Monday, February 9, 2015

Big hospitals aren't easy (or good)

Calderstones hospital is the one last big NHS Foundation Trust remaining full of people with a learning disability.  There are over 200 people there.  It's in rural Lancashire but many of the people there are from elsewhere.  It's recently had a poor CQC report, mainly focusing on excessive use of out of date restraint methods.  Quite a lot of the people with a learning disability there can't simply come out under 'care in the community' without agreement from the Justice Department.  These are some of the facts.

Much of the rest is rumour - because no-one will speak about it.  Not the NHS, not Lancashire County Council, not Calderstones themselves.  There are rumours that it is to be closed - a 'senior figure in Whitehall' is quoted as saying "we know what we have to do, we have to close Calderstones."  Stephen Bubb, who did the report following the Winterbourne View scandal would like to see it closed.  CQC doesn't seem to know what it thinks - as usual.

There have been suggestions for a plan to close it down in a planned, phased way for over 10 years - but nothing seems to be happening.  From where I'm sitting (not a million miles away) it seems that the management and staff there are doing the best they can in an impossible situation - and failing, though probably not through their own fault.  But that isn't the point.  Calderstones isn't there for the staff or the management or the NHS - it's there for the people with learning disabilities who have to live there.  And if it's not up to scratch, something has to be done.  The fact that this is the result of an under resourced if well meaning organization desperately having to rely on agency staff doesn't make it a good place to be.

It isn't good to be restraining learning disabled people face down on the floor for long periods.  It isn't good to be having some of them live in dirty wards.  It isn't good that their medication is being stored and potentially administered unsafely.  It may be the governments cuts that are to blame for this situation but it can't be allowed to go on.

Also it can't simply be shut down.  Where will the people there go?  On what basis will the Justice Department let them live in the community?  How will Lancashire County Council Social Services cope with such a large sudden influx of people who have a right to live in the area - when they're cutting the learning disability budget by 15% this year.  It isn't easy.  There isn't a quick fix.  But we have to decide to do something.

The most worrying part for me is the silence.  No one wants to talk about it.  None of the responsible bodies has a comment.  The media doesn't care - it's got 'cuts fatigue' and learning disability isn't sexy - until it goes wrong - like Winterbourne.