19. Vulnerable adults ― what difference can training make?
Resolution submitted by the RCN Gwynedd Branch
That this meeting of RCN Congress takes action to ensure that vulnerable adults are given the same consideration as vulnerable children, and that fully resourced training for all nurses who care for vulnerable adults is made mandatory
Report on this debate
Wendy Hughes, Gwynedd Branch, introduced this resolution by saying that awareness of abuse is not covered as standard in nurse training. Issues such as staffing levels can lead to a situation where vulnerable adults are put as risk, so Wendy argued that it is a "duty of care" to give nurses the knowledge and skills to ensure that patients are not abused.
Wendy referred to the NMC code of conduct which states that people should be treated with dignity and spoke about "unintentional abuse", the inability to meet patient’s needs such as hydration and nutrition, which compromises the patients dignity.
David Williams described the abuse of vulnerable adults as a "complex phenomenon" and called for training for all staff on a regular basis to raised awareness of the issue.
Alan Mawbey said the need for this training was "a no-brainer".
Rebecca Neno called for an increase in support for vulnerable adults and their families. She echoed many delegates saying that the abuse of vulnerable adults does not receive the same level of media attention as child abuse and asked "how many adults have to die before we address this issue?"
Wendy replied to say she believed that training for nurses to recognise and understand the issue of abuse of vulnerable adults can make a huge difference.
| For | 369 | 98.14% |
|---|---|---|
| Against | 7 |
1.86% |
| Abstain | 2 |
| For | 33 |
91.7% |
|---|---|---|
| Against | 3 |
8.3% |
Background
The range of people that may be considered vulnerable includes older people who are frail, those with physical or mental disabilities, people with learning disabilities, the homeless, those who are detained in custody, victims of domestic violence, those in residential or sheltered housing, those receiving domiciliary care, those who are ill and receiving health care, or those who are susceptible to being bullied.
The Care Standards Act set out the Protection of Vulnerable Adults (PoVA) scheme, while the Safeguarding Vulnerable Groups Act (Parliament, 2006) added an extra layer of protection to the pre-employment process ― including Criminal Records Bureau checks for those working with vulnerable adults and children. In Scotland, the Protection of Vulnerable Groups (Scotland) Act 2007 (Parliament, 2007) aims to establish a similarly robust vetting and baring scheme, as does the Safeguarding Vulnerable Groups (Northern Ireland) Order 2007 in Northern Ireland (Statutory Instrument, 2007). In addition, the Mental Capacity Act was implemented in 2007 to protect people with learning disabilities and mental health conditions. The Welsh Assembly Government remains committed to maintaining the balance between the promotion of independence, and the safeguarding of vulnerable adults; in 2000, the Social Services Inspectorate Wales issued strategic guidance to Welsh authorities ― entitled In Safe Hands ― which established a framework for the development of local policies and procedures for the protection of vulnerable adults.
In Northern Ireland, a key recommendation of the recent Bamford Review of Mental Health and Learning Disability was that appropriate training and education, in relation to the care of vulnerable people, should be built-in to training programmes for health and social care staff, including those working in the independent sector, and carers. This training should be undertaken on an inter-agency and multi-disciplinary basis where possible. The Department of Health has also begun a process of consultation for Deprivation of Liberty safeguards, which are expected to be implemented in early 2009.
In 2007, the RCN Learning Disabilities Nursing Forum produced guidance designed to support frontline staff working with adults with learning disabilities. The Mental health nursing of adults with learning disabilities publication, together with Meeting the health needs of people with learning disabilities both available at www.rcn.org.uk/publications, provide valuable advice and information for health care professionals working with vulnerable adults.
References and further reading
Parliament (2006) Safeguarding Vulnerable Groups Act, London: Stationery Office. Available from: www.opsi.gov.uk/acts/acts2006
Parliament (2007) Protection of Vulnerable Groups (Scotland) Act, London: Stationery Office. Available from: www.opsi.gov.uk/legislation
Statutory Instrument (2007) The safeguarding vulnerable groups (Northern Ireland) order, London: Stationery Office (SI no. 1351(N.I. 11)). Available from: www.opsi.gov.uk