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Evidencing good practice in adult protection: informing the protection of people with learning disabilities from abuse
Journal of Adult Protection, The, Aug 2005 by Northway, Ruth, Davies, Rachel, Jenkins, Robert, Mansell, Ian
abstract
The importance and challenges in providing a good practice evidence base for adult protection are outlined. The literature search, review and mapping exercise that formed part of the Abuse of Adults with Learning Disabilities: Policy, Practice and Educational Implications in Wales research study is detailed. The article presents examples from this evidence mapping exercise and considers the importance of adult protection research to the future development of policy and practice.
key words
good practice adult protection learning disabilities abuse policy practice
The challenge of evidencing good practice
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The growing field of adult protection deserves to have high quality research and theoretical underpinning to inform its policy development and practice. Policy makers and practitioners should feel confident that their activities are the most appropriate for the circumstances and that they are well informed. Unfortunately adult protection policy and practice, to date, has not been developed from a strong and substantive research basis. There are several reasons why this is the case and these need to be considered in order to understand the context in which the field of adult protection has developed.
First, adult protection does not have a history of research interest. The vast majority of adult protection research was conducted from the late f 98Os onwards at the same time as the momentum began for policy and practice initiatives. Adult protection spans so many areas of health and social care activity that there was clearly earlier research that had relevance to adult protection (for example, research into physical restraint or sexuality). However, this dispersed evidence was not pulled together in any cohesive way to provide a historical context of adult protection research.
The lack of visibility of adult protection amongst the academic community reflects the fact that much adult protection research has its origins in the difficulties, dilemmas and observations of practitioners. Co-authoring of adult protection papers between practitioners and academics appears more common-place than in many other areas. In many ways this is a positive facet of adult protection research and one that can be maximised upon. However, the lack of academic 'research communities' with a common interest in aspects of adult protection has contributed to the lack of historical grounding of the field.
Second, adult protection research has tended to focus on relatively small-scale studies, undertaken across small areas and with a narrow focus (for example, sexual assaults amongst people with challenging behaviour in one local authority area). The irony is that to receive substantial research funding researchers need to justify the extent and nature of the abuse problem. Yet without larger scale research studies the prevalence and incidence issues are still being grappled with. The problem with these smaller studies is that they are often not widely known about or there is a failure to extrapolate lessons from them for other populations or areas. In particular, there is a lack of dissemination of research output in this area beyond national boundaries. For example, a trawl through the UK adult protection literature uncovers few references to the adult protection training activity that exists in parts of the USA (Abrams et al, 1984; Miltenberger, 1999).
Third, the consideration of adult protection as an umbrella term to cover the protection of all vulnerable adults from abuse is relatively new. Indeed the term vulnerable adult itself only became popular in the 1990s. Our recent research found that the majority of adult protection policies that covered all vulnerable adults were developed between 1998-2001 (Northway et al, 2004). Previously, aspects of adult protection were found within either the client groups or service settings categories. For example, a body of evidence exists related to adult protection issues for older adults under the heading 'elder abuse', or research into the problems of long-term care institutions. These divisions are not surprising as they represent the divisions that have existed across services. Yet, as with small scale studies, the problem of divisive research is that awareness of studies outside a distinct area is minimal and attempts are not made to consider what lessons can be learnt in other contexts.
The exception to this lack of extrapolation has occurred with research into child protection. It has been acknowledged for several years that as the 'forefather' of adult protection there are likely to be lessons that can be carried from the experience of child protection across to the adult domain (Brown & Stein, 1998; White et al, 2003). This is evident at different stages of the investigative process from the conducting of joint police/ social services investigations through to the provision of special measures for vulnerable witnesses giving evidence in court. Equally vocal are those who urge caution on the use of child protection to provide a template for good practice in adult protection (Williams, 2002). Indeed, the inquiries that have resulted from failures in the child protection system (eg The Victoria Climbiè Inquiry, Home Office, 2003) suggest that a wholesale duplicating of this system could have detrimental effects for vulnerable adults.
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