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Panorama Undercover Hospital Abuse Scandal

 

The Panorama programme has again exposed shocking abuse of people with learning disabilities, 8 years after the Government loudly and publicly committed to “transform care”. As a society we are shocked to see and hear it on TV, yet it appears that those who are in positions of power and influence to drive the change are incapable of doing so. People with learning disabilities, families and others have been highlighting this failure for years, and there are pockets of really good work from some committed people in health and social care working together with families, but apart from warm words of “commitment” there is no evidence of widespread action that makes a difference.

The issues remain the same as they were 8 years ago:

  • People with learning disabilities and their families are not listened to or valued as partners

As one parent said “They do not see our children as human beings”

  • Commissioners simply purchase places from providers that say they provide good support – and don’t review peoples care or focus on outcomes

For example, the Children’s Commissioner report published earlier this week showed that a third of children had not had the CETR review they were entitled to within the last 12 weeks and of those reviews that had taken place, many did not focus on key issues, such as whether a child felt safe or the medication they were on.

  • The money is in the wrong place – it is not invested in early intervention and community support and services

Local Positive Behaviour Support Teams can prevent admission AND save millions of pounds and “Crises can be well managed locally in what look very cost-effective ways using a positive behavioural support approach” Professor Martin Knapp, LSE (Source: Paving The Way).

  • Regulation and inspection is not robust or capable of uncovering abuse

It required a special inquiry by CQC to identify the extent of restrictive intervention people are facing, called for in response to concerns raised by a family-carer.  It has required a second Panorama programme to identify another culture of abuse.  Why are existing CQC and Ofsted inspection and regulation regimes insufficient to identify restrictive intervention and abuse of disabled children and adults?

  • Whistle-blowers are not encouraged or supported appropriately

A whistle-blower raised concerns about Whorlton Hall, leading to a CQC inspection in 2018, however it took an undercover reporter expose the abusive culture.

Family carers of people with learning disabilities and autism raise concerns but are not taken seriously: “I kept telling them over and over that something was seriously wrong… I have over 100 emails I sent…..they ignored me, they wouldn’t listen. Then eventually it came out- my son and others there had been repeatedly abused - the service closed down”

  • There is a continuation of tinkering round the edges of a system that is not fit for purpose

One family-carer, when asked about the impact of restrictive intervention on her son in a state-funded service, said the system had “destroyed him and our family” (Source: Reducing restrictive intervention of children and young people, Case Study and Survey results, CBF 2019). 

The LeDeR report, published 21st May 2019, showed that 71 adults with learning disabilities received care that fell so short of good practice that it significantly impacted on their well-being or directly contributed to their cause of death.

 

The abuse shown in these institutions is not just a one-off.  It is the inevitable consequence of a system that fails to value the lives of people with learning disabilities.

 

We knew 8 years ago that the WHOLE system had to be transformed – education, health, social care and community and local government. No one part can deliver the change required on its own, but because of administrative convenience only one part of Government leads this work, and even that part doesn’t deliver.

 

"It is approaching 8 years since I viewed the dreadful images of my eldest son being abused at Winterbourne View. The Government's response was a clearly defined promise to empty Assessment and Treatment units and close them down. They have undeniably failed in this endeavour and thus failed over two thousand people, and their families, who are still incarcerated in hospitals and units across the country”  Ann Earley

 

CBF Chief Executive Viv Cooper said “Children and adults with learning disabilities have the same rights to have good lives and feel safe as we all do. It’s time for the Government to lead and act to show that they value people with learning disabilities or autism and to deliver that basic human right.”

 

For families worried about their relative’s care, see the webpage below for information and where to go for support:

https://www.challengingbehaviour.org.uk/information/information-sheets-and-dvds/when-things-go-wrong.html

 

View the Panorama programme here: https://www.bbc.co.uk/iplayer/episode/m00059qb/panorama-undercover-hospital-abuse-scandal

 

Family carers Ann and Emma give their thoughts 8 years on from Winterbourne View and in response to last night's Panorama here: https://www.challengingbehaviour.org.uk/cbf-articles/your-stories/

23rd May 2019

 

 

Background information:

 

About the Challenging Behaviour Foundation:

The Challenging Behaviour Foundation (CBF) is the charity for children and adults with severe learning disabilities whose behaviour challenges and those who support them.

Our vision is for anyone with severe learning disabilities who displays behaviours that challenge to have the same life opportunities as everyone else. We’re making a difference to the lives of children and adults across the UK through:

  • providing information about challenging behaviour
  • peer support groups for family carers and professionals
  • supporting families by phone or email
  • running workshops to reduce challenging behaviour
  • speaking up for families nationally / campaigning

We work to improve understanding of challenging behaviour, empower families with information and support, and help others to provide better services and more opportunities.

