Date approved: 21/01/2013
QNIS PROJECT: ELFAP01
Final Report
Facilitating Adult Protection training: Evidence and
practice in community nursing.
Dr Martin Campbell
Senior Lecturer
Abstract
This was a Queens Nursing Institute Community Project involving collaboration between NHS Grampian and the School of Psychology & Neuroscience, University of St Andrews. The research builds on a previous QNIS Partnership in Research Project (Campbell & Chamberlin 2012).
The main aims of this project were to:
conduct a training needs analysis and training preferences study of community nursing staff operational knowledge of Adult Protection legislation and procedures as defined by the Adult Support & Protection (Scotland) Act 2007
design and deliver a one-day training based on the training needs analysis and expressed preferences, and
evaluate the impact of this training on pre-training knowledge.
The main group of participants was 18 Community Nurses working in a range of disciplines: learning disability, mental health, older people’s services, acute services, substance misuse, and Accident & Emergency. In addition 12 Community Nurses completed the first stage of the project only – training needs analysis and training preferences.
Individual and group scores for knowledge questionnaires were analysed pre- and post-training. Post-training increases on individual scores ranged from 2.5-27.5%, with a mean average of 15%. The differences between pre- post-test scores were statistically significant (Wilcoxon Signed Ranks Test).
There was no correlation between group scores and level of training or experience. Recommendations are made for future training.
Introduction
Increasing awareness of the need for legislation to provide a context for adult protection activity in Scotland grew throughout the 1980s and 90s, leading to the publication of Report on Vulnerable Adults (Scottish Law Commission, 1997).
In England and Wales the Department of Health and Home Office (2000) produced No Secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. In Scotland concerns were raised by the 2002 case of a woman with intellectual disabilities admitted to her local general hospital in Scotland suffering from multiple injuries. The injuries were the result of physical and sexual assaults over several years. NHS, social services and the police had previously been aware of the ill treatment of the woman, yet no action had been taken to prevent this chronic abuse. In the Mental Welfare Commission enquiry that followed (MWC/SWSI, 2004) it became apparent that failures within health services and social work had allowed three vulnerable people to be seriously sexually abused and another to be seriously physically neglected over a period of 30 years.
This enquiry served as a wake-up call throughout Scotland and subsequent research pointed to systemic failings in the approach of responsible agencies (Hogg et al. 2009a; 2009b). Between 2004-2009 the Care Commission in Scotland (now the Care Inspectorate) recorded 1530 specific abuse and neglect complaints against adult care homes. Of these complaints 56 per cent have been upheld or partially upheld.
In the light of the concern, the Adult Support & Protection (Scotland) Act 2007 was
introduced. The Scottish Law Commission’s Report on Vulnerable Adults (1997) specifically identified the requirement of a ‘strengthening of expectation that where there are allegations of abuse these will be taken seriously and pursued stringently’ (Brammer, 2006). The Report anticipated that the main groups who would benefit from the new legislation would be older people and those with learning disabilities, but noted the need to recognise that other adults may be at risk, including those with mental health problems.
at risk of harm and because they are affected by disability, mental disorder, illness or physical or mental infirmity and
more vulnerable to being harmed than an adult who is not so affected.
Under the Act individual staff are obliged to report suspicions of all forms of harm, neglect, or abuse, for example physical, psychological, financial or sexual abuse, neglect, discrimination or withholding information about entitlements. Guidance from the Nursing and Midwifery Council (2010) emphasises the professional duty of nurses to “put the interests of the people in your care first and to act to protect them if you consider they may be at risk”.
The 2007 Act was intended to complement existing legislation filling gaps that relevant to adult safeguarding that had been identified. The Act was supported by a Code of Practice (Scottish Government 2008a) Guidance for Adult Protection Committees (Scottish
Government 2008b) and a set of national training materials (Scottish Government 2008c).
In addition, the Protecting Vulnerable Groups (PVG) Scheme was introduced in Scotland in February 2011. Disclosure Scotland, the body responsible for the registration system, has advised NHS employers and other registered bodies to check all existing employees, with a view to PVG registration. Some of this checking will be done retrospectively.
There are certain duties under the Adult Support & Protection (Scotland) Act 2007. In the event of an allegation or suspicion of harm, for example, a duty is placed on statutory agencies including councils, the police and NHS to collaborate where an adult is deemed at risk of harm. These provisions have led to considerable activity, including the production of multiagency operating procedures and task groups at local level, (Penhale et al 2007).
