CQC report claims people with learning disabilities often not at the centre of their own care

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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

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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