Inspectors warn NHS trust over failures in services for disabled people

23 March 2007

The Commission for Social Care Inspection has warned an NHS Trust that it must dramatically improve standards in the care homes it runs for people with learning disabilities, or face the possibility of prosecution.

Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust (BLPT) operates 19 care homes and a home care agency.

Among the failings found by CSCI during recent inspections of the Trust’s services were:

• a lack of clear guidelines on managing residents’ behaviour, together with inappropriate methods of control and restraint;
• poor management of aggression by some residents against other residents and staff;
• concerns about the Trust’s policy on reporting incidents under the protection of vulnerable adults (POVA) procedures;
• examples of restrictions placed on all the residents of a service because of the behaviour of one person – for example, the kitchen kept locked and the room lights controlled centrally by staff;
• residents’ needs are not properly or regularly reviewed, and there is little evidence of person-centred planning;
• a lack of specialist help and support for people who use services;
• new staff appointments are not always subject to the necessary checks;
• staff lack relevant training;
• a lack of social and recreational opportunities for residents;
• the poor physical condition of some of the homes;
• a lack of clear service contracts for residents and poor management of their personal finances;
• poor admission and discharge procedures.
• It has also been established that an assessment and treatment unit run by the Trust, where personal care is provided, needs to be registered with CSCI as a care home. An application to do so has been submitted and is being processed.

As a result of the pressure put on BLPT by CSCI to improve its poor standards of care, the Trust announced last month that responsibility for its services is to be handed over to other social care providers.

Mike Rourke, CSCI’s Director of Inspection, Regulation and Review, said: "By the Trust’s own estimate, it could take two years or more to implement fully the transfer of responsibilities to other providers.

"We are determined that everything possible must be done to ensure the safety and welfare of the residents while that process takes place.

"We will continue to carry out frequent inspections and visits and closely monitor the Trust’s progress on its action plan.

"We will also use our enforcement powers, which include prosecution if it should be necessary."

CSCI says that standards in nearly all the care homes run by the Trust fall well short of meeting the Care Homes Regulations 2001 and the national minimum standards.

"The supported living service also fails badly to meet the domiciliary care regulations and standards.

Mike Rourke said: "Clearly this is unacceptable. "

We are talking about people with learning disabilities who deserve much better from those who are charged with providing them with care.

"We have been meeting regularly with senior managers at the Trust and have done our utmost to help them raise standards in their services.

"There have been some improvements, but we need to see dramatic change to the standards of care at these homes.”

In July last year, CSCI called a meeting with representatives of the East of England Strategic Health Authority, Bedfordshire County Council and the joint commissioning team of the local Primary Care Trusts to discuss its concerns about BLPT.

Following this, CSCI formed a dedicated team to increase the level of scrutiny of all the Trust’s services.

Inspectors will continue to monitor closely the performance of the Trust in meeting standards at their homes.

Ends

Notes to editors

1. Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust registered its services with CSCI in 2003. Social care services provided by NHS organisations were exempt from registration until the Care Standards Act 2000 came into force in 2002. A further, transitional, period of one year was allowed for NHS services to be registered.

2. CSCI is the single inspectorate for social care in England, responsible for regulating and inspecting all social care providers, whether in the public or independent sector, and for assessing the performance of local councils in delivering their personal social services functions.

3. The Commission’s primary aim is to improve social care by putting the needs of people who use care services first.

4. The Commission is chaired by Dame Denise Platt DBE and has five Commissioners. The Chief Inspector is Paul Snell. CSCI staff work across nine regions in England - aligned with the government offices of the regions.