Category Archives: Oxfordshire County Council

Learned helplessness my arse

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The term ‘learned helplessness’ was new to me a few weeks ago. I still don’t know what it means. Other than a random excuse for the paucity of good care on offer at Slade House site (now known as chunkypoundland until the intricacies of potential land sales, profit taking and the like are laid bare).

The story of LB’s death and the subsequent damning CQC inspection (which Rich, barely containing his ire at the pre-Crimean levels of care identified regularly mutters ‘They found faeces on a chair?’) is documented in this blog. I recently acquired the quality review report that took place in November/December 2012. Four months before LB went into the unit. An internal inspection organised by the local authority/clinical commissioning group to make sure they were buying services fit for purpose.

It ain’t a pretty read.

What is astonishing is that the reviewer mentions clear concerns but didn’t mark them as actionable. And reader/s of the report obviously did nothing. The bar of what is acceptable is set so low I can’t help coming back to the ‘if this had been a dog home’ type thoughts. And they don’t see it. This isn’t learned helplessness, it’s ignorance. There’s no thought to what it must be like to experience living in the place. No reflection on the absolute powerlessness of the patients. Their ability to communicate hammered by medication dished out liberally, or crushed by brutality experienced at the hands of heavies in the name of ‘restraint’. And the possible/probable  distancing of families.

I know this blog is used in teaching health/social care students, but for those of you who have been working in this area for a long old time now, particularly if your job involves reading and responding to quality reviews (in a clean, warm, comfortable and safe environment, sitting cosily on a shedload of power/influence), here’s a quicky quiz to help you reflect on the level of your bar.

Based on a hypothetical quality review report. Just to mix it up at bit, let’s imagine that the provision is known to have problems and was recently acquired by an out of county Trust (one of those too big to fail jobbies).

    • The design, decor and under utilisation of areas are identified as ‘specific problems’ and ‘too cold and clinical’. Do you a) do nothing b) act?
    • Patients report that noise and other behaviours disturb them, make them uncomfortable and at times scare them. Do you a) do nothing b) act?
    • Feedback suggests that discharge from the service has been variable. Do you a) do nothing b) act?
    • It isn’t clear that patients are receiving therapies from their records, but the reviewer was ‘informed’ they do. Do you a) do nothing b) act?
    • Feedback from patients and observations on the ward suggest that activities are minimal within the unit. Do you a) do nothing b) act?
    • Observations show that staffing levels cause delays in allowing patients to be able to leave the unit for agreed periods of time. Do you a) do nothing b) act?

Quick totting up of scores: a = 0 points  b = 1

If you scored between:

0-1: back out of health or social care now. Do not pass Go.

2-3: you should take a long hard look at yourself and give your working practice  some full on critical reflection. Perhaps spend time in the provision you commission. Hang out with the patients and learn that they are actually, er, human, just like you. Oh and dust off your copy of the Mental Capacity Act and reacquaint yourself with basic human rights principles while you’re at it.

4-5: Ok. Follow above advice, keep following up on actions and make sure this focus doesn’t fall by the wayside.

6: Good on yer.

 

One final point. Almost funny but isn’t. Because none of this is. In the minutes/reports available online for this period, everyone (Sloves, CCG, LA)  dutifully report their Winterbourne JIP related actions. In detail. The same people, I assume who read and ignored the content of a report that provided clear indications (albeit couched in a flimflam language of ‘we were informed that stuff was happening’ even though it clearly wasn’t) that there were serious issues around what was being described as ‘care’ in ChunkyPoundland. Er, how does that work?

The level of blinkered stupidity is astounding. And we really should stop with the obsessive focus on Winterbourne View. It really ain’t helpful and I suspect may have created more harm than good at ground level in some places.

Sunshine and shade

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Back from a week in the sunshine. Have to eat my (sun) hat on this one. Rich sourced the holiday through Teletext. Yep. Teletext. As clunky as in their television heyday but, if you can grit your teeth, ignore the blue website, and the need to pick up the phone to book howl, there are cracking holiday bargains to be had.

While we were away, news broke about the closure of the Slade House site. Not news to us. Not because Sloven keep us informed of developments relating to LB. Tsk. Don’t be silly. We only get that ‘right’ if we meet with the CEO face to face. But ‘news’ all the same. Coated with classic Sloven nonsense about ‘definitely closing it but we will be consulting with, er, patients, families, etc…’ (If nothing else, this whole miserable and beyond sad story is putting the spotlight on how meaningless so much talk is, in overly bureaucratic, jargon laden, and ultimately fake and shallow, profit driven (dominated?) organisations).

