An end to abuse? Government publishes final report on Winterbourne View

Monday 10 December 2012

Care and support minister commits to moving people with a learning disability ‘inappropriately placed’ out of long stay hospitals

The Department of Health has today (10 December) published its final report following the abuse of people with a learning disability at Winterbourne View assessment and treatment centre.

The report, 'Transforming care’, commits the government to an 18-month programme of action, which will be led by a national team.

The programme aims to reduce the number of people with a learning disability who are being sent away to assessment and treatment units like Winterbourne View, and return as many people as possible to their communities.

Health and care commissioners will have six months to prepare individual care plans for people currently in assessment and treatment units and a further 12 months to find ways for people to be cared for in their communities.

The report outlines 60 actions to transform services and the ways that people with a learning disability receive support and care. Among its actions, are:

• A commitment to move anyone inappropriately being cared for in a hospital to community-based support by June 2014.
• Bringing forward plans to hold the senior managers, directors and board members of care organisations accountable for the quality of care that their organisation provides by spring 2013.
• Introducing high-quality care and support services in all areas by April 2014, including joint plans that meet best practice guidance for those who have behaviour described as challenging.
• Issuing new guidance on the use of restraint.
• Involving people with a learning disability and their families in decisions about care and support.

The Department of Health will report on the progress that has been made by December 2013.

Mencap and the Challenging Behaviour Foundation want to thank everyone who has taken action to influence the final report, which has a strong action plan and will hopefully result in real change. In a joint statement, Mencap’s chief executive, Mark Goldring, and Viv Cooper, founder of The Challenging Behaviour Foundation, said: “The horrific abuse uncovered at Winterbourne View shone a spotlight on a care system that has failed some of the most vulnerable people with a learning disability. In today's report, the government shows that it has listened to families and campaigners by committing to a national programme of change.

“But words are not enough. To achieve this, commissioners in local government and the health service must take urgent, joint action to develop local services, provide support to children and families from early on, and ensure that no one else is sent away. The many hundreds of people with a learning disability who are still far from home, in institutions like Winterbourne View, must now be able to quickly return to their communities, to be close to their loved ones."

Culture change

Launching the report, care and support minister Norman Lamb said: “One of the most shocking revelations to come out of this case, is the fact that many of the 3,000 people with learning disabilities who are in ‘hospitals’ – often for years – should not be there.”

The minister said that a complete change in culture is needed to bring the situation to an end. He said that people with a learning disability, autism, mental health issues or behaviour described as challenging have a right to be given support in their communities – near to family and friends.

Holding those at the top to account

The report addresses the need to ensure those higher up an organisation, not just frontline staff, are accountable for quality of care. “This case has revealed weaknesses in the system’s ability to hold the leaders of care organisations to account,” continued Lamb. “This is a gap in the care regulatory framework, and we intend to close it.”

Following the scandal at Winterbourne View, the Care Quality Commission (CQC) was criticised for missing opportunities to detect the abuse that was taking place.

The report recommends that the CQC continues to strengthen inspections and regulation of hospitals and care homes for people with a learning disability. This will include unannounced inspections involving people who use services and their families, as well as measures to make sure that services work within the agreed model of care.

“What happened at Winterbourne View was unacceptable,” said David Behan, the CQC’s chief executive. “CQC has already taken a range of actions, including setting up a specialist whistleblowing team. We are committed to doing more, including continuing to make unannounced inspections of learning disability and mental health services and taking action to ensure the quality and safety of services and drive improvement.”

Download the Department of Health's final report and programme of action concordat (including easy read versions)

Read our article on the sentencing of care workers involved in the abuse at Winterbourne View

Watch the BBC report on the government's final Winterbourne report, which includes an interview with Mencap's chief executive