Nearly half of the 145 hospitals and care homes inspected nationwide by the Care Quality Commission (CQC) did not meet required standards in terms of care, welfare and whether people were safe from abuse, the report showed.
The unannounced inspections were carried out in the wake of abuse uncovered by the BBC's Panorama programme at Winterbourne View hospital near Bristol.
The undercover footage showed staff at the hospital appearing to taunt and abuse the vulnerable adults in their care.
But there was no evidence in this report that pointed to abuse on the scale uncovered at Winterbourne View hospital, CQC chairman Dame Jo Williams said.
There were "lessons to be learned" by care providers about the use of restraint and an "urgent need" to reduce the use of restraint. Staff should be trained to use more appropriate ways of restraining patients, the report said.
The inspections focused on examining the general care and welfare of people who used the services as well as whether people were safe from abuse.
Independent services were twice as likely (33% compliant) to fail to meet these standards as NHS providers (68% compliant).
The CQC also found that some assessment and treatment services admit patients to care for disproportionately long periods of time and discharge arrangements take too long to arrange.
Of the 145 locations inspected, 69 failed to meet one or both standards and 35 failed on both standards. There were minor concerns over the locations that met both standards and only 35 fully met both standards with no concerns, the CQC said.
The locations were made up of 68 NHS assessment, treatment and secure services, including two residential care homes, while 45 were independent assessment, treatment and secure services. There were also 32 residential care homes included in the report.
Dame Jo said: "People who use these services need care and support and they and their families need to be treated with care and respect.
"While our inspections found examples of good care, too often they found that services were not meeting the individual needs of people.
"Although many of the services we inspected were intended to be hospitals or places where people's needs were assessed, we found that some people were in these services for too long, with not enough being done to help them move on to appropriate community-based care.
"All too often, inspection teams found that people using services were at risk of being restrained inappropriately because staff often did not understand what actions count as restraint, and when restraint happened there was inadequate review of these putting people at risk of harm or abuse.
"While the findings published today highlight serious concerns about the nature of services for people with learning disabilities, we can offer some reassurance.
"There is no evidence that points to abuse on the scale which was uncovered at Winterbourne View Hospital.
"However, every single case of poor care that we have found tells a human story and there is plenty of room for improvement to help a group of people whose circumstances make them particularly vulnerable."
Patients and carers joined CQC inspectors and professional experts in producing the report.
Former learning disability services patient Laura Broughton described seeing bored and distressed patients who were not treated as individuals.
She said: "Some of the people I met could have more help in getting a better life. They were often bored and distressed and staff talked to them not as adults but as though they were children.
"Some of the people weren't treated as individuals and certainly not in a personal-centred way.
"I felt that some people didn't get the opportunities they could have because they couldn't speak or because others thought their behaviour was challenging."
Care staff not recognising seclusion as a means of restraint was one of the problems identified in the report.
Bernadette Hanney, the CQC's project lead in the review, said: "We found that people were being taken to their bedroom and shut in and basically not allowed out and staff weren't recognising that (was a form of restraint).
"If somebody's not recognised that what they are doing is secluding somebody then they are ultimately not going to put in safeguards either."
One person mentioned in the report has been kept in care services for 17 years, which is far too long, according to Ms Hanney.
She said: "We were quite surprised to find that some people's length of stay in these services ranged from the lowest we found was six weeks to the longest we found was 17 years, which is unacceptably long."
The problems found in the report were down to an "organisational culture" rather than individual members of staff, Ms Hanney said.
She said: "We didn't find individuals who were caring for people in an inappropriate manner.
"What we found was an organisational culture of care that had become normalised."
But some homes that were non-compliant with CQC standards were actually the best, according to family carer Julie Thorpe, who also contributed to the report as an expert.
She said: "From discussions with other carers we often found that homes that were non-compliant were the best from what we were looking for - the way we saw people being treated, the general loving, caring atmosphere.
"That's something that we talked about together - why do we feel that these non-compliant homes are the best?"
Dame Jo said: "All providers need to look at what we found, question themselves day in, day out about whether or not they are meeting the standards and really keeping people safe."
Dame Jo said a copy of the report has been sent to the NHS chief executive, Sir David Nicholson.
She said: "We believe it's really important that those new commissioning bodies, the clinical commissioning groups, really do pay special attention to people with a learning disability.
"They must not do it alone, they must do it with their partners, but we know that, unless they do pay special attention to this, it's all too easy for people with learning disabilities to be overlooked."
Care services minister Paul Burstow insisted problems in the sector were not caused by the removal of ring-fenced funding.
He told BBC Radio 4's World At One programme: "This is a problem that has been festering in our system for years, even when there was plenty of money.
"It's about how you use the resources available. There are commissioners up and down the country, NHS and social care, who are commissioning, with the resources available to them, excellent services.
"It's not about money in this case, it's about commissioners commissioning the right sort of services in the first place."
PA
Tidak ada komentar:
Posting Komentar