Challenging Behaviour National Strategy Group The shortfall between policy and practice: the role of CQC and lessons learnt from the Learning Disability Review Dame Jo Williams, Chair Care Quality Commission 5 October 2012

The Learning Disability Inspection Programme was launched in response to the issues found at Winterbourne View. An advisory group was established to provide experience and expertise to CQC 150 locations were inspected across NHS, independent healthcare and adult social care settings. We reviewed whether people experienced safe and appropriate care, treatment and support and whether they are protected from abuse. Inspections were carried out by CQC inspectors, professional advisors and ‘experts by experience’ both people who have used services and family carers. 2 Background

3 Shortfall between policy and practice Overall care was not centred on the person –with people fitted to services rather than services fitted around them 48% of locations non compliant with one or more outcomes Care plans were not accessible to people or made in a format they could understand Lack of meaningful activities to promote independence Good quality advocacy was not always available People in assessment and treatment services stayed for disproportionately long lengths of time Staff failing to recognise abuse Restraint not been delivered inline with care plans Seclusion not recognised as a form of restraint

What can we do going forward? Whole system response and approach required from to include: policy makers, providers, commissioners, regulators and of course relatives and carers and people who use the services. Innovative commissioning Real person centred care planned and delivered All people with a learning disability are people first with the right to lead their lives like any others, with the same opportunities and responsibilities, and to be treated with the same dignity and respect. They and their families and carers are entitled to the same aspirations and life chances as other citizens. (Valuing People 2001)

55 Follow up inspections: Of the 71 locations which were non compliant (including the pilot sites) we have done: 34 follow up inspections undertaken 24 locations now compliant 10 reports in draft stage Further unannounced inspections planned

Conclusions  Leadership, Leadership, Leadership  Institutions are potentially dangerous  Culture – How does the regulator Monitor/Evaluate?  Experts by Experience Invaluable  Role of citizen regulators and Healthwatch

Contact us 7 Website: Call us on via our National Customer Service Centre: Telephone: Fax: Write to us: CQC National Customer Service Centre Citygate Gallowgate Newcastle upon Tyne NE1 4PA