Citizen-led developmental support could be effective in limiting abuse or neglect

Last week, the BBC’s Panorama programme Undercover Care – The Abuse Exposed, revealed the abuse and torment that a group of vulnerable people with learning disabilities and autism experienced within a private long-term hospital.

The programme exposed clear failings in the management and external monitoring of care services and highlighted some fundamental flaws in the current model of regulation by the CQC and in the nature of the institutional care provided. This model of hospital based care failed to support and protect people. Criticisms include: the size of the unit (24 beds), the remoteness of the service (on an industrial estate), people placed miles from home with little interaction with families, a locked ward with limited connection to the outside world and a serious lack of skilled staff. All of this made worse by no one engaging people in a purposeful way, with clinicians failing to use professional judgement and with higher management being absent.

People with learning disabilities will always be at higher risk of abuse and neglect in such enclosed institutions where the fundamental beliefs of the organisation lack clarity about the dignity, rights and uniqueness of the people they support. The service at Winterbourne View lacked any process or pathway to helping people develop more independence and move on to a less restrictive environment.

It is essential that the inspection and monitoring processes used by the CQC and care managers are re-designed as there is too much room for abuse to go unnoticed within the current system. We would recommend a local citizen-led service to challenge these services, which might help to bring local people closer to those who need support. A local service which helps develop and improve care and support and which involves family carers as well as people with learning disabilities in visiting and giving feedback would reduce the chance of this type of abuse.

One example of this type of support is our Quality Checking project commissioned by the Kingston Adult Social Care. This involves local people with learning disabilities carrying out checks on the services provided and includes Kingston council’s own supported living service. FPLD staff support and mentor the team of quality checkers and work with providers to improve their service. The quality checking team offer a service that talks to tenants about their experiences and talks to managers and staff. The information gathered will be compiled for a report and action plan, which will then be fed back to the participating tenants and service providers. This will be a continual process and we will return to these services to check on progress and propose a new action plans.

We feel that this kind of citizen-led developmental support in each local community could be effective in limiting the risk of abuse or neglect in all forms of institutional, residential and supported living . Of great importance is that we must call for a reduction in the large institutional models that persist despite policy directives against this type of care. They will always carry risks and a more local and personalised approach should be on offer to all.