Adult Safeguarding Policy and Law: A Thematic Chronology Relevant to Care Homes and Hospitals

Abstract

Elder abuse is a 'social problem', as illustrated by the production of policy documents and legislation that define and revise the scope and nature of the problem. This article synthesises and discusses the policy documents and legal changes that have taken place in England since 2000, when the first policy guidance to address adult safeguarding as a whole was produced. The focus of this article is on particular locations, namely care home and hospital settings, and the applicable policy and legislation. The policy documents and legal changes identified are analysed using Blumer's five phases of policy implementation and Matland's ambiguity-conflict matrix to explore their implications for policy implementation and coherence. The analysis suggests that responses to elder abuse have created different kinds of ambiguity and conflict, requiring both top-down and bottom-up policy interventions.Keywords: Elder abuse, safeguarding, care homes, hospitals, social problems, social policy. 2 IntroductionThis narrative review charts the many policy statements and actions that have been constructed concerning adult safeguarding, formerly termed adult protection, in England. It adopts a social administration perspective, seeing policy as an expression of government intent while acknowledging the interplay of intent and the views expressed by powerful interest or pressure groups. Most policy on the subject of adult safeguarding is formulated by the Department of Health, which is responsible for health and social care in England, although other government Departments (such as the Home Office) are authors, sometimes jointly, of some statements, proposals and legislation.The article attempts to chart the emergence of 'elder abuse' as a social problem, through a thematic chronology of policy documents that identify, then define the problem and propose solutions. Some of these policies relate to potential or actual perpetrators of abuse: people (including volunteers) working with adults at risk of harm through the vulnerabilities of The specific focus of this chronology relates to the safeguarding of older people in care home and hospital settings in England, in which large numbers of people live or receive care and treatment. Comas-Herrera et al. (2010) reported that there were 325,000 older people living in long-term care settings: about 105,000 funding themselves, 192,000 funded by local authorities and 29,000 funded by the National Health Service (NHS).There have been many national and international estimates of the prevalence of abuse in the community (ranging from 2 per cent to 6 per cent, Milne et al., 2012), with a generally increasing trend (Biggs and Haapala, 2010). However, less attention has been 3 paid to the prevalence of abuse in long-term care settings, which requires a different approach to the definition (Dixon et al., 2013) and consideration of a set of variables relating to organisational culture, which have a very distinct impact in these kinds of establishment . However, some estimates of prevalence in these ...

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