Care & Support Services - Safeguarding Standards

Criminal Records Bureau (CRB)

Criminal Records Bureau

The Criminal Records Bureau (CRB) was created in 1997 to assist organisations in screening potential staff and identify those who are unsuitable to work with vulnerable adults and children.

Every person who works in social care should undergo a CRB check to ensure they are suitable to hold a position of trust.

This section explains the CRB and its screening procedures:

- What the CRB is and why it was created?
- Who is considered vulnerable?
- What checks are made?
- Who can request a CRB check?

What is the Criminal Records Bureau?

The Criminal Records Bureau (CRB) is a Government public/private partnership initiative which is an executive extension of the Home Office. The Chief Executive Officer is directly responsible to the Home Secretary for the quality and performance of the Bureau. The CRB role is to provide information, referred to as 'disclosures', to assist organisations in screening potential staff and to highlight people who would be considered as unsuitable to work with children or vulnerable adults.

Why was it created?

The CRB was conceived under Part 5 of the Police Act of 1997 in response to growing concern about the safety of children and vulnerable adults. It was apparent that abuse could come not only from strangers; it was also the case that many were being harmed by those who were employed to care for them and who were in a position of trust. Before the CRB was set up the capacity of an employer in the care sector to carry out checks on potential employees was more limited and was considered to be an often slow and inconsistent process. What was felt to be required was an improved one-stop central personnel checking system where criminal records could be checked alongside other available sources of information.

The CRB has been operating since April 2002 and in just 30 months to October 2004, the Bureau had carried out 5 million confidential checks and received 50,000 requests per week. The projected cost of the Bureau for the first 10 years of operation is considered to be around £400million.

Who is considered vulnerable?

Those people who are considered vulnerable include:
- Children (i.e. under 18 years)

Any adult who:
- Receives accommodation and nursing care or personal care in a care home
- Receives personal care in their own home
- Receives healthcare services from the NHS or similar
- Receives services from an establishment which supports people with a learning disability

Any adult who has:
- A substantial physical or learning disability
- A physical or mental illness, chronic or otherwise
- An addiction to alcohol or drugs
- Substantial reduction in physical or mental capacity
- A dependency on others to assist with basic physical functions
- A severe problem in communication
- An impaired ability to protect themselves from abuse, assault or neglect

What sort of checks are made?

There are two major checks (or disclosures) and they are referred to as either a 'standard disclosure' or an 'enhanced disclosure'. There is an intention for a 'basic disclosure' but this is not operational yet. The difference between the two disclosures relates to the nature of employment sought and this is subsequently reflected in the depth of checking which is carried out.

Standard Disclosure

This is a check for convictions (including spent ones), cautions, reprimands and warnings recorded on the Police National Computer. Depending on the post applied for, certain checks can be made with other lists held such as Department of Education and Skills or Department of Health, where names of 'unsuitable' people are also recorded.

Enhanced Disclosure

This is a check for those people who will be employed in posts regularly involving caring for, supervising or being in sole charge of children or vulnerable adults. It consists of the same check as for the 'standard disclosure' plus additional checks with local police for other information and intelligence they may hold.

A prior identity check is delegated to the registered bodies requesting either of the above disclosures.

Who can request a CRB check?

Only those bodies and agencies who have been appropriately registered and thus deemed to require the information. The individual being checked must have also consented.

There is a responsibility on any organisation who is supplied with disclosure information from the CRB to regard it as confidential. An individual can request their own 'standard disclosure'.

Do the CRB charge for undertaking disclosure checks?

Yes, there are a number of fees. These are often paid by a prospective employer.

Protection of Vulnerable Adults (POVA) Scheme

This was launched in July 2004 and is a scheme derived from the Care Standards Act (2000). It holds a list of unsuitable care workers who have harmed, or placed at risk of harm, vulnerable adults in their care.

