Excessive, illegal physical restraint plus the overuse of medication were part of the institutional abuse committed by Cornwall NHS Trust staff against learning disabled people, according to a damning report.
Because of an abusive culture, hospital and care staff were adverse to the input of “outsiders”, such as clinical psychologists, said Healthcare Commission inspectors in a report on the trust’s learning disability services.
The report, co-written by the Commission for Social Care Inspection, followed a 12 month investigation last year into a the trust’s Budock Hospital near Falmouth (a treatment centre for 18 inpatients), two other treatment centres, four children’s units and 46 supported houses each with up to four learning disabled residents.
The report stated that Budock Hospital staff “were extensively trained in the use of restraint, but had little other training.”
“Staff tended to stand around, talking to each other, waiting to react to the actions of those on the ward,” read the report.
One patient spent 16 hours a day tied to a bed or wheelchair for what staff believed was for that person’s protection.
Inspectors also said that “pro re nata” (PRN) medication – which should only be prescribed occasionally when controlling epilepsy or challenging behaviour – was often given to a person who was “not sleeping” or “wouldn’t settle”.
Once a patient was given PRN medication because he was impatient for his dinner and became distressed.
The report, which examined statements stretching back to 2001, describes years of abusive practices at the trust and the failure of senior trust executives to tackle it despite several internal inquiries.
Physical abuse and misuse of people’s money was also common.
Investigators found evidence of staff hitting, pushing, and dragging patients.
Some staff were also reported to have withheld food and given people cold showers.
Since the investigation, sparked by relatives of the abused learning disabled people, Cornwall Partnership NHS Trust has sacked staff. One ward at Budock has also now closed and action has been taken across the trust to address the unacceptable levels of physical restraint.
The report has recommended that the trust’s services for learning disabled people be “redesigned” by local health and social care organisations, taking into account the needs of every learning disability service user.
The new chief executive of Cornwall Partnership NHS Trust has apologised to service users and carers.
Lezli Boswell, who started her role in May this year, said the trust’s failings are “shocking and shameful”.
“There are no excuses,” she added.
“The trust fully accepts the recommendations in the report and we are determined to work together with partners to quickly and effectively address problems raised and to implement all its recommendations. To this end a detailed action plan will be developed to respond to the recommendations.”
Ms Boswell has apologised in writing to learning disabled patients and their carers.
A police investigation has been launched into the abuse.
Christine Braithwaite was part of the investigation team for the Healthcare Commission. In an interview with the Western Morning News newspaper she said it was the worst abuse and lowest standard of care she had seen.
“The conditions we found were totally shocking and all of us were very upset by some of the things we discovered,” she said.
“It was clear there had been abuse and some people had suffered real harm as a result. Investigators who have worked up and down the country said it was the worst they had ever seen.”
Ms Braithwaite singled out Budock Hospital as one of the worst examples.
“When we first arrived, there were no staff on duty. They were all in the garden smoking,” she said.
“The environment was totally stark – there weren’t even curtains in the rooms and mattresses were bare, with just a plastic cover.
“There was nothing for people to do to the extent that the activities cupboard had one Beano annual in it.”