Learn News

The Right Support in The Right Place

By Alan Rosenbach, Sector Expert

A nation’s greatness is measured by how it treats its weakest members is the quote attributed to Mahatma Ghandi. It is an important statement when we think about it in relation to people with a learning disability or autism and their families.

The 5th anniversary of the closure of Winterbourne View Hospital was at the end of May 2016. In the immediate aftermath of that awful exposure of cruelty and abuse the Care Quality Commission inspected 132 hospital services of a comparable type to Winterbourne View. These were services that were defined as “assessment and treatment units” which were either medium secure or low secure with provision of care.

It became clear that there were many hundreds of people who had been in these units for disproportionately long periods of time (average of seven years) and often away from their home communities. Since then we have had regular data collections from both providers and commissioners and five years on there are still some 3,200 people in these institutions. Hospitals are not homes and the cost of warehousing people in this way is around £650 million per year.

Government and its partners have been committed to making sure that those who can should be discharged from these hospitals to their local communities. There have been care and treatment reviews for the majority of the individuals in these institutions. It would appear that although many individuals have been discharged many have not and yet more people are being admitted.

There is a good deal of evidence that behaviours which are seen as challenging and lead to ratios of carers to individuals that seem over whelming are linked to being in an institutional setting. We know that there is always an imbalance of power between those caring and those being cared for. This is always exacerbated within an institutional setting. Such settings can make people with a disability and autism feel very vulnerable. The means to communicate this feeling of being made vulnerable can then add fuel to the fire and behaviours being labelled as challenging or deviant.

What is needed is a systematic programme of work that leads to a closure of most of the hospital beds for those with a learning disability and autism. The resources currently being used to deliver these services should be redeployed into the community. The expertise should be used to provide guidance and support for the many thousands of care staff who provide high quality care and support day in and day out for those in care homes or being supported at home.

I recently was on the judging panel for the National Learning Disability and Autism Awards covering the categories of “support worker award” and the “managers award”. The level of skill, expertise, capability and commitment was astonishingly good and of exemplary standard. There are many more individuals out there all committed to supporting people with learning disability and autism live a full and active life outside of hospital and institutional care. We need to have confidence in them and we need to encourage more people to come into this sector because so many people want a society that does well be it’s weakest members.


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