The Act also mandated the setting up of interagency Adult Protection Committees (ASPs). The twenty nine ASPs in Scotland have a wide ranging remit including responsibility for training and staff development. There is, however, an absence of research in evaluating the impact of the approved Scottish Government training materials on staff knowledge and understanding of the 2007 Act.
Level 2: (For those staff who have contact with people at risk of harm). Requires good awareness of adult protection issues, and an operational knowledge and
understanding of the Act, to be able to respond appropriately whilst providing support and/or treatment. This level of training is aimed at community nurses and allied health professionals, as well as home care, care home, support and housing staff.
Level 3: For Council Officers, health service managers, police, other specialists and staff from regulatory bodies.
The training programme has been given a high priority in provider organisations and is included in induction programmes, as well as ongoing in-service training. A total of £7.8m was made available to authorities for the period October 2008 to March 2009 to assist with implementation of the Act, including training. NHS authorities and their partner organisations have been involved in the development and implementation training strategies.
There is an implicit belief that staff training will improve staff performance. The Health Select Committee (2004), for example, asserted that training for staff could increase the
identification and reporting of abuse. However evidence from previous evaluation of similar training for staff working with people with learning disabilities has reported mixed results (Hogg et al, 2001; Cullen, 1988; Hastings, 1996; Taylor & Dodd, 2003; Campbell & Chamberlin 2012).
Evaluation of adult support and protection activity has received increasing attention, with a particular emphasis on whether those at risk of harm feel safer because of Adult Support and Protection activity.
The Scottish Government training materials to support the implementation of the Act are well planned, covering the core elements of Adult Protection (Scottish Government 2008c). What is noticeably lacking in this important process is any means of verifying whether staff
knowledge and understanding of how the Act is implemented improves as a result of the training. Staff attendance has been taken as the main measure of training compliance.
“devising ways in which the training can be better evaluated in order to establish the effectiveness and impact of this style of training, including a review of the evaluation format; follow-up of learning outcomes with participants and any deficiencies that need to be addressed should also be considered” (Dodd & Lamb, 2004).
Similarly, Slater (2002) has described a local strategy for implementing No Secrets training, and Richardson et al (2002) found a lack of knowledge among staff dealing with elder abuse.
Community nurses can play a crucial role in implementing adult protection measures (Davies & Jenkins, 2004). A pilot study, looking at community nurse knowledge about adult
protection at two time points found that the level of knowledge recorded was below what would have been expected for this group, given the level of training and experience. No correlation was found between individual scores and training or length of work experience (Campbell & Chamberlin, 2012).
The current project is a follow-up project involving an initial analyses of training needs and training preferences, followed by a test of existing knowledge, before and after an intensive, one-day training. Most participants have previously undergone training approved by the local Adult Protection Committee (NHS Grampian/Aberdeenshire Council/ Grampian Police, 2010), and based on national training materials.
This project is innovative in two ways: it is a piece of action research involving collaboration between academic and NHS Grampian staff to investigate the impact of training and identify any gaps in service provision; it also involves nursing staff participants in the design of the training intervention that was delivered and evaluated.
This Project builds on a previous QNIS Partnership in Research Project:
Evaluating knowledge and understanding of the Adult Support and Protection (Scotland) Act 2007, now published in the Journal of Adult Protection (Campbell & Chamberlin 2012).
Participants
Participants, who were recruited through negotiation with area Clinical Nurse Managers in NHS Grampian, were community nurses working in a variety of settings.
28 nurses were recruited for this project.
19 of these participants completed the training needs analysis, pre-training questionnaire and attended the training day
18 participants completed all stages of the project. Participants had a range of professional remits as follows:
Community Learning Disability Nurses – 9
Inpatient Services – 1
Community Psychiatric Nurses (Older People) – 2
District Nurses – 1
Community Psychiatric Nurse (Adult) – 1
Primary Care Mental Health – 1
Community Health Partnership – 1
Accident and Emergency – 1
Team Leader CLDT – 1
A variety of reasons were given by participants who withdrew from the project. These included increased workload, lack of allowance of work time to complete the project, staff shortages, failure to read emails in time, and illness.
In addition to the 28 originally recruited a further 12 nurses agreed to complete the training analysis and training preferences questionnaire
Measures
The measures used in this study were as follows:
(A) Questionnaire on training preferences and learning styles (Appendix 1). This was used to collect information about (i) preferred types and methods of learning, (ii) information about existing training and (ii) learning styles.
