31 May 2019 update: Independent review into regulation of Whorlton Hall announced
Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (lead for mental health), at the Care Quality Commission, said:
"The footage captured by Panorama shows sickening abuse of vulnerable people. As soon as the BBC told us that they had evidence of abuse we alerted the police and they are now investigating.
"Working with the local authority and NHS England we have acted urgently to protect the people living at Whorlton Hall. Sixteen members of permanent staff were immediately suspended and CQC inspectors, NHSE England, a safeguarding team from the local authority and clinical staff from the local NHS mental health trust have all been onsite to ensure that people are safe.
"We also wanted to assure ourselves that people were safe in other services operated by this provider. We have carried out unannounced inspections of a number of services for people with a learning disability and/or autism operated by Cygnet (OE) Limited. We are also undertaking a review of all locations operated by this provider looking across safeguarding, whistleblowing, incident reports and complaints to explore whether there are any areas of concern.
"When we last inspected Whorlton Hall in March 2018, we did so as a result of whistleblowing concerns. Our inspectors identified concerns around staffing; staff sometimes worked 24-hour shifts, agency staff were not receiving appropriate training, and not all staff were receiving individual supervision. We found the provider in breach of regulations and told them to address these issues.
"It is clear now that we missed what was really going on at Whorlton Hall, and we are sorry. The patients we spoke to during this inspection told us they felt safe and had not experienced aggression towards them. We also spoke to health care professionals who had formal caring roles for patients at the hospital, but who were independent to the hospital; they did not raise any concerns. This illustrates how difficult it is to get under the skin of this type of 'closed culture' where people are placed for long periods of time in care settings far away from their communities, weakening their support networks and making it more difficult for their families to visit them and to spot problems. When you add staff who are deliberately concealing abusive behaviour, it has the potential to create a toxic environment.
"We will urgently explore ways in which we can better assess the experience of care of people who may have impaired capacity, or even be fearful to talk about how they are being treated because of the way that staff have behaved towards them. We must do all we can to lift this cloak of secrecy. We will also be reviewing what we could have done differently or better that would have meant we were able to identify and stop this abuse more quickly.
"I want to be clear that the majority of people with a learning disability and/or autism are receiving good care from caring, professional staff – even in hospitals that are delivering care to people who are a long way from their home and family. But ultimately, many of these hospitals are not the right place for some of the people they are asked to admit, and they cannot form the close links with the community services that are essential to ensuring that people don't get 'stuck' in the system.
"People with a learning disability or autism who have complex needs should have expert, person-centred care close to home – our interim report into restraint and segregation reinforces this message. This care must start early in life and provide support in a crisis, to prevent the need for hospitalisation. If hospital care is in the person's interests, this must be close to home and for the shortest possible time. The staff who provide care must be properly trained and supported to look after people with such complex needs.
"Our interim report also calls for stronger safeguards in the wider system to better identify closed and punitive cultures of care – or hospitals where this kind of culture might develop. In particular, we recommend a strengthened role for independent advocates for people who are held in segregation in hospital.
"I know that seeing this footage will be particularly shocking for people with a learning disability or autism and those who have family members who are being cared for in a hospital for people with a learning disability or autism. I want to reiterate that most people are getting good care from caring staff. But if patients, families or staff have concerns, they should contact us.
"We are sorry that we did not identify the abusive practices at Whorlton Hall – but we do act on concerns from members of the public every day. Over the past three years, we have placed seven hospitals for people with a learning disability and/or autism into special measures, leading to closure in three cases."