The blight of enhanced CRBs returns

The case of T, R (on the application of) v Greater Manchester Police & Anor [2012] EWHC 147 (Admin) (09 February 2012) concerns a student who had single entry on his otherwise unblemished enhanced CRB: at age 11 he received a police warning for bicycle theft.

Problems with enhanced CRBs are a recurrent theme among issues I am asked to advise on. The bottom line is that they have always been difficult to challenge, but a 2009 court ruling (see my blog post at the time) did seem to offer some hope of a remedy. The main problem with that remedy is that so far as I can see, the police have largely concluded it doesn’t affect them. Therefore, they do not routinely offer a right of reply before doing the damage.

Enhanced CRBs offer real potential for real injustice. Here is why: they include information, the accuracy of which has never been tested, and never will be tested. Just imagine (if you have to imagine – this has happened to real people I know!) that you are arrested upon suspicion of an offence. The police, after investigation, for any number of reasons decide not to prosecute. They can and do still include the information on enhanced CRBs. It may well relate to a very serious crime. Indeed, it is more likely to be included if the crime is more serious, as the test for inclusion is effectively its potential relevance to the purpose for which the enhanced CRB is sought.

So the enhanced CRB alludes to your having been under suspicion of a very serious offence, of which you may be entirely innocent. Guess what? It can stop your career in its tracks. And since you are innocent, you will want vindication. But you can’t get it, because there is no forum in which to get vindication. The reality is, that you are worse off than if you had been prosecuted and stood trial.

The truth is, attacking the content may not be the best line of attack, because of the legal difficulty doing so. There are at least two other remedies to consider:

• the decision to go for enhanced instead of standard CRB in the first place. The circumstances in which they are permitted are strictly prescribed, but this is frequently overlooked in a risk-averse age which says “belt and braces is best”;
• the use that is made of the enhanced CRB by the organisation to whom it is directed. The police line is usually that it is for the recipient to test the information, not the police, but rarely is this done.

Back to the case of T. In his case, it was a warning that was included. Untested; but unlike the situation described above, at least the warning was accepted at the time. In my experience, that may not be equivalent to an admission of guilt. It may follow legal advice that it would be pragmatic to accept a warning rather than the hassle of a trial – advice that is unlikely to have borne in mind the hassle caused to your study a decade later.

But even assuming there was an admission of guilt, T’s case was that bringing up his childhood misdemeanours so much later infringed his human rights. The court was sympathetic, but bound by precedent. The real alert, I think, needs to be that the Rehabilitation of Offenders Act is plainly powerless to prevent the blight of enhanced CRBs upon the rehabilitation of offenders.

Allan Norman is a registered social worker and a solicitor at Celtic Knot.

Bye Bye Bower

Yesterday Cynthia Bower resigned at the Chief Executive of the Care Quality Commission. I remain amazed that she was ever seen as competent to run it in the first place but it’s easy to be wise in hindsight. Her departure is no surprise as the organisation has consistently been shown to be ineffective and unable to effectively or safely keep within its remit as the regulator of health and adult social care services in England.

As the Guardian states, at the time of Bower’s appointment by the Labour Government

Andrew Lansley, the then shadow health secretary, said at the time: “We have to ask whether it is right that the person in charge of the West Midlands strategic health authority at the time, Cynthia Bower, is now to be put in charge of the national regulator which heads up these investigations and which will be responsible for ensuring that this never happens again in Mid Staffordshire or elsewhere.”

Lucy at The Small Places refers to some of the closing statements at the Mid Staffordshire Inquiry which shine a light on the actions in the CQC at the time. She quotes Dame Barbara Young’s evidence – who had resigned as CEO of the CQC and was asked why – saying

I really believed strongly that we could only do a good job if we were on the ground locally inspecting with rigour and understanding what was happening locally in health core systems and in hospitals that were delivering services. And I knew that we were finding it quite difficult to ensure that that was the case with the resource we had. And I could see further restrictions in resources on the horizon, because by then it was clear that the service was going to share in cuts. And I could also see that that was going to happen at a time when the quality of care was going to be even more at risk than usual as a result of health core cuts in services.