(B) Questionnaire on existing knowledge about the Adult Support & Protection (Scotland) Act 2007, the purpose and context of the legislation and its implementation in practice. There were 40 items in this questionnaire and a sample of the questions is given in Appendix 2. This on-line questionnaire comprised multiple choice questions (n = 31) and True/False questions (n = 9)
Both (A) and (B) were delivered online, through the University of St Andrews Virtual Learning Environment, Moodle system.
Level of previous training in the Adult Support and Protection Act, and length of time working with people at risk of harm were also recorded
Procedure
The procedure was sequenced as follows:
Ethical approval by University of St Andrews and approval for participation by NHS Grampian.
Recruitment of participants through contact with relevant NHS Grampian Clinical Nurse Managers and subsequent follow up with participants who volunteered to be involved
Information sheets and consent forms completed by all participants.
Development of training preferences/ learning styles questionnaire. This
questionnaire was developed based on most favoured methods of training delivery for post-registration nurses (RCN 2004, 2010).
All participants were enrolled as temporary postgraduate students of the University of St Andrews and given email/computer accounts to allow access to questionnaires online.
1-8 June 2012: Completion of training preferences/ learning styles questionnaire by participants.
14-18 June: All participants completed knowledge questionnaire under test
conditions (time limited to 59 minutes, but no restriction on access to written materials or other sources of external information).
Analysis of training preferences responses and incorporation of expressed training preferences into the one-day programme (15 August 2012)
Analysis of knowledge questionnaire responses and development of one-day training programme to incorporate topics on which working knowledge was strongest/weakest
Training day 15 August 2012 (in NHS Grampian). See programme in Appendix 3.
20-27 August: Post training testing. Online knowledge questionnaire was completed for a second time by all participants under same test conditions as before. The order of presentation of the questionnaire items was randomised, to control for familiarity, recency and primacy effects.
Analysis of pre- and post-training scores, plus participants’ evaluation reports on training day.
Final write up of project.
The project steering group which consisted of the two principal project managers, plus support staff from University of St Andrews and NHS Grampian as necessary, met at various key stages in the project to discuss progress and to any adaptations to the agreed
procedure.
Results
Training preferences
Between 1st and 8th June 2012 an audit of participants’ views on effective/preferred training methods was carried out. This was completed by 40 nurses in total – 22 completed online
Type of learning (Figures 1-3)
Qualifications (Figures 4-6)
Training Activities (Figures 7-10)
Demographic Information (Figures 11-14)
Figure 1
Figure 2
0 2 4 6 8 10 12
Receiving information updates Gaining new knowledge Training in therapeutic skills
Which type of learning is most important to you?
0 5 10 15
Single module course (3 months) Short courses (1–2 days) Teaching seminars (1–2 hours)
Which method of training do you prefer to acquire new knowledge?
Summary analysis training preferences QNIS 2012
Figure 3
Figure 4
0 5 10 15
Short courses (1–2 days) Teaching seminars (1–2 hours)
Which method of training do you prefer to receive information updates to your practice? Choose from the following according to your preference?
0 2 4 6 8 10
Makes no difference Quite important Very important
How important is it to gain a recognised qualification and/or accreditation for any training that you undertake?
Figure 5
Figure 6
0 5 10 15
Academic qualification Certificate for Continuing Professional
Development portfolio No preference Professional qualification
What is your preferred type of qualification and/or accreditation for any training that you undertake?
0 5 10 15 20
For personal development To give greater confidence in my
practice
To improve my practice To improve my practice
Figure 7
Figure 8
0 5 10 15 20
Brainstorming: (quickly generating ideas individually or in a group) Small group work (in-depth discussion on
particular topics in groups of 3-6) Buzz groups (2-3 minutes in groups of 3 to
generateas many ideas as possible)
When you attend a training event which of the following training activities do you prefer?
0 5 10 15 20
Case studies (interpretation and analyses of real or fictional cases)
Problem solving (being given some information about particular cases and being asked to
provide a correct solution)
Role play (taking a particular perspective and acting it out, to explore an issue from that point
of view)
When you attend a training event which of the following training activities do you prefer?
Training Activity Preferences
Figure 9
Figure 10
0 5 10 15 20
In house speakers (inviting person from own organisation to give presentation) Preparing a presentation (participants work on
a topic for part of the day and present to the whole group at the end of the day) Resource speakers (invited external speakers to
give presentation)
When you attend a training event which of the following training activities do you prefer?
