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Abuse and neglect in institutional care
Tuesday 07 August 2012
‘Out of sight’ report highlights cases of abuse and neglect
A report published today (7 August) reveals the scale of the abuse and neglect of people with a learning disability at assessment and treatment centres like Winterbourne View.
In May 2011, the BBC’s Panorama programme broadcast undercover filming of staff at the privately-run Winterbourne View assessment and treatment centre, as they physically abused the people they were employed to care for.
‘Out of sight’ has been published by Mencap and The Challenging Behaviour Foundation. Since the Winterbourne View scandal, the two charities have received 260 reports from families who are concerned that loved ones with a learning disability are being neglected or abused in institutional-style care.
The joint report highlights a number of serious incidents reported by families, including physical assault, sexual abuse, withdrawal of food and water and the overuse of restraint by physical and medical means.
There are currently many hundreds of people with a learning disability living in institutions similar to Winterbourne View. In many cases, the units people live in are hundreds of miles from home, leaving them at particular risk of abuse and neglect. Although intended to provide short-tem specialist treatment, more than half of residents remain in assessment and treatment units for two years or more, and nearly a third stay for more than five years.
Systemic failings
Mark Goldring, Mencap’s chief executive, said: “We fear that unless the government commits to a strong action plan to close large institutions and develop appropriate local services for people with a learning disability, there is a very real risk that another Winterbourne View will come to light.”
Together, Mencap and the Challenging Behaviour Foundation are calling on the government to urgently address the systemic failings in the care of people with a learning disability, by closing large institutions and developing appropriate local services.
The Care Quality Commission’s recent inspection programme of 145 hospitals and care homes for people with a learning disability revealed that half of services failed to meet essential care and safeguarding standards.
'Out of Sight' has been published on the day that South Gloucestershire Safeguarding Adults Board published its serious case review into the abuse at Winterbourne View. The review, written by adult protection expert Margaret Flynn, finds that the abuse at Winterbourne View resulted from serious and sustained failings in the management procedures of service provider Castlebeck Care Ltd.
It recommends greater investment in community-based care in order to prevent people from ending up in Winterbourne-style services, as well as calling for the end of ‘t-supine restraint’ in such units, where patients are laid on the ground and staff use their body weight to restrain them.
Criminal convictions
Yesterday (6 August), the last of 11 Winterbourne View workers to be accused of abuse pleaded guilty. Michael Ezenagu, 29, admitted two charges of ill-treating a patient.
All 11 defendants will be sentenced together in a few weeks’ time.
Read the ‘Out of sight’ report
Read the findings of today's serious case review
Read the findings of the NHS review into commissioning of care and treatment at Winterbourne View
Take Mencap’s action to send the report to your MP and to ask them to attend a parliamentary debate on Winterbourne View
Comments
I watched the Winterbourne programme, when it was shown on TV, how horrendous for the adults and families involved. I do agree there needs to be a more robust recrutiment programme, and alot more specialist training for people who want to work in this field. It is not a job, you do when you need money, it is a passion for the people with LD and this should be reflected in the way they perform their roles.
When I was undertaking my degree, I chose as my placement a self advocacy project, through them I was sent to visit the few adult day care services in the area. How shocking was this, one I visited had rows and rows of adults with learning disability "working" earning a few pennies and what were they doing? tying five coat hangers together for the local theatre. There was not any stimulation, they were in no way encouraged to speak to each other. They did this Monday to Friday. Another well what can I say, boredom was not the word for the clients.
I had worked for many years in a local government childrens respite service. The training we received was second to none and always followed up. We were encouraged during regular supervision to think about our training needs in order to support the young people better, all unit policies were followed at all times, with the addition of OFSTED inspections the homes were thoroughly regulated and followed all of the care guildelines. I
I now work as an Inclusion worker with young people and adults with LD and other disablities, and it really breaks my heart, to find central government are withdrawing funds from a much needed caring regulated service, with correct inspections, supportive management and staff who actively care for the ones they are supposed to care for. It seems anyone can open a home, employ inadequate staff who are more interested in their mobile phones, use restraint and pour medication down the clients necks, then say they are perfoming a good service.
I am fed up of conducting home visits for young people and adults who have complex health needs. and telling the families there is nothing up to standard for them out there. I am disgusted at contacting social workers, if the family have them to ask for care plans etc, and not receiving any replies. It is like for them out of sight out of mind as long as the people are receiving some sort of service who cares, what happens to them.
I have a daughter who is currently detained in a hospital. She was detained at Melton Mowbray, Assessment and Treatment Unit ( Castlebeck) Thankfully she has since moved. We had been complaining to the local commissioners and local MP with limitied sucess about her treatment and environment. She has had her head shaved twice and in her room she had a mattress and a box of tissues. Physical restraint was order of the day, Any advice as to how we can complain and be taken seriously when we have a daughter who at times exhibits challanging behaviour.
