasions prior to taking him to spend the night with him and his fiancée. Despite apparent attempts by the couple to deflect attention away from them, and to implicate a “promiscuous teenager”, the court found both parties in the couple culpable of sexual assault.

The public inquiry into historical child sexual abuse has been scaled back[10]. It will undertake to assess how organisations responded to abuse claims rather than investigating claims of an establishment cover-up and whether or not allegations against Westminster figures are true, which was one of the perceived strengths of the inquiry. The Times reported that since 2015 until this most recent decision, it has cost £56.2 m (O’Neill, 2018).

At the end of 2017, Lord Carlile criticised the Church of England for its “rush to judgement” in handling allegations of sexual abuse against George Bell, the former Bishop of Chichester who died in 1953[11]. At the beginning of February 2018, the Archbishop of Canterbury was criticised by historians for stating that there was a “significant cloud” over George Bell[12]. The Archbishop declined to rescind the claim, observing that:

Our history over the last 70 years has revealed that the church has covered up, ignored or denied the reality of abuse on major occasions […] As a result, the church is rightly facing intense and concentrated scrutiny.

A former headmaster of St Benedict’s School, who became the abbot of west London’s Ealing Abbey before going on to work at the Benedictine headquarters in Rome, was found guilty of rape and other sexual offences at the end of 2017. Andrew Soper[13] also subjected pupils to sadistic beatings. Soper had withdrawn money from Vatican bank accounts and became a fugitive in Kosovo. He was sentenced to 18 years.

In the early months of this year, we have also heard about the trial of Matthew Falder, a former Lecturer in Geophysics and Cambridge graduate who was described as a “warped and sadistic” paedophile, who blackmailed victims and shared abuse tips and images on the dark web. During his trial, Falder admitted 137 charges, including rape, against 46 people, some of whom attended his court hearing. Through his use of blackmail, victims were coerced into various acts of degradation, including licking toilet seats and self-harming. Falder was eventually caught after several years by an international global taskforce, involving security services from Europe, the USA, Australia, New Zealand and Israel due to his involvement in the “dark web”. And in a very rare step, the University of Cambridge has indicated that it is “actively pursuing” stripping Falder of his academic qualifications. Falder has been jailed for 32 years, with a further six years on licence on his release. Several of his victims have stated that they are also serving life sentences as a result of his abusive actions[14].

Once again, home education is at centre stage. California parents David and Louise Turpin have been charged with torture and child endangerment after their 13 severely malnourished children were rescued. Seven of the Turpins’ legally adult children did not appear to be so because of their physically compromised condition[15].

Early February saw the publication of a Safeguarding Adults Review (SAR) on a care home run by the National Autistic Society (NAS), Mendip House in Somerset[16]. Residents of the care home were subjected to bullying, humiliation and “cruel behaviour” by the staff in ways that appear alarmingly reminiscent of events that took place at Winterbourne View private hospital some years ago. The review report stated that there was a group of controlling male staff, which had dominated the home; eventually five staff members were dismissed. The home closed in the autumn of 2016 around five months after several whistleblowers had made reports to the CQC. The review determined that the NAS was “primarily accountable and responsible” for the abuse that took place in the home. Funding for the home predominantly came from Somerset Clinical Commissioning group, but seven different local authorities were involved in relation to placements of the small number of residents. It appears that an earlier report had indicated that concerns might have been addressed sooner if fewer authorities had been involved. The review report recommended that there should be changes to the way that care placements are managed, including the almost obvious conclusion that commissioners (in the form of clinical commissioning groups and local authorities) must monitor placements and quality of care effectively. Once more it seems that concerns are raised about remote commissioning and the inadequacy of the review system for distant placements – with a striking and conspicuous need for renewed and increased scrutiny. When will this increasingly critical situation be resolved?

Finally, the charities – and we have glimpsed some terrible secrets. In late January 2018, we heard of a “Presidents Club Charity[17]” for captains of industry. Specifically, there was a men-only fundraising dinner at which 130 hostesses were groped and propositioned, having been asked to sign five-page, non-disclosure documents. Organisations have since said that they do not want donations tainted by such entrenched sexism, but there are pressures in such austere and cash strapped times[18]. Onto Haiti, and Oxfam is not the charity we imagined[19]. Post-earthquake allegations of sexual exploitation by aid workers during 2010 are shocking, the consequences of which continue to evolve. Once again, some much-needed space is being given to those who experienced assaults and threats – but this is very belatedly – once again.