So you’d be a regulator in a very difficult position, with government, accountable to government, but responsible really to the public, with less resource to regulate effectively, and services being more at risk And it just felt to me that that was not a job that my skills were best suited for.

Lucy, in her excellent post, points out, quite rightly that it was the Labour Government that was responsible for establishing the CQC in its current form. This goes beyond the party political. It is about creating a system which has allowed a more rigorous inspection regime to lapse faced with cost and faced with the potential to cause a political ‘stink’ when hospitals in particular might be found to be ‘failing’.

And where now for the CQC? Bower leaving was necessary but it looks as if the problems that run through the organisation are far more endemic than a change at the top. There needs to be trust restored in an organisation which is supposed to regulate services that we all depend on wholly.

My experience is more in the social care side than health and I see the dilution of regulation has happened over the years with poorer services, fewer inspections and inspectors with more experience in auditing paper records than inspecting care homes thoroughly ‘on the ground’.

Meanwhile, Paul Burstow calls for Dignity Codes for older people – who will be responsible for ensuring these ‘codes’ that apparently he wants care workers to sign up to are upheld? and his now cancelled so-called ‘excellence’ schemes which was unravelled and ratings sites – they all seem to be attempts to cover up the need for strong regulation and inspection because that would cost more money.

So Bower’s leaving is just an admission of failure and acceptance that she should never have been in that post to start with. She has barely displaying competence in ‘leadership’ but leadership is not just about one person and while the systems remain in place, we wait to be see if there will be any really useful changes in a regulatory body which has had such a difficult birthing experience.

What makes a good Best Interests Assessor?

Community Care carried an article a couple of days ago about Paul Burstow and the College of Social Work potentially turning their attention to the current training of Best Interests Assessors and finding the paucity of the system as it exists now to be in need of reform.

I’m a Best Interests Assessor as well as an AMHP (Approved Mental Health Professional). There’s a general awareness within the sector about what being an AMHP may be – there’s a lot less understanding about what is involved in being a Best Interests Assessor. The role itself is much newer having developed from the Deprivation of Liberty Safeguards which were a tacked onto the Mental Capacity Act (2005) by the Mental Health Act (1983) as amended 2007.

Lots of dates and lots of legislation but the role came into being in 2008 and created this role of ‘Best Interests Assessors’ who could be nurses, social workers, psychologists or occupational therapists with a couple of years experience who would be trained specifically to carry out particular assessments under these new legislative frameworks and make recommendations on the basis of these assessments as to whether someone who lacks capacity is being a) deprived of their liberty in a hospital or care home and b) whether it is in their best interests.

It can get enormously complicated but that’s perhaps, the reason that the focus has turned to the training of BIAs.

I was an ‘inaugural’ BIA, meaning that my training took place before the legislation had actually ‘gone live’. It took place over five days at postgraduate (masters) level training  delivered by a university and requiring an examined essay and presentation.

The problem is that we were then released into a ‘vacuum’ – there was an incredible feeling of insecurity about what these assessments required but there was also a hope that case law would eventually arrive to clarify! (oh, how deluded we all were!).

As it happens, case law is coming thick and fast now and each legislative decision adds layers of complexity. We have a better idea of the rate of referrals and the amount of time a good quality assessment takes so reappraising the course isn’t a bad idea.

Some AMHP courses now incorporate Best Interests Assessor training. I’m not sure I see this as necessary.

I’m not even sure more than five days is needed regarding an understanding of the legislation.

What is absolutely needed is constant and ongoing updates/training/discussions and forums to promote constant learning.

Currently there are no established and consistent  regulations concerning continuous professional development of BIAs – it is up to the local authorities to themselves decide. I’m fortunate that I have access to a host of BIA update training and a chance for specific supervision related to this role. I see it as fundamentally necessary, particularly at the rate with which the legislation framework changes, to be constantly in touch with the latest developments.

I also think that it is necessary for any new BIA (something that was impossible for me when I trained for obvious reasons) to have a similar experience as AMHPs have of ‘shadowing/fronting’ assessments with a more experienced BIA alongside them to get a feel for the type of work that i is.