I have a young adult with learning disabilities and other complex needs, and as a parent and a professional (I am a registered nurse with specialist experience in LD and associated conditions) am appalled to hear of such abuse, alarmed that it seems to be exposed in such a way and fearful that the diminution of funding to these cinderella services plus the imperative to drive down costs (led by the government) will result in less inspection, fewer dedicated, well trained and involved staff and poor management. I am happy to say that my child's care has been exemplary over the last 10 years., Speaking as a former manager of such an establishment, there are good high quality guidelines for the recruitment, training, supervision and appraisal of appropriate staff, which should be embedded in the management structure of any organisation.
In order to deliver good, nay excellent standards of care, staff terms and conditions of employment should be transparent and sound contracts adhered to.
If the organisation does not have a robust and clear commitment to supporting their vulnerable client group and meeting these guidelines, and also training and supporting their staff team, no amount of hard work on the part of the manager can turn around a culture of indifference.
It is not all about the money: there are many people working in this sector who are committed to the well-being of their clients for less money that shelf stackers earn, and many others who are inappropriately employed simply to keep the staff establishment adequate.
Vulnerable people deserve better, the dedicated underpaid and caring staff deserve better.
Since CQC have to cover such a wide range of facilities, is it any wonder that the LD population have again "dropped off the radar"?
It is high time that the LD nursing speciality is recognised for its specialist worth, and incorporated into registered nurse training.
Do remember that there are many people who well supported, it isn't all like Winterbourn. We just need to know what is to be done to prevent more of the same
Former manager
In answer to a poorly paid workforce, I could not agree more, most staff are on little more than minimum wage, with no anti-social hours payment given.
Some companies now do not pay for CRB/disclosure costs, it is up to the employee to meet these costs.
With long hours, often without breaks. Working overnight for as little as £15 for a night, for so called 'sleep-ins', when you are on duty which could be as long as 24hrs for a shift.
I know it is not just about pay, but where is the encouragement and reward for staff, if you can get paid the same for working in a less stressful environment with 'normal' hours?
Most companies now employee management who are not Registered Learning Disability Nurses and are unaware this speciality exists. As far as | am aware most of the requirements are NVQ which in my opinion do not have the same level of training and expertise and do not have to maintain constant standards which are regulated.
I have Aspergers syndrome and Dyspraxia and have also worked in Learning disabilities hospitals and institutions before my mental health problems took hold, there was some terrible abuse in one hospital in the 1980s and it took about 5 years to get the people doing the abuse bought to justice and i remember no one would listen to me when i spoke out for resident's rights at the time. It was awful, people who abuse others especially those who can't speak out and defend themselves should be put into prison and punished.
Just a quick update regarding the investigation into suspected abuse at the John Daniels Centre(a day centre for people with learning disabilities) in Penzance. Five peope who had been arrested has had their bail extended ut eptember. I agree (from a service user ) point of view that poor management is a serious problem. had my care assessment checked yesterday by a social worker from the HQ of social care in Cornwall (mine is based in a different office) and was told it was "wrong"
I work in a service supporting adults with learning disabilities. Most of the staff are first rate people who care about the way their service users are treated andf looked after. The care sector in general is poorly paid (Cleaners get paid more than I do, with a lot less responsibility) and will employ anyone that can pass a CRB check, whether they have the ability to do the job or not. I think most 'ground floor' workers would agree that the problem is poor management. here are a few of the gripes and moans I hear daily.
1. why do we employ people who can hardly speak english. Service users have difficulty understanding some native english speakers so what chance have they got when staff constantly chat in serbian/Lithuanian/Russian/Polish etc etc
2. Training is inadiquate. Companies seem to be reluctant to spend money on anything other than the most basic training. A poorly trained workforce is a potentially abusive workforce.
3. Support/Care workers have no 'professional' standing or career structure. The Government should recognise that we do a similar job to other healthcare professionals in the NHS and they should ensure we have a similar career structure to that within the health service.
4. The CQC should NEVER advise companies of their intention to visit. In my experience, only the best staff are rostered on for these visits and they are rehearsed in what to say. CQC get an unrealistic view of these services and the support they provide.
5. I have worked for a number of companies in this sector and in my view NONE are any better than the others. Poor management is endemic in the industry and all companies need to invest more in proper management training.
6. All companies should work together to share valuable resourses, including manpower to provide quality services to all service users.
I, like thousands of my colleagues up and down the country, could go on and on listing what is wrong with the system. Unless a proper management structure with fully trained managers is put in place along with proper career structure and training for ALL staff, I fear very little will change.
I really wish this report was published after the Olympics. I realise it's been a long time coming but feel it would of got more exposure. I have emailed my local MP to urge him to read the report. Again if it received more media coverage and parliament were not on their jollies then possibly it would be on a higher agenda where it clearly needs to be. I hope it's findings are acted on.
There has been some reaction t to this in cornwall some of the relatives of those involved has said their concerns weren,t being listen too. and a disability campaigner has appeal for an attiude change from professionals and from society in general. towards people with learning disabilities Once again most of the care system in cornwall has stayed silent over this.. Bullying is still taking place in the county as l speak which concerns me greatly as l want it to stop.