It is not often that a TV programme moves you to tears, but
last night's Panorama was one such show. Secret filming at
Winterbourne View, a learning disability hospital in Bristol,
exposed such shocking treatment of its residents that it almost
defied belief. The routine abuse suffered by the residents at the
hands of those who were supposed to care for them - including
vulnerable 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 admits
that he is 'haunted' by what he saw. Aside from the individual
human suffering exposed by the programme, it raises some
uncomfortable questions for the learning disability hospital and
care sector and the regulator, the Care Quality Commission (CQC).
For all the work in recent years on Valuing People and the wider
personalisation agenda it shows that people with learning
disabilities can still receive shockingly bad treatment and that
they sometimes still don't have a voice. All too often, the views
of people with learning disabilities' are ignored or discounted as
being 'unreliable' or just plain 'made up'. This has to change.
People with learning disabilities need to know that their worries
will be listened to - just like anyone else in society - and
mechanisms need to be in place to ensure that that happens. There
certainly need to be more training to help staff to listen
effectively to people with learning disabilities, including those
with communication difficulties. The Panorama programme
also shows that the core vetting processes only weed out some
people and should not be viewed as guaranteeing fitness for role.
For instance, Criminal Records Bureau (CRB) checks only prevent
those with convictions working with vulnerable people, not those
who are unsuitable. Strong recruitment and employee monitoring
policies need to be in place in both hospitals and care homes.
Meanwhile, the CQC is being criticised for not picking up on the
abuse in its inspections of Winterbourne View. Surely the time has
come for the CQC to do more than just planned inspections.
Hospitals and care homes are generally notified weeks in advance of
an inspection, giving them ample time to hide any indications of
malpractice. Staff will tend to be on their best behaviour when the
inspector calls. An unannounced inspection - perhaps even an
undercover inspection - is more likely to give a true reflection of
what life is like in a care home and, in cases where abuse is
happening, a greater chance of it being exposed. It seems that the
CQC is coming round to this idea. In response to Panorama,
the regulator has proposed a programme of risk-based and random
unannounced inspections of a sample of the 150 hospitals providing
care for people with learning disabilities, which care services
minister Paul Burstow has accepted. But to my mind it should not be
a sample but should cover all hospitals. A sample may still miss
other Winterbourne View's - and there may well be others. Having
said all this, we must not assume that cases like this reflect
general practice standards across the sector. The majority of staff
in learning disability hospitals and care homes are undoubtedly
dedicated and provide high levels of care to people who live in
those 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 poses
major challenges. But it can also be the most rewarding of jobs.
The last thing we should do is to allow what is hopefully isolated
bad practice to undermine the good work of the majority, or scare
people off a career in the sector by imagining that bullying and
abuse are par for the course. While those exposed in last night's
Panorama should feel the full force of the law - and, if
found guilty, be banned from working in hospital or care settings
again - their behaviour should not be allowed to tarnish the whole