This feels like a neglected corner of social work and social care in that it is a role that still is predominantly taken by social workers but few apart from those who actually do it, have an understanding of what it might entail.

We need to support each other on this – especially as so few of the trainers are actually Best Interests Assessors themselves – in my experience. This is an area where peer-led learning and understanding of the role could really move into the fore front.

I revert back to my premise that everyone working in social care with adults needs a better understanding of the Mental Capacity Act. That would form a better basis for those who do go on to become Best Interests Assessors.

I’ll be interested to see if Burstow picks this up. There’s a long way to go to improve both the Deprivation of Liberties Safeguards and the way that they are assessed and implemented. It’s quite right that the training and in particular professional development of BIAs is considered alongside this.

I’d be interested in what other BIAs thought about how training both initial and ongoing could be improved. Please feel free to leave comments!

Photo by anniebby

A Dignity Code for Older People?

The Daily Telegraph today prints a letter which sets out the need for a ‘Dignity Code’ in Health and Social Care calling on Hospitals, Care Homes and other institutions to prevent ‘issues of abuse and neglect’.

The article accompanying the letter, the Telegraph says, will encourage care workers to have this code written into their contract.

Discontent at the UKCP

Earlier this week I commented on the worrying state of complaints procedures at the United Kingdom Council for Psychotherapy. Since then somebody has forwarded on to me an e-mail that’s doing the rounds in the UKCP. It appears to show a senior figure in the organisation expressing thinly-veiled criticisms of the way the UKCP is run.

The e-mail poses a series of questions to the candidates in the forthcoming election for UKCP chair. The author suggests, “It has been said by some of those in positions of authority in the UKCP that the members should keep quiet and let the Board get on with running the organisation” and that “There is little transparency in the spending of the members’ money”.

The author also appears to have a low opinion for the current proposals for psychotherapy to have “assured voluntary registration” (where self-regulating bodies such as the UKCP get a stamp of approval from the Council for Healthcare Regulatory Excellence) rather than statutory regulation. They ask, “Those with statutory titles i.e. psychiatrist, practitioner psychologist, psychiatric nurses, social workers etc are already perceived as being more professional. By going the VQA route do we not join the licensed service professionals such as hair dressers, beauticians, carers and day care workers?”

The full text is below.

Why the NHS will always be a Political Football

Today a member of the government on the radio said that the NHS should not be a political football how wrong can he get? The NHS has always been a political football because it is what this nation holds dear as our core of humanity. Without the NHS we would have less work, poorer living conditions, poor health and social care, more isolation, homelessness and poverty. What will it take for politicians to realise that it is not the business world that is keeping our economy afloat (or not) but our healthcare service which is one of the biggest employers in the country. Much of our country may not be very good on the industrial side now that all our industries have been farmed out to other countries, where the health and social care is less favourable shall we say. But we are very industrious at taking care of ourselves and making sure that we look after our bodies so that we can work. We could not do this without the NHS and for all its faults it is the engine that keeps this country running from the staff, to patients, to suppliers, to tax payers and managers, we all have an important role to play in this political game. For many people in the UK our lives depend on the NHS in many ways and it is for that reason it will always be a political football. Today, the tactic of excluding people from discussions who are not ‘constructively engaged’ is the same as in any game, they are simply picking the ball up and not playing anymore.

The UKCP’s Dangerous Method – Why It Matters

Last Friday I posted about a worrying case in which the UKCP has been taking since February 2009 to investigate the conduct of a psychotherapist, during which the individual has been able to carry on practising regardless.

The case is important because of the self-regulating nature of psychotherapy in the UK. The UKCP is currently trying to position itself to become an “assured voluntary regulator” for the profession, whereby its complaints and disciplinary procedures will receive official endorsement. Cases such as this could cast doubt on its ability to take on such a role.

Protecting Our Children: Will It Change Attitudes To Social Work?

