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The Human Equilibrium

July 16, 2016

Yesterday, I spoke at a conference in York. The conference was titled: “Social Work is Human Rights”. One of the speakers was the excellent Gavin Harding from NHS England Transforming Care team. Gavin, who has a learning disability and has spent time held in an ATU, is also the Mayor of Selby ( He gave a rousing talk and ended with the great parting shot: “You lot don’t get placed in ATUs. Why should people with learning disabilities?”

Gavin’s talk made me hastily change how I was going to present mine. I usually tell the Get Steven Home story as a chronological narrative. I still did that, to a fashion, but bearing in mind the title of the conference, I wanted to stress more than ever the “humanness” of Steven. How a normal human being with autism could get caught up in a horrendous and dangerous situation for a year of his life. Why should he end up in an ATU, when you lot don’t?

On the train I home, I was feeling pretty good and then foolishly clicked on the following link:

A 28 bed (!!!) unit for people with autism has been put into special measures after failing another CQC inspection. Lots of questions started floating around my head:

  • How did those 28 people end up there?
  • How will they get out and start to leave fulfilling lives like Gavin and Steven?
  • How do the owners get away with it?

This morning, I found the actual CQC inspection report. I’m not normally lily livered but I could only get about 2/3rds of the way through it. It is distressing reading ( A few lowlights:

Five patients were prescribed high doses of antipsychotic medication without this being identified and there were no monitoring guidelines for high dose antipsychotic treatment. There were no monitoring guidelines for rapid tranquillisation.

How can this be? Giving people medication that they haven’t been prescribed! Isn’t that a crime? Please don’t give me the argument that they probably lack the capacity to decide about their medication. Without prescription from a clinician, what makes this any different from them being given heroin?

We reviewed the legal files for five patients during this inspection. Of these, four contained evidence of periods of detention without this being legally authorised, whereby the patient was not subject to detention under the Mental Health Act or subject to a Deprivation of Liberty Safeguards (DoLS) authorisation. The patients had not been aware of this, had not been allowed to leave and had continued to be given treatment. 

How can this be? Illegal detentions. Don’t blame the MHA, MCA or DoLs for this. The residents won’t get anywhere those pieces of legislation because the management of the unit don’t want them near the legislation. It is a conscious decision not to apply the law. Where does this law breaking go from here? Bear in mind, this was a CQC report and they are only adopting special measures, can one call in the police to investigate at least two possible breaches of law? Doesn’t seem much point in taking out a safeguarding referral – the professional safe guarders will be from the same organisation that commissioned the service and sent the 28 people to their doom.

On all the wards, the kitchen areas were locked and so patients had to ask staff for access to the kitchen. This meant that patients had no access to drinks except when staff let them into the kitchen. Some patients told us they tended to purchase and keep snacks and drinks in their bedrooms but this was dependent on finances and access to leave.

The above may not be illegal in itself, although it probably falls into the deprivation of liberty category. What it does show though is the crux of all this. The owners of Bigfoot Hospital (WTF) are a company called Equilibrium (why do these companies have such darkly ironic names? The 28 residents can’t possibly have any equilibrium in their lives, although there is probably plenty of equilibrium in the owner’s bank accounts). The big feet at Equilibrium can’t possibly see their residents as human. And if you don’t see somebody as human, then their human rights aren’t going to figure on the radar.

They’re not alone though. The UK has a weird relationship with human rights. There is a deep unease and suspicion about the Human Rights Act. Me and several other people with positive human rights stories were plastered all over the London underground last year and on billboards throughout the country. However, for most people that I speak to outside of the disability world, human rights begins and ends with Abu Qatadar and Theresa May’s cat story. This Daily Mail type distrust allows companies like Equilibrium break the law. They can treat their residents with contempt because they hold the law that protects people with contempt.

For people who have followed the Justice for LB campaign, the actions and responses of Equilibrium must ring a few bells. It’s the same attitude that allows Southern Health, despite report after report, inquest after inquest, governor’s resignation after governor’s resignation, to treat their public with sneering, arrogant contempt. The Chair and CEO can respond to fears expressed by My Life, My Choice that they can’t use Southern Health services because they might die, with talk of learning lessons, action plans, people and family engagement. It’s all bollocks. It’s further contempt. Because out comes another report this week of another death in their service and the company statement is exactly the same as all the other statements they have made in the last four years:

It’s not enough to be human to have human rights.

You have to fight a system that refuses to see you as human.

That’s why you lot never go to ATUs.

From → Social Care

  1. Sadly there has been other reports showing usage of drugs being administered without clinical diagnosis for that drug being used. That includes in hospitals settings, both public and private. So this isn’t a surprise that liquid coshes are being used to ‘manage’ behaviour in homes as well.

    The true answer to Gavin’s question is simple – because people don’t give enough of a toss about people with learning difficulties and/or autism.

  2. Mr Trebus permalink

    Gavin was inspiring, and so were you. Hearing the story ‘live’ from ‘the horses’ mouth’ (so to speak) rather than anecdotally was a proper lump in throat moment.

