Department of Health publishes interim report on Winterbourne View

The Department of Health (DH) has released its interim report on the Winterbourne View scandal and set out 14 national actions to improve the care and support of vulnerable people with learning disabilities or autism (25th June 2012). The report is based on the Care Quality Commission’s (CQC) findings from the inspections the regulator carried out at similar units to Winterbourne View at the request of care services minister Paul Burstow last year. It also draws on the experiences and views of people with a learning disability, autism, and challenging behaviour and their families, and the expertise of doctors, social workers and other care professionals. The report highlighted four main findings:

• Too many people are placed in in-patient services forassessment and treatment and are staying there for too long
• This model of care goes against government policy and has noplace in the 21st century. People should have access to the supportand services they need locally – near to family and friends – sothey can live fulfilling lives within the community
• Winterbourne View was an extreme example of abuse, but there isevidence of poor quality of care, poor care planning, lack ofmeaningful activities to do in the day, and too much reliance onrestraining people
• All parts of the system – commissioners, providers, individualstaff, the regulators and government – have a duty to drive upstandards. There should be zero tolerance of abuse.

The 14 actions include:

• Open access for families and visitors including advocates andvisiting professionals will be promoted and people will beencouraged to be involved in reviewing the care that theyreceive
• The CQC will be encouraged to carry out unannounced inspectionsat any time and to look at how their registration requirementscould be changed to improve the quality of services
• The DH will work with the NHS Commissioning Board Authority toagree by January 2013 how best to embed Quality of HealthPrinciples in the system, using NHS contracting and guidance
• The NHS Commissioning Board Authority will support ClinicalCommissioning Groups to work together in commissioning services forpeople with learning disabilities and behaviour which challenges.Health and Wellbeing Boards will bring together local commissionersof health and social care in all areas, to agree a joined up way toimprove services
• The DH will work with the Department for Education, CQC andothers to drive up standards and promote best practice in the useof positive behavioural support and ensure that physical restraintis only ever used as a last resort.

Burstow said: “There is compelling evidence that some people withlearning disabilities are being failed by health and care services.While people in some parts of the country receive good quality andcompassionate care – near to family and friends – this is notalways the norm. “Our national actions will mean that people haveaccess to good care, closer to home. They will make sure those whoprovide care, commission care and care staff – know exactly whatpart they must play and what standards are expected of them.”

Mark Lever, chief executive of the National Autistic Society, welcomed the DH’s report: “Parents and carers of people with autism put agreat deal of trust in a care system that all too often failssociety’s most vulnerable. “The report identifies what is wrongwith the current system and sets out the agenda for reform. We nowurge the Government to build on this framework and ensure action istaken at both a national and local level to restore peoples’ faithin the system and prevent further cases of malpractice and neglect.”We urgently need stronger checks and balances to identify poor and abusive practice locally, and make sure it is stamped out.”

In a joint statement, Mencap’s chief executive Mark Goldring, and the Challenging Behaviour Foundation’s chief executive Viv Cooper,said: “One year on from Panorama’s undercover investigation into a private hospital for people with a learning disability, people continue to remain in large, out of town units for long periods oftime, isolated and at risk of abuse and neglect. “Action is needed to stop people with a learning disability and behaviour thatchallenges being sent away to these services. “The government’sproposals on local action will not be enough to create the systematic change needed. We are looking for a direct commitment fromgovernment to put in place a strong, practical action plan with clear targets when it publishes its final review in September.”