Failing to protect
The dismal story of abuse by staff at a private sector specialist care unit is depressingly familiar. While the operator is clearly culpable, why did the regulator and other independent bodies also fail these vulnerable patients?
Abuse at Whorlton Hall uncovered by BBC’s Panorama and reported on page 24 revives disturbing memories of the Winterbourne View scandal in 2011, where patients were routinely emotionally and physically abused by staff.
The horrors of Winterbourne, owned at the time by Castlebeck Care, caused outrage and saw commissioners and providers pledging that lessons would be learned and steps taken to consign such events to history.
So why was an undercover reporter able to expose similarly appalling treatment of people with learning disabilities and autism in a privately-run unit just eight years later? The answer is unclear, but what’s certain is that there was no shortage of opportunities to uncover the problems.
Whorlton Hall’s owner Cygnet Health Care was quick to tell HealthInvestor UK that, while it had been unable to identify and prevent the abuse, neither had myriad independent bodies, including NHS and local authority commissioners and advocacy monitoring organisations that visited the unit 336 times in the 18 months prior to Panorama’s revelations.
Most worryingly, the Care Quality Commission made seven visits to Whorlton Hall in 2018/19 and failed to identify any hint of abuse, which, of course in no way exonerates Cygnet, but raises difficult questions for the regulator.
At a recent parliamentary Human Rights Committee hearing into the affair, CQC chief executive Ian Trenholm denied his organisation was aware of any abuse, and defended its decision not to publish a report in 2015 which criticised aspects of Whorlton Hall’s care and found the unit “required improvement”, with concerns including inadequate staffing levels, a lack of training and a failure to follow patients’ care plans. A subsequent report in 2016 gave the NHS-funded unit an overall rating of “good”.
“If any evidence of bullying or abuse had been detected, the police would have been called and the home would have been closed down,” said Trenholm, who sought to play down suggestions that the abuse was historic and should have been picked up earlier.
“I agree that we do need to reflect on, and change, our methodology – the reviews we have commissioned will look at how our regulatory methods work and whether they protect individuals properly.”
The CQC has launched an independent review into its handling of the draft report, as well as a wider review looking at the entire regulatory history of Whorlton Hall from 2015 to 2019.
But Trenholm was clear that even the most stringent and meticulous inspections cannot guarantee to uncover poor or abusive care if those concerned are determined to conceal the facts.
“I think if people are seeking to behave in this way, what we can do is minimise the risk of it happening to the absolute minimum. But I don’t think I can honestly, hand on heart, sit here, and promise you it will never happen again,” he told MPs.
Such honesty is admirable, but the CQC’s frank admission that it is far from infallible is a stark reminder for care sector operators and investors that quality and governance must be prioritised to protect vulnerable patients.
