Lessons from Winterbourne hospital…

I have just watched last night’s Panorama programme on the i player.

The story is splashed across the news- a private hospital, run by Castlebeck (an organisation I know reasonably well) was visited by an undercover reporter, and in 5 weeks, abuse was captured on film that beggars belief.

Support workers behaving like a mob, led by a tattooed gang leader, using casual violence to whip up incidents to relieve boredom.

Vulnerable people treated like cattle. Punishment masquerading as restraint. Cold showers, dangerous physical restraint, a total lack of meaningful activities.

Anyone watching this who has not spent time in institutional care will wonder how on earth something like this could happen. Anyone who has will feel both sickened and yet unsurprised.

The culture of any institution can easily skew towards the darker sides of humanity- as demonstrated so notoriously by Zimbardo’s Stamford prison experiment. Some things will make this more likely-

  1. Poor leadership- in this case the senior nurses appeared passive, weak and complicit with the worst abuses, even if not active participants. Leadership in this case needs to set deliberate agendas of care and kindness- as well as deliberately placing the people cared for at the centre of everything that happens.
  2. Poor recruitment/retention of staff- in this case, Castlebeck pay support workers paltry £16K a year, and I suspect had a very high turn over. Those that stayed became affected by the toxic culture. The best would not stay.
  3. Poor model of care- why on earth we still need places like this is beyond me. I have made some placements to other Castlebeck institutions- they are incredibly expensive (around £3000-£5000 a week) and are often a placement of last resort for people who we have no other way of keeping safe. When things get this far it simply means that we have failed. Castlebeck and other organisations like them are care factories, with profit margins carefully squeezed. They have high sounding mission statements, but little incentive to invest in real change for people they care for.
  4. Poor alternatives- the cost of care is so high, and every where local authorities are being forced to cut budgets. Because of this, community based options are hard to find, harder to finance and tend to be oversubscribed. So we are forced to consider Castlebeck- often because other options have failed, and we have no choices left.
  5. Poor regulation- I have seen inspection reports and care commission reports describing in glowing terms establishments I would not send a dog to. Reports that focus on trivial matters such as the condition of curtains rather than the more difficult to measure atmosphere of warmth and cheerfulness that the best places exude. In Scotland, the care commission has been reduced- in size and effectiveness.
I have had my own experience of working in toxic situations. They are not so uncommon really- for all of the above reasons. Here are two examples-
My first job was in a Childrens Home in Nottinghamshire- since demolished. It was a violent, scary place- with riots, abuse and physical restraint commonplace. The Officer in Charge was a powerful woman who ruled the place (staff and residents) with her fists. I was 21 years old, fresh from studies and had no idea what I was letting myself in for. I vividly remember carrying a screaming, biting swearing scratching 10 year old boy to his bedroom in an attempt to calm him down, and throwing him onto his bed. He was not hurt in any way (whilst I was covered in scratches and bruises) but I was mortified at my lack of control, and how acceptable such things could become in environments like this. It was time to get out- which I did as soon as possible. I was very relieved when the home closed shortly after I left.
Fast forward a couple of decades, and I am now a social work manager, visiting a resources allocation meeting in another area in order to try to gain access to some funds for a service user we are working with. The room was full of about 7 other people- senior member of health and social work, who have the responsibility for making decisions about how to allocate funds. The atmosphere was sneering, cynical and disrespectful of ever person discussed- each of whom appeared to be regarded as a scrounger who was trying to pull a fast one. I was so appalled that I raised the issue with my line manager in supervision- a mistake as it turned out, as he ignored the supposed confidentiality of this discussion and used it to fight his own political battles, leaving me to deal with the damage to professional relationships. And nothing was changed.
When we are paid to care for other people, we can easily lose sight of the fact that people are beloved, beautiful and made in the image of God. It becomes hard to hold on to our values and our passion.
It becomes hard to remember that the greatest we can aspire to is to love. Particularly in the drudgery of it all. But without this, we are lost.
Perhaps the greatest problem with Winterbourne and places like it, is the fact that wider society places such little value on the care that is provided, and on the individuals it is provided to.
So- well done BBC. May this bring about some real changes.

5 thoughts on “Lessons from Winterbourne hospital…

  1. The last few sentances I’ve made in to a poster, as I feel I may need when I become disillusioned with the care system, to help me try and remember why we do it, and that each individual counts.

  2. Watching this made me think about how thin the line is between good and evil, and of what Solzhenitsyn said: “the line separating good and evil passes not through states, nor between classes, nor between political parties either, but right through every human heart, and through all human hearts. This line shifts. Inside us, it oscillates with the years. Even within hearts overwhlemed by evil, one small bridgehead of good is retained; and even in the best of all hearts, there remains a small corner of evil.”

  3. Excellent article. Everything thst is wrong with society is personified here. How could we ever trust out loved ones to such a environment but what if there is no choice? A tragic situation.

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