ADULT SUPPORT & PROTECTION ( SCOTLAND) ACT IMPLEMENTATION GROUP
Thursday 12 July 2007
Present
Jean MacLellan, SE Health Department: Adult Care and Support - Change Team (Chair)
Diane Strachan, SE Health Department: Adult Care and Support - Change Team
George Kappler (in place of Margaret Anne Gilbert), Mental Welfare Commission
Jan Baird, NHS Highland
Val de Souza, Association of Directors of Social Work
Sandra McDougall, Scottish Association for Mental Health
Nicola Smith, Enable Scotland
Steve Porter, Social Work Inspection Agency
Ronnie Barnes, British Association of Social Workers
Jan Killeen, SE Justice Department: Adults with Incapacity/Trusts/Succession
Linda Headland, Community Care Providers Scotland
Dr Mini Mishra, SE Health Department: Primary Care Division
Bill Skelly, Association of Scottish Police Superintendents
James Hogg, Dundee University
Shaben Begum, Scottish Independent Advocacy Alliance
Ian MacMaster, Scottish Care
Ann Ferguson, Age Concern
Apologies
Gill Swapp, Care Commission
James Elder-Woodward, Inclusion Scotland
Andy Miller, Scottish Consortium for Learning Disability
Dr Andrew Fraser, Scottish Prison Service
Linda Allan, NHS Glasgow
Peter Willox, Association of Chief Police Officers in Scotland
Jess Alexander, Scottish Social Services Council
Gerard McEneany, Apex Scotland
1. Welcome and introductions
Jean MacLellan welcomed all members to the second meeting of the Adult Support and Protection (Scotland) Act Implementation Group. At the last meeting group members had requested that a representative from Scottish Care be invited to attend meetings and Jean extended a particular welcome to Ian MacMaster who was attending the meeting on behalf of Scottish Care.
2. Comments on 'Short Introduction to Part 1' document
At the first meeting, the group had discussed different formats for communicating information about the Act. It was agreed that a 'short introduction to the Act' would be a useful document to have. A draft version of the document was produced and circulated to group members for comment. A revised draft of the document incorporating the comments received was circulated prior to and at the meeting. The following points were noted in discussion:
· Page 4 -'An adult at risk must consent to any intervention under the Act'. This was thought to be misleading, particularly in cases where an adult may lack capacity and therefore may be unable to give their consent.
· Page 5 - 'The council appoints APC members'. It is not sufficiently clear whether the representatives nominated by the relevant Health Board and police must also be approved by the council through an appointment process.
· Page 1 - Need to add in the introduction that Part 1 of the Act is not yet in force and add in likely dates for commencement.
· Page 5 - 'Advance statements…are not overridden by the new Act'. It was noted that advance statements are specifically related to treatments for mental disorders and as a result do not really fit in this context. The wording should be amended to read 'Statements expressed in advance about the individual's preferred care or treatment must be taken into account'.
· Page 1 - '…because they are affected by disability, mental disorder….'. Comment was made that an individual's needs often fluctuate over time and so perhaps it would be better to say '…because of the extent and/or way which you are affected by…'. However, it may be difficult to amend this wording without distorting the legal meaning of the Act.
· Page 4 - '…inflicted by a person in whom the adult at risk has confidence and trust…'. Some in the group did not like the expression 'confidence and trust' and felt that 'dependency' better reflected the position. Again, it was noted that 'confidence and trust' is the wording which appears in the Act and so it is difficult to change the wording in the intro document without distorting the meaning.
· Page 3 - Need to add a statement to make it clear that nothing in the Act allows an adult to be detained.
Action: It was agreed that the above changes would be made to the draft and then the revised draft circulated to members for final comments.
3. Update on Code of Practice Working Group
Jean noted that the Code of Practice Working Group had been established and met on two occasions so far. The group has split into 3 sub-groups which are each working on a different section/chapters of the Code of Practice. Progress has been good so far and the plan is to prepare a draft Code by end of October so that it can be issued for wider consultation. The draft is likely to be considered at the next meeting of the Implementation Group in October.
4. Update on Communications Strategy
At the last meeting, group members were asked to complete the communications strategy template that was circulated at the meeting and return it. Contributions would then form the basis of a draft communications strategy. Unfortunately, the return rate of completed templates was quite poor.
A paper was presented at the meeting which consisted of a composite of the responses received. Group members who had not yet submitted information were encouraged to do so.
Action: For next meeting, the completed templates will be analysed and then pulled together into an outline communications strategy including the type/format of additional information documents that may need to be produced and variety of dissemination mechanisms that can be used.
5. Discussion on User Involvement
Again at the first meeting it was suggested that those with a particular interest in user involvement could meet to discuss the issue in more detail. As a result, a meeting took place in Glasgow, facilitated by SCLD, and a paper outlining the discussion, prepared by SAMH, was circulated to the group for information.
Sandra McDougall introduced the paper at the meeting. She explained that it was not intended to be a list of actions that should be taken but more an exploration of the possibilities. It discussed the challenges of involving adults in the implementation process and ensuring that their views were appropriately represented.
