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Winterbourne View Hospital

Volume 542: debated on Wednesday 21 March 2012

I promised to update the House about ongoing activity in relation to Winterbourne View private hospital and other services for people with learning disabilities.

The House will wish to note that four people employed at Winterbourne View hospital appeared in Bristol Crown court on 16 March and pleaded guilty to offences under the Mental Capacity Act 2005. They have been referred for sentencing reports, alongside the three people who pleaded guilty on 9 February. A further four people are due back in court after Easter.

The Care Quality Commission (CQC) has now completed their focused inspections of 150 services for people with learning disabilities. The reports from these inspections are being published in batches, and a further 19 reports are being published today. They can be found at:—86 inspection reports have been published so far. These reports have found poor practice in some of the units and frequent areas of concerns include limited person-centred care, limited appropriate activities and a lack of monitoring and learning from incidents of restraint.

Where CQC has identified concerns, the provider is required to inform CQC when its improvement actions have been completed. CQC will follow up to check that the improvements have been made, including further inspections where necessary. Where CQC has issued warning notices it has been back to inspect and found the locations to be compliant.

In the original proposal for the learning disability review the plan was to undertake two phases. Phase one was the inspection of 150 locations. These inspections have now been undertaken. Phase two was the inspection of registered services for people with learning disabilities covering a wider range of services than those included in phase one, notably adult care providers.

However, CQC has taken the opportunity within phase one to inspect 33 adult social care locations. Following discussion at the CQC inspection programme advisory group, CQC decided not to proceed with phase two at this time but wait until the national report on the findings from the LD inspection programme had been published and then reassess the options.

A programme of thematic inspections is starting this April looking at domiciliary care agencies. This will test the tools for inspecting this type of service so they can be used for other care groups. This programme of inspection will focus on older people.

Once the criminal proceedings are completed, we expect the serious case review, chaired by Dr Margaret Flynn, to be published. The serious case review is looking at:

i. the effectiveness of the multi-agency response to concerns raised and events

within Winterbourne View hospital since January 2008;

ii. the role of commissioning organisations in initiating patient admissions and

the role of the regulator; and

iii. the operational policies and practice, including the governance

arrangements of Castlebeck Care (Teesdale) Ltd.

The review is considering information submitted by Castlebeck, NHS South Gloucestershire PCT, NHS South West, South Gloucestershire council and Avon and Somerset police.

These reports will feed into the wider departmental review of Winterbourne View together with evidence from other investigations and reports. The review team are actively engaging with people with learning disabilities or autism and family carers, as well as with commissioners, professionals and providers to explore the emerging issues and possible options.

The review is considering all the evidence carefully and assessing the implications for policy and practice across the system, including for commissioners, providers, professionals, regulators and Government. Everyone has a part to play in addressing these issues to help prevent abuse and to drive up standards for people with learning disabilities or autism and challenging behaviour.

While these reviews and inspections are ongoing, we are taking action to address emerging issues. For example:

CQC has amended its whistle blowing policy;

the whistle-blowing helpline for NHS staff has been extended to staff and employers in the social care sector from 1 January;

on 18 October, the Secretary of State announced that the NHS constitution is being updated to include:

an expectation that staff should raise concerns at the earliest opportunity;

a pledge that NHS organisations should support staff when raising concerns; and

clarity around the existing legal right for staff to raise concerns about safety, malpractice or other wrong doing without suffering any detriment;

we are working on legislation that will require stronger local action in relation to safeguarding adults; and

where issues for local management are highlighted in the NHS review, they will be developing actions plans to deal with this.

Ministers will report findings from the departmental review to Parliament and determine what further action is necessary.

I will continue to update the House as things develop.