Who should be barred from working in care services?

Exploring approaches to barring people from working in social care services.

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Martin Stevens, Jill Manthorpe, Shereen Hussein, Stephen Martineau, Joan Rapaport, Jess Harris

Social Care Workforce Research Unit

Introduction

• Background

• The POVA List

• The research

• How to Synthesise unsuitability

• POVA List implications for concept of vulnerability and risk

Background

• Increasing policy focus on safeguarding/protecting adults, particularly since the late 1990s

• No Secrets (2000) first dedicated Government policy

• Protection of Vulnerable Adults (POVA) List introduced in England in Care Standards Act (2000), implemented 2004

• Independent Safeguarding Authority introduced by the Safeguarding Vulnerable groups Act (2006)

• Manifests desire to ‘Bring future into the present’ (Adam, 2005: 298)

The Protection of Vulnerable Adults (POVA) List

• It creates a list of people, held by the Secretary of State, who are considered unsuitable to work with vulnerable adults in England and Wales (DH Guidance, 2006)

• Mandatory to refer workers dismissed after having harmed or placed at risk of harm

• Mandatory to check if new employees have been barred (illegal to employ)

• Illegal to seek work with ‘Vulnerable Adults’ when barred

• Independent Safeguarding Authority broader remit, includes health, prison and private settings

POVA Research

Purpose: To inform developments in the operation of the POVA List

1. What are the commonalities & differences in a sample of referrals to the POVA list?

2. What factors are associated with decisions to put staff onto the POVA list?

3. How are decisions made about whether to put staff on the list?

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Synthesising unsuitable people

Initial reaction

Contextual influences

Referral

Case investigation

Reaction and judgement

Evidence gathering

Person Harm

Misconduct

Synthesis

UnsuitableNot unsuitable

Emotional reaction and moral judgement

• I think, to be honest, it is only born from experience of handling these cases and I suppose, I shouldn’t possibly say this, but also I think down to instinct in some respects.POVA team member

• You know, so I definitely think she was wrong in what she was doing in taking that £3/£6 per week, without having taken the bills into account that in itself is abusing the kind nature of that person.Practitioner

Factors supporting unsuitable verdict

Yes. The first criteria is we look is there harm, then suitability and in suitability there are a number of factors we would look at. How serious the abuse was, the effects on the vulnerable adult the number of times …like a history of repeated things…POVA team member

Dimensions of unsuitability

Harm caused

Person (alleged perpetrator)

Misconduct

Building a picture

Person...claims mitigating circumstances that one of them nipped him,

Harmalthough he if you are an old lady being put to bed and someone throws water at you and shouts at you then I think that is emotional harm caused there and I think physical

UnsuitableNot unsuitable

Misconduct…the fact that he [Rob] has shouted and thrown water at a resident when helping them to bed

Conclusion

• Unsuitability created as a relatively fixed trait, solidifying judgements of risk and vulnerability

• Unsuitable person one of a set of:– blameable scapegoats; the dishonest, inhumane,

disorderly criminal 'others’ to society's truthful, humane, orderly 'self’ (Hollway and Jefferson, 1997: 260)

• Approaches to maintain good decision making• Responding to ‘personalisation and choice’• Individualistic focus – a response to a genuine

dilemma?

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Contact details

• Martin Stevens– e-mail martin.stevens@kcl.ac.uk; tel 020 7848 1860

• Jill Manthorpe– e-mail jill.manthorpe@kcl.ac.uk; tel 020 7848 1683

• Shereen Hussein– e-mail shereen.hussein@kcl.ac.uk; tel 020 7848 1669

• Jess Harris– e-mail jess.harris@kcl.ac.uk; tel 020 7848 1665

• Joan Rapaport– e-mail Joan.Rapaport@kcl.ac.uk; tel 020 7848 1769

• Stephen Martineau– e-mail Stephen.martineau@kcl.ac.uk; tel 0207848 1694

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