0 2 4 6 8 10
Participatory media (using different forms of media –photography, video, collage as …
Textbooks Using CD ROMS or interactive website (working through a series of questions and answers on… Using internet resources (researching a topic in
your own time)
Worksheets
Figure 11 Figure 12 0 5 10 15 20 Female Male Gender of participants 0 2 4 6 8 10 12 14 30-39 40-49 50-59 60-69
Age range of participants
Demographic information
Figure 13
Figure 14
0 5 10 15 20
Yes No
Have you had any specific training (post registration) about Adult Support and Protection?
0 5 10 15 20
Less than 1 day 1 day 1-5 days
If you have had specific training about Adult Support and Protection, what was the duration of the training?
Figure 15 Figure 16 0 2 4 6 8 10 12 14
I am thorough and methodical. I often produce off-the-cuff ideas that at first might seem silly or half-baked.
0 2 4 6 8 10 12 14 16
I am normally the one who initiates conversations.
Figure 17 Figure 18 0 2 4 6 8 10 12 14 16
I am careful and cautious. I am flexible and open minded.
0 2 4 6 8 10 12 14
I investigate a new topic or process in depth before trying it.
I like to try new and different things without too much preparation.
Figure 19 Figure 20 0 2 4 6 8 10 12 14 16 18
I am happy to have a go at new things. I draw up lists of possible courses of actions when starting a new project.
0 2 4 6 8 10 12 14 16
Figure 21 Figure 22 0 2 4 6 8 10 12 14 16
I am loud and outgoing. I am quiet and somewhat shy.
0 2 4 6 8 10 12 14 16 18
Figure 23 Figure 24 0 2 4 6 8 10 12
I speak fast, while thinking. I speak slowly, after thinking.
0 2 4 6 8 10 12 14
I am good at picking up hints and techniques from other people.
I ask probing questions when learning a new subject.
Figure 25 Figure 26 0 5 10 15 20 25
I am practical and down to earth. I am rational and logical.
0 2 4 6 8 10 12 14 16 18
Figure 27 Figure 28 0 2 4 6 8 10 12
I like to know the right answers before trying something new.
I try things out by practicing to see if they work. 0 2 4 6 8 10 12
I analyse reports to find the basic assumptions and inconsistencies.
I rely upon others to give me the basic gist of reports.
Figure 29 Figure 30 0 2 4 6 8 10 12 14 16 18
I enjoy working with others. I prefer working alone.
0 2 4 6 8 10 12 14 16
Others would describe me as serious, reserved, and formal.
Others would describe me as verbal, expressive, and informal.
Figure 31
Figure 32
Scoring procedures for Learning Styles analysis: each preference (high score) from the question is used to determine learning style.
The majority of participants (>82%) had a preference for learning through Concrete 0 2 4 6 8 10 12 14 16
I use facts to make decisions. I use feelings to make decisions.
0 2 4 6 8 10 12 14 16 18 20
Abstract Conceptualization and Active Experimentation.
The results of this analysis of training preferences were used to design the format of the training day on 15th August 2012 (Appendix 3). This was a combination of speaker presentation, case study analysis, small group work and short participatory activities.
Existing knowledge of the Adult Support and Protection Act and its
implementation.
Between 14th-18th June 2012 all participants were asked to complete a questionnaire under test conditions to measure existing knowledge about Adult Protection legislation and its implementation. This questionnaire was completed by participants again, following the training day (20th-27th August 2012). (Four participants withdrew from the project at pre-training stage, citing a variety of reasons. The remaining 20 participants completed the 40-item pre-training knowledge questionnaire. Two participants withdrew from the project at post-training stage, citing a variety of reasons.)
What follows (Figure 33 and Table 1) is a summary of the pre- and post-training scores for the 18 participants who completed all stages. (Maximum score is 100).
0 10 20 30 40 50 60 70 80 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Pre-training Post-training Participants Sco re o n q u estio n n ai re
Pre-Training Post-Training
Mean average 51.2, SD 7.8 65.6, SD 8.6.
Median 52.5 67.5
Range of scores 32.5-60 45-75
Table 1
The Wilcoxon signed-rank test was used to compare the repeated measurements on a single sample, i.e. pre- and post-training scores. There was a statistical difference between the scores (Z = -3.738, P = 0.000).
As the participants completed the training preferences survey anonymously it is not possible to demonstrate correlation between previous training and scores on the knowledge
questionnaires. There was no relationship between the time taken to complete the knowledge questionnaire and final scores.
