Saturday, November 3, 2012

Expensive, unhealthy and dangerous

A comment heard outside here, prompts me to expand a little on some misconceptions about sending people to places like Winterbourne View.

Placements like these are often much more expensive than decent community care or local support, it isn't usually Social Services who place people with learning disabilities there and they are conventionally used to solve a crisis but end up becoming a semi permanent 'home'.

They're expensive because they're not just private sector, run for a profit.  They accept people at short notice and so conventionally run at under capacity.  (They do also make obscene profits from peoples misery.)
It's often the NHS (in the guise of the local PCT) rather than Social Services, who refer people to these places.  They do this because it's an easy, quick response to a crisis - which could usually be solved better locally, but they can't get their act together quickly enough.  having watched Panorama, we could name any number of learning disabled people who were similar but living fulfilled lives in the community.  They're not the most difficult 'cases'.
It's often done where the person's care is being paid for under 'Continuing Health Care'.  Under this the PCT can take whatever decisions it wants without the agreement of family or carers.  Continuing Health Care is fully funded by the NHS, so is often 'sold' to families as free care home provision - but family then lose all rights over what care is provided - this is rarely made clear.
People get sent to places like Winterbourne in response to a crisis, ostensibly 'for assessment'.  But as NHS/Social Services staff are overstretched and subject to high turnover, the 'cases' doesn't get looked at again and rarely by the same person, so the person stays there - inappropriately and at great expense.

These 'hospitals' are dangerous, out of sight, out of mind places.  They're often 'locked' and have only public access to reception areas - they're the modern day asylums, albeit with nice decoration and decent toilets.  And they're prime places for abuse to thrive in secret.  So much so that it becomes the norm and even covering it up becomes a part of normal procedure - "always fill your restraint forms in" etc..

CQC should be actively working to close down these units.  It would improve care, prevent abuse and save money.  This is such a 'no brainer' there isn't even a need to rant.  So why aren't CQC doing it?