Early support vital to avert care home abuse

Undercover footage of abuse perpetrated at Winterbourne View care home shocked the nation last year. Residents with learning disabilities, including an 18-year-old girl, were filmed being taunted, assaulted and subjected to violent restraint by support workers.

The government ordered a review into support for vulnerable people with learning disabilities in the wake of the case, the interim report of which has now been published.

But campaigners and children’s charities are warning that too little is being done to support children with learning disabilities to address any behavioural problems before they make the transition to adulthood.

Christine Lenehan, director of the Council for Disabled Children, says children’s services must consider what Winterbourne View means for disabled children who display behaviour that families find difficult to manage.

“The adults who went into Winterbourne View didn’t suddenly develop those behaviours or needs for that sort of level of service when they were 18,” she explains. “It came primarily from childhood. Children’s services have a need to identify challenging behaviour and look at how to manage that as early as possible.”

One of the big issues, Lenehan says, is that children fall through the gaps between services and miss out on necessary support.

“We’ve got real issues around children who need both learning disability and child and adolescent mental health services (CAMHS),” she says. “They often get stuck between the two. The learning disability services don’t have mental health and behaviour expertise, and the CAMHS services say that the children’s IQ is too low for them to work with, because they don’t have a programme that operates at that level. Children’s services must play a role in improving support and developing joint working.”

Early intervention
Lenehan argues that early intervention can prevent problems escalating, but says families who are worried about their children’s behaviour and seek support are too often told that “it’s not yet bad enough” to merit extra help.

“The default position is that if behaviour doesn’t improve, then children are sent away to residential special schools,” she says. “We want residential special schools to be a placement of choice, not a placement of last resort. That’s not a negative comment on schools – but we don’t want children going there at crisis point, with no real plan for their future or support to help them get control of their behaviour.”

Vivien Cooper is chief executive and founder of the Challenging Behaviour Foundation, which produced a report into abuse at care homes in partnership with Mencap. Both charities want to see a phased reduction in the number of out-of-area residential school and college placements for children and young people with learning disabilities.

She argues that the Department of Health’s (DH) interim report pays too little attention to supporting children and young people to prevent them ending up in homes such as Winterbourne View.

Cooper believes that no children’s service, be it health, education, or social care, should be allowed to tell families that they are not commissioned to see children with disabilities.

“All children’s services must ensure they can access the necessary expertise to assess and support children presenting with challenging behaviour and their families,” she says. “At times, this will mean that highly specialist services need to be approached in order to support local provision.”

Such support is vital to stop challenging behaviour in childhood from getting out of hand and reduce the use of restraint, she says.

“There is a lack of clarity around training requirements for staff supporting children and young people with learning disabilities and behaviour described as challenging,” she says. “Statutory requirements need to be introduced.”

Beverley Dawkins, Mencap’s national manager for profound and multiple learning disabilities, says children’s services must recognise that people’s journey to institutions like Winterbourne View often starts in childhood.

“When services don’t provide the right support, families often have to face the heartbreaking fact that they can no longer support that person safely in the family home,” she says. “Once far from home, they are then more likely to remain so, once they move into adult services. Families can continue to be told there is nothing suitable for them locally.

“This must change. The DH final report on Winterbourne View must put a strong action plan in place so that children with a learning disability and behaviour that challenges get the support they need, and stop ending up in units like Winterbourne View, where they are particularly at risk of neglect and abuse.”

Winterbourne view