There is a statutory 'duty of care' on providers to check if a prospective employee care worker is included on the list. A POVA check is carried out along with a CRB disclosure, although in due course the CRB state it may stand alone as a check. A person who is on the POVA list cannot be employed in a care position.

Care providers are also under a duty to refer to the POVA Scheme for possible inclusion any employee they suspend or dismiss for misconduct which has harmed, or placed at risk of harm, vulnerable adults. The Secretary of State will then decide on the subsequent inclusion on the POVA list after reviewing the facts and considering any representations.

Further information:
Criminal Records Bureau:
Tel. info. line - 0870 90 90 811.
Website: www.crb.gov.uk

POVA Scheme:
Copies of the guidance available from:
Department of Health,
P.O. Box 777,
LONDON SE1 6XH
Tel: 0870 155 5455
Website: www.dh.gov.uk

Protection of Vulnerable Adults

'There can be no secrets and no hiding place when it comes to exposing the abuse of vulnerable adults.'

This is the opening line of the Government document 'No Secrets - Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse' (2000).

An awareness regarding abuse has slowly developed over the years from the work of Goffman (1961) regarding asylums and institutionalisation and the numerous official enquiries about abuse in NHS Mental and the then called Mental Sub-normality and Mental Handicap Hospitals. In recent times the emergence of groups like VOICE-UK and RESPOND have further highlighted instances and evidence of abuse to a vulnerable group of people and have acted to promote advocacy services to support them.

Several high profile cases (e.g. Beverley Lewis, The Longcare Inquiry) of abuse of adults with a learning disability had taken place in preceding years to 'No Secrets' and protection practices appeared to require a consistent and formalised approach, such as that which had evolved with Child Protection. The Government had signalled its intentions to provide a greater protection to vulnerable people in its White Paper 'Modernising Social Services Departments (1998)' and also in the Home Office document 'Speaking Up For Justice'.

Definition of a vulnerable adult

This was derived from a Lord Chancellor's paper in 1997 called 'Who decides?'. It is a person who is 18 years of age or over and 'who is, or may be, in need of community care services by reason of mental or other disability, age or illness; and who is, or may be, unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation'.

What constitutes abuse?

A mainstream dictionary definition of the term abuse refers to 'behave cruelly', 'harm', 'hurt', 'ill-treat', 'injure', 'maltreat', 'manhandle', 'molest', 'oppress', 'torture'. It also pertains to more emotional experiences like 'denigrate', 'curse', 'insult', 'malign', 'revile', 'scold', 'swear' and 'vilify'.
Abuse is described in the document 'No Secrets' as: 'a violation of an individual's human and civil rights by other or other persons' (Please click here to see section on 'Rights' on this web site.)

From these lay and formal explanations we can see there can be an extensive range of potential abuse for a vulnerable person to experience. The main forms of abuse are listed below:

Physical abuse

This would include actions such as hitting, shaking, pushing, kicking and slapping etc. Inappropriate use of medication or restraint would also be considered as physical abuse.

Sexual abuse

This is rape, sexual assault or sexual acts which were not, or could not, be consented to.

Psychological and emotional abuse

This includes actions such as threats, humiliation, blaming, controlling, intimidation, coercion, verbal abuse and harassment.

Financial abuse

This would be theft, fraud, exploitation or coercion surrounding a person's financial and material resources.

Neglect and acts of omission.

This is the ignoring of physical or medical needs. Failing to care for someone with the necessities of life.

Discrimination abuse

Abuse that is based on a person's race, disability, gender or sexual orientation, or other forms of harassment.

Abuse can be perpetrated towards vulnerable people by an individual, a group of people, or even an institution. It can be in the form of a single act or repeated acts. Its origins can arise from a clear and deliberate intent to abuse, or be a case of negligence, or be based in ignorance.

