Last reviewed 14 February 2012
Last year saw yet more cases of the theft of valuables and possessions from service users in the care sector, many of the crimes perpetrated by the very staff paid to protect them. Martin Hodgson investigates the situation.
In September 2011, in a typical case, a care worker from a home in Oldham was jailed after being found guilty of stealing gold rings and jewellery from vulnerable residents, including one aged 101. The mother of two targeted three pensioners at the home — including two who suffered from dementia — because she was short of money at Christmas. She was discovered after an inventory of jewellery was checked.
In another case, in November, the Care Quality Commission issued three warning notices on a care home in the South East. Amid the range of issues, the CQC found that there had been thefts in the home which had not been reported to the proper agencies by managers, and a member of staff told inspectors that a fellow member of staff had been reprimanded for “whistleblowing”.
In 2012 the CQC has announced that it will target home care services in a “themed inspection” following similar concerns in that sector.
What are the risks of theft and lack of respect for property in the care home sector and what can care home managers do to ensure they have the right policies and procedures in place?
Property thefts by staff in the care sector
The highest standards of probity and honesty are required from care home staff at all times and care home managers should never compromise these standards or accept anything less. Staff in a care home setting will generally have access to the personal possessions of many of their service users and it is therefore vital that they can be trusted to have complete respect for this property.
Theft from a service user by a member of staff who is in a position of trust and has a duty to protect is a serious form of criminal abuse and should be treated as such. Homes should have robust policies about abuse of all types and these policies should be well known to staff and carefully articulated to them. At induction all new staff should be taught about abuse and about the standards of honesty they will be expected to meet. Safeguarding training should then be a feature of ongoing training programmes for all staff.
All cases of suspected theft should be properly investigated and, where necessary, reported to the police and the appropriate disciplinary action taken.
Quite aside from the criminal aspects of thefts, the Care Quality Commission, with which all care organisations must be registered, includes issues of safeguarding service users from financial abuse as part of its compliance requirements.
Guidance about Compliance: Essential Standards of Quality and Safety, published in March 2010, contains the outcomes that the CQC expects service users to experience if a provider is compliant with the regulations. Within this guidance providers of adult social care services must comply with the requirements of Regulation 15 and Outcome 10: Safety and Suitability of Premises.
According to the regulations, providers must by law ensure that service users, and others having access to premises where a regulated activity is carried on, are protected against risks associated with security.
Other areas of the standards also relate to the personal security of service users.
For example, Outcome 7: Safeguarding People who use Services from Abuse is principally concerned with protecting service users from all manner of personal threats, including financial abuse and theft.
In addition, Outcome 12: Requirements Relating to Workers states that providers must ensure that they protect service users against the risks of being looked after by inappropriate, unsuitable or unsafe staff by having effective recruitment and selection procedures in place, including measures such as Criminal Records Bureau (CRB) checks and vetting and barring procedures.
All care services must comply with these outcomes.
Thefts from residents
Care home managers must be proactive and implement a zero tolerance policy to thefts by staff. At the same time training programmes must stress the need for core values such as dignity and respect for service users to be demonstrated at all times.
While most thefts are of money, including some carried out by care home managers, a substantial amount of thefts are of property, especially small, high value items such as jewellery. However, other items often stolen include clothes, ornaments, heirlooms and even furniture.
In a care home setting there are often many reasons put forward to explain the disappearance of personal possessions and money from service users. Some residents may be confused, depressed or have mental health issues that make them unreliable in keeping track of their possessions. They may talk about possessions they owned in the past that have long since disappeared.
Another way that some thefts are explained, especially of small items such as jewellery, is that they were given to the care worker as a gift.
Care home managers should never allow reports or rumours of thefts and disappearances to be disregarded for such reasons. Each case should be investigated properly, especially those involving elderly residents who may be confused as these may precisely be the type of residents targeted by thieves.
Allowing gifts to be accepted can lead to accusations of coercion, exploitation and fraud. All homes are therefore advised to have a strict policy which outlaws the acceptance of gifts or cash.
In order to decrease the incidence of theft, in every home:
a zero tolerance approach to theft and fraud should be taken
staff should be trained to respect the property of service users at all times
recruitment procedures should consider very carefully the background of anyone whose work will bring them into contact with service users and should include appropriate CRB checks
staff training at all levels should deal with abuse and safeguarding
staff working with service users should be supervised carefully
any suspicion, evidence or reports of abuse should be followed up promptly
staff should be encouraged to watch for any evidence of abuse and to report these immediately, if necessary “blowing the whistle” on others
a climate of openness should be created in the home, which allows for the passing on of any concerns whatever their source
policies and procedures relating to abuse should be widely publicised and kept up to date
property inventories should be kept and service users and relatives should be encouraged to report any unexplained disappearances of property.
Prevention strategies generally fall into three categories, those of "removing opportunity" for theft, increasing general security and ensuring only honest people have access to vulnerable service users.
