Learning disability commissioners should not retain the services of a large NHS trust simply because it is “too big to fail”, families have warned following three damning inspection reports into its services.
The call, in a report by Oxfordshire Family Support Network (OSFN), a group of parent carers of people with learning disabilities, comes amid significant concerns about the quality of services in the county run by Southern Health NHS Foundation Trust, and speculation that its contract will not be renewed by commissioners.
Three Southern Health learning disability facilities in Oxfordshire – Slade House, the Piggy Lane care home and the Evenlode unit – have been subject to damning Care Quality Commission inspection reports over the past year. In addition, an independent review found that 18-year-old Connor Sparrowhawk died preventably last year at Slade House’s short term assessment and treatment team unit (Statt) after being left unsupervised in the bath.
The OFSN report included evidence from families about the problems with services in Oxfordshire. Parents described being shut out of care decisions when their child reached 18, not being helped until they hit crisis point as well as a lack of suitable, local services for young people with learning disabilities.
‘Too big to fail’
The OSFN report did not call on commissioners at Oxfordshire County Council not to renew Southern’s contract when it expires at the end of next year. However, it warned that the council should not “allow providers to continue providing services on the basis that they are ‘too big to fail’ as it is simply too risky for vulnerable people with learning disabilities”.
Southern is one of the biggest mental health and learning disability providers in the country, having acquired responsibility for running learning disability services in Oxfordshire, Buckinghamshire, Wiltshire, Dorset and Swindon in 2012, to add to its portfolio of services in Hampshire.
The OSFN report, funded by Oxfordshire Healthwatch, said this had resulted in a loss of local accountability, which needed to be reintroduced through the publication of data on service impact that would hold both commissioners and providers to account.
It also said that families had “expressed real concern about how such poor services could be commissioned in Oxfordshire”, following the CQC’s inspection report last November into Slade House.
Last week, BBC Radio Oxford reported that Southern Health would lose its contract when it expired at the end of next year. Oxfordshire County Council and Oxfordshire Clinical Commissioning Group are currently reviewing local learning disability provision, which they said was partly prompted by the reports into Southern Health services and Connor’s death.
No decision on future of services
However, they said that they continued to work closely with Southern Health, which itself said that no decisions had been taken on the future of learning disability services in Oxfordshire.
More recent CQC reports on the John Sharich House assessment and treatment unit at Slade House and Piggy Lane found some improvements but also highlighted remaining failings. The Statt unit at Slade House is closed.
The OFSN report also included descriptions from several parents about their children being placed in secure units hundreds of miles away from home and being physically restrained and injured.
But there was also an example of a much better alternative. The report described a teenager who had a very traumatic time sectioned in a hospital 170 miles away but on discharge was supported to go to school, play sports and work in a local café project, which vastly improved his confidence and happiness and that of his family.
The report called on commissioners and providers needed to more closely involve people with learning disabilities and their families, as experts by experience, in the design and delivery of services.
OFSN is now seeking funding to pilot a peer-to-peer network of support and advocacy for families, so that families can be more closely involved in the oversight of services.
The report also raised concerns about support for young people, saying that Southern urgently needed to develop a policy on transition between children’s and adults’ learning disability services.
‘Fragile support systems must radically change’
Report author Jan Sunman, a project worker at Oxfordshire Family Support Network, said: “Our purpose in writing this report was to give a voice to a very hidden group of families, and to show how they struggle with fragile support systems that need to radically change in order that they and their relatives can have a basic quality of life that the rest of us take for granted. Families are isolated and desperate for good support and advice. They often have a poor understanding of the rights of their relatives. We are calling for significant improvements in the way that young people, like Connor, are supported. We would also like to explore the idea of families who have experienced such challenges being trained to support other families who are facing a similar situation.”
John Jackson, director of social and community services at Oxfordshire County Council, welcomed the report, saying: “We are keen to work with the network as well as Healthwatch Oxfordshire to take forward their ideas as part of the commissioning work we are doing over the summer which will involve further discussions with families, carers, other organisations, and commissioners about improving services to meet their needs.”
A Southern Health spokesperson said: “We welcome this report, and were very pleased to be able to provide a comment prior to publication. We will continue working with commissioners and relevant parties to deliver effective services.”