Friday, October 30, 2015

How to throw the Calderstones baby out with the Winterbourne bathwater

It's good news that the government has at long last agreed to stop provision of 'care' for people with a learning disability in 'hospitals' distant from the patients homes.  The Winterbourne View scandal was years ago now and the Budd Report recommended it long ago.

It's bad news that it is to be implemented in an under resourced and careless way that will cause at least as many problems as it will solve.  See below -

If you're going to reduce services on this (or any) scale, you need to put a properly resourced alternative in place to care for and support these people.  Official warning - this is a time of "continued financial pressure" for councils who will have to pick up the bill.

You need to do it carefully.  The closure of Calderstones in Lancashire will be a very large chunk of the numbers that the government will claim towards its target of 1,300 to 1,700 in the next 3 years.  But Calderstones isn't anything like Winterbourne View.  True, the people there have learning disabilities, but 90% of them are there as a result of involvement with the criminal justice system.  They won't be going back to homes in their local community.  At best they will stay there with Calderstones rebranded in a takeover by Merseycare NHS Trust - to take it out of the official hospital numbers.  At worst, the patients will be sent (back) to prisons to be bullied and mistreated - for many, the very reason they were sent to Calderstones in the first place.  Most of calderstones is a secure institution, few of it's patients will end up in the community, but the government will claim it's hitting it's targets.

In all this, bear in mind that it wasn't the official watchdog, CQC, who raised the issue of the abuse at Winterbourne (and other places).  It was family members with support from the media.  (I don't usually like the media, but they did a good job of work on this one.)  CQC did give Calderstones a poor report and there were definitely problems.  But Calderstones was improving and got excellent reports for some of its initiatives.  Simply closing it down is a cynical piece of sleight of hand to massage the numbers and does so at the expense of the care of some of the most vulnerable (and hard to deal with) people with learning disabilities.

There isn't enough money being put aside to give good, local care in the community for the people in all the 'hospitals' that will be closed - that's partly why it's taking such an unconscionably long time.  And social care budgets are still being cut.  If we properly funded good, local care in the community, we wouldn't have remote, abusing 'hospital settings' to close down.

Saturday, October 17, 2015

Gazing at the navel of CQC

CQC have just published their annual report.

The main thrust seems to be along the lines of 'many care services are OK, we're a bit worried that most are unsafe in some way - often because they haven't enough of the right staff - but it can all be sorted out by good leadership.'  So that's really reassured me - not.

It would be difficult to imagine a more complacent piece of navel gazing,
in the face of a health and care service in dire crisis from cuts, privatization, staff reductions and thousands of disabled people being left to fend for themselves.

Someone needs to remind CQC of a few things -
Winterbourne View issues -  'rebranding' it as Transforming Care won't solve the problem - and isn't.
Cuts and 'budget pressures' are not challenging - they're a disaster for the people losing services.
Saying things are improving despite these pressures is akin to praising the re-arrangement of the deckchairs on the Titanic.
Saying that quality is variable, and unsafe services are your main concern, is admitting that CQC is failing to protect people.

You can't solve these sort of major problems with a bit of 'good leadership' here and there - it needs resources, hard work at ground level and a willingness to seek out and eradicate poor and unsafe services.  None of which CQC can provide - tickbox self assessments are not enough.
It has no resources, it doesn't experience the actual care work and it isn't CQC who has blown the whistle on the big disasters - it's TV and journalism, prompted by family carers unable to get anyone else to listen.

The report can be summarized as 'It's been a difficult year, things are pretty bad but we think we're doing OK, considering.'  A rather less self absorbed and more problem solving approach would be more acceptable, but on balance I think I'd rather just have a better regulatory and inspection body than the one we seem to be stuck with.
We may be going to hell in a handcart, but thank goodness we've got CQC to tell us how well oiled the wheels are.

Friday, October 16, 2015

Condolences to the family of Connor Sparrowhawk

My condolences to the family of Connor Sparrowhawk.  So sad to hear about the death of another person with learning disabilities, failed by the care system and a life lost to us.  I find it difficult to comment on this sort of thing as the important thing is the family who have lost a son.

I will therefore only pose a few short questions.
How was a death after an epileptic fit in the bath accepted by anyone initially as from 'natural causes'?
Where was (and is) CQC in this tragedy - and more importantly why weren't they there to prevent it  (Too busy to have carried out an inspection)?
Why is it that the only real check on the quality of care is still the family?

