A commissioning tale

I re-read the FOI docs from Oxon County Council (OCC) at the weekend. What they demonstrate is so depressing I thought I’d write a bit about them with the hope that other local authorities/commissioners might look at their own responses (and their staff responses) to learning disability type issues in their work and think differently.

The unit LB was in (STATT) was jointly commissioned by OCC and the Oxon Clinical Commissioning Group. OCC were in charge of reviewing the quality at the unit. What still astonishes me is that, after LB died, there was no immediate flocking to STATT to check the quality of the provision. In fact, an updated quality control review conducted in May 2013 was being circulated on July 22, just over two weeks after LB died:

OCC response

Clearly no concerns whatsoever about the quality of provision at the unit. And LB?


At this stage of course, Sloven had decided he’d died of, er, natural causes, so everyone could carry on with business as usual. Learning disability trumping every other part of a quirky, gentle, humorous, young dude. To such an extent that no one in Sloven, OCC or OCCG seemed to say “Eh? 18 years old? In the bath? Something is clearly wrong here.

Rich and I have often thought how, if LB hadn’t died, the provision at STATT could have continued indefinitely but really it wasn’t his death that put a stop to it. It was the CQC pitching up two months later. They failed the unit on everything and published an inspection report that makes the back of my hands prickle, it is so damning. It documented a place that had long lost any whiff of care. A space empty of any meaningful interaction, any therapeutic engagement, dirty, unsafe, empty and toxic.

A shocking, shameful uncovering.

So how did OCC towers respond to this? They’d allowed a group of people to ‘live’ in such a terrible environment even after a young person died? At a cost of £3500 per week each. (Around £112,000 in the time between LB dying and the inspectors arriving). The response seems to be a mix of fear, defensiveness and bravado. And statements that reveal the inhumanity with which learning disabled people are both treated and perceived.

cqcAgain, an astonishing response. On so many levels. But no one challenged it. Despite the blinking, bleeding obvious awfulness of it…


Perhaps an essential ingredient for culture change is a more critical engagement with how applicants perceive learning disabled people at a recruitment/promotion level. Involving learning disabled people and families in the process. Having the wrong people in the wrong jobs clearly allows crap ‘care’ to continue. And, at worst, actively contributes to it.

5 thoughts on “A commissioning tale

  1. Well thry are not going to flock to check the quality of the provision if it means they have to do some real work are they? Life is so much easier in Commissioning Cloud Cuckoo Land.

  2. One does wonder what kind of “rigorous action” they had in mind. Suspect it wouldn’t be anything very sensitive, as not getting caught out seems a higher priority than, you know, actually caring about the people they were supposed to be looking after. Looking after people who need and deserve a high level of care can be challenging, of course. Isn;t being able to accept that and have systems that work kind of the point?

    The notion that a clinical team would notice things that a social care team wouldn’t blink at it a bit extraordinary as well, but probably accurate. Beyond depressing, but accurate. Is there no way these people can bring themselves to say: “This isn’t good enough” and hang their heads in shame?

  3. Prior to cost cutting removal of ‘back office’ admin, band 1 or 2 admin kept records of equipment with dates for checking and replacing. Not official, just a notebook that lasted decades.
    I don’t think management knew half of the systems we had to keep things running safely.
    It has been 15 months since I was dismissed due to ill health by southern health.
    I worked in a different location.
    I still have the expiry dates of fire extinguishers, plasters, etc in my memory!
    Not in my job description, but I was trained in the 90s by ‘old school’ admin who saw role to ensure all items safe and working so that patients and staff can do their thing uninterrupted.

  4. Everytime I highlight crap care, I’m always thrown the ‘well the aren’t paid much’ ball, and if it ain’t written in the care plan, then forget! There should be a common sense clause somewhere.

  5. In 2012/13 Surrey Commissioning asked for a breakdown of how the £2,400 a week fee was spent on Martin’s care. Surrey informed me they had received a breakdown, which I never saw. I never heard about this again, and in the spring of 2013 the Care Manager stopped contact with me due to operational pressures (Gloria Foster was abandoned by SS and not visited for 9 days – she eventually died). Now commissioning has disappeared totally – no way could they be accountable. No way will they read your blog. Depressing it is, and what about the House of Lords select committee’s latest report – nothing at all has been done to change anything. Martin has been in a residential care home for nearly seven years illegally, at a cost of £124000 a year.

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