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Winterbourne cases spark call for closure of learning disability institutions

Another care home scandal like Winterbourne View could happen again unless the government takes action, campaigners warned today.

Charities called for the closure of large institutions caring for people with learning disabilities and said they should be looked after near their own homes.

The call came as a serious case review was due to be published into the abuse of vulnerable patients at the private hospital in Hambrook, south Gloucestershire.

Mencap and the Challenging Behaviour Foundation warned that moving people hundreds of miles away from their families risked another care home scandal.

The two charities said a report they had compiled, Out of Sight, detailed a series of serious cases of abuse and neglect of people with a learning disability in institutional care.

They said they had received 260 reports from families concerning abuse and neglect in institutional care since the BBC Panorama programme uncovering the Winterbourne View scandal aired in June last year.

Yesterday Michael Ezenagu, 29, became the eleventh member of staff at Winterbourne View to admit offences relating to the ill-treatment of patients. They will all be sentenced at Bristol Crown Court at a later date.

Today’s joint report details a number of serious incidences reported by families, including physical assault, sexual abuse and the overuse of restraint.

It also explores the plight of families to have their loved ones moved closer to home.

There are currently hundreds of people with a learning disability in assessment and treatment units like Winterbourne View and other similar institutions, the charities said.

Many of these are located hundreds of miles from home, where people are at particular risk of neglect and abuse, Mencap and The Challenging Behaviour Foundation said.

While units were developed to provide short-stay specialist treatment plans for people with a learning disability who have experienced a crisis, in reality many stay a lot longer.

The report called on the government to close all large assessment and treatment centres and ensure that smaller units are integrated with local services.

It also said that local services should be developed in order that no vulnerable person is sent far away from home.

The report also called for the government to ensure that the Care Quality Commission has the power to only register services that are in line with the policy recommendations in the Mansell reports and is also able to take action to deregister or enforce their recommendations.

The scandal at the now closed hospital was not the first time this type of abuse had been uncovered.

In 2006 an investigation into homes run by the Cornwall Partnership Foundation Trust revealed “widespread institutional abuse” and described years of abusive practices and the failure of senior trust executives to face up to concerns.

Last year lawyers acting for 165 people with learning disabilities, who claimed to have been physically, emotionally and verbally abused, won nearly £6.5 million in a settlement of a High Court damages claim.

The CQC also discovered that some people’s length of stay in units ranged from six weeks to 17 years.

A Department of Health spokeswoman said: “We are clear that wherever possible people should be supported to live in their own homes within their local community.

“In a small number of cases people might need access to good quality assessment and treatment services which might include some short periods of in-patient care.

“However this is not a substitute for high quality care within the community. It is vital all services are commissioned properly, reviewed regularly and not used as a long-term solution.”

Readers' comments (5)

  • This is a complex problem resulting from embedded institutional culture. Although it is right that individuals are punished,they are only part of wider issues that leads to such a situation. Low pay, low status, lack of power are just some of individual issues. Societal issues of more emphasis on safety than quality of care result in the QCC doing a poor job. Until some of this changes, these atrocities will be repeated

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  • A person with a "behavioural" problem almost blinded me in one eye. She had been bought to A&E with self inflicted wounds to her forearms.

    The Mother assured me and a colleague that her daughters screaming and spitting meant nothing and claimed the exhibited behaviour was "normal" for her. We spoke to the girl and moved to examine her arms. That is when she scratched at at my eye ( I was left with a deeply scored cornea).
    I was no longer able to continue working. The A&E Consultant told the Mother her daughter would have to be restrained and sedated before any treatment could be given. Mother refused and took her daughter away. She must have had the complaint pre written as it was submitted on the same day. The allegations were all malicious and untrue.

    I spent some six months receiving active ophthalmic treatment and I am left with a permanently scarred cornea which affects my vision.

    Further investigation revealed that this patient had a long history of attacking people with screaming and spitting being a predictor to an imminent attack. The Mother deliberately withheld this information from A&E staff.

