Real regulation, not CCTV, is needed in Care Homes

It seems an almost monthly event in the UK nowadays: somebody, somewhere, unearths a case of abuse of the most vulnerable in our society. The elderly, disabled and infirm have all been victims to this apparent epidemic within some corners of the care industry, of apathy and even hatred towards the people who need protecting most. Every month, the news arrives on our doorstep like the expected dormouse the car brings home after a night on the hunt. Every month, the government and various relevant organisations lament their dismay and disgust at the fresh discovery.

While these stories are thankfully still rare enough to make the news, each individual case reveals a blight on our society: care staff who have little commitment to the people for whom they care, often undertrained and overworked, playing God with the vulnerable people they work with. Most recently this can be applied to the Old Deanery care home in Essex, where footage of an undercover investigation revealed shocking treatment of the elderly people in its care. Perhaps the most shocking thing about this treatment, however, is that it does not set any precedent at all: just like Winterbourne View and the Mid Staffordshire Hospital scandals before it, it was uncovered not by the regulator - the Care Quality Commission - but by the BBC's investigative journalism programme, Panorama.

The Minister for Care Services, Norman Lamb, has again responded in the same way: deploring the actions of the staff filmed abusing patients. And once again, comes the announcement that CCTV is to be considered in care homes to enable closer monitoring of staff's behaviour.

My brother has been in the care system since the age of 8 when it was realised that my parents could no longer cope with his autism and learning disabilities. To him, a care home should be one thing and one thing only: a home. While his surroundings have changed (for good or for bad) as he has developed, the one thing that hasn't is that he is entrusted by the State into the care of a provider who is expected to provide him with comfort, safety and stability. This has not always been the case: he was one of the 48 adults placed into the care of Castlebeck Care at Winterbourne View hospital in Bristol. And so while he has been the victim of abuse himself and lives the consequences every day, I have to express huge concern at Norman Lamb's intentions to install CCTVs in homes like his.

For my brother, his home is his solace from the rest of the world: here he has privacy, space and comfort. In actual fact, his home to him is what my home is to me, only my support network of friends is replaced in Ben's world with care staff. And he places as much trust in his network to support him and provide him with happiness as I do with mine.

I am not about to examine what has made a tiny minority of care staff who may appear as normal people in public, behave in the ways we see time and time again on our television screens and on our doorsteps. But I can only deduce that they must never have, and have never been, suitable people to care for our most vulnerable. CCTV is not about to change the suitability of care staff for their roles. It will, however, impose on the privacy of my brother and other people - some of whom are not disinclined to expose themselves around their home. But the key fact remains that this is their home. And we all walk to the toilet in the night without pyjamas.

Mr Lamb has said that CCTV could potentially be used in homes where there have been 'concerns about abuse.' To which the logical response is: monitoring of people's behaviour will not act as a catalyst cultural change in a working environment, except perhaps to compound the secrecy of certain elements of abuse. It certainly does not make people more innately suitable for their roles. Not does training new staff - also announced by Lamb - as cultures that exist already will continue to exist as new staff feel pressure to behave according to the expectations of their colleagues, though restraint techniques are clearly better taught by professionals. 

Good care homes do not need the threat of CCTV to add stress to their staff and thus their residents. What care homes need are tighter regulation: it is currently the case that if a supported living placement does not provide personal care then it is not subject to regulation by the CQC. I asked the CQC to clarify this position and was told that personal care does not include giving medication to a resident, but does include administering it. But only if the recipient is watched while taking it.

Turning your back on somebody when they take medication can remove the need for supported living homes to undergo regulation by the CQC.

Casting our minds back to Winterbourne View, and even despite being regulated by the CQC, much of the abuse uncovered there (and in many other abuse cases) was nothing to do with personal care. This loophole could be concealing some dangerous secrets, and the threat of CCTV will not touch these places as with current legislation, they can avoid CQC regulation altogether.

What we need, therefore, is blanket regulation of (and staff training for) all care homes, hospitals and supported living placements in the UK; a responsive regulatory model which monitors the appropriateness of staff to their roles and responds appropriately to concerns; and the respect of privacy for residents and patients in their home environments. This country's care system is one of its proudest assets, but relying on technology to enhance it at the expense of people's privacy is too 1984 for 2014.

Family murder-suicide in Spain is proof of care failings

A British man, his Irish wife and disabled daughter have been found dead in Spain, in what is being labelled as a suspected 'murder-suicide.' It is the latest in what is becoming all too frequently a family affair involving disabled children. The family reportedly left a suicide note suggesting that their daughter's disability had become too much to cope with.

An occurrence that is no longer a rarity, struggling families with disabled members often find themselves pushed into a corner of society where they are forced to struggle alone with the effects of having a vulnerable adult to care for. Often subjected to abuse, and almost always left without adequate support, each harrowing case highlights the tragedy of having to care for a loved one with a disability.

My twin brother, a sufferer of autism and bipolar amongst other things, has been in care since the age of 8. We took the difficult but necessary decision to place him into care as his behaviour became progressively harder to manage. Other families, through no fault of their own, feel they cannot make this step. And I can't blame them: the care system today is fundamentally flawed and often morally void. It is true that there is no better unit to care for a disabled person than the family unit, however often the strain of looking after somebody with distinct care requirements and - in the case of my brother - challenging behaviour, becomes too much for one family member to be able to bear.

It is the tragedy of the social care structure that these people do not receive adequate support in their choices, whichever they may be. Faced with the prospect of being placed into a care system which has given us the Winterbourne View abuse scandal, people are sceptical and highly suspicious of the care network. The Care Quality Commission is one cog in this complex network of agencies, and has been described as "not fit for purpose" by Stephen Dorrell, the chairman of the Commons health committee.  The government have announced a series of reforms to the watchdog. But what families really need to see is drastic changes to the entire care system. Transparency, an efficient regulator and family rights over the care of their respective family members are necessary to demonstrate the safety of the industry to service users and their support network. It is true that the people who know each individual best are the people who have been there for them throughout their life, not profit-making care providers and agencies with multiple case loads and a high staff turnover.

For families wanting respite, it should be provided to them without the fear of entering into a system which could prove harmful and ultimately destructive for the unit that each fights so hard to protect.

For families who simply can no longer cope with the daily care needs of the vulnerable adult, they need the peace of mind that their loved-one will be safe, secure and happy.

For families on the edge, they need to know that there are people there to help.

All of these are changes the government needs to make to reestablish a genuine support network to restore trust in the care system. Without such changes, trust in placing a loved one into the care system will remain low, and I fear that the tragic events that have unfolded in the last few days will continue.