Monday, 10 December 2012

Winterbourne View Report: Smoke & Mirrors?

Any action to improve the lives of those with learning disabilities has to be welcome and many of the proposals in the Governments Winterbourne View Final Report are good yet that does not mean the report should go unchallenged especially as there are some inconsistencies where it appears the Government may be trying to deflect responsibility introducing ideas that, actually, really already exist.

Norman Lamb and others have focused a lot on corporate responsibility. Norman Lamb said “This case has revealed weaknesses in the system’s ability to hold the leaders of care organisations to account. This is a gap in the care regulatory framework, and we intend to close it”.

In fact the Health and Social Act 2008 made care organisations accountable and open to prosecution if they fail to meet the regulations, and Castlebeck certainly failed on a number of them. The Care Quality Commission also has the power to cancel a providers registration. In addition there are also the legal requirements under the Health & Safety Act 1974, the HSE’s guidance states:

“Recent case law has confirmed that directors cannot avoid a charge of neglect under section 37 by arranging their organisation’s business so as to leave them ignorant of circumstances which would trigger their obligation to address health and safety breaches.
Those found guilty are liable for fines and, in some cases, imprisonment.”

As the abuse at Winterbourne View clearly breaches the Health & Safety requirement to keep everyone in the place of business safe, surely Castlebeck should have been prosecuted.
Rather than taking time to draft new legislation surely it would make more sense to ensure existing legislation is being used effectively.

We also need to take care over how the Government frames the action which it proposes to take, for example in its timetable for action we have:
From June 2012 – CQC will take enforcement action against providers who do not operate effective processes to ensure they have sufficient numbers of properly trained staff, &;

From April 2013 – CQC will assess whether providers are delivering care consistent with the statement of purpose made at the time of registration

Although welcome moves the real question, unanswered by the report, is why were these not already happening? Both are required by the Health & Social Care Act regulations and, as such, form part of the requirements of registration. Yes there has been a change of leadership at the CQC and things have improved but it does not mean that such things should be omitted from the report nor does it excuse the absence of any action to ensure such things do not happen again.

The report also fails to answer the question of Government inaction on social care, particularly in terms of those with Learning Disabilities where the principles of Valuing People seemed to have faded in to dim memory. Much of what is being proposed should already have been in place and it is the Governments neglect of social care that means they are now only acting because they are forced to.

There is also a serious omission from the report that is equally important to the Winterbourne View case and that is Whistleblowing. Action could have been taken much sooner if the reports to Castlebeck and CQC were acted upon and some of the abuse witnessed in the Panorama film would not have happened. Yet nowhere in the list of action to be taken is a review of existing Public Interest Disclosure law, the responsibilities of statutory bodies to act or even report when abuse is alleged.

For all the effort to prevent abuse it is still down to people reporting it before it can be truly uncovered, I doubt very much if regulatory bodies have uncovered abuse through annual inspections, and therefore there has to be much more done in the way of encouraging people to disclose abuse along with a much more robust response when such reports are made that reports all allegations not just those that make it to safeguarding referral stage.

It would be wrong throw out the baby with the bath water and there are some very positive proposals in the report. It is right to end the existence of these pseudo-hospitals and it is right to move all people with learning disabilities toward person centred support.

We need more action on learning disability services and not just for those who find themselves confined in so called hospitals. Abuse happens in other places to and we need equal action to eradicate hate crime in the community where life is not regulated by the CQC.

This report should just be a start, let's have a new white paper on how the Government and society will support those with Learning Disabilities to lead fuller and safer lives.