So what did Panorama’s follow-up to its Winterbourne View documentary tell us? Not much that we didn’t already know: that little has altered in learning disability institutions in the 18 months since the original broadcast – and that the need for change is greater than ever.
On the whole, Monday’s Panorama was a depressing watch. It found that 19 of 51 former patients of Winterbourne View have been subject to new safety alerts since they moved out, and that more than half had moved into similar institutions, rather than back into the community.
That little has changed was unsurprising. The Care Quality Commission’s (CQC) review of 145 learning disability institutions, made in the wake of Winterbourne View, found that nearly half of those failed to meet at least one essential care standard. There has also been no new legislation or regulations from Government in the intervening period.
Many within the sector – including Terry Bryan, the original whistleblower at Winterbourne View – have repeatedly said the time for talking has passed; action must be taken now to address the problems in residential care sector. And they are right.
Large long-stay institutions like Winterbourne View should be closed. While there is a need for assessment and treatments centres for a very small minority of people with learning disabilities, they should be for just that: assessment and treatment. As soon as someone enters one of these centres, plans should be put in place for their return to the community.
Currently, people with learning disabilities and behaviour that challenges can get stuck in these places for long periods. The CQC found someone who had been in an assessment and treatment centre for 17 years. What on earth was being assessed there?
But closing institutions like Winterbourne View will only change so much. More will be needed to ensure care for people with learning disabilities becomes as good as it should be.
For instance, a lot of people end up in institutions because their community care package has broken down – these must become more robust and able to deal with changing needs.
Panorama did show what can be achieved with the example of Simon. He was one of those abused at Winterbourne View, but 18 months on he is thriving in the community in supported living and is happy and healthy.
And, his care package costs £1,400 less per week than it did when he was resident in Winterbourne View.
Finance is a huge consideration when planning care services, whether we like it or not. Around the country local authorities are cutting their learning disability budgets, and this inevitably leads to greater scrutiny of care package costs. Simon’s case shows that good care can be cheaper to provide.
All it takes it a little imagination from commissioners and providers. Then they can ensure that the emphasis in support arrangements is on prevention, rather than reaction.
There are, of course, many other factors that need to be addressed if services are to improve, such as the provision of more and better training for frontline care staff (and better pay), the review of restraint practices and guidelines, and the effective monitoring of services.
The Government’s final report on Winterbourne View is promised by the end of November. Care Services Minister Norman Lamb has said that the report will contain “robust” measures to tackle this “national scandal”.
It has to. The report must have teeth if Government is to ensure that change does happen – it needs more than just guidance or voluntary standards. If needs be, legislation should be included to ensure the institutions are closed.
This is the opportunity to make lasting and effective change and it must not be squandered. Implementing change will not be easy, but is absolutely essential. If the necessary change isn’t pushed through, another Winterbourne View will undoubtedly hit the headlines.