Many organisations and adults were experiencing 'consultation fatigue' and so should try to avoid the assumption that adults should automatically be involved at all stages of implementation. In fact it would be better to consider the areas where they should definitely be involved or where a valuable contribution could be made. For example, the Code of Practice may offer limited opportunities for service users to influence as much of it will be based on the Act itself but there may be particular chapters where they could have input.
Adults could be involved in developing training and awareness raising. Also when providing information about the Act, it should be explained as part of the wider context of abuse i.e. what happens when you experience abuse, what should you do etc.
Focus groups are one way that views could be sought but some adults may have difficulties in attending events and so arrangements should be made for contributions to be made by e-mail.
Sandra outlined a event that had been held for service users on the Mental Health Act. It avoided traditional settings (as feedback was these could be seen as imposing) and instead used a marquee as the venue. It incorporated an art area and video box alongside traditional discussion groups format. It was also considered important to end the session on a lighter note given the serious nature of the discussions and so a BBQ closed the event.
In discussion, the following points were noted:
· Need to have different way of involving older people. For example, a user panel of older people similar to the one visited by the Health Committee for views during the parliamentary process.
· Potential costs - some adults may need additional support to participate in consultations/events as it goes beyond the level of the regular support that they receive.
· Not appropriate to make people feel that they personally have to disclose during consultation/events.
· An event could be based around a drama group.
· Issue of capacity building within organisations. Better to have discrete initiatives that are well-planned in advance. Need to develop a programme of activities involving those with a legitimate interest including carers.
· Some people who have been abused may feel more comfortable attending events with an advocate and advocacy agencies could help with this.
· Difficult to engage young adults in consultation processes.
· SWIA have a group of carers who could be involved in any user involvement process.
· Need to be clear about the objectives that are trying to achieve from engagement.
· Need to be clear about the differences between 'asking' vs 'telling'
6. Update on Protection of Vulnerable Groups ( Scotland) Act
Jean gave an update on progress towards implementation of PVG.
A Programme Board has been established to manage what is a complex process. The Board meets monthly, members include officials from Education, Justice & Health Depts, as well people from Disclosure Scotland and their partners BT.
Secondary legislation is a specific project. There are over 40 separate regulations provided for in the Act with 23 identified as necessary for commencement. Many are inter-related, so plan is to brigade these together for the purposes of consultation. Within this are two pieces of secondary legislation to further define the scope of the protected adult definition within section 94. These will prescribe the types of 'healthcare services' which will be included within the definition and also what is covered by 'welfare services'.
Another key area of current activity is the development of policy on 'autobar' offences, and the supporting determination procedures which will allow the scheme to process individual cases. It is important that the scheme operates proportionately and gets the balance right between those automatically deemed unsuitable, where some determination is needed, and those with offences that don't need to be considered e.g. one-off speeding offences.
7. Training and Education Materials
A short discussion paper was circulated at the meeting with a series of initial questions relating to training and education around the ASP Act. Group members split into three sub-groups to discuss the questions and then reported comments back to the main group. The following points were noted from the feedback:
General Awareness Raising
· Across West Lothian, broad training around 'adults at risk' already exists. It is primarily multi-agency training which refers to the basics of the ASP Act. However, training is unlikely to go beyond this at this stage as awaiting the Code of Practice or further guidance on the Act.
· Detailed training on the ASP Act will need to be developed but it is too early at the moment.
· Should be looking to increase general public awareness that abuse/exploitation does happen. This will contribute to a change in public attitudes around this issue.
· Need to have a press campaign -consider using small slots on TV?
· View that there is a general dearth of training materials around adult protection more generally. Although it was mentioned that the Lothian and Scottish Borders have developed an inter-agency training video on adult protection that would be suitable for general awareness raising/training.
Practitioner Training
- There will require to be different levels of training depending on the level of responsibility.
- Ideally should be inter-agency.
- One key area that should be covered is boundaries of responsibility.
- There are related issues around:
- Risk assessment
- Pre-disposement factors
- Capacity
- Routing of legislative mechanisms - initial assessments and at what point decisions have to be made/taken.
- Beyond practitioners need to train legal teams/sheriffs/courts/specialist independent advocates so that they are aware of subtleties of practice.
Local APU Training
· Financial memorandum identified a training officer post.
· Would need to use for multi-agency training and induction - a large volume of training will require to be co-ordinated (will one post be enough?)
· Initial focus on this post should be training the trainers!
· How far should this be everyone's responsibility?
· It would be useful to establish a network of training posts to provide peer support and encourage exchange of best practice.
Post-qualifying training
· The group agreed that it could be useful to have a post-qualifying award in adult protection.
· It could be a generic course which retains multi-agency working at the core with modules in specific areas of practice.
· Colleagues within the Executive who deal with Section 9 grants for training are doing some work around child protection training and there may be lessons that could be learned for adult protection.
· As much of the training as possible that is provided should be accredited in some way.
· Will always be difficulties in linking the theory with the reality of practice side of things.
· Need to avoid being elitist.
8. Date of next meeting
The next meeting of the Implementation Group will be held on 31 October,St Andrews House, Edinburgh.