Half of learning disability services not meeting core standards

Half of learning disability services inspected in the wake of the Winterbourne View scandal are not meeting core essential standards of care, the Care Quality Commission has revealed.

Just 52.3% of the 150 hospitals and care homes inspected were compliant with the outcomes on safeguarding and care and welfare that they were measured against as part of a national review conducted by the CQC. 

The findings were revealed at this week’s Community Care Live by Bernadette Hanney, the CQC national project lead for the learning disability review, which was triggered by the revelations of abuse at Winterbourne View hospital in Bristol last year.

“This is obviously cause for concern,” said Hanney, who said the key gap revealed by the inspections was a lack of person-centred care for the service users concerned, many of whom have learning disabilities and other complex needs, such as behaviour that challenges.

In terms of safeguarding outcome, the biggest area of non-compliance was in the use of restraint, which was down to staff not being trained in restraint, ineffective monitoring of restraint and a lack of learning from incidents. In respect of the care and welfare outcome, the biggest problem area was care planning, with many plans not accessible to the people for whom they were drawn up.

The unannounced inspections typically lasted two days and were carried out by CQC inspectors, specialist practitioners and experts by experience – service users and carers with experience of similar services. Over 100 of the services were NHS or independent healthcare assessment and treatment units, low or medium-secure units or rehabilitation services, while the rest were care homes.

Compliance with both outcomes was greatest among NHS providers at almost 70%, followed by adult social care services (just over 40%) and then independent healthcare services (just under 40%).

The CQC is due to produce a national report on its review next month, one of a string of reports designed to learn lessons from the Winterbourne View case that will be published over the summer and early autumn, including:-

• A serious case review, due in August, following the conclusion of the Winterbourne View court case;
• An NHS serious untoward incident review, designed to draw together lessons for NHS commissioners, which will be published alongside the serious case review;
• A Department of Health review, drawing on the other investigations, designed to draw together key lessons and provide recommendations for service improvement.

The DH will publish an interim report from its review next month and emerging findings were outlined at Community Care Live by deputy director for independent living Patience Wilson.

She said the DH had found that too many people with learning disabilities and behaviour that challenges were being placed in assessment and treatment units and were staying there too long; that the model of care in these services was outdated and that care was often of a poor quality.

Wilson said the review would call for more services to be developed to support people with learning disabilities and other needs locally, reducing the need for out-of-area hospital placements; for service users to have better access to advocacy; and for commissioners to do more to measure the quality of the care they were purchasing.

Image: Milton Montenegro/Photodisc/Getty

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