On the subject of dosh/profit (or whatever it is), it’s probably timely to include an image of the ‘buildings’ that are being closed and apparently leased or sold on the Slade House site. Because we ain’t really talking about a building or two here. We’re talking about a tasty old prime chunk of land (just) within the Oxford ring road.  Sandwiched between an Oxford Brookes hall of residence and a housing estate. Just across the road from Currys, where I went and bought LB a mobile DVD player to watch his beloved films/boxsets the day after he went into the unit.

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The closure (subject to ‘consultation’) of the Slade House site raises some fairly weighty questions about ‘good care’, responsibility, provision, support, loss (life and aspiration), profit and what happens when a ‘too big to fail’ NHS Foundation Trust, takes over, pretty much ignores, and then closes a failing service in a different county.

And who cares?

The jangling of keys

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Years ago I worked as a waitress in a Beefeater restaurant. Not a great experience but one of many not great working experiences. The manager was a complete arsewipe. Arrogant and bullying.  And he marched around with an enormous set of keys jangling from his belt.

I was always struck by his keys. He couldn’t possibly need to unlock so many locked things.  And they were menacing. Even though I thought he was a tosspot.

This evening I was sent a copy of a review of the unit LB was in, conducted in November/December 2012. This review is, as anyone following this foul and harrowing tale of inhumanity, a depressing and telling read. Shining more light on the beyond inexcusably shameful practices inflicted on learning disabled people in the UK. It includes the statement ‘The jangling of keys was commented on by several people’.

Deep, deep breath. That several people commented on the key jangling fills me with horror. A nasty, bullying, hideous action. And in this context, behind locked doors. Powerlessness.

How much horror happens in learning disability provision? [Howl]

It’s too late to say much about this ‘report’ right now. I’ll just present a taster.

statt reviewI just want to reiterate what I tweeted earlier with the luxury of more words.

  • Can health or social care professionals working with learning disabled people think about what they allow to pass as acceptable ‘care’?
  • Can relevant organisations (providers, commissioners, local authorities) stop batting the responsibility ball back and forth, apparently carelessly, and simply do something?
  • Can anyone – author, colleague, administrator, committee member, trustee, observer, partner, friend, whoever – who sees a report which reports inhumane practice just say so?

Reading this report, I wouldn’t take Chunky Stan or Bess anywhere near STATT.

Heartbreaking.

When I was a kid…

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..we lived by the sea in Southend. High tide, the pier, cockle sheds, pen pals, taking photographs with a kodak camera, and a background soundtrack of the Carpenters, Simon and Garfunkel. And Jacques Loussier, or Jack Brewscheeya as Rich called him, years later when we saw him perform with my mum and dad.

I can remember thinking about growing up a lot as a kid. There was a kind of sky’s the limit type framing to this. And a reasonable grasp of my limitations. I tossed out ‘tennis champ’ (sob) after a couple of humiliating wipe outs at a local summer competition. Artist went when I was disappointedly mediocre in art lessons. Writing? Hmmm. My diary excerpts speak for themselves. But I still had a big old world to dabble in. And mess around with.

I don’t know what LB thought about his future. Other than it featured a beautiful girlfriend and world domination on the ConnorCo front. We never found a way of talking about this properly. Partly because there was no apparent time limit on it. Just banter type stuff. Constrained by the consistent fight/concern about and experience of micro, nonsensical support over the years. Four hours ‘respite’ a month for about ten years. A focus that pushed what mattered to the nether regions. The lack of effective support offered by services a dominating and wearing part of everyday life.

LB didn’t have the luxury I had of options at his age. Of anything really. His ‘adult life’ (all six months of it) was firmly and fiercely mapped and inscribed in terms of indicative budgets, resources and allocations. His potential – artist, entrepreneur, litter picker, caretaker, comedian, model, whatever – was never acknowledged, recognised or even thought about (except by us). And once he kicked out at this non life, it was game over really. The flimsy, poorly resourced, beyond rigid and ignorant world of ‘support’ laid bare.

imageThat he died (he died?) is so raw, so extreme, so I don’t know how to make sense of it. But, at the same time, it focuses attention and underlines how completely shite things for young dudes like him. In 1971, the government published Better Services for the Mentally Handicapped. 43 years later, we are still getting it so wrong for so many.

Astonishing. Heartbreaking. And so fucking unnecessary. Those ‘better services’ have continued to erase all humanity, thought, celebration, aspiration, recognition of skills, abilities, talents and strengths off the board. Leaving a deficit based metal box of jargon, tick boxes and cost cutting. With no real choice or control. Classy.