There appears to be a lack of understanding about what safe, person-centred care looks like in learning disability residential settings, according to an initial report by care regulator the Care Quality Commission (CQC).

Additionally, leadership and governance needs to be stronger to ensure that services are safe and meet essential standards. Worryingly, only one of the five services inspected for this report was found to be fully compliant with the government’s essential standards of quality and safety required by law. At two of the services inspected, Kent House in Wirral and Townend Court in Hull, inspectors found safeguarding concerns that required prompt action.

But some good practice was also observed, such as at Rose Lodge in Tyne and Wear, where inspectors found support plans were comprehensive to ensure that responses to behaviour that challenges were appropriate, reasonable and proportionate and justifiable to that individual. These are the first 5 reports the CQC will publish from its targeted inspection of 150 hospitals and care homes for people with learning disabilities.

Dame Jo Williams, chair of the CQC, said: “These inspections are the first of many, but already we can see the effects of a lack of strong leadership and governance. Where we have found problems, they can often be traced back to poor procedures or poor understanding of procedures. “Another recurring issue in the first inspections is a lack of person-centred care. It is especially important that services make sure that the care of people using these services, many of whom have extremely complex and individual needs, is tailored to their needs. “ Williams added that the CQC inspectors have been joined by ‘experts by experience’ – people who have first-hand experience of care or as a family carer and who can provide the patient perspective as well as professional experts in our learning disability inspections.

Terry Bryan, the nurse who drew attention to the alleged abuse at Winterbourne View, and who is now one of the professional experts working with CQC’s inspection teams said: “After Winterbourne View, there was a consensus that the inspection processes at the time did not always stand up to close scrutiny. The current unannounced inspection programme has been slimmed down sufficiently to obtain honest ’snapshots’ of daily life for people who live in services, together with ’gut feelings‘ about the services themselves. “By using people who have either worked extensively in the care sector, or who have experience of that support first hand, we are now managing to obtain more substantial and qualitative results. However, the Commission should not be expected to work in isolation, as there is also wide consensus that providers' local governance procedures be sufficiently robust, because ultimately, that is where the real daily safeguarding operates.”

A national report into the findings of the programme will be published in the spring.