May 312012
 
ehrc01-cripclop

With thanks to http://www.kingqueen.org.uk/archives/70

For letting us repost- pop over for some more brilliant stuff!

The Care Quality Commission (CQC) has come in for somewhat of a bashing recently. But I didn’t think they would lie as well.

In response to a recent documentary exposing care home abuse, CQC said the following in their media statement:

CQC carries out an unannounced inspection of every care and nursing home in England every year – more often if we believe people may be at risk. This system of regulation can and does identify poor care which CQC then takes action to tackle.

What?!

A quick look at the five care homes I’d stayed in in the last year revealed last inspection dates as follows:

  • Summer 2010 (in response to a specific incident, last “proper” inspection November 2007)
  • January 2009
  • November 2009
  • February 2011 (in response to specific allegations)
  • December 2009

Not one was inspected in the past 12 months. 0%.

Personal experience with looking for care homes for a relative confirmed the impression that most care homes have gone well beyond 12 months without an inspection.

I smelled a rat. So I asked CQC how many homes it had indeed inspected. The response came. Answering a slightly different question, CQC admit they did 13,082 inspections of care homes over the last 12 months. There are 17,756 care homes. So at least 26% of homes didn’t get inspected. I say “at least” as where CQC identifes problems at a care home they conduct more than one inspection. (hence why I think their FoI response is disingenuous.)

Let’s look at these once again.

  • “CQC carries out an unannounced inspection of every care and nursing home in England every year – more often if we believe people may be at risk.”
  • Of the 17,756 English care homes, CQC did 13,082 inspections over the last 12 months.

Is it me, or do the figures not add up?

Where did this come from?

The sad thing is we always knew CQC would be an appalling, incompetent mashup.

It was formed from a merger of the Healthcare Commission, the Commission for Social Care Inspection (CSCI) and the Mental Health Act Commission a couple of years ago. Having worked with CSCI, who were at least trying to do things right, me and other service users raised the concern that it would follow the sad precedent of the subjugation of disabled people’s rights following the Disability Rights Commission being subsumed into the Equality and Human Rights Commission. Sadly, we were right. Our concerns that social care would always be lower priority than healthcare were realised.

It didn’t help that the new body was given new, overarching registration standards. These same standards applied to all bodies registered – from acute hospitals, to dentists and care homes. The result being the emphasis on residents rights was lost, and the regulations simply weren’t specific enough for the situation. We lost rights in the change.

Then CQC sacked 70% of its inspectors so that it could register dentists. They adopted what they acknowledge as light touch regulation. They ceased grading care homes, and largely stopped inspecting them. The majority of care home reviews became based on self-declaration by care home managers. Inspections became very rare. Now, precisely which poorly performing care homes would state this to the regulator do you think?

Abuse

All this came to a head during the very sad and distressing Panorama documentary of the systemic abuse of people with learning difficulties at Winterbourne View. CQC became a very public whipping boy, held accountable for a lot of what happened. Much criticism resulted, including a select committee and the PM criticisng CQC for reducing inspections. Many made a comparison with the seminal Silent Minority documentary exposing the “care” of people with learning difficulties in institutions in the early 1980s. (Documentary available to view online – very distressing too.)

Meanwhile, there’s been blood on the carpet and accusations of gagging orders on staff etc. CQC has become a toxic brand. It’s been desperately attempting to reinvent itself, so far (in my view) failing miserably.

Consequences

If it wasn’t so serious, this would be funny. The reality is, though, that people are suffering as a result of this disgusting shambles. Care home residents are some of the most vulnerable, most disadvantaged, most disempowered people in this country. Abuse is the norm, not the exception in my experience; it just varies in degree. Without an effective regulator, the thousands of people in care homes up and down the country suffer even more abuse, poor treatment, curtailment of life opportunities.

CQC are ineffective, stuffed up, an ineffective regulator who lie about themselves to try and stop the torrent of legitimate criticism aimed their way. They are beyond redemption and need replacing.

(With grateful thanks as always to the wonderful Crippen for his inciteful cartoon

 

 

Jun 032011
 

Indications of shock and disbelief came from all quarters of social media from watching the Panorama program Undercover Care: The Abuse Exposed. While I had to force myself to watch, it was sadly not news for me. Like the whistle blower, disabled people have long been voicing our misgivings about how people with learning difficulties[i] bear the brunt of disability hate crime. It is not so long ago that Fiona Pilkington committed suicide [ii] because she could no longer bear the abuse; she contacted the police no less than 13 times in the year of her death.

