How isolation from communities fosters abuse

The London Borough of Islington has commissioned the Elfrida Society to trial a new service – known as Circles of Protection – with the aim of pairing vulnerable people placed out of borough with local volunteers. Sarah Reilly explains how it works.

Quote: As long as we place vulnerable individuals out of borough we need to safeguard them. What price do we place on their safety? What price do we place on the human rights of our most vulnerable members of society?


The exposure of Winterbourne View showed the potential for the abuse of people with profound and multiple learning disabilities and mental health needs who are isolated from communities.


People placed in residential homes outside the borough with statutory responsibility are particularly vulnerable as they often have complex needs and may be challenging to work with. They frequently have no family involvement and are placed in rural areas where no one, other than the staff, regularly goes into the service.


We now recognise that the isolation of these services fosters the environment that enables abuse.


‘Eyes, ears and voice’

In response, the London borough of Islington commissioned the Elfrida Society to trial a new service. Tony Bamforth, CEO of The Elfrida Society, worked with Islington’s Joint Commissioning Team to develop a Circles of Protection pilot. The aim was to address the isolation of vulnerable people with learning disabilities, by pairing service users with local volunteers who would regularly visit them in their home. The intention was two-fold: to safeguard the service user against abuse, by being their ‘eyes, ears and voice’, and to enhance the quality of the service user’s life by offering a relationship that is prompted by interest and concern, not defined by a paid role.


The work appeared straightforward but the reality was challenging: finding volunteers from a distance is not easy; neither is locating people who have the time as well as the humanity to make a relationship with a person with no language and complex needs. Also, for a number of reasons, not all the individuals referred are suitable for a volunteer.


However, now in its second year the Circles of Protection service has evolved a model that works. The Circles of Protection Coordinator visits the service users referred to assess their needs and suitability; local links are developed and volunteers recruited, DBS checks and safeguarding training is carried out and volunteers are supported in their role; additionally the Coordinator works locally, in Islington, addressing concerns.


There are three modes of delivery:


• simple matching of a volunteer with a service user;

• supported matching which requires additional input from the Coordinator;

• direct contact maintained by the Coordinator with local professional involvement to monitor concerns and report back.


Effective delivery requires strong links with Islington’s Learning Disability Team.


All the individuals under the ‘circle of protection’ have benefitted. One service user was deemed unsafe in her placement and swiftly returned to Islington. A safeguarding alert has been raised regarding another and Islington’s Brokerage Team is urgently looking for another residential home. Levels of neglect have been uncovered, particularly around health: health reviews have identified undiagnosed health issues that are now being managed.


Medication reviews have shown that dangerously high levels of medication have been prescribed and there has been over use of PRN medication to sedate individuals, rather than manage distress. Neglect is, after all, another form of abuse.


Positive benefits

The project is already having positive benefits: a woman who loves to draw now has her own desk and chair in her bedroom; she could not ask for this, but her advocate did. One man proudly wears a suit to church every Sunday, accompanied by his befriender, and has become an appreciated member of a community. A woman who used to be afraid to go out now plays tennis with her befriender once a week and then goes out for lunch; when her befriender arrives she runs to put her shoes on.


These are all people with restricted lives whose needs and feelings are easily ignored.


The Circle of Protection service developed by The Elfrida Society is a bespoke service that is time intensive and genuinely person-centred. As long as we place vulnerable individuals out of borough we need to safeguard them. What price do we place on their safety? What price do we place on the human rights of our most vulnerable members of society?


Sarah Reilly is the Elfrida Society’s Circles of Protection Coordinator.