For media enquiries please call the CBF Office on 01634 838739 or email info@thecbf.org.uk

 

Whorlton Hall

The hospital featured on BBC’s Panorama programme ‘Undercover Hospital Abuse Scandal’ was Whorlton Hall in County Durham. The hospital ‘provides assessment and treatment for men and women aged 18 years and over living with a learning disability and complex needs’.

Whorlton Hall is run by Danshell Group (formerly Castlebeck Care, which owned Winterbourne View Hospital), but the company is also referred to as Oakview Estates. The parent company is now Cygnet Healthcare. Danshell run many hospitals and care homes around the UK.

The latest CQC report for Whorlton Hall is here: https://www.cqc.org.uk/location/1-894121431

 

Winterbourne View Hospital and Transforming Care history

In May 2011, the BBC broadcast a Panorama investigation “Undercover care” which exposed, through secret filming, people with learning disabilities being abused by staff who were paid to support them in Winterbourne View, a private hospital  run by Castlebeck Care  (BBC report, documentary at: https://www.youtube.com/watch?v=m1b5M123Zdo). There was public shock and outrage, and a criminal investigation resulting in convictions and prison sentences.  The scandal exposed significant systemic failures – people with learning disabilities were being channelled into inpatient services, often at high financial cost, which delivered poor outcomes and which, as the late Professor Mansell put it, were being used as “dumping grounds which are damaging people”. The Care Quality Commission carried out a Learning Disability Review (CQC LDR) of 150 similar services- and 48% failed to meet CQC’s basic standards of care and welfare and safeguarding. The Government committed to action to address the systemic issues that were exposed, and published an interim report in June 2012, followed by a final report in December 2012 which had an accompanying Concordat with 63 actions (Transforming Care). This report committed a programme of action (and £2.86m) and to reviewing every person with a learning disability in an inpatient setting by June 2013, with everyone who was inappropriately placed to be moved out by June 2014.

 

In January 2013 the LGA-led Joint Improvement Programme was set up and tasked with delivery of the Transforming Care actions. Programme progress was slow and targets were missed.  Two successive Programme Leads were appointed over the course of 18 months, but each resigned after a few months in post. There was a failure to meet the 2014 deadline.

 

A National Audit Office investigation (Report at: NAO report), a Public Accounts Committee inquiry (PAC) and a NHSE commissioned review by Sir Stephen Bubb (Time for Change) all highlighted lack of programme progress. In response, NHSE became more actively engaged and in October 2015 “Building the Right support” was published (BTRS). This set out a 3 year plan to close 35-50% of inpatient beds for people with learning disabilities and develop the right support and services in the community, in line with the NHSE Service Model, by March 2019. A Delivery Board was set up which included NHSE, LGA, ADASS, the Department of Health and CQC. Despite significant efforts by many since 2011 to highlight the need to get the right support in place for children, the report did not include the DfE, Ofsted or ADCS and missed an important opportunity to commit to early intervention, prevention and a lifelong approach. 48 Transforming Care Partnerships (TCPs) were established as the mechanisms to drive change, and were tasked with developing plans to deliver the Building the Right Support commitments.

 

In March 2017, a follow up investigation from the National Audit Office concluded that “…the Department, and its programme partners are not yet on track to achieve value for money through the programme to close hospital beds for people with a learning disability”. The recommendations from the report included addressing funding flows, workforce, data collection, community capacity and whether Care and Treatment Reviews (CTRs) lead to discharge into community provision.

 

In January 2018, Ray James (former ADASS representative on the Transforming Care Delivery Board) was appointed as the NHSE lead for Transforming Care. In March 2018 Ray set out in a letter that NHS commissioners plan to decommission “just over 900 beds previously used by patients with a learning disability, autism or both” over the course of 2018/19, and to “publish more detailed, provider-level plans for bed closures in the spring of this year.”

 

Since the start of Transforming Care there have been six different ministers with responsibility for social care (and the Transforming Care programme). The Ministerial responsibility for social care has been consistently demoted, from a Ministerial position in 2012 to part of a Junior Minister role in 2017, but in early 2018 the role was upgraded.

 

The Transforming Care programme failed to deliver against the targets set in Building the Right Support (2015-19). In March 2019, Building the Right Support ended- bed closures were approximately 19% against a target of 35%- 50%. In response, the NHSE 10 year plan has included the bed closure target and moved it to 2024.

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