    The patient was banned from the A&E except in the case of life threatening emergency. We later found that she had been banned from school and her GPs surgery. The girl was a threat to herself and others. She was eventually found a long term residential place. I sincerely hope she is being well cared for.

    There will always be a need for some individuals to be placed in a secure environment and it is unlikely this level of care can be ever provided locally

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  • appropriate and early interventions must be brought into practice to avoid such devastating and needless accidents as the one above. these individuals need the right care to protect the public as well as themselves and those looking after them.

    I knew a young house officer who lost an eye in A&E through a 'drunk' (if you excuse a label which I usually prefer not to use - an emotional and moral reaction rather than a professional one, I admit) punching his fist through one of the glass swing doors.

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  • costs have a lot todo with the care someone with an ld recieves, commissoneers always look for the cheapest provider and not the best care

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  • dikod1

    Interesting comments and complete agreement with initial one..i.e. it is a COMPLEX PROBLEM and arguemts have been continuing from well before I commenced LD nursing in 1975 in one of the "bad old bins"..Leybourne Grange Hospital, Maidstone, finally closed in '93. I remember drinking alcohol freely for the first time, hearing fellow students playing their Dylan records and arguing about what constituted good care and which wards and which charge nurses were the best ones, and which were the worst. Becoming aware of the patients with the worst reputations and wondering why, why?..cross-examining staff about care practices and virtually pinning down the clinical psychologist about why it was that XXX's anger was so impossible to manage and suspecting that being confined to an empty room had to have something to do with it, "but why does he hurt people so horribly even when he's outside and happy?" and standing in awe of the utterly literally life-long and single career commited Irish ward sister on the kids physical disability ward ("Cot & Chair") who stood by at every meal time checking that said kids were being fed in keeping with her meticulous guidance and ready demonstrations, no care plans or risk assessments and in some cases taking an hour of patient mini spoon feeding whereas today the risk assessed conclusion would almost certainly be to simply fit a PEG tube. "Wat dja tink your doin...we're troin ta teach these children to discrimate and taste their food and you're mixin it op loik cuncrete!".."Sorry Sister" "Look let me shows ya..look,.loik this..stand behind then ya not a distraction...hold the jaw gently and speak to her..gently...tap her lip gently with the spoon..see...look she knows...good girl..stroke her cheek..that tells her you love her..there now you doit..thats it and dont rush..thats it..good girl..you've got all the time you need and warm it up again if its too cold.." "thank you Sister.."
    If the said ward sister was today told to turn cold drinks into sppon fed jelly via "thick n easy" because the risk analysis declared normal drinks too likely to cause choking she'd immedietely button-hole the 22 year old Speech and Language graduate and demonstrate exactly how to ensure that didnt happen and how to deal with it in the unlikely that it did including advice on how to change how you were doing it to avoid any recurence. Unfortunately such practical skills are being lost (or may have already gone) within community provision which is provided by risk averse services who although understanding that we operate within the rule of law also know only too well that more precisely we operate within the rule of lawyers. Indeed we all now have learnt to think like them..eg possible repercussions to an unanticipated event that will inevitably result in at least three possible outcomes (including the likely calling for the managers scalp).."so why dont you 1,2,3? Therefore to cover all three we'll a,b,c now, but all that should be fortunately covered in the risk assessment, what! its not? then when was it reviewed? When? Wheres the attached careplan? But it refers to one so where is it? Well tell him that will have to wait; we want him here now! Listen, do you like what you do? Well get your priorities straight, when the SHTF unless you have covered this stuff and can argue and most importantly prove what you say which everyone will disbelieve anyway, and get this, that its UP TO DATE OK, you will throw everything away and you will be history RIGHT..and more to the point leaving me to sort out the mess and having to explain why our standards are so poor..RIGHT?" "Sorry Sister..".."The times they are a changin"..

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