I’m sure anyone who watched Panorama tonight would have been appalled at the systematic and violent abuse of adults within a Castlebeck facility supposedly offering care and rehabilitation for people with learning disabilities and complex needs. The Castlebeck ‘hospital’ (Winterbourne in Bristol) secretely filmed is a locked unit housing 24 adults in conditions in which there was nothing for them to do except wait for the next round of abuse from staff, which included assaults, cold fully clothed showers, water poured on people outside during Winter and constant threats and intimidation. Arrests have now been made. This ‘care’ cost the taxpayer around £3000 per patient per week. Inspectors, CQC, failed to intervene despite three allegations of abuse from a senior nurse and a recent conviction for a staff member caught abusing a patient. They have apologised and propose to carry out 150 unannounced hospital inspections. Ironically, Castlebeck boasts it is the winner of the HSJ/ Nursing Times Top 100 Healthcare Best Employers award 2010.
Deeply depressing. How many Winterbournes are out there amongst the remains of the UK’s long stay institutions? No form of care and support is immune from abuse, but the Castlebeck horror story illustrates the real risks in institutional care which is locked away from view and makes no attempt to value people as individuals or to help people aspire to ordinary, independent living. The perceived risks of support being led more by individuals themselves and of community-based support such as Shared Lives, should be balanced against the protection they offer from institutionalisation.
This shocking case also illustrates the need which is common across social care – for everyone to have an independent advocate to whom they can have access whenever they want and who will speak up for their rights come what may. Advocacy simply isn’t part of the current system and, at a time when care and support is supposedly being reformed to give people ever greater choice, the decreasing availability of support to make choices is a gaping wound in our sector.
Something that has left a really bad taste for me though, is not just the failures of the social care sector, but also the failures of the BBC team investigating Castlebeck. Their undercover reporter filmed people who had nobody to turn to, being the victims of criminal abuse and violence. Being in possession of a hidden camera does not put you outside of the law and the duties you have to your fellow human beings. The untrained, uncaring ‘careworkers’ of Castlebeck forgot not only that the people they were paid to support were humans, but just as importantly, they forgot their own humanity. Similarly, the reporter saw himself as a journalist, and forgot that he is also a citizen. The senior, experienced nurses and supervisors of Castlebeck ignored or actively aided and abetted the abuse. The young reporter appears to have been similarly left without guidance by his producers. Had he been filming for a few days, a lack of immediate action may have been excusable, but to stand by and fail to even object for five weeks? The BBC carried on filming, telling us how much they were suffering as they watched the abuse. As soon as they had witnessed widespread, ongoing abuse, they should have switched their cameras off and picked up the phone to the police.
Escaping the invisible asylum 
The problem with ‘independent advocacy’ is that a lot of the organisations are actually paid for by the organisations they visit which is true if you visit a number of their annual reports.
What actually could be done is that control and restraint training (or the prevention of violent and aggression training) needs to be tightened up legally. When they teach staff that as long as something is ‘reasonable’ and ‘proportionate’ they you can do whatever you want in the situation then no wonder it is the first intervention used. In actuality a care environment is nothing like a ‘street’ environment due to the vast difference in the distribution of power in the relationship between patient and staff member.
I also goes to show how inept the CQC actually is; as when they visit, even unannounced everybody knows that they are coming. The way the staff member dictated what to write in the paperwork was a prime example of why an ‘outstanding’ report actually means not that much. Especially if the staff are supporting patients who have histories of ‘false allegations’ written all over their reports…. that in itself should be a warning sign!
I completely agree that the footage portrayed absolutely disgusting and frankly unbelievable violence. I also agree that the duty of the reporter should have been with the patients and not to allow another five weeks of abuse. I felt that some of the phraseology used to describe the patients was actually quite derogatory and served to justify some of the behaviour directed towards the patients. Adjectives such as difficult only serve to paint the patients in a negative light. Similarly, these individuals are probably increasingly ‘difficult’ because of the non-existence of training for the staff.
At the beginning of the documentary they said that the only people who would be named and shamed were those who had been perpetrators. I do not think that the carers who were not directly involved in the abusive outbursts should be out of the reach of justice. Allowing these acts to continue is complicit in my opinion and there is no reason that they should not uphold their duty of care to the patients. I was also extremely angered by the fact that Castlebeck is turning over a profit of £19 million (if I remember correctly). Why then are they not using this money to hire people with qualifications and put more money into facilities and activities for the patients? Surely this would be a better investment than a locked doors hospital which serves not other purpose – as far as I could tell from this documentary – than containment. If the government has contracted Castlebeck to fulfill this duty on behalf of the state they should feel thoroughly ashamed. This is not how tax money should be spent and it is certainly not in tune with the big society of inclusion, enabling and community cohesion of which David Cameron speaks.
I apologise if this post is somewhat incoherent but having just watched Panorama on the i-player I had to vent my upset and anger and your blog was the first that I came across.
i watched the programme last night and found it very upsetting to watch myself have a disabled child and if i ever put them into care you expect good quailty of care i was a carer for many years for mencap and we never treated our clients like that at the end of the day they are human and they have rights those staff should be locked away for a long time and should be treated like those clients we put our faith in these people to care for our love ones .it think tht they should have been arrested before my heart gose out to the clients and there famlies at this time
My wife and I were completely shocked by the intensity of abuse recorded by the reporter and fear that staff could well have been on better behaviour with a new member of staff. If institutions like this are going to be the choice of local and health authorities and such a culture of evil is allowed to develop I fear the only way of really addressing it is for this kind of secret filming. Clearly just blowing the whistle wasn’t enough. So I have some sympathy with the BBC who have revealed what many of us know already; large, impersonal institutions should be closed down. Such cruel behaviour very easily becomes acceptable in a weak and unmanaged environment.
I thought that the BBC let the CEO and the CQC off the hook by not insisting that they say WHY they didn’t react to the original complaints. It’s OK to be sorry but where was the “error of judgment” made? I guess we’ll eventually find out through the trials of these people.
Clearly though, in spite of improved training and awareness raising about safegaurding and protection over the last decade there are rubbish organisations that are driven by something other than supporting people to live an ordinary, meaningful life.
Finally I have found someone who has also raised the issue of why Panorama allowed this abuse to continue!
Disturbingly I feel that the need to produce a Documentary clouded the judgement of the reporter.
Surely these are educated individuals who run this programme and by not reporting this behaviour they allowed these cruel and sadistic levels of abuse to continue for 5 weeks!!!!!
Jackie Mccormick – I thought people would have stopped shooting the messenger in this day and age?
If people don’t report what happens then nothing would ever change.
I like how you try and shift the buck to the journalist as opposed to Castlebeck’s abhorent training, development and whistleblowing policey.
in fact; if you watched the show the lead nurse reported everything he saw to both Castlebeck management and also the CQC yet still nothing was done and without panorama filing for a prolonged period they may never of found out the true nature of the place as it takes a while for colleagues in an organisation to feel comfortable with someone and revert to their naturalised behaviour.
You need to have evidence to make changes; Castlebeck themselves are still minimising their role as evidenced by saying they are ‘disgusted by the allegations’
Allegations are not the word for something without evidence!!