Case studies

Dealing with abuse without hard evidence

Governance | Dame Mary Marsh | 1 Jul 2007

Gilly Green, head of UK grants at Comic Relief, and Dame Mary Marsh, director and chief executive of NSPCC, give advice to a conflicted chief executive.

Dear editor,

I am a relatively new chief executive of a charity providing residential care for vulnerable adults. On the surface, everything seems fine and we have passed recent regulatory checks at our three centres.

I was visited recently by a former senior member of staff who made serious allegations regarding subtle and systematic abuse of many of our residents in one of our centres. He was articulate and produced a dossier of incidents which he left with me. Evidence, if it exists, appears to be circumstantial and anecdotal.

My director of services informs me that although she has been unable to prove it, she is certain that abuse is taking place but because it is so sophisticated, evidence of actual abuse is impossible to gather. Believing that any publicity about abuse would be hugely damaging to the charity, my predecessor and the chair had, in the interests of the charity, decided the charity would turn a blind eye. Trustees were not informed of the issue or the decision.

The next day, I visited the centre unannounced with my director of services and clearly the head of centre was very put out. There seemed to be rather a lot of staff scurrying around as soon as they became aware of our arrival. Cumulatively, a number of things were suspicious but we found nothing we could use as hard evidence.

My chair's wishes remain unchanged and I am told that, without evidence, the police would not take me seriously. The chair has made it clear that my job is at risk if I were to take unilateral action. The head of centre retires in two years time. My director of services and I have put in place various measures to make life more difficult for abuse to occur but it is only scratching the surface. I believe the police should be informed and a full investigation carried out.

I do not want to see the charity damaged and I have a young family and a large mortgage but I'm not prepared to see vulnerable people facing potential or actual abuse.

Yours sincerely,

Chief executive facing a major dilemma   

Dear chief executive,

Sometimes there are no easy answers or entirely comfortable solutions. Quick fixes are rarely sustainable or possible, especially when dealing with complex human interactions. Many residential care homes provide an excellent quality of care, but abuse can and does occur and you are right to be concerned. The chair has taken the decision to turn a blind eye in the interests of the charity, but whose interests is the charity set up to serve its own or its service users?

Without hard evidence it is more difficult to act, and questionable as to whether the police will engage. Much of the abuse or neglect you suspect may not be criminal as such but rather the result of poor management practice resulting in inadequately-trained, low-paid and demotivated staff. But subtle and insidious abuse or neglect can escalate; poor practice can become abusive practice, and the longer it goes on, unchallenged, the harder it will be to change it.

So perhaps this is where you might start as a relatively new chief executive to implement a training and awareness-raising programme which aims to bring about a change in the culture of your organisation. This way you are sending a clear message that abuse is unacceptable and that everyone has a responsibility to recognise it, prevent it and do something about it if they suspect it. This approach should help in tackling both the unintentional abuse reflective of poor practice, as well as ensuring that abusive behaviour is more likely to be challenged.

You rightly feel a moral duty to take action, and two years is too long to wait until the head of centre retires. You need to go back to your chair and make clear that you are not prepared to stand by and let this happen. Perhaps he will agree to the proposed plan of action described above, and you might be able to run a short session at a board meeting for trustees to become more aware of the issues, and subsequently promote this shift in culture from the top. But you should also make clear that if this is not accepted, you will feel you have no choice but to take stronger action including possible external regulatory or investigative action. 

In tackling the abuse of vulnerable people, be it those with learning disabilities or older people, it is essential to bring about a fundamental change both in the culture of organisations, and more profoundly in the attitudes of society. In trying to focus its funding, Comic Relief has made tackling elder abuse one of its priorities in recent years but the awareness of abuse remains low for all vulnerable adults and people are insufficiently conscious of what behaviour constitutes abuse and what should simply not be tolerated. It is time for change.

Gilly Green is head of UK grants at Comic Relief

Dear chief executive,

I write as a chief executive of a child protection charity. As I hope you will understand I find this dilemma shocking and very disturbing. Statutory responsibilities for the protection of children require that such allegations in the context of childcare require immediate investigation even if the evidence is not substantial. So I find the fact that this issue was buried originally of deep concern. I assume too that the decision to do this was not taken formally with the matter put on record together with all the evidence available at the time.

The reputational risk of such an investigation would need to be carefully managed but there is a far greater risk if this comes into public scrutiny later and it is clear that no action was taken deliberately at the time. Meanwhile there is a real and substantive risk, corroborated by the director of services, that vulnerable adults in your care are suffering abuse. Surely the welfare of your service users is your most critical responsibility?

You need to promptly assemble all the evidence you have, including the basis for your director of services' views and the reports from the visits of regulators, and then take stock of it. I am surprised that the regulators have not identified any concerns given their increased focus on the  users perspective. Do you have any results of their consideration of such feedback? What about any concerns or complaints from the relatives or friends of your service users at this centre over recent years? The level of abuse you may be confronting may not be of the severity to constitute criminal behaviour but it could certainly be neglectful, harmful and completely inappropriate care. You are likely to need an independent investigation of all this but not necessarily from the police.

You need to present a robust case to your chair in the context of rapidly changing attitudes in society at large to the abuse of vulnerable adults following on from the progress we have made towards intolerance of the abuse of children and young people. I wonder how your chair sees his or her accountability and that of the board in this setting?

You have a great opportunity as a new chief executive to ensure that the standards in place in all your centres are the same supported by appropriate safe recruitment, induction, ongoing training and management supervision. Everyone should know that it is their responsibility to ensure that any abuse is entirely unacceptable and to take immediate action to stop it if it does. This responsibility is shared by the trustees too. You could also make sure that all your staff are clear how they can contact you, or whoever you chose to nominate in your senior team, directly and confidentially.

You need to act in partnership with your chair and the rest of the board. Once you have been explicit about their responsibilities in all this they should welcome the measured and rigorous response you propose, whatever that is, based on the evidence you assemble. They and the charity will be far more at risk if they do not.

Dame Mary Marsh is director and chief executive of NSPCC

Directory: Comic Relief | National Society for the Prevention of Cruelty to Children (NSPCC)
Who's Who: Dame Mary Marsh