We are all living longer and while this is a cause for celebration, it also poses challenges in how we protect people vulnerable to harm and abuse in Irish society.
All of us at any point in our lives may be vulnerable to abuse for example, due to social isolation, illness or disability, poverty, addiction, or homelessness.
Mahatma Gandhi said that “the true measure of any society can be found in how it treats its most vulnerable members”.
Our Constitution commits to guarantee equality of all citizens before the law but are all citizens afforded equality of safety and protection?
Social work is the named lead registered profession for adult safeguarding in Ireland, tasked with the assessment of neglect and abuse of adults at risk.
On Adult Safeguarding Day, 2022 the Irish Association of Social Workers (IASW) are clear; as a society, we are failing to safeguard adults at risk of harm and abuse. Today, the IASW launches its ‘Position Paper on Adult Safeguarding: Legislation, Policy and Practice’ which provides an overview of current challenges and recommendations for reform.
The Irish State has a poor record of safeguarding adults as seen in the failure to protect adults from abuse and neglect in Leas Cross (2005), Aras Attracta (2014), in the ‘Grace’ case and most recently in the ‘Brandon’ case.
Brandon was a vulnerable man with intellectual disabilities who required protection himself and committed at least 108 sexual assaults on fellow residents from 2003 to 2016 with full knowledge of HSE staff and management.
Trends confirm that older women, people with disabilities, people living with dementia, female Travellers, and other groups are at higher risk of abuse, yet currently we have no adult safeguarding strategy targeting the abuse of these high-risk groups.
Unlike in the UK, there is no legislation in Ireland compelling the State to identify and respond to social care needs, for example, the provision of home care, respite or housing which might reduce or eliminate the risk of abuse and support an adult to live their lives in accordance with their will and preferences.
Currently access to health and social care services and supports is random and often a ‘postcode lottery’, dependant on where a person lives.
The State is failing in its duty to protect the lives and well-being of adults at risk. Its arm’s length approach of increasingly abdicating responsibility for the provision of care and support to private bodies and family carers has raised issues about its ability to intervene where there are protection issues.
Social workers report significant challenges accessing adults at risk, for example, where there are allegations of abuse, social workers do not have a right of entry into private nursing homes; nor can they enter the home of a person, where a family member who may be a perpetrator of abuse acts as a gatekeeper, refusing access to the adult experiencing abuse.
There is also a concerning culture within the HSE and other organisations which at times, appear to ‘turn a blind eye’ to abuse and prioritises the protection of the agency in question, rather than the protection of the adult experiencing harm or abuse.
There is a concerning lack of transparency when safeguarding failures occur. In other jurisdictions swift, cost-effective safeguarding reviews are published in full, for example, the Northern Ireland Commissioner for Older Persons Investigation into Dunmurry Manor Care Home.
In the Republic, however, adult safeguarding reviews are rarely published in full and are ‘owned’ by the HSE or service provider who is then the gatekeeper of information about failures in their own services.
This means that residents and families remain uninformed about the true extent of failings within their ‘home.’
The watershed cases of ‘Grace’ and ‘Brandon,’ show that in certain circumstances, adults at risk repeatedly experienced abuse, which could have been prevented with timely and appropriate legal measures.
Without these legal measures, social workers continue to be unable to adequately protect adults at risk of abuse in Ireland.
Hiqa has also consistently warned that they need more powers to adequately protect vulnerable adults in residential services.
While the recent strengthening of Hiqa’s powers is to be welcomed, they do not go far enough, and Hiqa continues to identify examples of serious safeguarding failings.
These systemic failings echo failings in the delivery of child protection services in Ireland in the 1970s, 1980s, and 1990s when Ireland experienced a similar pattern of repeat child abuse scandals before fundamental reform led to the introduction of legislation and a designated agency with a clear remit to safeguard children.
Safeguarding laws must be introduced to better protect adults who are vulnerable to harm and abuse.
The IASW believes that the provision of additional legal measures and interventions is urgently required and calls for the introduction of comprehensive adult safeguarding legislation.
Legislation must be underpinned by human rights principles that prioritise the will and preferences of adults at risk in line with the Assisted Decision-Making (Capacity) Act, 2015; new legislation designed to support people to make their own decisions.
In the Brandon case, health and social care staff witnessed the traumatic sexual assault of vulnerable adults.
IASW is now calling for mandatory reporting by key personnel in our frontline services to ensure that staff are mandated to report the abuse of adults in certain circumstances.
Mandatory reporting should only relate to concerns about the abuse or neglect of a person who is unable to adequately seek support for themselves, due for example to illness, frailty, capacity, intellectual or physical disability and mental health issues, or where there is evidence of severe coercive control influencing an adult's ability to provide informed consent on matters related to personal safety.
Finally, the IASW has called for the Establishment of an Independent Statutory Social work-led adult safeguarding agency outside the remit of the HSE, with a focus on holistic, multidisciplinary, and rights-based practice.
"We know that early experiences of abuse make someone far more likely to experience repeated abuse throughout their adult life."
The IASW believe that the Department of Children, Equality, Disability, Integration and Youth (DCEDIY), is best placed to house the new independent safeguarding authority, given its experience in child safeguarding, disability, marginalisation, and inequality.
The existing expertise and human rights knowledge of DCEDIY make it the most appropriate home.
Across Ireland, certain individuals and groups live at higher risk of abuse. An accident or illness, or even just ageing, could place any of us, or those we love, in that same higher-risk category.
On Adult Safeguarding Day 2022, let’s take collective responsibility to create a society where all people are protected equally.
We must foster intergenerational solidarity, raising awareness that adult abuse is ‘All of our business’ and demand legislative reform which will ensure safety and protection for all.
Dr Sarah Donnelly is an assistant professor of social work in the School of Social Policy, Social Work and Social Justice, UCD and academic adviser on adult safeguarding to the Irish Association of Social Work
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