An analysis was done to identify the lowest scoring items on the knowledge questionnaire (items scoring less than 40% correct) and the highest scoring items (more than 80% correct). There were 15 lowest scoring questions and 9 highest scoring questions (see lists below). The areas of knowledge for the 15 lowest scoring questions were specifically targeted in designing the content of the training day on 15th August.
The lowest scoring questions were in relation to:
1. Categories of people referred as Adult Protection concerns in Grampian 2. Procedures for undertaking Significant Case Reviews in Aberdeen 3. Definitions of ‘Adults at risk’
4. Types of harm described in the Adult Protection legislation 5. Duties to inquire by the Council
6. Purpose of sedation, seclusion and restraint 7. Characteristics of victim precipitation
8. Characteristics of (i) predatory abuse and (ii) reactive harm
9. Functions of the law in shaping adult protection policy and practice. 10. Restriction orders with a right of appeal
15. Definitions of physical and sexual harm in the Adult Support and Protection (Scotland) Act 2007
The highest scoring questions were in relation to:
1. The age at which a vulnerable person (adult at risk) become an adult
2. The duty of NHS, the Council, Police and other agencies to share information relating to adults at risk of harm, including the outcome of any enquiries or criminal
investigations.
3. Definition of a person's "capacity" to make a particular informed decision. 4. Examples of financial types of harm.
5. The existence of a Grampian-wide Interagency Policy and Procedure for the Support and Protection of Adults at Risk of Harm.
6. The key client groups that have the greatest potential to be at risk are those who lack capacity to take decisions for themselves.
7. Factors that differentiates acceptable from unacceptable sexual activity. 8. Definitions of self-neglect in the context of an adult at risk of harm. 9. The responsibility for reporting an adult cause for concern.
Though all participants increased their individual scores between the pre-training and post training, all answered questions wrongly post-training that they had previously answered correctly. See Figure 34.
2 4 6 8 10 12
Questions correct pre-training but incorrect post-training
N u m b er o f q u est io n s
Half of the study population was learning disability nurses. Figure 35 shows the average scores between learning disability nurses and “other” nurses. Figure 36 shows the mean average scores of the two groups within the “other” nurses..
Figure 35 52.00 53.00 54.00 55.00 56.00 57.00 58.00 59.00 60.00 61.00
Learning Disability Other nurse
Average scores by care discipline - learning disability
(n = 9)
and other
nurses
(n = 9)
Pre-training Post trainning
52.00 53.00 54.00 55.00 56.00 57.00 58.00 59.00 60.00 61.00
Mental Health General Adult
Average scores of other nurses
(n = 9)
general adult community nurses
(n=5)
, mental health nurses
(n = 4)
Discussion
This research project involved a training preferences survey and Adult Support and Protection knowledge tests of community nurses in NHS Grampian. Participants currently receive training adapted from Scottish Government national training materials and approved by the local Adult Protection Committee (Grampian Police /Aberdeenshire Council/ NHS Grampian, 2010). The research builds on a pilot study (Campbell & Chamberlin, 2012).
This project was innovative in two ways: it was a piece of action research involving
collaboration between academic and NHS Grampian staff to investigate the impact of training and any gaps in service provision and it involved nursing staff participants in the design of the training intervention.
Participants in this study completed a training preferences survey in which they also indicated their preferred learning styles. Based on these expressed preferences an Adult Support and Protection training event was designed. Clinical Nurse Managers, who supported the study by releasing staff, requested that staff be credited with attendance at the training. In order to meet the mandatory requirement set by NHS Grampian for all staff to attend Adult Support and Protection, the first session of the training day was devoted to this and provided by the Joint Training Co-ordinator (Appendix 3)
All participants increased their score post-training and there was a statistically significant increase across the group. (Wilcoxon Signed Ranks Test Z = -1.807, P = 0.071). All
participants showed individual improvement in scores, ranging from 2.5-27.5% improvement. However, it is also worth noting that all participants responded incorrectly post-training to two or more questions they had answered correctly pre-training (this ranged from 2 questions to 10 questions) suggesting a degree of guesswork in pre-training performance.
