Evidencing good practice in adult protection: informing the protection of people with learning disabilities from abuse

The third theme covers literature on joint investigations. These are the collaborative inquiries of police and social services, who act as the lead agency for adult protection (in England and Wales). As with reporting, although a clear process is laid out in policy documents, the issue of joint investigations raises many practical and ethical challenges.

The fourth theme relates to justice issues. The current reality that people with learning disabilities often do not achieve redress following abuse has complex causes although recent policy initiatives have been dedicated to improving access to justice (Home Office, 1998; Home Office, 2002). Literature explores the issues involved in achieving justice, the extent to which these initiatives help and their limitations. What makes this area particularly challenging is that it involves engaging with agencies outside the health and social care domains. For example, papers written in collaboration with the police or members of the criminal justice system. Different policy frameworks, methods of practice, language and culture make this area of collaborative work a subject of much debate in the literature.

The fifth theme covers aspects of aftercare and monitoring. This theme spans post-abuse issues for the victims and perpetrators of abuse as well as service-level issues regarding the auditing of abuse incidents and the collation of monitoring data. In this regard monitoring goes full circle back to becoming a future abuse prevention issue. Issues that seemed to be important but were not covered by these main themes were added to a miscellaneous category.

Summary of the review

What is immediately apparent when reviewing the adult protection literature is that there is a lack of 'mapping' across from identified problems to potential solutions. Many papers highlight key concerns or make recommendations but few stand alone in detailing the nature of concerns, why they matter and then give detail to their proposed solutions. While this could be indicative of the infancy of the research area it requires effort on the part of the casual enquirer who hopes to gain an overview of the key concerns and good practice examples.

In cataloguing the collected sources a system of adult protection keywords were used. This provides a shorthand method for retrieving research of relevance and is an indicator of the attention paid in the literature to different aspects of adult protection (see Table 1). Two points need to be made about the interpretation of these figures. Firstly, not all articles that have a keyword assigned to them necessarily refer to the keyword verbatim. The concept may be assigned another name in the article or may be eluded to but not named. For example, lack of access to basic rights and choices within a long-stay institution would generally be viewed as a form of human rights abuse. secondly the review did not include all papers that made reference to a subject but rather those that had a clear relevance to the subject of the wider project, Abuse of People with Learning Disabilities. So, for example there is a substantial body of literature on the subject of elder abuse (especially originating in the USA); however only selections are used here.