Reducing the opportunity for property theft
In a care setting, the most common way for the opportunity for theft to be reduced is to encourage residents not to leave valuables lying around and to be more aware of personal security. In addition, signed inventories of possessions and valuables should be kept and agreed by relatives or representatives where required.
Care home managers should provide a range of systems and facilities to cater for the different ways in which residents may want to keep and have access to their money and valuables. All residents should have locked cabinets in their rooms for the security of small amounts of cash and valuables, with a key that they may keep if they wish to. A communal safe is a good option to provide for larger value items. Residents should be encouraged to keep their valuables in such a place and all deposits should be recorded and signed for.
Developing an effective security culture and taking sensible and proportionate security measures is an important element in helping care home residents live with dignity and respect. Residents need to feel that they and their possessions are safe. Many people who move into residential social care, particularly elderly or vulnerable people, have a natural fear of crime and achieving better levels of security may be one of the reasons for their move.
The approach to the security of the premises should be based upon a risk assessment. Importantly the risk assessment should not just consider threats from outside of the home but also threats from inside.
The use of access controls to a home is an effective way of keeping intruders and unwanted visitors out and maintaining security. This is especially relevant at night when staff may feel more vulnerable and the home should be secured.
Security arrangements must at all times be balanced with the need to keep care home premises welcoming, user-friendly environments with adequate access for users and relatives.
Listening to the opinions and feelings of residents, staff, visitors and experts in security is the best way to ensure that this balance is kept and that all security initiatives taken are reasonable.
It is an essential safeguarding measure that everyone working in a care service is trustworthy and reliable, and that anyone who might want to harm or take advantage of service users is prevented, as far as possible, from working with vulnerable adults. Managers should therefore make a series of checks before appointing anyone — employees, volunteers or trainees — to any position caring for service users.
Checks should include:
verifying the identity of applicants
checking an applicant's right to work in the UK
checking professional qualifications
performing criminal record checks
This is supported by Outcome 12: Requirements Relating to Workers of the CQC Essential Standards, which states that providers must ensure that they protect service users against the risks of being looked after by inappropriate, unsuitable or unsafe staff.
In addition to the above checks, managers should ensure that all staff are appropriately trained, monitored, appraised and supervised.
Responding to incidents of property theft
A clear message should be sent to staff that theft from service users will not be tolerated and will always be referred to the police.
Staff should be encouraged to report any thefts or suspicions of thefts to a manager or supervisor without delay. If there is any evidence or suspicion that theft has occurred or is likely to occur, the issue must be thoroughly investigated. Action taken must be recorded and reported, if necessary, to the CQC.
All action taken in response to allegations, evidence or investigations of theft must be carried out in accordance with the home's established policies and procedures. Where there is evidence of theft then the case should be reported to the police and the home should follow its agreed disciplinary procedures.
Care staff who are convicted of thieving from residents should be referred to the Independent Safeguarding Authority so that they can be barred from working with vulnerable adults again.
‘Whistleblowing" describes an action whereby an employee makes a public disclosure to a third party about some wrongdoing of the employer or of some other member of staff in an organisation, such as malpractice, fraud, negligence or abuse.
Staff can feel intimidated by abusers, especially if the abuser is a member of senior staff, and there is also often a pressure to "stick together" with colleagues. Many staff are therefore tempted to keep quiet and ignore abusive activities such as thefts from residents.
To ensure staff feel free to report incidents every home should have a whistleblowing policy. This should state that staff will be supported if they take the step of reporting abuse and that to keep quiet about an abusive situation may in itself constitute a disciplinary or even criminal act.
The CQC have set up a new confidential whistleblowing phone line on 03000616161.
Theft from the employer
Respect for property not only applies to materials stolen from residents. In any business there is also the problem of theft from the employer which, in a care home, often includes items such as stationery supplies, linen, toiletries and food. In extreme cases it can also include items such as medication and drugs.
What can employers do to minimise and stop such thefts?
The first step is to recognise the problem and gain an idea of the scale of the thefts. The best way to do this is to tighten up on stock control and ensure inventories are accurate.
Linen is a good example. Care home employers are only likely to realise that items of linen are going missing if they identify the fact that stock levels are falling faster than would be expected through normal wastage.
The same principle applies to food and office supplies.
Managers should ensure they:
keep detailed and up-to-date registers of all assets, together with serial numbers if appropriate — items should also be marked with a unique identification code or a similar security identification marker
complete regular audits of property and assets — small portable equipment should be checked frequently
record missing items — if theft is suspected the police should be informed.
As well as keeping detailed inventories employers should also consider better security arrangements for items and spot checks.
Better security arrangements can be as simple as locking supplies in a store cupboard and having staff sign for qualities when they take them out.
Spot checks would not only include checks of assets and inventories but also financial spot checks on the prices paid for items. Managers should watch out for unexplained variations in costs and for variations in delivery details. Vigilance throughout the entire supply chain may identify such fraud