The Government has committed to removing people with learning disabilities who are inappropriately placed in long-stay hospitals within the next 18 months.
In its long-awaited final report into the Winterbourne View scandal, the Government has set out an 18-month programme of action that aims to reduce the number of people with a learning disability sent away to assessment and treatment units like Winterbourne View. The programme also intends to ensure the return of as many people as possible to their local communities.
Local health providers will have 6 months to review all current hospital placements and a further year to find ways for people to be cared for in their communities.
“The abuse at Winterbourne View was criminal,” said Care Services Minister Norman Lamb in a statement to Parliament. “We know what change is needed; it is now time to ensure that it happens. We are setting out how we will address poor care and abuse, and ensure that excellent care becomes the norm.”
Lamb added that there will be measures to hold organisations that provide sub-standard care to account. “We will examine how corporate bodies and their boards of directors can be held to account under law for the provision of poor care and for any harm that is experienced by people using their services.”
Wider failings will also be tackled, he added. “We must stop people being placed in hospital inappropriately and ensure that services are commissioned which properly meet people’s needs. That requires the NHS and local government to work together.”
The programme of action includes:
• By spring 2013, the Department of Health will set out proposals to strengthen the accountability of boards of directors and senior managers for the safety and quality of care which their organisations provide
• By June 2013, all current placements will be reviewed, and everyone in hospital inappropriately will move to community-based support as quickly as possible – no later than June 2014
• By April 2014, each area will have a joint plan to ensure high quality care and support services for all people with learning disabilities or autism and mental health conditions or behaviour described as challenging, in line with best practice
• Regulator the Care Quality Commission is to strengthen inspections and regulation of hospitals and care homes for this group of people, including unannounced inspections involving people who use services and their families
• A new NHS and local government-led joint improvement team will be created to lead and support this transformation
This programme is backed by a concordat signed by more than 50 partners, which sets out what changes they will deliver and by when. The Government will publish a progress report on these actions by December 2013.
Mark Goldring, chief executive of Mencap and Vivien Cooper, founder of The Challenging Behaviour Foundation, issued a joint statement welcoming the report, but warning that it has to be backed up with action: "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 [the] 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.
“The report and concordat are a commitment to make this happen. The Government will be judged on whether change takes place across the country, with vulnerable people with a learning disability finally getting the support they need, close to home.”
Fiona Ritchie, managing director of Turning Point's Learning Disability services, also welcomed the report, but worried that some of the measures outlined in the concordat may not come to fruition. “As usual, the devil is in the detail. For example, the concordat mentions primary care trusts (PCTs) developing a database, however with the current reforms taking place there is a risk that there are no longer learning disability experts in place to make this happen or put adequate monitoring of this in place.
“Also, the claim that commissioners will focus on personalisation for individuals with learning disabilities is positive, but, with cuts from all angles continuing to bite and some commissioners already saying they can’t afford to promote independent living, the implementation of this will be a huge challenge.”
Ritchie added it is vital for learning disability service providers to work together. “We need to work together to ensure people in acute assessment, treatment units and private hospital provision have the specific care they need. However, treatment plans should be temporary and the impetus should be on the move to less restricted services and supported living in the community. It is vital we work together as providers of learning disability services to move the aims of the concordat from rhetoric to reality.”
Meanwhile, Steve Scown, chief executive of learning disability services provider Dimensions, welcomed the publication of a good practice guide alongside the report. “[This] will enable providers, policymakers and the public to know more about what is working in social care,” he said. “At the same time, there are certain realities that must be addressed – especially given the challenges of the on-going economic climate.
“In particular, funding the right support and creating a culture where local authorities pursue proactive and positive approaches to social care that will improve quality of life and not focus on the cheapest outcome that benefits the purse not the person.”