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Legitimising Death in a Care Chair

May 8, 2016

Six months on from the Mazars report into the unexpected, uninvestigated deaths of 1000s of patients in the care of Southern Health and where are we when it comes to the deaths of people with learning disabilities? We’re up shit creek without a paddle if a news report that emerged yesterday is anything to go by.

The BBC reported on the death of Mary Dowd. In their report they describe Mary as “elderly” and inform that she may have had a cardiac arrest whilst sitting in a care chair. Their report can be seen here:

The excellent George Julian dig some digging and came across this report into the same incident –

It’s very different from the BBC report.

The “elderly” Mary Dowd was 51! Why on earth use that adjective? Is her death more legitimate because she is “elderly”? Does the reader see the word “elderly” and skip on to the next article? Probably. And in Mary’s case, you’ve got the legitimising jackpot – learning disability and elderly. Boom. Nothing to see here. Move along now. Not worth getting into a lather about the death of someone elderly and with learning disabilities.

What the dickens is a “care chair”? Sounds all cuddly doesn’t it? You can imagine the QVC presenters salivating in sincerity as they present this item. The second article tells us that Ms Dowd was strapped into her care chair. Ah! Poorly staffed – let’s strap ’em in. We’ll call it a care chair. Make it sound nice. Draw attention away from the straps.

And then the killer. Ms Dowd was strangled by the strap in her care chair. Left unattended with horrific echoes of Connor Sparrowhawk being left alone and locked in the bath, Ms Dowd slipped down in her care chair and strangled by the strap. Let’s not beat about the bush. She was restrained and was killed by that restraint. Being elderly, care chairs are red herrings. The care less approach of the company felt it was appropriate to restrain their clients and she died.

I’m sick to death of legitimising language. The language that suggests an inevitability about the fate of the learning disabled in State care. Language that firmly identifies the person as the problem and the care provider as the victim of a terrible tragedy.

A couple of weeks back, the BBC reported how several patients had escaped from a facility run by Southern Health. One patient had managed to get to France, been brought back and escaped again. He was still missing at the time of the report. Sloven’s Medical Director, Lesley Stephens popped up on the news and started talking about the “difficult complex needs” of their client group. Lesley – your organisation claims to be mental health specialists – do your fucking job and stop losing people. In using those three words, “difficult complex needs”, Ms Stephen’s dehumanised her patients. She othered them in attempt to gain some sympathy. “Oh, poor Lesley. It must be awful having to deal with people like that”. Job done. Another scandalous example of “care” but you’re off the hook.

True story. I was set up on a blind date over 35 years ago. We were staying on a farm and my mate tried to fix me up with one of the dairy maids. We talked about our jobs and she came out with the classic – “I’d love my job if it wasn’t for the bloody cows”.

One of the dudes from Seven Days of Action recently had a “care plan review”. The hospital have given up. The only “care” featuring on his care plan is restraint and medication. That’s not a care plan. That’s a torture plan. It’s a plan to turn  an unhappy dude into an unhuman. An animal in fact. Yet, this plan is legitimised because the dude is deemed to have “challenging behaviour”. I’d like a word in the shell like of Mr Responsible Clinician. “Mr RC. You find this challenging because you’re not up to the job. You’ve copped out. You can keep on drawing your salary and sit on your advisory boards in spite of your incompetence”.

We need to keep calling this out. I’d like to stop using the term ATU because we know that nothing that can be remotely called assessment and treatment takes place there. The name legitimises their existence. Joe Public sees the name and if they think about it at all, will assume that it is completely the right environment for those creatures with difficult complex needs and challenging behaviour.

Let’s call a spade a spade and from now on call ATUs what they are – Medication & Restraint Detention Centres. Less cosy but more honest.

When the BBC can indulge in such shoddy, complicit reporting as they did with their reporting of Mary Dowd’s death, my heart sinks to my boots at the prospect of any real breakthroughs coming post Mazars.


From → Social Care

  1. Leo permalink

    Mark. You always say it like it is. Well done. Love the blog. Bbc is a cop out organisation.

    Yes I agree. I hate the term ATU. I call it an institution.
    But I know your terminology. It’s very much that.
    All they do is drug our kids And restrain them. Don’t I know it. Because it’s much easier drugging and restraining my son then give my son some estimulation that is to much hard work.

  2. Jean permalink

    We have a very severely disabled child.

    The issue between Southern and Mazars would seem to be painfully obvious.
    It is that establishment professions, NHSE, NHS Improvement have the same reservations about the methodology behind the Mazars report as Southern Health’s medical professionals. Reports seem to serve different purposes. We never get to hear about Verita 1 much anymore, what about Verita 2?

    Where it becomes frustrating and heart sinking is as follows. I watch and observe from a different part of the country and now see how entrenched the arguments are, and how they are played out using social media using inflammatory statements & language.

