Healthcare Commission damns learning disabilities services

An inquiry into healthcare services for people with learning disabilities in England has today revealed widespread poor standards of care and a general lack of understanding of human rights. The Healthcare Commission’s audit of specialist inpatient healthcare services, the first of its kind, found that most services, in both the NHS and independent sectors, failed to meet 21st century standards.

It criticised services for failing to provide personalised care or support residents to live independently. The audit, which covered the 72 NHS trusts and 17 independent providers of specialist health services, found “significant institutional failures” were depriving residents of their human rights and dignity in many cases.

The Healthcare Commission called for a strong performance framework to be put in place to shift the way services are commissioned and provided. In 2008, the commission will introduce performance indicators, as part of its 2008-9 annual health check, and will audit all NHS trusts’ performance on learning disability services every year.  It will also conduct a national review of the way services are commissioned with the Commission for Social Care Inspection.

Anna Walker, chief executive of the commission, said: “We want this report to be the first stepping stone to enduring change. This is a longstanding problem and we don’t want simply to deliver another depressing assessment and then move on.”

In response to the report, care minister Ivan Lewis said the long-awaited follow-up to the 2001 Valuing People, published tomorrow, would include proposals to transfer responsibility for commissioning services from the NHS to local government and focus on ensuring people have access to appropriate supported accommodation.

The probe was instigated in July 2006 in the wake of the damning report into services at Cornwall Partnership NHS Trust by the Healthcare Commission and CSCI. This was followed in January by another scathing report by the Healthcare Commission  into services run by Sutton and Merton Primary Care Trust, including Orchard Hill long-stay hospital and a number of homes.

Today’s audit found learning disabilities staff were committed, but suffered from poor leadership, poor training and the absence of a performance framework to guide the services.

Among a series of failures, it found there was widespread poor planning of care, limited access to advocacy, and a lack of external and internal scrutiny from trust boards, service managers or commissioners.

The audit highlighted that there was “a potentially large and hidden issue” where organisations were providing residential care instead of specialist healthcare. It raised the question over whether the NHS should be providing services for these individuals.

The report identified safeguarding issues at six services, run by five organisations – Bromley PCT, south-east London, Care Principles in Stafford, Coventry and Warwickshire Partnership NHS Trust, North Lincolnshire PCT, Sandwell Mental Health and Social Care Trust – which have all been referred to local authorities.

Community Care is campaigning to improve the life chances of people with learning disabilities.

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