Questions raised over abuse audit decision

The government and its care regulator appeared mired in confusion this week over the decision to hold a national audit of healthcare facilities for people with learning difficulties.

The Department of Health and the Care Quality Commission (CQC) last week announced a major national inspection programme, in the wake of serious allegations of abuse uncovered by the BBC’s Panorama programme, at Winterbourne View, a private hospital near Bristol.

But the CQC admitted to Disability News Service this week that its predecessors – the Healthcare Commission and the Commission for Social Care Inspection – had reported the findings of a similar audit less than four years ago.

That audit was carried out in the wake of a report into “years of abusive practices” at homes and hospitals run by Cornwall Partnership NHS Trust, which found service-users had been hit, kicked, over-medicated, mocked, deprived of food and given cold showers and been subject to “over-zealous or premature use of restraint”.

Despite repeated calls over the last week, no-one at the Department of Health has been able to explain why there was a need for another audit so soon after the last one.

More crucially, it is not clear whether progress on the thousands of recommendations made in December 2007 following the last audit are still being monitored by the CQC, which took over responsibility for both health and social care regulation in 2009.

In 2007, the Healthcare Commission had called for “sweeping and sustained changes to neglected services for people with learning difficulties”, while concluding that “most services for people with learning difficulties provide poor standards of care”.

The audit had covered 72 NHS trusts and 17 independent organisations, with inspections at 68 of them. The report made 2,548 recommendations for improving aspects of care.

The Healthcare Commission said at the time: “We want this  report to be the first stepping stone to enduring change. This is a long-standing problem and we don’t want simply to deliver another depressing assessment and then move on.”

But the findings of the 2007 audit appear to closely match many of the alleged failures at the Bristol hospital, including insufficient attention paid to safeguarding; poorly planned care that fails to involve people with learning difficulties; a lack of stimulating activities; a lack of leadership; and residential care provided in institutional settings.

CQC admitted that services provided by Castlebeck, the company that runs Winterbourne View, were among those inspected during the 2007 audit, although it said the company was not required to take any improvement action.

A CQC spokesman said the new audit had been “widely welcomed” in the wake of the Panorama documentary because there was “an expectation from all those who were shocked by the events at Winterbourne View that immediate action would be taken to assess whether people were being safely cared for at similar facilities around the country”.

He added: “We are very much aware of the findings of the national audit that were published in 2007.

“Although the nature of this proposed programme will be somewhat different, it may enable us to draw some broad conclusions about whether there has been overall improvement since the audit report was published.”

Meanwhile, South Gloucestershire Council has again failed to explain why it appears not to have acted over allegations made by a whistleblower more than seven months before the BBC screened an investigation into the scandal.

More than days nine after the BBC Panorama programme was aired, the council has so far been unable to explain why it appeared to have taken no serious action to investigate the claims until Panorama notified it of its investigation.

The whistleblower first emailed a hospital manager with allegations on 11 October last year, and they were passed to the council on 28 October.

At some stage in November, the council informed the CQC and confirmed that it would be holding a multi-agency “safeguarding meeting” to examine the allegations.

But the safeguarding meeting did not take place until 1 February this year. It is still unclear what action the board took after the meeting, who was present, or why it took so long to discuss the allegations.

Meanwhile, a total of 11 people – eight men and three women – have so far been arrested and released on police bail, in connection with the allegations of abuse and ill-treatment at Winterbourne View.

9 June 2011