Practitioner Conceptualisation of Vulnerability in Adults at Risk of Abuse

The recognition of abuse and neglect of vulnerable adults is a relatively new phenomenon. In the

academic community adult protection research has received sparse attention.

A decade of commentary by researchers, practitioners and campaign agencies indicates a general

consensus about the confusing and ambiguous nature of the term 'vulnerability'. A few studies have

drawn attention to confusion over what constitutes vulnerability, noting the lack of clarity over

definitions. Fewer still have sought to elicit the views of staff on applying this concept.

This study explores what signs of vulnerability professionals in human services employ when

assessing the risk of abuse/exploitation to adults and what contextual factors or operators have a

bearing on their conceptualisation and subsequent responses. Additionally, it explores how the

findings and recommendations of Serious Case Reviews (SCRs) could be understood in the light of

this.

The study exploits the researcher's insider position, giving voice to practitioners by describing and

interpreting the conceptualisation of vulnerability from the perspective of current police officers,

health or social care practitioners working in safeguarding adults practice.

A mixed qualitative methods design was used including document analysis, focus group discussions,

individual interviews and direct field observations of practice. The demographic and thematic

analysis of SCR reports provided another layer of data.

It is argued that professional conceptualisation of vulnerability to abuse is highly differentiated,

identifying characteristics which fall into 3 domains. These relate to an adult's personhood

(Character), their Circumstance (Context) and the Conduct or Condition of persons who exploit

them. Characteristics of these categories included inability to understand, inability to communicate,

inability to protect oneself, neediness and reliance on others, lack of relationship skills, and the

status of being cared for.

Despite this differentiated concept of vulnerability professionals described constraints acting upon

their understanding, and their authority and autonomy to act. These organisational constraints

served to reduce the shutter size on the lens of practitioner gaze on vulnerability. With reference to

Lipsky's model of Street Level Bureaucracy and use of discretion, it is argued that the constraints on

professional response to vulnerability are a function of criteria in law and policy, and the legitimised

work by employers.

This thesis argues that to understand the findings of SCRs and implied criticism of practitioner

understanding of vulnerability, there has to be an understanding of the context and other influences

on decision making in practice. It suggests description rather than definition of vulnerability to

policy makers to liberate professionals from criteria driven decision making. This approach concurs

with the views of Judge J Munby (2006) who was careful to avoid a definition of a vulnerable adult

and emphasised that the characteristics outlined were 'descriptive, not definitive: indicative rather

than prescriptive'.