Winterbourne View scandal and government response

On 31 May 2011, a BBC Panorama programme exposed serious failings and abuse of people with learning disabilities and autism at the Winterbourne View care home. Owned by Castlebeck Care Ltd, Winterbourne View was an independent sector hospital that took NHS-funded patients.

While the majority of patients’ places had been ‘purchased’ by NHS organisations (as opposed to local authorities), the events at Winterbourne View were of significant relevance to the social care sector.

The Care Quality Commission (CQC) carried out a review of Winterbourne View in June 2011. The CQC found serious concerns about the quality of services and took enforcement action to close the hospital. The regulator then inspected 150 services as part of a focused programme to review care provided by similar hospitals and care homes for people with learning disabilities.

Interim government report

The government set up a departmental review of Winterbourne View in the aftermath of the scandal and published an interim report in June 2012. The interim report was unable to comment specifically on the scandal due to the ongoing legal proceedings.

The report focused on wider issues relating to the care system and the quality of care for people with learning disabilities and autism in hospital services for assessment and treatment.

The interim report concluded that:

• too many people had been placed in inpatient services for assessment and treatment and had stayed there for too long
• there was evidence of poor quality of care and care planning and an over-reliance on restraint techniques.

In the report, Minister of State for Care Services Paul Burstow stated:
'There is compelling evidence that some people with learning disabilities and autism are being failed by health and care. Around the country there are excellent examples of personalised care, focused on supporting people in their community. But that excellence is not universal. There is insufficient focus on personalised care planning. And too often the care which people receive is poor quality. This is not good enough.'

Final government report

The Department of Health published Transforming care: A national response to Winterbourne View Hospital, the final report of its review into the Winterbourne View scandal, in December 2012. The response stated that the scandal had exposed the flaws in the wider system's ability to hold the leaders of care organisations to account.

Winterbourne View, along with the CQC's inspections of 150 care homes and hospitals, had highlighted that many people with learning disabilities or autism had been placed into residential care or hospitals, when they should not have been there or had been there for too long. The report also found that there had been widespread 'failure' in the commissioning, planning and delivery of services in the health and care system.

The report established the ‘Transforming Care’ programme of action to 'transform services for people with learning disabilities, autism, mental health problems, or behaviours described as challenging'. It set out the following actions:

• there would be a review of all current hospital placements for those with learning disabilities or autism by 1 June 2013. Those found to be inappropriately placed in hospital care would be moved to receive community-based support by no later than 1 June 2014
• each area was to have a locally agreed and joint plan to ensure the planning, commissioning and delivery of high quality services
• a joint improvement team led by the NHS and local government would be established to lead and support service transformation
• boards of directors and managers would have increased accountability for safety and quality of care
• the CQC would strengthen its inspections of hospitals and care homes
• the government would monitor and report on progress nationally.

As a result of these actions, it was anticipated that there would be a significant reduction in hospital placements for people with learning disabilities. However, it did not fulfil its promise to enable people to live in their own homes, where possible, by June 2014.