When a case such as the Panorama program highlights these real occurrences, there are knee jerk reactions and  righteous noises about the support workers – and rightly so, some of them were arrested. But these abuses are, sadly, not rare and it also misses the crux of the issues.

These support workers were working in an environment (and society) which has no respect or regard for disabled people. They see them as ‘patients’ to be restrained and vent their boredom in bullying and abusing the people in their charge to pass their time. There was no supervision, no managerial support. It’s all very well to vilify them but there are some bright ideas afloat that unemployed people should be sent ‘to serve the community and take care of disabled people’. Disabled people are held hostage by the label as the ‘most vulnerable’, as subjects to be ‘taken care of’ and also, in this scenario, as punishment. Support workers are badly paid and as we can see in the program, scarcely trained. I am fortunate enough to know many support workers who care about the people they support in the community but these sterile ghettos/ care institutions where people with learning difficulties are kept locked up are not the type of places they would chose to work given a choice. These ‘inmates’, because that’s what they are effectively are rather than patients,  are not for all intents and purposes, ill. They are disabled people. Moreover the  treatment meted out to them by being kept in such institutions causes additional mental health issues.

Clare Wrightman, Director of Grapevine, Coventry, a charity that helps people with learning disabilities to grow their lives tells us:

‘As an advocacy organisation we know that people with a learning disability are on the receiving end of abuse and ignorance, especially in the new institutions. In the Panorama expose independent advocates were completely absent. Our workers are a vital part of safeguarding the most vulnerable.
Why did we close long stay institutions run by the State as part of government policy only for local government to commission new ones from the private sector? People can be supported to live in their communities close to the people who really care about them’

Ellen Clifford, who has worked within the People First movement said:

One point I do think needs to be made is how traditionally there is such a risk averse approach to support for people with learning difficulties, favouring segregated institutional based care. This programme shows  the extent of the dangers that are faced by people placed in exactly those type of settings that are purported to be safer for them as opposed to being supported to live independently in the community.

She continues:

the Quality Care Commission (QCC)  clearly failed when it was given evidence of abuse on a plate which it ignored. There needed to be improvements in its systems. However as Panorama rightly identified, the core issue is that locked institutions should not be allowed to exist. The programme at times described people as “not being able to look after themselves” and as having the mental age of children, however that approach fails to recognize the abilities, talents and contributions which all people with learning difficulties have; as one of the programme experts said at the end, there is no reason why any of those people could not live better in the community with support.

The privatisation of care homes must be seen as a factor contributing to the existing abuse at places such as Winterbourne. Private companies are seeking to make a profit from an industry which is already severely underfunded, the outcome can only be inadequate quality of support with the subsequent incidences of abuse. Supporting people with challenging behaviour is a complex and difficult job which requires intelligence (high levels of both IQ and EQ), understanding and training. You do not get support workers with that mix of skills and attributes for the kind of wages that the the so-called care sector pays. Not when you consider the executive salaries which are also paid out to the Directors.

The coalition government is pushing for a Big Society but without state intervention and regulation to ensure people get the support they need, there is every danger, as the Panorama programme provided evidence, of cultures of abuse becoming more widespread and accepted.

The programme highlights the key value of user led organisations: one of the experts described how the staff cannot have viewed the patients as “human beings just like them” in order to have engaged in the treatment they did. Where disabled people are visibly part of service commissioning and provision we can provide a constant reminder that we are indeed people just like them. If we don’t want people in our society to be abused as seen on Panorama then society needs to invest in our organisations.

Jim Mansell from the Tizard Centre, Kent University was one of the experts in the programme. What is highlighted on the Panorama programme is already detailed in a chilling report by him and his colleagues.[iii]

What we want to know is when is this austerity driven government going to see that this privatised, institutionalised care is not cheaper but that it costs disabled people and their families dear in depriving them of their human rights to live independently with support in the communities that includes them.

—-Eleanor Lisney


[i] Disability hate crime needs to be tackled  http://www.guardian.co.uk/society/2011/jun/01/disability-hate-crime-keith-philpott

[ii] Fiona Pilkington case: police face misconduct proceedings http://www.guardian.co.uk/uk/2011/may/24/fiona-pilkington-police-misconduct-proceedings

[iii] Exploring the incidence, risk factors, nature and monitoring of adult protection alerts, Jim Mansell et al.

https://shareweb.kent.gov.uk/Documents/adult-Social-Services/adult-protection/tizard-report.pdf

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