1. Surveillance in Care Homes
Christine Pearson
Designated Professional Safeguarding Adults

2. Background..
There is an apparent increase in the use of surveillance in care situations There have been a number of cases reported to Safeguarding in York and North Yorkshire
May 2016 – Hull – Care home staff were filmed abusing and humiliating a lady with dementia. They received 12 month community orders, were told to pay £1,500 each in compensation and were banned from the industry for life at Hull Crown Court.
The family are supporting an e-petition, set up by Hudgell Solicitor’s as part of its ‘Love Our Vulnerable and Elderly’ (LOVE) campaign., to get CCTV to be made compulsory in care homes.
Read more:

3. Surveillance is..
The monitoring of a place, person, group or on-going activity in order to gather information.

4. Overt surveillance..
Is where the individual or group being monitored would reasonably be aware of the monitoring
e.g. CCTV cameras with clear signs saying that they are in use
e.g. families informing care home manager that they are monitoring care

5. Covert surveillance..
Is where the individual being monitored would not reasonably be aware of the surveillance occurring
e.g. use of hidden audio or filming equipment for a specific purpose
Winterbourne View Hospital…abuse and neglect exposed by BBC Panorama following whistle-blowing by ward charge nurse. Serious Case Review – national significance led to transforming care plan for people with learning disabilities

6. Who might use surveillance..
Care home companies
As a measure of quality?
To gather evidence about a particular concern
Not recommended by CQC to be the sole measure of quality – not a replacement for well-trained, caring staff, audit, other quality measures. If companies are using it for this purpose they will need to demonstrate that they have taken in account – purpose, intent, use & storage of data, who has access, individual, family, staff (trade unions), visitors – professional & public – consent and knowledge.
CQC powers allow them to have access to information that has been recorded – where they consider it necessary and proportionate to do so to exercise their function as a regulator.
Police/safeguarding will also have access where concerns are raised by individuals or families

7. Who might use surveillance..
Individuals/families
Who are concerned about the quality of care
To relieve anxieties about care
Suspected abuse and neglect can be difficult to evidence so families may take the decision to try to capture evidence for a time-limited period.
Individuals themselves may be anxious about being looked after by others so may gain some comfort knowing care episodes are being recorded.
Any examples??

8. Who might use surveillance..
Covert surveillance is more likely to capture sensitive, intimate or deeply personal information. Its use must satisfy a more pressing purpose and legitimate aim to remain proportionate and lawful.
You may want to use surveillance for more than one purpose – if so each of these purposes must be identified as necessary and proportionate in its own right.
Consider Data Protection Act
Info gathered for one purpose must not be used for another incompatible purpose e.g. recording made for the sole purpose of protecting vulnerable people from abuse should not be used as a record of staff time-keeping for disciplinary purposes

9. Example..
Care home provider is concerned that there have been a series of theft from a communal living area of the home. Many people in the home are living with dementia or experience difficulties with communication. The provider decides that the prevention and detection of crime is a legitimate purpose to consider installing a surveillance system in the room.
The purpose of the use of surveillance must consider how it will support the needs and interests of people using the service. The purpose should be clearly identified and evidenced.

10. Dignity & respect..
Individuals being cared for are entitled to ‘dignity and respect’ Regulation 10(1) – dignity and respect – [which includes] 10(2) ensuring the privacy of the service user

11. Consent.. Explicit consent should be clear.
The individual must be told..
How information will be gathered
For what purpose
How will information be used and accessed
Any special aspects that may affect the individual, such as any disclosures that may be made
This includes staff and service users being recorded.

12. Consent..
Where consent is required it must be freely given and not obtained by coercion or threat It is important that any refusal, or withdrawal, of consent is respected Appropriate records must be maintained to demonstrate consent was fairly and lawfully obtained
Consent is not a one-off act it should be updated and reviewed regularly
CQC may wish to see the records

13. Capacity to consent..
Statutory principles of the Mental Capacity Act (2005) apply. Where an individual lacks capacity a care provider cannot seek that consent from others, such as their family member unless the person has relevant powers under a health & welfare lasting power of attorney. This means that surveillance which is particularly intrusive may require permission from the Court of Protection
Can decide on proportionality

14. Protecting privacy and dignity..
It is the responsibility of the care provider to be aware of the need to treat people with dignity and respect.
Repositioning camera or limiting time to avoid capturing intimate care
Gathering information that is less identifiable i.e. use of sensors
Allowing staff to turn off surveillance at certain times
Some privacy protections will be relevant to all surveillance i.e. ensuring only those who are authorised can access the information

15. Protecting privacy and dignity..
If there is concern that surveillance may be unreasonably intruding on the privacy or rights of a person using the service or others then this should be properly assessed.
Deliberately damaging surveillance devices, deleting recordings or removing the device with the intention of not returning it is likely to be considered as a criminal offence.

16. Any questions?