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Article
Publication date: 2 August 2013

Margaret Flynn and Vic Citarella

This paper concerns the fall‐out from a TV programme which exposed the arbitrariness of cruelty at a private hospital that purported to provide assessment, treatment and…

2092

Abstract

Purpose

This paper concerns the fall‐out from a TV programme which exposed the arbitrariness of cruelty at a private hospital that purported to provide assessment, treatment and rehabilitation to adults with learning disabilities, autism and mental health problems. The paper seeks to address the issues involved.

Design/methodology/approach

It describes the principal findings of a Serious Case Review which was commissioned after the TV broadcast, and outlines some of the activities designed to reduce the likelihood of such abuses recurring.

Findings

From policy, commissioning, regulation, management, service design and practice perspectives, events at Winterbourne View Hospital highlight a gulf between professionals, professionals and their organisations, and leadership shortcomings.

Originality/value

The English government responded promptly and encouragingly to the wretched circumstances of patients at Winterbourne View Hospital with a “Timetable of Actions”. The Serious Case Review which was commissioned after the TV broadcast contributed to the growing scepticism of “out of sight, out of mind” placements. It covered wide‐ranging territory.

Details

The Journal of Adult Protection, vol. 15 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 5 August 2020

Stephen J. Macdonald

This paper aims to conceptualise the residential and psychiatric hospital as a space where criminality and social harms can emerge. Because of recent media scandals over the past…

Abstract

Purpose

This paper aims to conceptualise the residential and psychiatric hospital as a space where criminality and social harms can emerge. Because of recent media scandals over the past 10 years concerning privately-owned hospitals, this study examines the lived experiences of service users/survivors, family members and practitioners to examine historic and contemporary encounters of distress and violence in hospital settings.

Design/methodology/approach

The study consists of 16 biographical accounts exploring issues of dehumanising and harmful practices, such as practices of restraint and rituals of coercive violence. A biographical methodology has been used to analyse the life stories of service users/survivors (n = 9), family members (n = 3) and professional health-care employees (n = 4). Service users/survivors in this study have experienced over 40 years of short-term and long-term periods of hospitalisation.

Findings

The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. Practitioners recalled comprehensive experiences of violence within historic mental hospitals, although violence that may be considered criminal appeared to disappear from hospitals after the Mental Health Act (1983). These reports of criminal violence and coercive abuse appeared to be replaced with dehumanising and harmful procedures, such as practices of restraint.

Originality/value

The data findings offer a unique interpretation, both historical and contemporary, of dehumanising psychiatric rituals experienced by service users/survivors, which are relevant to criminology and MAD studies. The study concludes by challenging oppressive psychiatric “harms” to promote social justice for service users/survivors currently being “treated” within the contemporary psychiatric system. The study intends to conceptualise residential and psychiatric hospitals as a space where criminality and social harms can emerge. The three aims of the study examined risk factors concerning criminality and social harms, oppressive and harmful practices within hospitals and evidence that violence occurs within these institutionalised settings. The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. These reports of violence include dehumanising attitudes, practices of restraint and coercive abuse.

Details

Journal of Criminological Research, Policy and Practice, vol. 7 no. 2
Type: Research Article
ISSN: 2056-3841

Keywords

Article
Publication date: 24 October 2023

Lucy Jade Jones and Ceri Woodrow

The purpose of this clinical audit was to review the adherence to the 2017 care and treatment review policy across two NHS assessment and treatment units. Care and treatment…

Abstract

Purpose

The purpose of this clinical audit was to review the adherence to the 2017 care and treatment review policy across two NHS assessment and treatment units. Care and treatment reviews should be offered to people with an intellectual disability and/or autism who are at risk of admission into a mental health hospital.

Design/methodology/approach

Admission and discharge data was collected across two assessment and treatment units between January 2019 and December 2022. Adherence to the care and treatment review policy was also reviewed as was length of inpatient stay. A retrospective evaluation was conducted. Triangulation of data was collected via the trusts’ electronic patient record system and NHS analytics team. Descriptive statistics, Mann–Whitney U test and a one-way ANOVA with post hoc tests were used in the analysis.

Findings

An increase in behaviours of challenge and deterioration of mental health were the main reasons for admission. Forty-nine percent (30) of those admitted to the assessment and treatment units accessed a care and treatment review. Care and treatment reviews were more frequently provided for individuals experiencing longer inpatient stays.

