06 | September | 2013

There I was. Reflecting on grief, music and summer. When a mate bounced the CQC Review of Learning Disability Services into my inbox. The core gist cut and pasted below in italics.

About the inspections This review focused on services that provide care for people with learning disabilities and challenging behaviours. Our inspectors carried out 150 unannounced inspections that looked at two national standards. These standards related to:

care and welfare.
safeguarding (protecting people’s health and wellbeing, and enabling them to live free from harm).

The inspections took place at 71 NHS Trusts, 47 private services and 32 care homes. Our inspectors were supported by 51 professional advisors and 53 Experts by experience (people who receive care or carers).

Our findings

Five of the 150 inspections were pilots and were not included in the overall analysis. Therefore, of 145 inspections:

35 met both standards.
41 met both standards with minor concerns.
69 failed to meet one or both standards.

Many failings are a direct result of care that is not centred on the individual or tailored to their needs. Our findings show that some assessment and treatment services are admitting people for long spells of time, and discharge arrangements are taking too long to arrange. Commissioners now need to review the care plans for people receiving this type of care so that people can move on to community-based services.

Almost 50 per cent of hospitals and care homes that were inspected did not meet national standards.
Staff needed to be given appropriate training in restraint techniques.
Safeguarding concerns were identified in 27 care services.

Follow up inspections

Our inspectors have returned to 34 services where we found most serious concerns. These services have provided us with action plans on how they will meet national standards. We have also followed up on all 27 concerns relating to people’s safety and have confirmed that these services have contacted their safeguarding team in their local authority.

Deep breath.

Please read (and re-read) the above carefully. And then take another deep breath.

How can such damning statistics, reporting on the lives of people, be so carelessly presented and, at the same time, dismissed?

35/145 services were doing what they should be doing. Eh? Less than 25%. People ‘accessing’ these services are those who typically need looking out for, care, encouragement and, often (don’t shudder), protection. Society incorporates (or should incorporate) a diverse range of people with different abilities, capacities and capabilities but state organised services are failing to provide ‘good enough’ support in 75% services reviewed?

The CQC state that ‘Commissioners now need to review care plans for people’ so they can move on to effective services’. Wow. Can there be a greater exercise in blandness? Ineffectiveness?

Did you get that commissioners? You all busy at it? Reviewing these care plans?

As if.

What a load of billy bullshit. Learning disabled people are so off the radar when it comes to commissioners I don’t suppose many of them would have any idea this review exists. Total farce.

But from the CQC perspective, the ball has been chucked elsewhere. Into next door’s garden. Never to be retrieved. Doesn’t matter really. Because it doesn’t really matter. These are learning disabled people we’re talking about.

More damning statistics before the close of the statement; 50% of hospitals didn’t meet national standards, restraining training is lacking (sob) and 27 services had safeguarding issues.

Then the last bit that I’ve re-cut and pasted below. It’s such a masterpiece in billy bullshit and prevarication it deserves a second reading and highlighting:

Our inspectors have returned to 34 services where we found most serious concerns. [Eh? Not all 69? How was this whittled down? Geographical location of inspectors? Availability of inspectors? What was the criteria?]

These services have provided us with action plans on how they will meet national standards. [Er, what does this mean in practice? Is it going to be followed up? Are the action plans appropriate? How soon will these services be of an acceptable quality for the people receiving them?]

We have also followed up on all 27 concerns relating to people’s safety and have confirmed that these services have contacted their safeguarding team in their local authority. [~~Mmm. That’s a relief then~~. Are the safeguarding team any good? Is anyone going to check on what they do? Is there a timescale attached to this?]

People are ‘living’ in these settings. On the receiving end of the sub-standard practices identified (over and over again). Practices that no one with any power to effect change is going to do anything about. Harrowing. My heart is broken by what happened to LB in one of these hellholes. I can’t bear to think of those who are enduring similar treatment and misery, at the hands of a care-less system. Monitored by a gutless organisation with seemingly no power to effect any change.

I can’t understand how we can be in 2013 and this unacceptable practice continues. Nonsense reviews published, publicly, without outrage.

Surely someone is going to do something to stop it?

During hours spent outside, or awake at night, I’ve been listening to music. Trying to find music that fits. Ironically, in the early days of LB’s ‘diagnosis’, when he was a just a pup, Faure’s Requiem was the soundtrack to my sadness. This shifted substantially over time and I can no longer listen to it. It didn’t fit. I was wrong. So much was wrong. LB wasn’t. And we certainly weren’t mourning him. Then*.

The weather’s been so unusual it’s created an almost film-like backdrop to our devastation. Consistently baking sunshine transforming mundane suburbia into a different world. I remark on this remarkable summer constantly. To pretty much everyone I talk to. It’s important that the sun has shone so unusually since LB died. It’s a summer that will be remembered. And the sunshine theme, with the ‘do’ soundtrack of summer songs, the late evenings sitting outside, the sunflowers, both shop bought and planted in our tatty garden, has a positive feel to it.

The day of the ‘do’.

So. Where am I at with the sounds? Anthony and the Johnsons were a stalwart companion for the first couple of weeks. Capturing the sadness exquisitely. But then they became a tiny bit annoying. And irrelevant. I listen to ‘Toast‘ by Tori Amos. Written in memory of her brother who died. And ‘Coral Room‘ by Kate Bush. About the loss of a mother. But ‘This Summer’ is creeping in as an unexpected frontrunner. A song I used to listen to on my commute home from Royal Holloway where I led five seminars every Friday on a contemporary social theory module. A regularly fraught experience of scrabbling to understand and make sense of the favourite theorists of the course leader (a white male-centric bunch) probably inches ahead of the students.

I’d sit on the train from Reading to Oxford, early evening, frazzled by the full on intensity of the day and the speed reading that built up to it. And I’d listen to this song. It was sad, calming and peaceful. A kind of vicarious insight into loss experienced by others. Always others.

Until a moment, a split second, one sunny early July morning, when I became ‘one of the broken hearted’. Without warning.