The CQC inspection of the unit where LB died is published this morning.
It’s damning. It’s devastatingly heartbreaking. For so many reasons.
It’s also unbelievable.
A bit of context… It’s 2013. Yes. Two thousand and thirteen. 2013. Post Winterbourne, post Francis. Post whatever. (And the Trust Board glibly minuted back in July that LB died of natural causes in a unit where everything was hunky dory.)
LB died. He drowned. Uncared for. Unsupervised. In a bathroom close to the staff office (where we now know staff hung out, filling in endless forms). In an NHS setting clearly permeated with a dangerous culture. Poorly managed, poorly trained staff. (But plenty of em). A culture of indifference. Disregard. Carelessness. Process stamping out common sense/thought. Not even the most basic level of care provided.
A toxic mix largely ignored (but not unknown about) by the Trust, by the Clinical Commissioning Group, by the Local Authority. And one that would probably have continued if LB hadn’t died.
What a fucking mess.
A unit where most staff didn’t (couldn’t?) interact with patients at a human level. Patients (all four or five of them) left to fester, be fearful, bewildered, bored, unhappy and unoccupied. We already knew from our experience there was nothing approaching happiness in this unit. But we had no idea how poor it was. No different to Winterbourne View really. Just a different type of abuse. This time under the watch of the NHS. With a worse end game. A patient actually died.
How could this be possible?
LB should never have drowned. We all know that. People know that who know next to nothing about epilepsy. It ain’t rocket science. No one should drown in a bath in hospital. Chuck epilepsy into the mix and it’s beyond comprehension. He was 18. A young dude. He’d never lived away from home. And didn’t want to. But he was, through a complete lack of support in the community, pitched into this space. This foul, stinking, failing space.
That he spent 107 days in this hellhole with minimal interaction from staff before dying on his own in the bathroom is something we are left to live with. A constant pain that is indescribable. There ain’t no turning the clock back. He’s dead. End of. A life over. A life completely and carelessly wasted.
But there should be some accountability. For so many reasons. Not least the smashing up of so many lives. His, ours, and others.
And we really need to ask how it is possible that learning disabled people continue to be treated so poorly?
Shameful. Completely shameful.
mydaftlife 
Heartbreaking. I’m so, so sorry.
CNUTS .
Love to you Sara
X
Big hug to you Sara…and dead right of course, there should be accountability Wendyxx
I am so sorry for your loss x
This is utterly, utterly shocking, Sara. I do hope that, now the CQC report is out, local and national media will put really searching questions to both the Trust and the Clinical Commissioning Group over the gross – indeed inhuman – mismanagement revealed of this unit and the right action will finally be taken.
I am so sorry for your trouble,
Paddy
I have been following your journey and I am so sorry for your loss but also the ultimate betrayal of your son moving somewhere where he should have experienced care ending in his avoidable death. I am so sorry that as a family you are not only experiencing your grief but are also having to fight to get to the truth. My heart goes out to you all and I really hope that this case will be picked up by the national media to bring to light how the most vulnerable members of our society are being let own.
Bethan
Wow. Post-Winterbourne, this is beyond my worst imaginings. Presumably there will be publicity at local and national level – not that that will help you, or bring LB back – but people ought to know.
…… because no one carers – they don’t see our kids as individuals but as a label of their disability……. it is abhorrent….. Solidarity
I searched for the report and as I read I really hoped it was the wrong one…then of course I realised it was the unit LB had a bath in;
“We asked about bathing and observation routines of those who may have an epileptic fit
on the unit. We heard from two nurses that these had recently changed. The senior nurse
in charge of the unit described that people with epilepsy were now “routinely observed
discreetly” whilst bathing. This had been an organisational response put into place after a
death on the unit this summer.” p12
Throughout the report, the inspectors comment upon the attitude of staff – anyone with a modicum of intelligence knows that when being observed, you are on your best behaviour yet the *nursing staff* (CQC descriptor) are a disgrace to the profession.
The CQC Report contains harrowing reading, more so when read in the knowledge that this is where LB died.
I’m so sorry for your devastating loss. xx
Words fail me. I am so, so sorry.
Are they going to do a serious case review?
Sorry for your loss.
I knew your Son and he infected me with his laugh. I worked there and seriously there were some staff that did care.
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