    Wouldn’t it be entirely sensible to get a group of you in a room to discuss the report. Warts and all. Perhaps get some professional mediation.

    Because there’s a few things rightly that need calling out. From both sides.

  3. Absolutely – kill people by neglect and pretty it up with language that makes it sound not so bad and more accidental; blame the person and obscure the situation with mis-descriptors and language that reinforces prejudice ignorance and stereotypes. We spent quite a time in care at one time trying to change the language – people(!!); behaviour which challenges us; going places with people (not taking people!!); stay over (not sleep-overs)…. The language used should be more accurate and consider its impact on people who don’t know. As Mark says we are not seeing ATUs that actually seem to be doing A&T. And indeed, how can they when they take people away from their usual supports and people who care and put them into a strange environment which doesn’t bear any resemblance to anything they’d recognise and puts them at the mercy of people who don’t know them and it seems far from listen to them? If they genuinely wanted to assess and “treat” (like listen and work out what really matters to the person and help it to happen) then they should be going out and spending time alongside the person in their normal environment and also listening to people who do know them – whilst also providing some ‘hands-on’ support. (Which incidentally we did have in some areas prior to it being stripped out by continued reorganisations of health) But ofcourse it’s more convenient to put people together in a building and provides a nice easy sinecure to the professionals there… (remind you of origins of the old long-stay hospitals?) Exactly for whom do these A&T units exist ‘cos it’s not for the people in distress and need? There will be people with learning disabilities or autism who have a mental illness crisis but helping this should be managed within the mental health service with the right adjustments and skills. Just why are we wasting people’s lives, families’ lives and resources? I can’t help feeling it’s more about profit so that’s why we perpetuate myths with the language used about people who don’t have a voice to challenge.

    • Rosemary you have hit the nail on the head.

      The simple truth is, each learning disabled/ autistic/ or anyone with a label, who is sectioned, as danger to themselves and/or others under MHA, or deemed illegally incapable of making decisions, under the MCA, is worth a minimum of £3,500 per week, and often much more, either to public NHS ATU, or, private provision including supported living.

      In addition, all the ‘experts’, drug companies, universities, charities, trainers etc, can feed in, and get even more income, safe in the knowledge, that whatever they do, is protected by confidentiality and the state.

      That is a lot of money, and the earning potential the vulnerable have, with no say in their services .

  4. Cathy Hodge permalink

    The BBC let the ball drop on this report. Poor reporting indeed.
    Once again, a person in care died from neglect.
    People in care should not be left unattended.

  5. Raf permalink

    Care chair – almost certainly just a supportive armchair for someone with a physical impairment. On wheels usually to facilitate transfers, can be tilted and reclined to relive postural stuff etc. May have specific extra bits to provide the correct support for an individual.

    That she was strapped in is very likely a red herring – in both my power wheelchair and my own specialist supportive armchair (a Symmetrikit Tiltrite if anyone wants to Google for pics) I have a padded lap belt and chest harness so that I can stay in a comfortable and as functional as possible position. If anything the report of Mary’s death sounds like she wasn’t strapped in *enough* – leaving someone in a setup where they can slide that far out of an appropriate sitting position is demonstrably terribly dangerous in the short term, but also being poorly seated fucks with comfort, risks pressure sores, affects how well you can use your hands, potentially hold your head up, swallow, breathe, communicate… if she’d been monitored (eg ‘cared for’) properly she might not have died but she’d still be being harmed by crappy seating. A common solution for people who slip down in their chairs is a pommel, a padded wedge between the legs to keep the pelvis positioned correctly. If her chair had had a pommel she could not have died the way she did.

    The relevant bits are:
    – by definition to end up with the belt at her neck something about her seating or her support in that seating was terribly wrong, in ways that would be obvious to any person remotely familiar with supportive seating. Several people must have ignored this for quite some time as there is no mention that she had recently become more impaired or anything.
    – the home ignored a safety alert specifically about belts on such chairs
    – the monitoring of her wellbeing was utter utter shit
    – just ‘monitoring’ is totally inadequate and inappropriate care for someone immobile in an armchair

  6. Debra permalink

    Turned a job down once they used the term safe holding (restraint) and said that one person was safe held for up to 7 hours but hay it’s ok a psychologist said they could. Ya just a licence to go over the top. And it’s restraining no matter what name they change it to

  7. As usual, clear expert analysis in every comment, about how most people without a voice are surrounded by people feeding off them is easy money. It’s a crime I watch daily, and the solutions are there for those people with caring families (and those without families should have befriending advocates), as care staff should be working with families, sharing the care.
    Compared with physical healthcare, care for those with learning disability or mental health is often (not always) a con, which they’d never get away with in an acute hospital where physical problems are treated.

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