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-
- 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.
- 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.
- 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.
- 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.
- 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.