LILY IS 83. She has diabetes and a cognitive impairment. Her social worker arranged a home-care package to help her with washing, dressing and taking her medications.
But, recently, Lily’s son, Seamus, has moved back into her home. His marriage has broken down and he is drinking heavily. He has taken control of Lily’s pension and savings and is refusing to allow Lily’s carers access to the house.
Matthew is 19 and has an intellectual disability. He was in the care of Tusla from the age of eight because of abuse and neglect by his biological parents.
He is now moving into adult services but, unable to access supported accommodation, has been returned to his parents’ care. Day care and respite care have been arranged, but his parents are preventing him from accessing these supports.
Failed by the State
Lily and Matthew’s stories are indicative of the thousands of people across Ireland who are failed by the State because of inadequate adult safeguarding provisions.
They have health and social care professionals fighting to ensure their needs are met, but these professionals are blocked at every turn.
Today, I am launching a research report that sets out how the absence of adult safeguarding legislation is impacting on adults who are vulnerable to harm and abuse.
For the report, UCD researchers interviewed professionals involved in adult safeguarding processes, including safeguarding and protection, medical, primary care, disability and mental health social workers, dementia advisors and a SAGE advocate.
The findings are shocking but come as no major surprise to those of us who have long campaigned for better safeguarding measures.
Participants described the referral process for adult safeguarding as being in disarray, with different initial assessments carried out in different areas; variations in practitioners’ understandings of what constitutes abuse; and differing interpretations of what constitutes a ‘vulnerable adult’.
Early intervention and the implementation of effective protection plans is difficult, due to a lack of services and resources, such as home care. In many areas, there are too few social workers available to carry out safeguarding measures, or their caseloads are so high that waiting lists are in operation.
Furthermore, the public body responsible for delivering care and safeguarding adults at risk, the HSE, has no statutory obligation to provide support services such as home care, which can help keep adults safe.
The lack of availability of community supports, coupled with limited access to housing or supported accommodation, creates massive barriers to safeguarding adults who are vulnerable.
GDPR interpretation and abuse
One of the most glaring findings of the research is the challenge GDPR has introduced for those working to protect adults who are vulnerable to harm and abuse. The way in which GDPR is being interpreted by many agencies lacks basic common sense.
For example, a person may be supported by the Mental Health Service, but the Service cannot share information on the person’s diagnosis, making it extremely difficult for social workers to carry out assessments.
Agencies or service providers can only use the initials of persons’ names when reporting safeguarding incidents, which poses significant barriers to pattern-forming assessments, where there may be ongoing concerns or multiple incidents relating to one person.
These rigid and overly cautious interpretations of GDPR are hampering effective information-sharing by the diverse agencies and individuals involved in adult safeguarding. An obvious solution would be for the Data Protection Commissioner to clarify what qualifies as good practice in relation to information-sharing and GDPR.
Family members with too much power
Another challenge revealed by the research is that too much power currently rests with family members, who can control whether a relative in need receives care or not.
Multiple incidents of coercive control and undue influence by family members were recounted to the researchers.
These included situations where adults at risk had consented to home care support, but family members were acting as gatekeepers, preventing service provision through intimidation or threatening behaviour.
Financial exploitation was also a recurring theme.
Solutions
Those who participated in the research highlighted factors that can contribute to effective safeguarding, including: Garda interventions at local level, robust policies and training for bank staff in relation to financial abuse, and the appointment of a designated Safeguarding Liaison Officer in the Department of Social Protection.
For my own part, I introduced the Adult Safeguarding Bill in the Seanad in April 2017. The Bill aims to put in place additional protections and supports for adults who may be unable to protect themselves.
If enacted, it would provide for mandatory reporting where an adult has experienced – or is at risk of experiencing – abuse or harm; and it would establish a National Safeguarding Authority.
Our justice system is badly outdated in dealing with adult safeguarding issues. But it can reform by following the same modernising approach that was implemented to deal with child abuse cases. We know the failings that exist; now, we must act to address them.
Senator Colette Kelleher is hosting a seminar in Dublin today, at which the research report, ‘Falling Through The Cracks: The case for change, key developments and next steps for adult safeguarding in Ireland’ by Dr Sarah Donnelly and Dr Marita O’Brien, School of Social Work, UCD will be launched.
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