Talk following the latest BBC Panorama disclosures concerning Castlebeck and Winterbourne View Treatment and Assessment centre was that it was a bit of a 'damp squib'. Yet it seems to me that is wrong. No, it wasnt as harrowing as the first undercover exposé. Nor were the additional signs of potential abuse anywhere near so brutal. But after what we all witnessed in the first programme, it is shocking that there is anything approaching abuse still to show.
The programme provided a methodical examination of post-scandal developments, and it very properly provides an introduction to the DHs final, considered response to events at the centre, due any week now; and it proved a further wake up call for everyone working close by and alongside vulnerable people.
We simply have to work better within our own organisations to protect vulnerable people, and we really must work better with our partners in this instance the NHS to ensure that the people both agencies serve are fully protected from whatever peril. Whatever else integration means, it must mean that! More, with the sentencing of those people who had been guilty of those crimes, the same spotlight that shone on them also shone on the darker corners of our caring services.
As I said in my speech this month to the national children and adult service conference in Eastbourne (http://tinyurl.com/cxgbq39), we in local government must work better with our NHS and independent and voluntary sector colleagues. The quality of services and the dignity with which people are treated depends on the training and support that care homes and agencies offer their staff; on their recruitment practices, and on the way in which their businesses are managed. This in turn is partly, though not wholly, dependent on the way in which such services are procured at a strategic level and used in support plans.
The quality of care that older and disabled people receive is heavily dependent on the workforce employed by independent sector domiciliary care agencies and care homes. So local authorities must engage better with them, understand what it costs to deliver good quality care, take an interest in the recruitment and retention of the workforce and - above all - procure services and work with individuals to design support plans that can meet people's needs and respect their dignity.
The sad thing is that this industry of care - one of the few growth industries in the country - is more or less a minimum wage industry. The people who care for our most vulnerable citizens can often be tempted away from those roles, however dedicated and caring they and however rewarding they find their roles to be in ways other than pay, because the local supermarket offers a better hourly rate. In a small way local authorities can seek to ensure that the price they pay for care allows for a reasonable rate of pay, but this will be in the context of a market where 'reasonable' is not far above £6.19 per hour. Beyond this the value which is placed on care is a national issue and not one which even the best local decisions can resolve.
Current pressures on council budgets mean a squeeze on prices which in turn means a squeeze on providers as they try to compensate for frozen or lower prices and sometimes to deliver care more cheaply. The loser, of course, is the person who we all say should be at the centre of what we do. As Andrea Pope-Smith, joint chair of our learning disability policy network, warned us at NCASC: Panorama wasn't easy viewing. It asked how much progress has been made in the last 18 months, and the answer is not enough: that step-change hasn't taken place yet.
For our part, the Association will shortly be sending out a document to all our members setting out a number of key questions that must be asked by commissioners of all provision for people with learning disabilities. Directors and their commissioning staff must know:
* WHAT placements have been made in the local areas and why, including even those care settings that local authorities do not use;
* WHETHER all service users have independent advocates;
* WHICH restraint methods are being used;
* IF there are any patterns around safeguarding referrals, and if the adult social services department is in touch with local families and carers.
It is absolutely imperative, as well, that people with learning disabilities are not kept at assessment and treatment centres for any length of time before being settled in permanent places to live, appropriate to their needs and their family circumstances.
We all need to work very closely with NHS colleagues on this matter, because they are largely responsible for making hospital placements of this type. We must ensure that together we look at peoples medium and long term future, and not just at their immediate needs.
So perhaps its worth paying tribute to Panorama rather than ignore it. It was a timely reminder to us all of the dangers and threats to the vulnerable, and just how easily, sometimes, our defences can be outwitted. I know it will prove a timely reminder to all our members and their colleagues to act on our advice and provide themselves with as much knowledge as possible concerning centres where people with learning disabilities are assessed and the care they receive in the places where they live.
We must acknowledge their vulnerability and, as with all vulnerable people, devote time, trouble and expense to making sure that those vulnerabilities are neither abused nor exploited.