The participants in this project were categorized within one of three care disciplines: Learning Disability (n = 9), Mental Health (n = 4) and General Adult (n = 5). General adult nurses showed the greatest increase between pre- and post-training in average score. Learning
providing high quality care. This highlighted the need for nurses to be discerning about the knowledge they retain and the need for them to be competent in accessing additional
information and guidance as necessary. This need to be able to easily access information to enhance knowledge was identified in a study of vulnerability and abuse (Parley 2007). In the present study, none of the participants claimed to have used an “open book” approach to improve their questionnaire scores even though this option was available and participants had one hour in which to complete the knowledge tests pre- and post-training.
NHS Grampian have provided all staff with Adult Support and Protection Z-cards that are concise and contain contact details and guidance for staff should they have concerns about an adult at risk of harm. All levels of training detailed in the introductory training are provided within Grampian by a Joint Training Co-ordinator and participants have some limited opportunity during training sessions to seek clarity. Training is mandatory for all staff
demonstrating the commitment of the NHS Board, and Adult Support and Protection has also been developed as an e-Learning Package. This allows the Board to record the number of staff who have completed the online package. Following completion of the package, however, evaluation of results could provide opportunities for an improvement plan for Adult Support and Protection. As with the Scottish Government Adult Protection training, there is a need for follow up to assess staff knowledge immediately following training, and longitudinally.
Effective training is seen as one of the main challenges in the newly emerging safeguarding remit of NHS and local authorities and it should be responsive to the identified needs for information and knowledge of those staff being trained. Dodd & Lamb (2004) recommended better training evaluation methods, improved follow-up of participant learning outcomes and identification of any reported deficiencies in the training.
The Adult Support & Protection (Scotland) Act 2007 has had a profound impact on
safeguarding activity in the country. It is important to emphasise, however, that this legislation alone cannot solve the problem of individuals at risk being harmed, even with the
superstructures, including training programmes that have been implemented since the introduction of the Act in October 2008. The Act is used in conjunction with a wide range of
The main findings of the project were that:
the level of knowledge in adult support and protection varied considerably across the community nursing staff
level of knowledge could be improved significantly by brief, targeted training.
to be most effective, this training should include diagnostic assessment beforehand, and should involve participants in the design of methods of training delivery
Finally, a point about staff attendance at training events is worth noting here. In this study a variety of reasons were given by participants who initially signed up and subsequently withdrew from the project. Unmanageable workload, lack of allowance of work time to
complete the training, staff shortages, failure to read emails in time, and illness were the main reasons given. One of the dangers of training that records attendance as the main measure of success is that some staff, working in key positions, don’t turn up because they are not
motivated to do so. Even with follow up training events, it is very difficult to ensure that all of the intended learning and training outcomes have been achieved.
There is a responsibility for nursing staff to work in a safe manner. In support of this, current mandatory training for NHS nurses in Scotland includes topics such as Health and Safety at Work, Infection Control and Manual Handling. Safeguarding Vulnerable Adults has recently been added to this list. There remain inconsistencies however, in how knowledge through mandatory training is being verified.
Davies, R. & Jenkins, R. (2004) ‘Protecting people with learning disabilities from abuse: A key role for learning disability nurse’, Journal of Adult Protection, 6, 2, 31-41.
Department of Health and Home Office (2000) No Secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. London: Department of Health and Home Office.
Dodd, K. & Lamb, L. (2004) Recommendations into practice: implementing the results of local research into adult protection, Journal of Adult Protection, 6, 1, 20 – 26.
Hastings, R.P. (1996) Staff training and management in services to people with learning disabilities: An annotated bibliography. British Journal of Clinical Psychology, 35, 3, 480-482.
Hogg, J., Campbell, M., Cullen, C. & Hudson, W. (2001) Evaluation of the Effect of an Open Learning course on staff knowledge and attitudes towards the sexual abuse of adults with learning disabilities. Journal of Applied Research in Intellectual Disabilities, 14,12-29.
Hogg, J., Johnson, F., Daniel, B. & Ferguson, A. (2009a) Interagency Collaboration in Adult Support and Protection in Scotland: Processes and barriers. Volume 1: Main Report. Dundee: White Top Research Unit: University of Dundee.
Hogg, J., Johnson, F., Daniel, B. & Ferguson, A. (2009b) Interagency Collaboration in Adult Support and Protection in Scotland: Processes and barriers. Volume 2: Recommendations. Dundee: White Top Research Unit: University of Dundee.
Honey, P. & Mumford, A. (1986). Manual of Learning Styles. Maiden Head: Peter Honey.
House of Commons Health Select Committee. Elder Abuse (2004) Second Report of Session 2003-4 Vol. 1. Report, together with formal minutes. London: The Stationery Office.
