Watchdog backs DNS call for national audit of ‘out-of-area’ placements

The care watchdog has backed calls for a national audit to find out how many people with learning difficulties have been abandoned in institutions far from their original homes.

The call for an audit was made by Disability News Service (DNS) after last week’s publication of a serious case review (SCR) into the “appalling and systematically brutal” abuse that took place at Winterbourne View, a private hospital for people with learning difficulties.

The SCR criticised the practice of sending people with learning difficulties to institutions far from their home areas.

John Pring, editor of DNS, first suggested a national audit in 2003, and repeated the call last year in his book Longcare Survivors: The Biography of a Care Scandal, which details his 17-year investigation into the institutional abuse of adults with learning difficulties at the Longcare homes in Buckinghamshire.

In the book, he raises concerns that thousands of people with learning difficulties appear to have been sent to live in institutions hundreds of miles from their original homes.

Many of these people were former patients of the old long-stay hospitals that began to be closed in the 1980s, and were simply abandoned in their new homes, which were often so far away from where they had been brought up that they received no visits, either from social workers or family members.

Many campaigners and social care professionals share these concerns, and believe such placements have put people at much higher risk of abuse, as was the case with Winterbourne View.

The call for a national audit was backed by Dame Philippa Russell, a member of the independent inquiry into the Longcare scandal, chair of the Standing Commission on Carers, and a former commissioner with the Disability Rights Commission, who has a son with learning difficulties.

She says in the book that there is a “desperate” need for national evidence of “what is actually happening” with out-of-area placements.

Neither the Care Quality Commission (CQC) nor the Department of Health (DH) was prepared to comment on the need for a national audit when DNS approached them last year.

CQC admitted at the time that it had no idea how many people had been abandoned in placements far from home, a question, it said, that was “not easy to answer with available data”.

But this week, following the Winterbourne View SCR, CQC said that, although the issue of out-of-area placements was “a matter for the Department of Health and commissioning bodies… we do believe an audit of the provision of out-of-area care would be a good idea”.

A CQC spokesman said its inspections of 150 services for people with learning difficulties, carried out after the Winterbourne View allegations were first aired last year, showed “too many people were in services away from their families and homes”.

He added: “We believe much remains to be done to ensure people with learning disabilities are provided with care in community settings close to their homes.”

A DH spokesman told DNS this week that the issue of out-of-area placements was under consideration but that he couldn’t pre-empt the department’s final report on Winterbourne View, expected later this year.

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Three-year cruelty campaign was not hate crime, says judge

A judge has sparked concern after refusing to treat a three-year campaign of cruelty in which a disabled man was repeatedly beaten by relatives as a disability hate crime.

Preston Crown Court heard last week that Ghalib Hussain, who has epilepsy and learning difficulties, was beaten with a stick, had a jump-lead clamped to his nose, and was headbutted and whipped.

Hussain had come to Britain from Pakistan for an arranged marriage with the daughter of Nek Alam, 72, from Accrington.

But he was rejected by his new wife, and subjected to a three-year campaign of harassment and emotional abuse at the hands of Alam and his three sons, Zahir, 33, Zahoor, 32, and Janghir, 29.

All four pleaded guilty to putting Hussain in fear of violence by harassment, over a three-and-a-half year period between 2007 and 2010.

Nek, Zahir and Zahoor Alam were each jailed for 15 months, while Janghir Alam was jailed for 10 months.

The court had heard that one of the Alams described Hussain as “mentally sick”, another said he was “a burden”, while one of the sons said he had a “childish mind” and was referred to as “the clown or the mental case”.

But although Lancashire police and the Crown Prosecution Service both treated the offences against Hussain as disability hate crimes, the judge, Jonathan Gibson, refused to increase their sentences under section 146 of the Criminal Justice Act, which allows for harsher sentences for hate crimes.

The judge told the court that he was “satisfied that this is a case where your frustrated reactions to his poor behaviour (as you saw it) overflowed and the poor behaviour was as a result of his disability”.

He added that Hussain had “displayed some difficult behaviour whilst in the care home [where he is now living] and, it seems to me, (and I sentence you on this basis) that he clearly displayed difficult behaviour whilst in your family home”.

A spokesman for the Judicial Office said the judge had told the court that he was sentencing the defendants “on the basis that they had not properly understood the nature of the victim’s disability and that they had reacted wrongly and criminally to what was, in their eyes, the victim’s difficult behaviour”.

But Stephen Brookes, a coordinator of the Disability Hate Crime Network, said: “It is going to frustrate us and the CPS when we are trying to drive the process of getting section 146 recognised if the courts are turning round and not applying what the CPS and the community feel is appropriate.

“I think it emphasises the fact that judges and magistrates do need to be brought into the real world in terms of training for the application of section 146.”

A CPS spokesman said: “The CPS explained the facts of the case to the court and suggested the court consider section 146… which sets out the basis for an increase in sentence where the circumstances of the offence show the offender demonstrated hostility towards the victim based on the victim’s disability or sexual orientation.

“We felt that was appropriate in these circumstances. The court did not agree with us that the specific circumstances of this offence fitted the criteria set out in section 146.”

He said the CPS was unable to comment further on the judge’s decision.

