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This article reports on the findings of the inspections and consultations undertaken as part of the evaluation of the National Service Framework for Older People. It focuses on what was found about the implementation of adult protection systems, by synthesising the inspectors' findings, drawing on older people's comments in meetings and interviews concerning care in hospitals, as an illustration, and by reporting the results from a survey. Together these sources of information revealed that adult protection systems are in place, and that the majority of older people say that they know to whom they can report concerns, but that older people and their families weigh up the decision to make complaints carefully. Questions are raised about the interface between adult protection and concerns about dignity and quality of hospital care.

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