'Regulate support workers to protect vulnerable people'
Senior lecturer, Peter Woodward, argues in light of the BBC Panorama case, the advantages of registration and the positive attitude of support staff towards registration, it should happen as soon as possible
The recent Panorama programme saw a covert reporter working in Winterbourne View, a private hospital for people with learning disabilities. This undercover investigation was spurred by the revelations of a nurse once employed at the hospital who contacted Panorama, having already reported this service to the Care Quality Commission on three occasions without action. Panorama presented evidence of systematic abuse and horrific cruelty that highlights a number of problems regarding the inspection, regulation, support and training staff receive.
People with learning disabilities remain marginalised and vulnerable, often within the services that are designed to support them. This is not the first example of institutionalised abuse. Recently, investigations in Cornwall and, in the wake of this, Sutton and Merton, have shown examples where services go inexcusably wrong and this vulnerable group suffers as a consequence.
The majority of those perpetrating abuse in Winterbourne View were unqualified support staff, four of whom were arrested. The nurses who managed the support workers are culpable too, complicit by doing nothing to stop the abuse.
While a qualified nurse is regulated by the Nursing and Midwifery Council and can lose their registration if found guilty of misconduct, support workers are still not regulated by a professional body. If the police find those arrested guilty of abuse at Winterbourne View, they should be unable to work elsewhere due to CRB checks revealing a criminal record. For those who do not face a criminal conviction, they may face dismissal with a job reference to reflect this - but there is nothing in place to stop them taking up similar employment elsewhere. It is uncommon for support staff to face criminal prosecution following abuse investigations so it is quite possible for someone to be suspended for misconduct in one service and to be working with vulnerable people for another provider the next day.
The call to regulate support staff is not new. I recall the UKCC recommending this in the late 1990s. Since then, the Department of Health has supported the idea and both the Health Professions Council and the NMC have been suggested as possible regulators. At present the NMC is exploring the feasibility of this.
It is estimated there are up to a million unqualified support staff working in the UK, the majority in private care. The numbers of people with learning disabilities and the older population are due to rise in the future and these vulnerable groups will have an increased reliance on unregulated staff. If unqualified staff are regulated, this should lead to a greater level of public protection by ensuring only the appropriately qualified gain entry onto the register, with revalidation to ensure standards and removal of those guilty of misconduct. This would also be to the advantage of service providers assured that they are employing someone who can safely undertake the role.
A recent Royal College of Nursing poll found 85% of healthcare assistants were in favour of regulation. Most support staff do an excellent job and deserve the benefits of being part of a professional body. Given the advantages of registration and the positive attitudes of support staff towards being regulated, it is difficult to see why this should not happen as soon as possible.
The introduction of a million people onto a register is not an easy task and without legislation this will not take place in the near future. It took a media exposé four decades ago to trigger the policies that began deinstitutionalisation for people with learning disabilities; it will be interesting to see if any change of policy is bought about by the latest.
Peter Woodward is senior lecturer in learning disabilities at the University of Greenwich