The BBC report on this is at

Friday, October 9, 2015

Consultation - the reality

Last week I went to our local (sort of) Learning Disability Partnership Board.  It's (supposed to be) a forum with representatives of service commissioners, service providers, the people who receive LD services and their family and carers.  When times were good, the council welcomed the input of carers and family members - they had the needs of their LD relatives at heart and were usually the ones actually doing most of the work.  This made Lancashire something of a centre of excellence.  But not any more.

Now times are hard, services are being cut.  We don't like this and had the temerity to say so - not usually in general terms but by raising real concerns about specific problems that were being created. This did not make us popular.  So, Lancashire Social Services tried to silence us, by first reducing the 9 local Partnership Boards to 3, and now reducing these 3 to 1 for the whole county. Unfortunately, the problems didn't go away, so we didn't go away either.

At the last meeting, all the time was spent 'discussing' (read being told) administrative matters like terms and conditions for the meeting.  Whenever someone tried to ask about an actual issue, they were slapped down with either, it wasn't on the agenda for the meeting (because we'd been given no access to setting the agenda) or it was just another thing that there was no longer any money for (as though this stopped it being a problem)

Eventually I became so angry that I walked out.  I don't think Lancs SS even noticed.  And if they had, they would probably have seen it as a victory.  They've already driven away the organizations that provide what little services are left with funding, health and housing had been driven out long ago, driving out the carers and families would be fine for them.  They could then tick the box that says they had consulted and involved the community by having their meeting.  (And they do see this as 'their' meeting - they decide if it should take place, where, when and they chair it) The meeting could then be more easily 'managed' as the only people left would be Social Services and a few people with learning disabilities who they could browbeat and shepherd into whatever decisions suited them.  Result - Lancashire gets it's policies and cutbacks rubber stamped as supported by the LD community.

Liars.   Nasty, manipulative, conscienceless.  

Lancashire used to have a reputation for good LD services, supported by strong, caring community links.  This is no longer true.  Services continue to be hacked for the most vulnerable in the name of 'needful austerity' - and a Labour led council justifies this because the tory government has cut it's funding.  It should be fighting these cuts not being a willing tool in implementing them.

Don't get old if you're a carer

Just a reminder of a long standing benefits injustice that most non carers aren't aware of - and are usually surprised to hear about.  The exclusion of elderly carers from carers allowance.

If you're a carer for someone with a disability, it is strongly recommended that you do not get old yourself.  A vast number of carers are in fact themselves elderly - it's really common.  And carers are entitled to carers allowance (little though it is).  Well not quite true.  If you start to get a state pension, you will normally have your carers allowance stopped.  (It's a bit more complex administratively than this - surprise, surprise - but that's the normal outcome.)

Caring doesn't stop or get any easier when people become pensioners, but the small payment for doing all the hours god sends and being on call for the rest stops - and so does any recognition of the value of all this effort incidentally.

If you're a carer, you probably know all about this.  Most non carers are surprised.  The government (all parties guilty here) are happy to stay quiet about it because there would probably be uproar if the voting public realized, and it keeps the governments spending bill down a little bit.

This is wrong.  It's also heartless, discriminatory and profoundly unappreciative of the work carers do.  Next time you hear a politician praise the invaluable work of a heroic carer, remind him/her/it that he/she/it has no right to speak about this until this injustice is rectified.

Stopping people living

Continuing cuts and distress of friends as a result is forcing me back onto blogging.  So this government wants local authorities to work smarter to save money.  So it insists that all Blue Badge renewals are now done online - so how does an 89 year old renew the Blue Badge that allows her transport to park close to the hospital door when she needs her next blood transfusion (a frequent event in her life.)?

Well, she gets her children or grandchildren to do it for her.  And they have the monstrous paperwork to cope with while she has to go through the demeaning and depressing process of spelling out exactly how disabled she is and everything she can't do any more to the people she doesn't want to say these things to - complete strangers or close relatives.  And she will have to do this every time it needs renewing.

And people are surprised the take up rate for this and other disability benefits, by people eminently eligible, is so low.  (Please don't get me started on the oxygen thieving wankers who fraudulently use Blue Badges just so they can park next to the cash machine.)

The disabled without children or advocates give up - many with children, find it so hard they don't re-apply.  And yes this saves money - because disabled people are deprived of a life.

This isn't working smarter, it's taking life out of people who want to live to save a few pennies.

This is what austerity means in practice and I for one didn't give anyone a mandate to do it.