Originality/value

There is limited evidence relating to outcomes and impact of care and treatment reviews. Further research is required to explore effectiveness of care and treatment reviews to understand benefits and appropriately prioritise resource.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 17 no. 4
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 2 August 2013

Joe Plomin

This article seeks to consider the lessons from one of the worst failures in adult protection in the UK in recent times: the abuse of a number of patients with learning…

2362

Abstract

Purpose

This article seeks to consider the lessons from one of the worst failures in adult protection in the UK in recent times: the abuse of a number of patients with learning disabilities or autism and challenging behaviour over a number of years at Winterbourne View private hospital in the outskirts of Bristol. The abuse persisted, irrespective of a number of attempts to alert a broad range of regulatory authorities and health professionals about the situation.

Design/methodology/approach

The article provides a detailed analysis of the lessons for professionals responsible for adult protection by one of the journalists most responsible for exposing the abuse at Winterbourne View private hospital. Drawing on information the BBC uncovered during the making of its two films about the subject, the author shares details of relevance to professionals responsible for adult protection and considers the implications of the catastrophic failure to protect vulnerable people.

Findings

This article shows how the lessons from the abuse at Winterbourne View have permeated only to some areas and professionals, not necessarily to where those lessons are most needed. The author suggests that further efforts are required to prevent another, similar scandal happening elsewhere in the UK.

Originality/value

The paper is a unique piece, sharing experiences from a journalist involved with exposing a scandal directly with professionals responsible for adult protection.

Details

The Journal of Adult Protection, vol. 15 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 8 February 2016

Bill McKitterick

The purpose of this paper is to examine the discourse of the leadership of professional and public policy responses to the scandals of the care and treatment at the private…

Abstract

Purpose

The purpose of this paper is to examine the discourse of the leadership of professional and public policy responses to the scandals of the care and treatment at the private Winterbourne View and NHS Calderstones Hospitals which demonstrates the lost learning from earlier attempts to provide humane care for the enduring numbers of people contained in similar settings.

Design/methodology/approach

An analysis of the use of general management and managerialism through commissioning, rather than a focus on pro-active self-leadership within professional practice or through collaborative, collegiate or distributed leadership has arguably been responsible for the lack of progress.

Findings

The emphasis on direction and action by government ministers, quangos, and managers across the NHS and local government has ignored and stifled the potential for initiative and self-leadership by professionals. This is notable for social work, aggravated by the absence of an engaged professional body for social workers.

Originality/value

This case study addresses the limitations of leadership approaches which focus on policy direction, general management, managerialist and commissioning approaches to the reform and delivery, contrasted with the potential of professionals self-leadership by practitioners.

Details

International Journal of Public Leadership, vol. 12 no. 1
Type: Research Article
ISSN: 2056-4929

Keywords

Article
Publication date: 5 May 2015

Yim Lun Wong, Rinzi Bhutia, Khalodoun Tayar and Ashok Roy

The purpose of this paper is to examine the trend of admissions and inpatient characteristics in a NHS intellectual disability hospital from 1975 to 2013, in particular looking at…

Abstract

Purpose

The purpose of this paper is to examine the trend of admissions and inpatient characteristics in a NHS intellectual disability hospital from 1975 to 2013, in particular looking at the effect following the Winterbourne View scandal.

Design/methodology/approach

A retrospective review of all admissions over a three-year period (January 2011-January 2013) was completed. This information was compared with admissions to the same hospital in three-year period over the last four decades (1975-1977, 1985-1987, 1995-1997, and 2003-2006). Number of admissions, gender, age, source of admission, length of stay, reasons for admission, type of admission, and diagnosis of psychiatric illnesses were included.

Findings

There were 87 admissions (including 29 from out of area) in the study period of 2011-2013. The number of admissions had varied over the years but male admissions were consistently higher than female. A majority of people stayed over six months. For the first time in five decades, there were more formal inpatients than informal ones. The diagnosis of Autism Spectrum Disorder (ASD) and of Attention Deficit Hyperactivity Disorder had increased.

Originality/value

This study has examined admission trends over five decades. It has highlighted that the Mental Health Act legislation is being used more frequently and that co-morbid mental disorders, such as ASD are commonly associated with those admitted to hospital. A well planned-out community health care system, as well as adequate social provision are keys to maintain people with intellectual disability in the community. Furthermore, a better understanding of the symptomology of challenging behaviours, and appropriate use of mental health legislation are crucial in providing a high-quality service that has clear treatment goals and values. Some of these issues have contributed to the failure of the recent initiative to reduce the size of the inpatient intellectual disability following Winterbourne View scandal.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 2 November 2015

Elizabeth Marlow and Nina Walker

The purpose of this paper is to look at whether a move to a supported living model of care from traditional residential group homes could improve the quality of life for those…

Abstract

Purpose

The purpose of this paper is to look at whether a move to a supported living model of care from traditional residential group homes could improve the quality of life for those with a severe intellectual disability and other challenging needs.

