Last week I had the great privilege and pleasure to be speaking alongside Terry Bryan, the senior nurse who blew the whistle on the Winterbourne View abuse scandal. We were speaking at a Community Care Conference on Improving Outcomes for Adults at Risk, as part of a panel that also included Gary Fitzgerald, CEO of Action on Elder Abuse. Terry himself came across as a man of great integrity, who had been thrown into the spotlight rather reluctantly. His account of the events leading up to the Panorama expose was remarkable mainly for its exposure of a catalogue of missed opportunities. Approaching the BBC was a last resort, he said, and even then not actually his idea. Terry noted that there is a need for a stronger civil rights approach to the issue of adult abuse, and called for direct action against those individuals and authorities found to be perpetrators.

My point was that so much of the work being done in this field seems designed to 'mop up' after abuse has occurred, rather than to prevent abuse from happening in the first place. What is happening in the environment of these institutions that seems to breed the kind of complacency, callousness and unaccountability that results in poor treatment of the most vulnerable? I identified three key factors: the failure to adequately vet, train and supervise frontline care staff; the profit incentive of Big Businesses that puts margins before quality of care; and the inspection and regulation regime that fails to adequately listen to residents' voices. Gary added that in his view, the perpetrators of abuse were not evil, or indeed easy to spot. They were in fact 'ordinary' people whose sense of power and responsibility had been corrupted by a system that failed to hold them to account.

I maintain that if we are to make real progress on this issue we need to focus on prevention, not just management after the event. There needs to be an investment of resources targetted at the root causes of abuse, and not just in the Serious Case Reviews that allow certain professionals to bemoan 'we did all we could'. In the community, adult abuse is a tricky issue to tackle because it is often hidden and intertwined with complex family and other dynamics. In care homes and hospitals, in this day and age, abuse must and should be preventable.

For our part, we are pleased to announce that Skills for Care have recently awarded us a grant to develop new, tailored, free training for advocates focusing on their particular role in the safeguarding agenda. It's early days, but over the next few weeks we will be putting together a programme for the training that will be delivered free of charge in six locations across England. We hope that the training will create the space for advocates to reflect and build on the special role they play in both supporting victims of abuse and ensuring that the person is at the centre of the decision making process. More details will be posted on the a4a website soon so watch out for that.