Review of care home details 'serious and sustained failings'

A PRIVATE hospital group in England owned by wealthy Irish investors including Denis Brosnan, JP McManus, Dermot Desmond and John Magnier has failed to “address corporate responsibility at the highest level” for the ill-treatment of patients, a major inquiry has concluded.

Eleven staff at the now-closed Winterbourne View hospital in Bristol, owned by Castlebeck Ltd, have pleaded guilty to ill-treating adults with autism and learning disabilities, with sentences to be handed down next month.

A serious case review into the conduct of Castlebeck, the National Health Service (NHS), Avon and Somerset Constabulary and the regulator of care homes, the Care Quality Commission, was ordered after the ill-treatment was revealed in a BBC Panorama investigation last year.

Secretly recorded film showed patients being held down, slapped, mocked and doused in water, while others were assaulted in showers or encouraged to throw themselves out of windows from the Bristol hospital.

“The abuse [there] resulted from serious and sustained failings in the management procedures of Castlebeck Ltd,” said Margaret Flynn, who produced the report for South Gloucestershire Safeguarding Adults Board.

“Castlebeck Ltd appears to have made decisions about profitability, including shareholder returns, over and above decisions about the effective and humane delivery of assessment, treatment and rehabilitation,” she said.

The 24-bed hospital charged the NHS £3,500-a-week on average to treat each patient, but this was “no guarantee of patient safety or service quality” for “uniquely disadvantaged” individuals. Castlebeck had made “ungrounded claims” about what could be provided and about the expertise of its Bristol staff and failed to disclose “the operational realities” at Winterbourne – their best performer in the group – to board members and shareholders, she said. “Although Castlebeck Ltd claimed high ideals, it has subsequently claimed little knowledge of events in Winterbourne. This plea is not compelling,” she said in a report that has led to demands that private care for such patients in Britain should be ended.

Castlebeck was bought in 2006 for £255 million by the Swiss-based Lydian Capital Partners, which was set up by Mr Brosnan as a private investment company after he stood down as chief executive of Kerry Group.

He was later joined by McManus, Desmond, Magnier and other wealthy Irish investors. The Bristol hospital was planned before they bought it, but did not open until after the purchase went through.

Following the BBC’s disclosures, recorded over five weeks, Castlebeck’s directors, including Brosnan’s son Paul, ordered an internal inquiry, changed management and closed three hospitals including Winterbourne.

Criticising Castlebeck’s attitude since, however, Flynn said the company acknowledges there was “insufficient senior management oversight” from Castlebeck’s headquarters of Winterbourne’s operations.

However, the Castlebeck inquiry did not consider clinical governance, staffing rotas or the use of agency staff, the failure to respond properly to a whistleblower’s allegations or visits by police on 29 occasions to the hospital. Furthermore, the company has refused to detail to the Flynn inquiry how the £3,500 weekly fee per patient was spent: “The company declined to answer because of the ‘commercial sensitivity’ of such information,” she said.

Equally, the company declined to share a full copy of the report it commissioned from PricewaterhouseCoopers after the programme was aired, while a copy of a review of individual Winterbourne managers was redacted.

Meanwhile, the GP who provided services to Winterbourne was advised by the Medical Defence Union and the General Medical Council not to share any information about the care of patients with the review.

The doctor was advised that permission from the ex-patients had to be secured, but this “was not feasible” because they “had been significantly traumatised by events at the hospital and further contact was likely to be unduly distressing”.

Responding, Castlebeck said the ill-treatment meted out to the patients “were both wholly unacceptable and deeply distressing for all concerned and we are truly sorry this happened in one of our services”.

Significant changes have been made since, it said. “We believe we have responded in a way that demonstrates our resolve to ensure that the events of Winterbourne View will not be repeated.” Castlebeck said the 150 investigations carried into other private and NHS care homes in England have “found a real gap between policy and practice in learning disability services”.

“Serious doubt has been cast on the sector’s ability to provide the right care and support for people with learning disabilities, autism and behaviours that may be described as challenging.”

‘He gets so anxious, crying and shouting out in the streets’

PRIVATE HOSPITAL Winterbourne View may now be closed but the legacy of suffering lives on for those who were ill-treated within its walls.

One patient, known as Tom, left before the undercover filming took place for another hospital, where his condition had improved until he saw TV images of the abuse later.

Since then, his condition has deteriorated. “His hygiene has gone down because he’s got all anxious about going in the shower. He says, ‘That’s where they used to do it’,” his mother records.

“He says, ‘I told you, Mum, didn’t I? I told you this was happening’.

“And I said, ‘Yes, you did tell me what was going on. And I did try to talk to the manager’.” On one occasion, Tom left his hospital “and gone up the moors and burnt all the clothes he had in Winterbourne. He’s burnt them all, so he’s got rid of the memories,” his mother told the inquiry.

Tom is now “so distressed” that he has had to be sent to a secure mental unit because the residential home in which he lived after Winterbourne could not deal with him.

Frequently, he left the residential home to come to his mother’s or grandmother’s homes, “sometimes drenched through” in his dressing gown, where he would barricade himself into a room.

There, he would urinate into cups. “Tom told his family that a male staff member wouldn’t let him go for a wee, so he had to do it in his room,” the report says.

“He gets so anxious, crying and shouting out in the streets. He’s got himself in such a bad way that he’s been up to the top of the car park a few times, saying he didn’t want to be here any more,” his mother said.

Tom dreams about his abuser “all the time”, she added.

“He probably absconded to get away from him. His mind is not working as it should. The tension in him builds up and then explodes.”

Describing him as “a lovely and loving, caring man”, his mother said his main concern now is that the other former patients of Winterbourne “are all right”.