Design/methodology/approach

Six men with severe intellectual disabilities moved from two residential homes into new-build individual flats. Their quality of life was measured using a battery of assessments looking at; environment, relationships, community participation, interactions, mood interest and pleasure, activities, physical health and challenging behaviour. These measures were taken before the move, immediately after and six months after the move. The views of staff and family carers were also assessed at each stage.

Findings

The move had a positive effect on the tenants in that it caused an improvement in their mood and a decrease in their challenging behaviours. Further improvements could be made in the tenant’s quality of life by introducing more activities. The initial concerns of family members about the move decreased over time. However staff found the changes to their working practices stressful.

Research limitations/implications

The study was a small scale one because of the small number of tenants. The tenants were unable to express their own views because of their limited communication abilities so a combination of direct observation and indirect measures were used.

Practical implications

In the light of the Winterbourne view report by Stephen Bubb this study looks at the impact on quality of life of a move to supported living for a group of people with complex and challenging needs who might otherwise be placed in an out of borough placement similar to Winterbourne view.

Social implications

The study also looks at the impact of such a move on the family members of the individuals and on the staff who had to change their working practices to adapt to both a new working environment and model of care.

Originality/value

This study also looks at the impact of a model of supported living for people with severe intellectual disabilities and complex needs rather than those with mild intellectual disabilities. This is particularly important in the post Winterbourne view climate when the authors need to look carefully at positive alternative models of care for these individuals.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 6
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 8 April 2014

Joe Hanley and David Marsland

The purpose of this paper is to explore the importance and nature of relationships of trust in care settings. The paper addresses the central question of what is it about these…

Abstract

Purpose

The purpose of this paper is to explore the importance and nature of relationships of trust in care settings. The paper addresses the central question of what is it about these kinds of relationships that is associated with harm and abuse?

Design/methodology/approach

The paper takes a discursive approach, based, implicitly, on an ecological framework of analysis.

Findings

The conclusion is that the relationships between staff and service users in residential care settings are characterised by non-mutual dependency, isolation and unequal decision-making powers. Therefore such relationships deserve special focus and attention in order to safeguard and protect the people concerned.

Practical implications

The paper implies that practitioners and policy makers should find ways to ensure that they listen more closely to people living in residential settings. Practitioners should ask more about the quality of relationships that people enjoy with the staff that support them.

Originality/value

The paper suggests that in order to safeguard people more effectively, practitioners and policy makers should reconsider the central focus of their energies and revisit issues such as isolation, in the lives of disabled and older people living in residential care.

Details

The Journal of Adult Protection, vol. 16 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 5 March 2014

Sophie Corlett

The Policy Watch series reflects on recent and forthcoming developments in mental health policy across the UK. The purpose of this paper is to review recent developments in mental…

223

Abstract

Purpose

The Policy Watch series reflects on recent and forthcoming developments in mental health policy across the UK. The purpose of this paper is to review recent developments in mental health policy, specifically the implications and learning for mental health services of recent scandals such as Mid Staffordshire and Winterbourne View and the various responses to them.

Design/methodology/approach

This paper reviews and summarises recent developments in national mental health policy in England and their implications for mental health service provision.

Findings

The paper outlines how learning from recent scandals such as Mid Staffordshire and Winterbourne View can be applied in mental health services.

Originality/value

The paper updates and discusses recent policy developments in the NHS and their implications for mental health services.

Details

Mental Health and Social Inclusion, vol. 18 no. 1
Type: Research Article
ISSN: 2042-8308

Keywords

Article
Publication date: 2 July 2014

Gyles Glover, Ian Brown and Chris Hatton

Two censuses, from 2010 and 2013, respectively, shed light on the trend in use of in-patient psychiatric care for people with learning disability or autism following the BBC…

712

Abstract

Purpose

Two censuses, from 2010 and 2013, respectively, shed light on the trend in use of in-patient psychiatric care for people with learning disability or autism following the BBC documentary exposing abuse of patients at Winterbourne View. The purpose of this paper is to consider the implications of the detailed trends for future care for this group.

Design/methodology/approach

Published data from a recent (September 2013) census are compared with the re-analysis of a census undertaken by the Care Quality Commission in March 2010.

Findings

An overall 35 per cent reduction in numbers of in-patients is made up of larger falls in groups generally easier to discharge (older, female, in general as opposed to secure units). There is also substantial variation around the country.

Research limitations/implications

There are some uncertainties about the comparability of the two censuses and the question of how complete enumeration was of people with learning disabilities in general mental illness beds.

Originality/value

The paper raise the question of whether the beds that are reducing fastest may be those most likely to be of value to a high quality and sustainable service in the long term.

Details

Tizard Learning Disability Review, vol. 19 no. 3
Type: Research Article
ISSN: 1359-5474

Keywords

1 – 10 of 282