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LISA... is a parent support and lobby group, for parents and families with a family member having an intellectual or multiple disability, and living in a supported accommodation group home in the State of Victoria, Australia.
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Box-ticking bureaucrats!
Desk-bound care inspectors let abusers off the hook

On-Line Mail, UK, June 3, 2011 By Luke Salkeld and Nick Mcdermott
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The social care watchdog which failed to halt the barbaric treatment of patients at a private hospital is completely hampered by red tape, a whistleblower claimed yesterday.

The Care Quality Commission has already admitted an unforgivable lapse of judgment after shocking scenes of abuse were uncovered at the centre for adults with learning disabilities [intellectual and multiple disabilities].

And yesterday it emerged that this "Quango", the CQC, has drastically reduced the number of inspections it carries out.

CQC is now investigating why staff ignored the pleas of a former senior nurse at Winterbourne View hospital in Bristol, where patients were routinely subjected to violent treatment from members of staff.

But an inspector who works for the commission said regular visits to hospitals had been sidelined by demands for increased administration and box-ticking.

The employee said: We are so deskbound that inspectors are unable to do what they are supposedly paid to do inspect. What was uncovered at Winterbourne is a direct result of this.

CQC is more interested in spending millions on IT systems and admin skills at the expense of actually ensuring that social care is up to scratch.

The source told the Daily Mail: A few years ago, I was carrying out two or three inspections a week. Now I'm lucky if I do that many in a month.

The inspector added that unannounced checks at hospitals can help to root out the kind of behaviour exposed by the BBCs Panorama programme earlierthis week. It showed employees of the hospital physically and verbally abusing vulnerable patients.

Four members of staff at Winterbourne View were arrested on suspicion of assault. And one been released on bail.

The hospitals owner, Castlebeck, has suspended 13 employees.

• Whistle-blower at centre of 'barbaric' care home abuse exposed alarm last year - but was ignored by regulator
• DAILY MAIL COMMENT: A Dickensian scandal for the 21st century

In one shocking scene, a female patient called Simone was repeatedly drenched in cold water and left to shiver on the floor. The CQC employee said yesterday: If an inspector had made an unannounced visit at that moment, that kind of behaviour could be stamped out.

As it is, hospital staff can be pretty confident that two years will pass without an inspector dropping by. We are not being allowed to do our jobs.

There is an atmosphere of shame in the office and my colleagues are glad what was happening at Winterbourne View has been exposed. We hope it will shine a light on the organisation so that urgent improvements are made.

Exposed: Another still from the Panorama film showing a patient being dragged across a floor.He said CQC is completely hampered by bureaucracy and red tape.

After the CQC was formed in 2009, to replace three separate commissions, a great deal of time was spent amalgamating data bases, the inspector said. For about three months last summer, we effectively had our inspecting duties removed completely. It was all about entering data and registering for a new IT system.

In the end, the former support worker quit last year, after witnessing constant swearing by staff to patients as well as physical abuse, including unnecessary grabbing, neglect, teasing, smacking and slapping, tripping up.

He had previously worked at another hospital in the Midlands run by the same firm, Castlebeck, where he had also expressed concerns about the quality of care.

He said of his time at Winterbourne: I know of numerous complaints to management from both supporting staff and nurses with next to no action being taken. They had plenty of warning, and could have stopped the abuse worsening if they had acted earlier.

He added: All too often, unsuitable people are taken on simply to make up staff numbers.

Many good members of staff have left due to grievances. As a result, the wards are left to the most unsuitable members of staff and it is no wonder the abuse can escalate.

He added: The cutbacks have made a difference too. There aren't enough inspectors to carry out the work we need to do. It is very frustrating that our resources are so limited, and that the resources we do have are so often misused.

CQC executives had travelled to Scandinavia and Arab states to advise foreign organisations, the inspector said.

The Government has ordered a report into how warnings from former nurse Terry Bryan of systematic abuse were not acted upon by CQC. Mr Bryan had become concerned about the standard of care and complained to the homes managers in a four-page e-mail in October. When managers failed to address his concerns he resigned.

As a result of his concerns, an undercover Panorama reporter shot footage of the regime at Winterbourne.

CQC issued an unreserved apology after admitting it failed to respond to Mr Bryans warnings but its chairman, Dame Jo Williams, said she would not resign, blaming an unforgivable error of judgment by staff for the failure to act.

Care services minister Paul Burstow has said that the CQC would have to stage unannounced inspections on care homes, rather than giving them advance notice.

Responding to the inspectors concerns, a CQC spokesman said: Inspection activity has dropped to lower levels while we have been engaged in registering care providers under the new regulatory system required by the Health and Social Care Act 2008.

It is a big job and we had to concentrate our resources accordingly. The rate of inspections is now rising again. Our aim is still to review every home at least two-yearly and for the great majority this will involve a site visit.

She said that CQC does not spend money on systems at the expense of inspections. IT systems exist to support the inspection regime.

Additionally, it is extremely rare for employees to travel abroad and its impact on operations will consequently be negligible.

An ex-carer at Winterbourne View last night claimed he had voiced his concerns about the appalling mistreatment in early 2010, but was ignored by management.


He was even discouraged from speaking to a whistle-blowing line, by his boss who said his standards were simply too high.

LISA Comment: The UK's CQC ("Care Quality Commission") is something between "Community Visitors" and "Independent Accreditation".

Here in Victoria, we see both the community visitor's program and the independent accreditation all watered down by the all powerful Department of Human Services who don't want meaningful service level and quality checks, as they cannot properly man-manage and support direct care staff toensure quality of life care is within the direction, intention and spirit of departmental care policies, standards and values.

Non government, CSO, service providers had significant independent accreditation expectations placed on them quite some time ago by the DHS. Yet, DHS, Disability Services, direct service provision is only now starting independent accreditation - watered down to, (a) a review of policy and procedure, not involving the visiting of group homes, (b) a monitoring process which will involve just visiting a group of homes selected as a representative sample. So some homes will get no effective evaluation!

Similar to the CQC Inspectors, DHS group homes are also bogged with bureaucratic paperwork. The offices in many DHS group homes, are big enough to run a small mining company. Staff spend time ticking-boxes, rather than hands-on time with the residents. All because DHS management, above house supervisor, can't properly man-manage and support direct care staff. So "box-ticking" is needed as an attempt to provide evidence of meaningful happenings.

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