Following the allegations of abuse uncovered by the BBC panorama programme, the Care Quality Commission (CQC) has been involved in a targeted programme of 150 unannounced inspections of hospitals and care homes that care for people with learning disabilities.
The programme is designed to identify whether people with learning disabilities are getting safe and appropriate care, treatment and support and in particular whether they are protected from abuse. At the end of last week, the CQC published a further 20 reports from this programme and intend to produce a national report from the findings of all the inspections later in the spring.
Prior to the publication of this final report, there are already some concerns emerging, in particular the issue of person-centred support. Person centred planning was at the heart of the Valuing People white paper as a method for ensuring that people with learning disabilities were at the heart of their own support, and was reiterated in the refreshing of the policy in Valuing People Now. Significant efforts have been put into producing clear guidance and providing national and local training in the policy. It is disappointing therefore that these first two tranches of reports raise this as a central area of concern.
The CQC reports suggest that many of the services inspected are failing to provide care based on the individual needs of people using the services, with many failing to involve people in the development of their care plans, which then lack detail regarding the person’s preferences. In addition, inspection teams found a lack of activities and in some cases, a lack of staff to deliver activities that had been planned. The inspections, whilst looking at a range of outcome areas, was particularly focused on essential standards of quality and safety: the care and welfare of people who use services, and safeguarding people who use services from abuse.
Of the 20 locations inspected, CQC found one location with major concerns on both outcomes, two locations with one major and one moderate concern and five locations with moderate concerns on both outcomes.
Only four locations were compliant with the care and welfare outcome, with having major concerns and eight with moderate concerns Regarding the outcome on safeguarding, only seven of the twenty locations were compliant, with one location having a major concern and eight locations having moderate concerns.
The CQC point out in their statement “All the services where concerns are identified must tell the CQC how and when they will improve. Those failing to meet essential standards could face enforcement action by the regulator if improvements are not made.”
This appears a fairly inauspicious start to the programme of inspecting specialist services for people with the most complex needs. The national report in the spring will draw conclusions from all 150 inspections.
You can read the reports at the Care Quality Commission website here
As a tutor, I find that teachers are often overwhelmed when the mentally challenged are forced into mainstream public education too soon. I also find that there are several conditions that can cause or mimic learning disabilities.
Dear ‘educator’, thanks for your comment.
I am not sure I understand your term ‘mentally challenged’, but it would appear from your link that you may be using the term ‘learning disabilities’ to refer to what what in the UK might be called ‘spcific learning difficulties’ such as dyslexia. The point you make about mainstream education is part of a current debate here in the UK and you can learn a little about what the supporters of socially incclusive education say, those who may feel equally that people are focred out of mainstream education, at the reverrse the bias campaign http://www.reversethebiascampaign.com/,
CQC inspection teams found ‘a lack of activities and in some cases, a lack of staff to deliver activities that have been planned.’ This is and always has been the reason why so many people with learning disabilities begin to be dissatisfied with their lives. People who have no power over their lives and depend on other people for much of their care feel let down when the activities planned for them do not materialise. It makes them unhappy, it makes them angry, it makes them challenging. Can you blame them.
Person Centred Planning which was to deliver more autonomy for vulnerable people has, in many ways, failed. It has failed because LA’s do not have the will or the funds to do it properly. In many cases they pay lip service to the numerous reports that advice them how to do it. My son’s PCP consisted of interview with a care worker who listed his likes and dislikes. It was back in 2005 and my LA were implementing their version of ‘Valuing People’. Almost every activity that he enjoyed doing in his then day centre, did not exist ‘out in the community’. Consequently his PCP was a farce.
Depression among people with LD is growing since the implemention of ‘Valuing People, and yet no one in authority is willing to monitor it. Why?
Thanks for your comment. The CQC report was looking specifically at findings from their inspections of specialist health services for people, many of whom not doubt had additional mental health issues. The fact that they found such a lack of activity and structure is disappointing. Your point about person centred planning is well made.
If local authorities chose to rebrand existing forms of service led planning, then this was completely outside the guidance. There are good experiences of truly person centred planning happening for people, but planning is clearly only the beginning – a starting point for action.