The excellent Protecting Our Children concluded on Monday evening. The practitioners and programme-makers deserve congratulations for an absorbing, honest and above all human depiction of contemporary social work to sit alongside the two Panorama programmes looking at children in care.

 

In all the meetings I’ve attended over the past three weeks, conversation has turned to the latest programme as soon as a lull in proceedings appeared and often when it didn’t. Generally it’s gone down very well, in sharp contrast to the scant few past series covering our world. I remember one dire effort that I think looked at a social work team in the north. Eminently forgettable, I nevertheless recall it began with a social worker guiltily shovelling down a giant doner kebab whilst at his desk then playing up to the camera in a manner that would have embarrassed David Brent. Gloomily we watched well-intentioned but ill-conceived and executed direct work with a young child and a succession of families unsure about what was happening.

Work! Fair?

There has been much recent debate about the extension of the idea of ‘workfare’ in the UK. ‘Workfare’ is supposed to be an extension of ‘welfare’ seen by the syntax used in the word itself. It is an idea which grew from the idea that people should not receive benefit entitlement as a result of unemployment without ‘giving something back’. In the context in which I’ll be using it, it refers to mandatory work ‘placements’ for people who are not able to secure employment in order to receive benefits that relate to being out of work.  It sounds quite warm and fluffy because of course people should be helped into work and ‘give something back’ but the word also implies a series of sanctions of this work is not undertaken.

A Greek Tragedy

I’ve been following the stories from Greece over the past couple of years as recession and euro crisis has hit with full force.  While I have a very perfunctory knowledge of economics (does an A level count?) and perhaps brush some of the details from my mind, it’s hard not to appreciate and empathise with the human cost of the austerity measures that are being driven though without a democratic mandate by the current Greek government, itself appointed.

I couldn’t fail though to be moved by the pictures that came in from Athens on Sunday night as the city burned while the politicians argued as they risked plunging Greece into ever sharper constraints demanded by the International Monetary Fund and the European Central Bank to fund another bailout.

While sometimes it’s easy to think of numbers such as 130 Billion Euros as beyond imagination – when a number reaches such a great number it becomes an intellectual equivalent to an statement of infinity, the figure, unfortunately, is real and the debt will be met at considerable human cost.

It’s not going to be those politicians who vote on this matter that will be punished by these measures.

CNN lists some of the proposed ‘savings’ and we can see exactly where the ‘pain’ is going to be felt

• Reduce the minimum wage straight away from €751 ($989) to €600 ($790) per month. For those under 25, the minimum wage will be slashed by 32%

• Cut pension provision and include a “strict link between contributions and benefits”

• Make 15,000 public sector workers redundant by the end of the year.

So who is going to pay the highest price to the IMF, European Central Bank and European Commission?

Those who have the least spare. The young, the unemployed (whose ranks will be growing with redundancies) and the pensioners.

We can joke about bloated public servants – and I won’t vouch for every one of those 15,000 jobs ( note that our own government does the same here) but public sector workers do have functions to serve and do work with people across all income brackets. These functions will be lost.

Again in the CNN article, chillingly, it is noted there are proposals to reduce spending on overtime of hospital doctors and make 1 billion euro savings on medication.

While there is a proposal to push through measures against tax evasion, that really is too little too late. The price is being paid by citizens for actions of previous governments and ruling classes who were more attentive to looking after their own then building better systems for their citizens.

As for the future, as well as the spectre of a move towards extremism across Europe as the impact of the bank-created recession builds there is likely to be more generations of emigrants of those most able to leave the countries that struggle the most. This will mean that those left behind struggle to a greater degree.

Unemployment in Greece is currently touching 21%. and it may yet defaulton the payments that have been demanded.

Caught between two evils, it’s hard to know or see a way out but there will be as there has to be.

We cannot ignore the pain inflicted on the southern fringes of Europe. Where Greece go, others may follow. Although we are not facing the same situations in the UK, the instinct of the ruling and political classes to save ‘their own’ at the expense of those who have least to give certainly rings true and while I doubt the empathy and solidarity of one social worker in the UK will have much significance to the people of Greece, it’s all I have to give. It seems so little.