A Lancashire police spokeswoman said: “We did deal with it as a disability hate crime because that is how we perceived it to be.”

Asked how the force felt about the judge’s refusal to treat the offences as disability hate crimes, she said: “It would not be appropriate for us to be commenting any further.”

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Abuse allegations company suspends four staff at second institution

The company at the centre of allegations of abuse of disabled people at a private hospital has suspended four members of staff at another of its care facilities.

Allegations of abuse at Winterbourne View, a “hospital” for adults with learning difficulties run by the company Castlebeck, were aired in a BBC Panorama documentary in May.

But this week it emerged that four employees have been suspended over alleged “misconduct” at another Castlebeck institution on the edge of Bristol, Rose Villa, a home for nine adults with learning difficulties situated less than 10 miles from Winterbourne View.

Two staff members at Rose Villa were suspended by Castlebeck following a review of care standards at the home on 1 July by the Care Quality Commission (CQC).

The visit was part of CQC’s review of all Castlebeck’s learning difficulties services in England, launched in the wake of the Panorama programme. Castlebeck has also commissioned its own review of all its care facilities across England and Scotland by consultants PricewaterhouseCoopers (PWC).

Another member of Rose Villa staff had already been suspended by Castlebeck over an unrelated incident last month, while a fourth member of staff was suspended this week, again over a separate incident.

CQC, which has been heavily criticised for its failure to take action over concerns raised by a whistleblower at Winterbourne View, has stressed that the Rose Villa allegations were less serious than those raised by the Panorama documentary.

The last regular CQC inspection of Rose Villa, in 2010, led to the home being given a “good”, or “two star”, rating.

A Castlebeck spokeswoman said: “In accordance with our policy we have notified and are working with all relevant authorities as enquiries are being conducted.”

Asked whether the latest allegations suggested wider problems with care standards across the company, she said: “We are currently in the midst of two wide-ranging reviews from the CQC and PWC and we wouldn’t prejudge the findings of either of those at this stage.”

Bristol City Council and NHS Bristol said in a joint statement that they were treating the latest allegations “with the utmost seriousness”.

A spokesman said: “Although we do not currently have any Bristol residents in the nine-bed unit, as part of our role as the lead safeguarding organisations, we have visited Rose Villa and reviewed the care and wellbeing of the residents as soon as we were made aware of the allegations concerning Winterbourne View.

“We have continued to visit the home regularly during the intervening period and have provided additional independent support to the home.”

But the city council was unable to say when the safeguarding team was first alerted to the concerns at Rose Villa, what action it took, or whether it was aware of any previous concerns about standards at the home before July this year.

Avon and Somerset police said it was assisting investigations by its “multi-agency partners”, which include Bristol City Council and NHS Bristol, but that there was no suspicion so far of any criminal offences having been committed by any of the four suspended Castlebeck employees.

The force is still investigating the Winterbourne View allegations, although Castlebeck has now closed the hospital.

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Panorama abuse scandal: Questions raised over new hospital ‘audit’

The government has agreed plans for a national audit of hospitals for people with learning difficulties, just five years after a similar investigation was carried out by two care regulators.

The audit was approved by care services minister Paul Burstow in the wake of a BBC investigation into abuse at Winterbourne View, a private hospital near Bristol.

Burstow said: “People deserve to receive safe and effective care. That’s what we expect from every care provider.

“I have confirmed with CQC [the Care Quality Commission] that they should undertake a series of unannounced inspections of services for people with learning disabilities.

“These unannounced inspections into care for people with learning disabilities will help inform future policy and focus attention on the 7/24 care obligation all providers have.”

But the Department of Health (DH) and CQC both appeared to have been unaware that a similar audit was carried out only five years ago, in the wake of another abuse scandal. Neither has been able to comment on why another audit is necessary so soon after the last one.

The Healthcare Commission and the Commission for Social Care Inspection – the predecessors of the current regulator, the CQC – announced the previous national audit of learning disability healthcare services in 2006, following their joint investigation into abuse at a Cornish NHS trust.

Many of the allegations at that trust were similar to those uncovered by this week’s investigation for the BBC’s Panorama.

The report in 2006 into “years of abusive practices” at homes and hospitals run by Cornwall Partnership NHS Trust 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”.

Rob Greig, chief executive of the National Development Team for Inclusion and the government’s former national director for learning difficulties, said that the “institutional nature of learning disability hospitals fosters a climate where abuse is a high risk”.

He said the financial crisis was threatening to reverse the progress made over the last 30 years towards ending institutional provision for people with learning difficulties.

And he warned that CQC budget cuts had reduced its “learning disability expertise” and its “capacity to undertake inspections”.

He added: “Whilst abuse in institutional provision is a long-standing problem, stronger commissioning, robust advocacy and more effective regulation are key components of preventing abuse – and current government policies risk all three being weakened.”

Meanwhile, a group of young disabled campaigners announced this week that they are to launch their own investigation into disability hate crime.

The investigation by the Muscular Dystrophy Campaign’s Trailblazers network of more than 300 young disabled people will examine how, when and where young people are experiencing hate crime, how offences are being dealt with and how to ensure that incidents are reported.

The investigation was sparked by the “bullying, intimidation and verbal abuse” of a disabled student by university security staff last year, and the poor handling of her case by the university.

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