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Two national inspectorates have slammed the "widespread lack of understanding" about the rights of people with learning difficulties after uncovering years of abuse in institutions, including physical abuse, run by Cornwall NHS trust.

Commission for Social Care Inspection chief inspector David Behan and Healthcare Commission chief executive Anna Walker said that although the abuse found in Cornwall was not happening everywhere, the quality of care in England was "not always what it should be".

The joint investigation into learning difficulties services at Cornwall Partnership NHS Trust revealed evidence of staff hitting people, withholding food and an over-reliance on medication to control behaviour.

And the investigation, which centred on Budock Hospital near Falmouth and several other units, found that senior trust executives failed to tackle the abuse. Inspectors have recommended the trust be put under special measures.

The Healthcare Commission will now launch a national audit and inspection programme of all NHS and independent learning difficulties service providers and aims to publish its findings next year.

It is also investigating allegations of abuse at Sutton and Merton Primary Care Trust (Inquiry at Sutton and Merton trust after staff sexual offence charges, 23 February), while a privately run unit in Norfolk closed down last November following an intervention by the commission.

Rob Greig (pictured left), the national director for learning disabilities, said that services in Cornwall ignored the standards of provision outlined in Valuing People, published in 2001, and so the occurrence of the abuse was not an indictment of the white paper's proposals.

He said the Department of Health would make a detailed response to the report following the publication of the Disability Rights Commission's investigation into health inequalities faced by people with learning difficulties, which is expected in September.

Cornwall Partnership NHS Trust's new chief executive, Lezli Boswell, who was appointed in May, said the abuse uncovered by the investigation was inexcusable.

The full report is available at www.healthcarecommission.org.uk

Abuse in Cornwall

One person spent 16 hours a day tied to their bed or wheelchair for what staff wrongly believed was the person's own protection.

Some doors kept locked as a method of dealing with challenging behaviour and staff gave people cold showers.

40 people referred to Cornwall Council under protection of vulnerable adults procedures.