This issue of the journal contains a number of papers about different aspects of safeguarding; from care homes to mental health trust hospitals and community-dwelling people who experience abuse and/or neglect. Our first paper is by Michael Preston-Shoot and is a further paper based on additional research on the issue of self-neglect. The paper considers the issue of self-neglect within SARs, which some readers will be familiar with from previous papers written by Michael and his colleagues. One aim of the paper is to update the database that has been developed about safeguarding adult reviews that focus on self-neglect and accompanying thematic analysis. Additionally, however the paper examines what components might be needed to move from action plans to changes in both policy and practice, where necessary. Several additional published reviews are therefore added to the core database that has been established and the thematic analysis that was previously developed, that contains four domains, is also updated in the paper. Further to this a framework for how to take action plans developed from the findings and recommendations from SARs in this area is introduced to enable Safeguarding Adults Boards (SABs) to ensure longer-term and strategic approaches to changes in policy and practice. This will be useful to those readers who are involved in work around both SABs and SARs but also to others who are interested in the overall evolution of safeguarding practice and policy development in this area.

Our second paper of the issue, by Marion Foley and Ian Cummins, focusses on the issue of sexual violence within mental health settings. The paper reports on the findings of a scoping study on the extent of recorded sexual violence of inpatients on mental health units. The study used Freedom of Information requests to local police forces and mental health Trusts to obtain information about recorded incidents of rape and sexual assault (by penetration) over a five-year period. The results indicated that there were significant variations in how such incidents were recorded by police forces and Trusts and that practices were inconsistent and inadequate. The resulting information gap also suggests that individuals with a history of in-patient mental health events may be less likely to have sexual assaults investigated or recorded as a crime. A number of recommendations to address this problem are made in the paper.

The third paper by Rita Khatri and colleagues from India is also related to sexual violence and concerns sexual harassment at street level of women in Mumbai. The paper is based on a research study that aimed to explore the issue of women’s safety on the streets of Mumbai. Methods used in the study included the combination of use of a structured survey, in-depth interviews and an audit of busy street areas by the researchers, considering a number of aspects that might affect the safety of women in these places. The findings included strong views about transport safety, perceptions, personal experiences and difficulties in relation to police involvement. The overwhelming majority (over 90 per cent) of the study respondents indicated concern and anxiety about safety most or all of the time when outside the home. A number of useful recommendations for future developments relating to safety are made in the paper.

The final full paper is by Steve Moore and is a further paper from him about elder abuse in care home settings. The specific focus of this paper extends his examination of commissioning practices, with this study concerning the perspectives of care home managers about the role of contract monitoring (external to the homes) in preventing abuse. A number of semi-structured interviews were held with the managers of 16 care homes in one area of England (two local authorities). Although care home managers usually regarded individuals involved in contract monitoring quite positively personally, they were perceived as relatively ineffective due to lack of knowledge about and experience of care provision. The results of the research imply that currently, contract monitoring may be of limited use in effectively establishing the nature of care provided in care homes, or potentially the presence of abuse. There are links too to some of the issues raised earlier in this editorial in relation to the findings from the SAR of Mendip House.

Our final offering of this issue is a book review by Neil James covering the second edition of Safeguarding Adults in Nursing Practice, written by Ruth Northway and Robert Jenkins. Although the book is aimed at student nurses, it will be of interest to practitioners from a number of different disciplines and aims to increase knowledge and understanding of practice, policy and research in safeguarding. Since books on developing practice in safeguarding are relatively thin on the ground, it is good to see publication of this second edition.

We hope that the range of articles in this issue will provide much of interest for readers. As ever, we are keen to publish work that is taking place in this broad area, across research, policy and practice and to encourage contributions from authors. If anyone has any ideas for papers for future issues and wishes to discuss these further, please do get in touch with one of the editors (Margaret Flynn and Bridget Penhale). Our contact details appear on the cover of the issue.

Notes

Reference

O’Neill, S. (2018), “Westminster abuse inquiry scaled back”, The Times, 1 February, available at: www.thetimes.co.uk/article/westminster-abuse-inquiry-scaled-back-jv6kg20hb (accessed 20 February 2018).

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