Two years on and the scandal of abuse and neglect uncovered at the Winterbourne View Hospital rightly remains an emotive issue. As the Department of Health presents its latest update on the transforming care programme, it is clear that, while progress has been made, much more needs to be done to lift vulnerable adults out of inappropriate care environments.
You can read the report in full and also this article by Minister for Care and Support, Norman Lamb, in which he acknowledges the work already done but expresses his desire to see the pace of change accelerated.
Those of you working in, receiving or providing care services will be affected by some of the changes in process and governance - and whether you agree with them or not, it is clear they are driven by a commitment to end the unnecessary suffering of vulnerable adults in care. The Social Care News blog welcomes your views.
10 comments
Comment by Rob Turner posted on
The system caused Winterbourne to happen. Care in the community led to a proliferation of in it for profit organisations sprouting up across the county. Castlebeck being one of the most successful which continued its expansion once its founding partners had reaped their own profits and sold it on to a venture capitalist. The unnessary suffering is necessary if the government and local authorities, want a so called affordable care provider. When the motive for social care is profit and greed, there is only one direction that the level of care we expect to be given to our most vulnerable.
Comment by Chris Sterry posted on
A lot is being done to reduce the risk of any other accurrences of a Winterbourne View occurring again. But one can not guarrantee that an occurrence will happen again or is in fact occurring. All the appropriate authorities, the people working in care related occupations and the persons being cared for and their relatives have to be constantly aware of the practices under going in any care situation. Where practices are seen to be failing or not to standard, it should be the responsibility for all to report it and the persons to whom the reports are given shgould always follow these through.
But currently all Social Services departments and their supporting councils are under extreme financial pressures due to the limited finance being available for distribution from Central Government and other areas. All authorities are looking to reduce their costs and in some areas this is limiting the care that is being provided, not necessarily in a recognised care setting, but is a persons own home.
Will the individual care being provided in a persons own home be the next Winterbourne View. If care is being reduced, as it currently is in many local authority areas, how far does the care need to be reduced to place persons in a position of vulnerability, if some are not already there. Being in a persons own home it does limit the scope of reporting, as what checks are made on the care being provided. Currently some authorities are having 15 minute visits when previously they were longer. What can effectively be done in 15 minutes, can it be washing a person, dressing a persons, feeding, toileting, etc. For many all these tasks will be required, but it is not possible to do these in the time alloted. The person or the carer will then have to decide, possibly on a visit by visit, which task will be done at that particular time. Is this what the passage of time has brought us to. Sufficient resources have to be provided for appropriate care to be available and be seen to be provided.
The Government has decided that International Aid will not be cut so that the vulnerable in other countries will be safeguarded, surely the same consideration should be afforded to the persons within the UK.
Comment by Sol Jorgensen BA Hons posted on
I am a lone parent of a severely disabled son. I have no living family. This instance of constant abuse of people like my son is insufferable in a society that wants to portray itself as civilised.
In 1970 I did an A level on Social Sciences- even then it was predicted that we would have a long living older and disabled generation(s).
I see no reason how this government lacks the foresight of my A level tutor of the 70's.
surely, all the people who are supposed to protect people like my son , with all the money given to this end.. and this abomination still happened.
Until CARERS ARE PAID A DECENT WAGE YOU PLACE THE MOST VULNERABLE IN SOCIETY IN THE CARE OF THOSE WITH NO QUALIFICATIONS.
carers are paid less than trash collectors.
HOW THEN CANNOT YOU PREDICT ABUSE.?
Comment by Shaun Keeley posted on
Sol Jorgensen BA Hons,
That's not right in the slightest.. carers may not be paid well enough in some homes but in all honesty that should not matter, people are people and the ones who are more vulnerable are no different to your younger son or someone else's daughter. Don't even get me started on the amount of money some residents pay in these homes man, I work in a care home at the moment and we have just been giving an "outstanding" review when the inspectors came in, and that's because we run the home well and look after the elderly, make sure they feel like they can be themselves and like it is there home because at the end of the day it is and will be for a lot of them until they sadly pass away. There is no excuse for abuse or mistreatment within homes. No excuse, especially not the amount of money your on.. your telling me if your not being paid well it gives you the right to abuse someone who has no intention of ever doing you wrong? It gives you the right to make others way of lives hard because your not getting paid what you want? That's just outrageous, care is more than just going in and making sure the residents wake up, eat, drink and then go to sleep.. it's about connecting with these people because they haven't got what you might have, they need care and someone to talk to, someone they can rely on because a lot of them have nothing but you. It's much more than what your saying and I'm sorry but money doesn't give any right to hurt or let someone else suffer.
Comment by Dr Felix Ugwumadu posted on
I welcome the Minister’s Report re; “Winterbourne” on how to protect the vulnerable in society. Yes the entire stakeholders (professionals, carers, politicians, families etc.) wholeheartedly condemn the dehumanising practices and treatment of service users in the institution. It is inconceivable that such high degree “institutional abuse” was not observed by the managers or clinical/social care practitioners that visited the home to carry out reviews. On reflection, the report outlined measures to address poor practices however, as a practitioner; the report did not go far enough rather; it represents a political rhetoric that rehashed what is already known. What is lacking was how to rein fence funding as well as monitoring quality services; to ensure what happened at “Winterbourne” would not happen again. We may see numerous reports on how to safeguard vulnerable users but, if that is not supported with adequate resources am afraid; we would be unable to achieve the objectives. I hope we are not in a haste to forget the philosophy of care in the community and normalisation principles as well as the guidance/policies and milestones to achieve that? Normalisation for me is a continuum and must be supported holistically and staff training should be part of it.
