Engage: Lifespan safeguarding – supporting the whole person across the whole journey
It’s time to think about how we can accompany someone on their life journey when it comes to safeguarding, in order to make sure they get the best support.
But is this really working in practice?
The recent raft of reports following up on progress on the Winterbourne View agenda have not made for inspiring reading. The LD Census report from HSCIC showed that there are still high numbers of people with ‘learning disabilities, autistic spectrum disorders and/or behaviour that challenges’ living as inpatients in long-stay hospitals, or assessment and treatment units.
Out of 46,473 people in contact with learning disability services across England, 3,230 were inpatients as of September 2014. This is 1,255 more than were recorded in September 2013.
Of the 3230 people who were inpatients:
- 2,400 were male, 830 were female, and 160 were under the age of 18.
- 28% had a care plan that involved them moving out of hospital – but 67% did not, and 5% were ready to leave hospital but were waiting for their care to be organised.
- 73% received antipsychotic medication. This is an increase since 2013, where 68% received it.
- 55% experienced one or more incidents of self-harm, accidents, physical assault, restraint or seclusion. This is a slight decrease since 2013 (when it was 58%). Females were more likely to experience an ‘incident’ than males.
- People’s average length of stay was 547 days, and were staying on average 34.4km away from home.
As Chris Hatton says in his article which looks into the various figures:
“Is this what you would expect for an average £3,426 per week? (totalling up to £575 million per year)”
The findings suggest that progress has been patchy at best with regards to providing good safeguarding across the lifespan and meeting the actions outlined in the Winterbourne View: Transforming Care report.
As David Brindle points out on the Guardian Social Care Network, the easy read version of Winterbourne View: Transforming Care Two Years On summarises it well:
“Some people were supported to leave hospital, but other people kept being sent there.”
It also raises the question of whether such places are able to adequately safeguard the wellbeing of people who are staying there, considering the high levels of self-harm, accidents, and assaults.
The recommendations of Winterbourne View: Time for Change were published last year. This pointed out that we know what good looks like – we know we need to reduce admissions, and provide better and more extensive community based support.
It says we need to strengthen the rights of people with learning disabilities, give people and their families a right to challenge decisions to admit them to inpatient care, and extend the right to personal budgets to more people with learning disabilities or autism. We need to change how we commission these services, build community capacity, close existing inappropriate institutions and hold people to account.
However, it looks like these aims are a way off being realised.
What can we do now?
LB Bill
There has been a groundswell of dissatisfaction from people who use services, their families, and other people who have been touched by the issue of people with learning disabilities spending too much time in institutions, and in the cases of Connor Sparrowhawk (LB), Stephanie Bincliffe and Nico Reed among others, dying in them.
The LB Bill, part of JusticeforLB, is aiming to
- Make it a legal reality for disabled people to be fully included in their communities.
- Make it harder for the state to force disabled people to leave their homes against their wishes, or the wishes of their families.
You can find out more and support the LB Bill here.
Getting better at safeguarding in practice: RiPfA/RiP Joint Workshop
We are running a series of workshops on lifespan safeguarding for people with learning disabilities to support Team Managers in reflecting on how we can do this better and make progress in this area.
Facilitated by Dr Margaret Flynn, author of the Serious Case Review into Winterbourne View and Amanda Harvey and Caroline Bennett from the National Children’s Bureau who recently authored a briefing for Research in Practice on lifespan personalisation, we will look at:
- Balancing child protection with Special Educational Needs and Disability (SEND) personalisation.
- Learning and recommendations from Winterbourne View.
- Impetus for adult and children’s services to work more closely together.
- Mapping the life course, identifying areas of transition/ risk/ change in terms of general trajectories, social trajectories, and ‘typical’ trajectories of people with similar characteristics.
- Prevention and proportionate risk enablement.
- How to encourage and develop protective factors and resilience in people who have had early experiences of abuse.
Dates and locations
- 11 March 2015, Birmingham
- 12 March 2015, Manchester
- 24 March 2015, London
- 25 March 2015, Bristol
Please email [email protected] to book a place – further information can be found here.
About the Author
Lindsey Pike has been a Research and Development Officer in Research in Practice for Adults (RiPfA) since February 2012. Prior to working at RiPfA she completed a PhD on how to maximise the effectiveness of safeguarding adults training, and worked at Cornwall Council in the Learning Training and Development Team of Adult Social Care.
To follow the Research in Practice for Adults blog, visit: https://www.ripfa.org.uk/blog
