It is not often that a TV programme moves you to tears, butlast night’s Panorama was one such show. Secret filming atWinterbourne View, a learning disability hospital in Bristol,exposed such shocking treatment of its residents that it almostdefied belief. The routine abuse suffered by the residents at thehands of those who were supposed to care for them – includingvulnerable people being repeatedly slapped, pinned down, dragged,teased and taunted – was, in some cases, nothing short of torture.Indeed, Joe Casey, the undercover reporter who filmed it admitsthat he is ‘haunted’ by what he saw. Aside from the individualhuman suffering exposed by the programme, it raises someuncomfortable questions for the learning disability hospital andcare sector and the regulator, the Care Quality Commission (CQC).For all the work in recent years on Valuing People and the widerpersonalisation agenda it shows that people with learningdisabilities can still receive shockingly bad treatment and thatthey sometimes still don’t have a voice. All too often, the viewsof people with learning disabilities’ are ignored or discounted asbeing ‘unreliable’ or just plain ‘made up’. This has to change.People with learning disabilities need to know that their worrieswill be listened to – just like anyone else in society – andmechanisms need to be in place to ensure that that happens. Therecertainly need to be more training to help staff to listeneffectively to people with learning disabilities, including thosewith communication difficulties. The Panorama programmealso shows that the core vetting processes only weed out somepeople and should not be viewed as guaranteeing fitness for role.For instance, Criminal Records Bureau (CRB) checks only preventthose with convictions working with vulnerable people, not thosewho are unsuitable. Strong recruitment and employee monitoringpolicies need to be in place in both hospitals and care homes.Meanwhile, the CQC is being criticised for not picking up on theabuse in its inspections of Winterbourne View. Surely the time hascome for the CQC to do more than just planned inspections.Hospitals and care homes are generally notified weeks in advance ofan inspection, giving them ample time to hide any indications ofmalpractice. Staff will tend to be on their best behaviour when theinspector calls. An unannounced inspection – perhaps even anundercover inspection – is more likely to give a true reflection ofwhat life is like in a care home and, in cases where abuse ishappening, a greater chance of it being exposed. It seems that theCQC is coming round to this idea. In response to Panorama,the regulator has proposed a programme of risk-based and randomunannounced inspections of a sample of the 150 hospitals providingcare for people with learning disabilities, which care servicesminister Paul Burstow has accepted. But to my mind it should not bea sample but should cover all hospitals. A sample may still missother Winterbourne View’s – and there may well be others. Havingsaid all this, we must not assume that cases like this reflectgeneral practice standards across the sector. The majority of staffin learning disability hospitals and care homes are undoubtedlydedicated and provide high levels of care to people who live inthose settings and help them to live the lives they want to.Working in learning disability services can be a tough call -especially when you’re caring for people whose behaviour posesmajor challenges. But it can also be the most rewarding of jobs.The last thing we should do is to allow what is hopefully isolatedbad practice to undermine the good work of the majority, or scarepeople off a career in the sector by imagining that bullying andabuse are par for the course. While those exposed in last night’sPanorama should feel the full force of the law – and, iffound guilty, be banned from working in hospital or care settingsagain – their behaviour should not be allowed to tarnish the wholesector.