MWC/SWSI (2004) Investigations into Scottish Borders Council and NHS Borders Services for People with Learning Disabilities: Joint Statement from the Mental Welfare Commission and the Social Work Services Inspectorate. Edinburgh, Mental Welfare Commission
http://www.scotland.gov.uk/Publications/2004/05/19333/36719
Nursing and Midwifery Council (2010) Raising and escalating concerns - Guidance for nurses and midwives
http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Raising-and-escalating-concerns.pdf
(accessed 28/10/12)
Parley, FF (2007) Vulnerability and abuse: An exploration of views 0f care staff working with people who have learning disabilities. pp 228 (PhD Thesis)
https://openair.rgu.ac.uk/bitstream/10059/225/1/FFParley%20Thesis.pdf
Penhale, B., Perkins, N., Pinkney, L., Reid D., Hussein, S. and Manthorpe, J. (2007) Partnership and Regulation in Adult Protection: The Effectiveness of Multi-Agency Working and the Regulatory Framework in Adult Protection. Dept. of Health/ University of
Sheffield/KCL.
Richardson, B., Kitchen, G. & Livingston, G. (2002) The effect of education on knowledge and management of elder abuse: a randomized controlled trial. Age and Ageing, 31, 5, 335-341.
Royal College of Nursing (2004) The post-registration education and training needs of nurses working with children and young people with mental health problems in the UK. RCN, London.
Royal College of Nursing (2010) Mental health nursing of adults with learning disabilities RCN guidance. RCN, London.
Scottish Government (2008a) The Adult Support and Protection (Scotland) Act 2007. Code of Practice. http://www.scotland.gov.uk/Publications/2009/01/30112831/1
Scottish Government (2008c) The Adult Support and Protection (Scotland) Act 2007. National Training Material for the Adult Support and Protection Act
http://www.scotland.gov.uk/Topics/Health/care/adult-care-and-support/legislation/ASPtraining
Scottish Law Commission (1997) Report on Vulnerable Adults (Scot Law Com No 158). Edinburgh: The Stationery Office.
Slater, P. (2002) Training for No Secrets : A strategic initiative. Social Work Education: The International Journal, 21, 4.
Taylor K & Dodd K (2003) Knowledge and attitudes of staff towards adult protection. Journal of Adult Protection 5 (4) 26–32.
APPENDIX 1
Universit y of St Andrew s/NHS Grampian/Queens Nursing Ins titute
Scotla nd
Questionnaire on training preferences and learning styles
Introduction
There are a number of ways in which education and training can be delivered, in different formats to meet the needs of NHS staff, including nurses. The following questions are intended to record your preferences for methods of training and also to give us some information on your preferred style of learning.
The information that you provide here will remain completely confidential and anonymous.
Most important type of learning
Which type of learning is most important to you? Please rank the following according to preference (1 – most favoured; 2 - next favoured, etc.)
Which method of training do you prefer to acquire new knowledge? Please rank the following according to preference (1 – most favoured; 2- next favoured, etc.)
Teaching seminars (1–2 hours) Short courses (1–2 days)
Single module course (3 months)
Preferred method of training delivery for information updates
Which method of training do you prefer for information updates to your practice? Please rank the following according to preference (1 – most favoured; 2- next favoured, etc.)
Teaching seminars (1–2 hours) Short courses (1–2 days)
Practical teaching sessions (1–2 hours)
Preferred method of training delivery to learn therapeutic skills
Which method of training do you prefer to learn new therapeutic skills? Please rank the following according to preference (1 – most favoured; 2- next favoured, etc.)
Practical teaching sessions following demonstration (1–2 hours) Short courses (1–2 days)
Single module course (3 months)
How important is it to gain a recognised qualification and/or accreditation for any training that you undertake?
Circle one of the following:
Very important Quite important Makes no difference Not at all important
What is your preferred type of qualification and/or accreditation for any training that you undertake?
Circle one of the following:
No preference
Please rank the following according to preference (1 – most important; 2- next most important, etc.)
To improve my practice
To give greater confidence in my practice For personal development
To develop a career pathway
To get promoted and gain a salary increase Other
Training activities
When you attend a training event which of the following training activities do you prefer? Please rank the following according to preference (1 – most favoured; 2- next favoured, etc.)