Criminal offences and abuse

With such a wide range of potential abuse for vulnerable people we can see a parallel for many such instances to be criminal offences. Abuse that appears to be an 'alleged' criminal offence requires police investigation from an early point in order that all the rules of evidence collection can be followed. This is vital should the Crown Prosecution Service ultimately wish to prosecute. There are numerous legal complexities to using the victim of abuse as a witness if they have a learning disability, therefore the collection of facts and evidence by the appropriate authorities is crucial if a case is to be subsequently pursued in the criminal court and corroborative evidence used.

The Learning Disability Task Force in their report of January 2004 on 'Rights, independence, choice and inclusion' includes a whole chapter entitled 'Crime against people with learning disabilities'. They are concerned about what appears to be a minimising of crime against people who have a learning disability. Descriptions like 'abuse' or 'bullying' get used in these cases, when for other people terms like harassment, assault, rape and hate crimes would be used. They are concerned about the intimidation and harassment people receive in their local communities, which leads to people being socially excluded. If the right words are not used, they feel crimes against individuals with a learning disability will not be taken seriously enough.

Who are the abusers?

Perpetrators can come from a wide range of people. They are often someone who is closely connected with the vulnerable person and is in a position of power and control. But in reality they can be anyone, such as family, paid care workers, professional staff, friends, neighbours, volunteers and strangers.

Neglectful and poor professional practice is sometimes referred to as 'institutional abuse'. This can range from practice which might be considered as either casual, not very satisfactory, or rushed, to more gross acts of ill-treatment or misconduct.

Intervention

The seriousness of any alleged abuse has to be established and is part of the process of considering how to appropriately intervene.

What needs to be considered following an allegation is:
- The degree of vulnerability of the person
- The extent, nature and context of the alleged abuse
- The length of time it is alleged to have been taking place
- The impact upon the victim
- The risk of such alleged abuse being repeated or escalating, towards either the victim or others who are vulnerable

The 'No Secrets' guidelines state that a process of assessment should evaluate the following:
- Is the person suffering harm or exploitation?
- Does the person suffering (or even causing) harm/exploitation meet the NHS and Community Care Act (1990) eligibility criteria?
- Is the intervention in the best interests of the vulnerable adult fitting the criteria and/or in the public interest?
- Does the assessment account for the depth and conviction of the feelings of the person alleging the abuse?

The first priority should always be to ensure the safety and protection of vulnerable adults. To this end it will be the responsibility of all staff connected with the investigation to act on any suspicion or evidence of abuse or neglect (see the Public Interest Disclosure Act 1998) and to pass on their concerns to a responsible person/agency.

The objectives of an adult abuse investigation will be to:
- Establish the facts
- Assess the needs of the vulnerable adult for protection, support and redress
- Make decisions about what follow-up action should be taken with regard to the perpetrator and the service, or its management, if they have been culpable, ineffective or negligent

Abuse investigation, procedure and process

The 'No Secrets' Department of Health guidance stated there should be the setting up of interagency guidelines between care agencies, promoting working together to protect vulnerable people. A multi-agency management committee should establish a framework to identify roles, responsibilities, authority, accountability and appropriate procedures. As a consequence local authorities, police and health services have now established some form of local 'abuse and vulnerable adult policy, practice and procedure' and many of these can be seen in more detail on the web sites of Social Services Departments.

Public Interest Disclosure Act (1999) - Whistle Blowing

Fear felt by staff has featured in a number of cases regarding abuse to vulnerable adults with learning disabilities and a consequent unwillingness to report malpractice or abuse committed by colleagues, organisations or institutions. Their fear was that they would be seen as someone who was a troublemaker and that their future careers would end up being blighted. Staff feared an organisation would prefer to 'shoot the messenger' rather than hear the message and risk adverse publicity.

This act is not solely for people working in the caring professions but for any employee in any sector of employment. It allows people at work to raise genuine concerns about crime, negligence, miscarriages of justice, dangers to health and safety and applies whether the information is confidential or not. It seeks to protect 'whistleblowers' from dismissal and victimisation and thus promotes the public interest and potential protection for vulnerable adults.