  3. “You lot don’t get placed in ATU’s” – Reading your article, I think that’s part of the answer. There are many people who still think that these things only happen to people who are somehow different. (Sorry to be blunt – I know I don’t have to convince you of anything.) Human rights will never be respected until we see all other people as human, first.

  4. weary mother permalink

    There is a very clear route to ATU……..

    My son is middle aged multiply physical and learning disabled and lives in so called supported living. He shares his flat with another learning disabled person who has no family support.

    They both have many additional chronic health needs and physical disabilities ….. they are both on a waiting list for learning disability nurse to support their access to routine GP health care assessment….far less support in a serious health crises.

    The LA have agreed current support – to live safely (far less happily) in community – is not sufficient. But they (LA) have no responsibility for son and room mate to access NHS. This is the responsibility of NHS in the new integrated NHS/LA..

    New LA support plan will state that both are LD and have serious needs and are eligible – (both have passed lengthy assessments by clinical pychologist) – but must wait to get to top of list for allocation of a LD nurse.

    The LA describes all the (unmet) chronic health needs and the repeated acute crises but support to access NHS ”Not our responsibility”. So – LD people/ ie son and flat mate have not got same rights as general community to access NHS. And without our/family support they could live in pain and misery – waiting.

    This wait to for LD nurse – access/health care support has gone on for ages and ages. Flatmate could have died recently without our family.. Both would be in very very poor shape without my support.

    I am still capable of filling health and other support gaps (at cost to my own health) but what of the rest who have no one to do this – what is happening to those with no family….now……..

    ….. deteriorated or dead ? Or……………………………

    ……………………………….moving ever closer to the door of an ATU ?

    • What you will also find is that despite the lack of any attention for physical health, which they like anyone else will need, and more so in view of the side effects of present and previous medication, they will be assessed, and their care provision payment be paid partly from the NHS to a huge amount.

      Yet this money would not be made available to the disabled living at home.

      The reality is, huge profits are being made by supported living providers from money from social care and NHS budgets, that is how their average and sometimes far more £3,500 a week is financed, and if a person is under 25, which is why they encage the young particularly, education funding can also be claimed.

      The government have devised the maximum amounts on an ad hoc assessment based on their assessed ‘needs’, the horror being that the worse the needs are made the more money is paid, is available to private ‘supported’/independent’ living provision, which is why it is being bought up by venture capital..

      Yet despite the huge sums paid out on the basis of need, all they get is tick boxed, unaccountable encagement, only perfunctory at best medical care, and drugs so they can be cared for as efficiently as possible by zero hour low paid workers.

      And as long as there is no accountability even for their deaths this will continue.

    • Trudy permalink

      Hands up anyone who has heard of an LA being put in court for failing to prevent the misery and or harm done – to their vulnerable people – by their contracted CARE services.

      Hands up anyone who has heard of any LA being penalised for failing to MONITOR the care that they commission.

      • Quite Right.

        We do not even have a record of the number of deaths in private mental health care like St Andrews let alone any accountability for the many deaths there see my blog posts.

        Or supported/independent living.

        Instead propaganda is launched that’s suggests that LD/Autism is somehow physical, to such an extent that patients are ill and die of natural causes.

        But the mentally different are not physically ill, and it is the administration and side effects of unnecessary, other than to make care easy drugs, that cause their death and illness..

        We can’t sue, as no lawyers would take case on no win no fee basis, as how could anyone beat all their expensive lawyers and experts paid with our public money.

        That is why this is happening and so many die and have such hellish, indescribably abusive, torturous lives.

  5. Pauline Thomas permalink

    Exactly Weary Mother.

    Joint commissioning from LA and NHS should be providing a safety net for your son and flat mate. However the wholesale distancing that LA’s are now adopting to rid themselves of any responsibility for the welfare of their citizens with a learning disability have begun to take effect

    This scenario is happening all over the country. People with LD get frustrated with lack of meaningful things to do. Cuts have bitten into their day care. Person gets angry or mentally ill. NHS clinician can only offer medication, when what is really needed is stimulation. LA says the cuts are because of the austerity measures forced on them by the government However it is remarkable how this austerity has not reached the people who are providing the care that the LAs have put their way. These companies are getting richer and richer by the day.

    If anyone who has not been given the label “learning disabled” loses their temper we accept that they have a grievance about something. If someone with LD has a grievance about something and loses their cool they are likely to be given a dose of Lorazepam, strictly for their own safety of course and regardless if this medication will eventually make them worse.

  6. As you have already blogged and I have here

    68% of learning disabled in institutions, be they ATU, or for life in supported/independent living, are coshed with antipsychotic drugs for ever , 90% regularly, as these drugs, effectively force them into becoming compliant zombies, unable to scream out any physical pain, or the terrible side effects they are experiencing.

    Read any of the studies and effects in books like, The Bitterest Pills by Joanna Moncrieff

    See the photos of Thomas Rawnsley they can hardly eat.

    And, their deaths in independent/supported, need not even be investigated.

    And if they are, it is internal, and even if there is an inquest, they are declared as dying of ‘natural causes’.

    They are, only, if lucky, being moved out of ATUs under MHA to for life ATUs in the guise of supported/independent living, this is the future for all autistic/LD/MENTALLY DISORDERED.

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