Brainstorming: (quickly generating ideas individually or in a group)
Small group work (in-depth discussion on particular topics in groups of 3-6)
Buzz groups (2-3 minutes in groups of 3 to generate as many ideas as possible on a particular topic)
Case studies (interpretation and analyses of real or fictional cases)
Role play (taking a particular perspective and acting it out, to explore an issue from that point of view)
Resource persons (invited external speakers to give presentation)
In house persons (inviting person from own organisation to give presentation)
Participatory media (using different forms of media –photography, video, collage as alternative ways to explore, present and reflect on issues)
Preparing a presentation (participants work on a topic for part of the day and present to the whole group at the end of the day)
Using internet resources (researching a topic in your own time)
Using CD ROMS or interactive website (working through a series of questions and answers on a computer based programme)
Problem solving (being given some information about particular cases and being asked to provide a correct solution)
Textbooks Worksheets
Demographic information
The information that you provide here will remain completely confidential and anonymous. It will give us an overall demographic profile of participants in this project.
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Have you had any specific training (post registration) about Adult Support and Protection?
P O S T - R E G I S T R A T I O N E D U C A T I O N
Title/type of training
Date of training (which year)
Duration of course
Less than 1 day
1 day
1-5 days
More than 5 days
Learning Styles
This is a series of questions about your preferred learning style.The information that you provide here will remain completely confidential and anonymous. It will give us an overall profile of preferred learning styles for the participants in this project.
Instructions
Read each statement carefully. Answer honestly as possible. There are no correct or incorrect answers here. It is best if you do not think about each question too long.
SECTION 1 (Doing & Watching)
Circle EITHER "Doing" OR "Watching" next to the statements below, depending on which you most closely agree with.
1. Doing - I often produce off-the-cuff ideas that at first might seem silly or half-baked. Watching - I am thorough and methodical.
2. Doing - I am normally the one who initiates conversations. Watching - I enjoy watching people.
4. Doing - I like to try new and different things without too much preparation. Watching - I investigate a new topic or process in depth before trying it.
5. Doing - I am happy to have a go at new things. Watching - I draw up lists of possible courses of actions when starting a new project.
6. Doing - I like to get involved and to participate. Watching - I like to read and observe.
7. Doing - I am loud and outgoing. Watching - I am quiet and somewhat shy.
8. Doing - I make quick and bold decisions. Watching - I make cautious and logical decisions.
9. Doing - I speak fast, while thinking. Watching - I speak slowly, after thinking.
SECTION 2 (Thinking & Feeling)
Circle EITHER "Thinking" OR "Feeling" next to the statements below, depending on which you most closely agree with.
1. Thinking - I ask probing questions when learning a new subject. Feeling - I am good at picking up hints and techniques from other people.
5. Thinking - I analyse reports to find the basic assumptions and inconsistencies. Feeling - I rely upon others to give me the basic gist of reports.
6. Thinking - I prefer working alone. Feeling - I enjoy working with others.
7. Thinking - Others would describe me as serious, reserved, and formal. Feeling - Others would describe me as verbal, expressive, and informal.
8. Thinking - I use facts to make decisions. Feeling - I use feelings to make decisions.
9. Thinking - I am difficult to get to know. Feeling - I am easy to get to know.
Thank you for taking the time to complete this questionnaire.
APPENDIX 2: Knowledge Questionnaire – sample questions (with answers)
1. At what age does a vulnerable person (adult at risk) become an adult?
x
a)
16
b)
18
c)
21
d)
25
Council
x
c)
Moray, Aberdeenshire and Aberdeen City
d)
NHS Grampian, Grampian Council
e)
Banff & Buchan, Kincardine & Mearns, Formartine
3. Under which of the following Orders may a Sheriff attach a power of arrest?
a)
Removal Orders
b)
Assessment Orders
x
c)
Banning Orders
d)
Disability Orders
e)
Disturbance Orders
4. Which of the following is a definition of “neglect” in the context of the Adult
Support and Protection (Scotland) Act 2007:
x
(a)
Failure to act
(b)
Overall culture is essentially neglectful
(c)
Poor care of basic needs
(d)
Harm caused by professional complacency
(e)
Act of commission
APPENDIX 3: Training Day Programme (15
thAugust, NHS Grampian)
9.00-9.30 Registration and coffee
9.30-10.10 Adult Support & Protection Training: Jacqui Mackintosh (NHS Grampian trainer with responsibility for compulsory ASP training)
10.10-10.40 Existing knowledge and training preferences (Martin Campbell)
2.15-2.35 Tea/Coffee
2.35-3.30 New knowledge and implications for practice (Martin Campbell)
