Dan Parton cutThe Care Quality Commission (CQC) has kicked off its major new programme of inspections of learning disability residential services. The regulator's initial report, on hospital-based assessment services contained a worrying phrase that stuck in LDT editor Dan Parton's mind: "findings so far suggest a lack of understanding about what safe, person-centred care looks like":

One question sprang instantly to mind; why? There is clear guidance available on this, as well as a raft of good practice case studies from charities, private sector organisations and local authorities alike. Several other questions swiftly followed; how have services got to be like that? Where is the leadership in these organisations to instil good practice? How has the inspection regime not picked this up before? And - most crucially - what is life like for the people being cared for in these institutions? The confines of a blog prevent me from going into all the potential answers here, but, suffice to say, none are positive.

While this CQC report focuses on only 5 services, it does not augur well for its investigations into the other 140-odd learning disability residential services it plans to visit. That only one of the 5 services inspected was found to be fully compliant with the government's essential standards of quality and safety required by law is shocking. This is basic stuff that should be in the very foundations of a service, not a benchmark to be aimed for.

Of course, this report may just have focused on 4 services that weren't very good, and it isn't generally the case that 4 out of every 5 services fail to meet basic standards. I certainly hope not. Indeed, the CQC was keen not to draw universal conclusions from its initial work. But it again points to the need for change in the learning disability residential sector, and reinforces the need for the continued drive away from institutional settings to supported living in local communities.

While there will always be a need for a - very - small number of residential places for people with learning disabilities and behaviour that challenges, they should not be for the long-term and plans for people to return to their communities should be in place from the day they enter any hospital-type setting.

Reports on the other learning disability residential services included in the programme will be published in the coming months, with a national report due to be released in the spring, which will draw conclusions about the overall state of these services. For the sector's sake - and for the sake of the people who live in residential settings - I hope they don't make for such grim reading as this first report does.