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.