Comment by Helen Dorr posted on
Bedes's View, Buddock Hospital, Death by Indifference" to name but a few. Only difference about Winterbourne View is that the BBC got on board. Still, why should the response to this be any different to previous "scandals"? We had a national audit after Cornwall but what difference did that make apart from keeping some people busy for a while? Truth is not enough people care enough to pay enough to make working with people with learning disabilities an aspirational career. It's tough, skilful, rewarding, amazing, joyous work to do - but people need to pay their bills. I know it is hard when we see some real villains abusing people who are not in a position to fight back, but there are still a lot of Winterbourne Views out there waiting to happen because they are staffed by people who get minimum wage for maximum responsibility. It is absolutely right and just that anyone abusing a position of care and responsibility should feel the full force of the law and the condemnation of the rest of society. However, we cannot escape from the fact that, particularly in the private sector, we have a system to care for people vulnerable to abuse that depends upon a group of people who are exploited. How is that ever going to work?
Comment by Ken Pugh posted on
To many people this will appear to be a complex and bureaucratic process. This makes it difficult for people to get their head around what's happening and how it might be relevant to them. We need some straightforward actions that relate to the everyday experience of front-line staff. Here are two suggestions:
1. Make it easy for all staff who work in, or who have contact with services, to comment on what they observe, regardless of whether their observation passes a 'whistleblowing threshold' .. and make all those comments available to commissioners.
2. Use training opportunities to enable care staff to understand how ordinary people can find themselves drawn into abusive practice .. and what they can do to use the 'essential social care values' to protect against that possibility.
Comment by Laurie Harper posted on
Particularly agree with Ken Pugh's second point. Let's remember the Milgram experiment, where ordinary people were drawn into behaving abusively, even murderously. Many, even those with misgivings, did as directed by someone they saw as a figure of authority. It isn't just about pay and funding; it's much more profound (none of the people who administered what they thought were lethal electric shocks to tothers in the experiment received payment).
Most of us have a natural desire to fit in with and be accepted by those around us (it's a healthy instinct - we need to cooperate to survive). They will behave as they believe is expected/demanded by the culture of an organisation for a variety of reasons - desire to be accepted, wish to be promoted, even fear of losing their jobs (all sound survival strategies).
It follows that organisations, and particularly those running and managing them, must ensure there is a clear culture of what is and isn't acceptable and that everyone knows what it is. Staff must be confident that they can speak up/blow the whistle if they have concerns, that those concerns will be investigated honestly and properly and that they will not be penalised for doing so.
Immediate tough action must be taken against anyone, no matter who they are, who commmits, condones or turns a blind eye to abuse. Rewards - promotions, respect, etc - must go to those who do the decent thing, not those who make the right noises. Are we ready to do all that?
Comment by Brian Frisby posted on
ARE WE MISSING THE POINT?
The DH/LGS joint improvement programme is an understandable and necessary organisational response to the events at Winterbourne View. It is appropriate that the Minister has acted to require local social care and health agencies to review their current arrangements for people with high support needs – and that local senior leaders are required (through health and well-being boards) to provide oversight.
There does appear to be a theme, however, that what failed the people who had been placed at Winterbourne View (and probably at other similar institutions) was the commissioning process – procurement, contracting and quality monitoring. This seems to miss the point that what failed the Winterbourne View residents/patients (and probably others at other similar institutions) was the model of care itself.
Should it not be of more concern, therefore, that what appears to be promoted as the response to Winterbourne View (and probably other similar institutions) is more and better commissioning – but provided more locally.
As others have identified in this blog, the works of Stanley Milgram, Erving Goffman and others and the periodic but routine scandals in institutional settings and have informed us for decades that the institutional setting will always dehumanise staff and incumbents and lead to various forms of abuse. These are core pieces of evidence that should be informing current practice.
Solutions to the challenges that people with very high support needs are available, but are not being promoted. For example, the work of the late Prof Jim Mansell, CBE (1993 and 2007) is available – on the DH website (albeit archived!):
Services for people with learning disability and challenging behaviour or mental health needs [Mansell report - revised edition 2007]
http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_080129
Guidance on how to go about delivering care and support to this ‘hard to reach’ (too much effort to listen to?) is available from the NDFTi:
Commissioning Services for People with Learning Disabilities who Challenge Services
http://www.ndti.org.uk/publications/ndti-publications/commissioning-services-for-people-with-learning-disabilities-who-challenge-/
The political will and leadership is being provided by the Minister, but where will the leadership to champion a more appropriate approach come from?
@Brian_Frisby
Comment by niciara posted on
i believe that the way these people were treated, were vile and disgusting and that their rights were not being met. Nobody deserves to get treated with that lack of respect and they should have protection from abuse and harm.