The Department of Health has this week published its interim report into the events at Winterbourne View, the private hospital in Bristol in which the BBC’s Panorama programme uncovered shocking abuse by care staff.
The reports finds that:
- Too many people are placed in in-patient services for assessment and treatment (A&T) and are staying there for too long.
- The model of care at Winterbourne view was outdated and did not reflect policy
- Poor quality of care, poor care planning, lack of meaningful activities and reliance on restraint was evident in a number of services
- The whole of the service system –commissioning, providing, staff, regulators and Government need to work to drive up standards with zero tolerance of abuse.
The report sets out 14 national actions which aim to improve the care and support of people with learning disabilities or autism and is based on the findings of CQC inspections and the experiences and views of people with learning disability, autism, and challenging behaviour and their families, and the expertise of doctors, social workers and other care professionals.
The national actions include promoting open access for families, advocates and visiting professionals, a programme of unannounced CQC inspections; a national public commitment to deliver the right care for people and work with the NHS Commissioning Board Authority to agree ways to embed Quality in NHS contracting and guidance.
However, initial reaction to the report is that it does not go far enough.
The Improving Health and Lives analysis of the the CQC inspections pointed out that half of the individuals included in the inspection were living in services with 20 or more people and that 64% assessment and treatment units were supporting at least one person who had been there for 3 years or more.
A joint statement by Mencap and the Challenging Behaviour Foundation has called for systemic change and the development of local skilled long term support to remove the need for placing people out of area and away from families and natural supports. They want to see a much clearer plan with targets and specific actions to address the issue.
The National Development Team for inclusion, whilst welcoming the statements about inappropriate long term use of assessment and treatment units, wants the Department to produce clear national targets, active practical support for local change and robust monitoring, all of which has been shown to drive change in the past.
The Mansell reports on challenging behaviour identified as far back as 1992 pointed out the need for local service and skills development and a range of alternatives to institutional care, and a recent report from the Association for Supported Living provides a range of practical examples of how this guidance has been put into practice in their report There is An Alternative
It will be interesting to see how the final report takes into account these responses, which while welcoming for the broad policy thrust, showed some disappointment in the lack of urgent action to bring about change.
You can read the full report here: Department of Health Review: Winterbourne View Hospital Interim Report