29/10/2012 Inside Out London


29/10/2012

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This programme contains some scenes which some viewers may find

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upsetting. This is Winterbourne View - once a private hospital near

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Bristol, that claimed to care... Now, notorious for the abuse of

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some of the most vulnerable people in society. It took an undercover

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Panorama investigation to expose the ugly truth... ..that showed,

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two of the patients, Simone... ..and Simon, facing some of the

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most disturbing abuse. Sadly, this is not specific to

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Winterbourne View. This is happening in many, many other care

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homes. Tonight, with exclusive access to their records, we reveal

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the mistreatment they've faced elsewhere in the care system.

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though this isn't the same as Winterbourne View, it's still wrong.

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And we reveal the trainer who eyewitnesses say advised, if all

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else fails, bring down a patient with a kick. If a person was too

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big to put on the floor to restrain, to kick them in the balls. Tonight,

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Panorama asks, have we really learnt from the hospital that

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Are you filming? Simon has moderate learning disabilities. Please be

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nice to my mum. Be nice to your mum? OK. Yes. And the dog. In some

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ways he's like a child. In other ways, Simon's like any 38-year-old.

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You have a visitor. Ah, a visitor. With support, he now lives just a

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short distance from his mother, Ann. This is the cameraman. I know he is.

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You all right? OK. I have got some heavy blocks and things, I thought

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you might help... Yeah. But a year and a half ago, life was very

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different. He was locked in a secure hospital... Winterbourne

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View, near Bristol. Gently, gently Only now is he telling his family

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all that happened there. Simon, please pull your trousers up, mate.

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They would put him in a cold shower. Let go when you're asked. What was

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that for? They would put his head down the toilet, they would

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physically hit him. Let go when you are asked. Look, look - this is how.

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Ow! Ow! ..and restrain him. stop fighting at us all! In court

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last week, Wayne Rogers - often the ring-leader - and ten others were

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sentenced for the ill-treatment and neglect of patients. He's been

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jailed for two years, the longest punishment handed down. The

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prosecutions were based entirely on secret filming by an undercover

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Panorama reporter. Evidence gathered during just 16 shifts with

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Set on an industrial estate close to the M4 near Bristol,

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Winterbourne View was owned by a private company,Castlebeck. But it

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was funded by public money. Patients here were out of sight,

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That's the conclusion of Margaret Flynn, the joint author of the most

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in-depth report into the abuse at Winterbourne View. After it closed,

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she spoke to former patients, changing their names to protect

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Patients were traumatised, in places where we should be most safe

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- in our bedrooms and in our One former patient whose fictional

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name is Tom has been so distressed, he has ceased to use a toilet, he's

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urinating in cups because he was so terrified of what happened to him

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when he used his own bathroom and This is the care home which Simon

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moved into when he was 18. He's happy here. He's where his family

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have always wanted him to be, near them. So how did he end up at

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Winterbourne View? Simon had for Winterbourne View? Simon had for

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some time been exhibiting, er, a more disturbed sort of behaviour.

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And the care home where he was and had been for many years had put on

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additional staff to cope. The care home estimated it needed an extra

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�600 a week to pay for the staff Simon needed at busy times. Before

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the local council, Wiltshire, made a decision on funding, doctors were

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asked to assess Simon. But not at home, in a hospital. When we

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questioned that, they told us that they would actually section Simon

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if we didn't agree to it. They would literally come along with an

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Wiltshire NHS and council say people aren't deprived of their

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liberty under the Mental Health Act, as a threat. It's only ever done on

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clinical need. For years the national policy has been for people

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with learning disabilities to be cared for in the community. That

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care is bought by commissioners on behalf of councils and the NHS.

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are you, Simon, are you all right? Fine. But when it comes to

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challenging behaviour, experts say hospitals, that should be the last

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resort, are used too frequently. Our contact with the families

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confirmed that had there been some some assistance for their daughters

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and sons when they were living in the community. Just a little bit

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more help, then they could have managed and they could have

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Simon's mother was told his assessment wouldn't be long just

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three to six months. But it's not uncommon for people with learning

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disabilities, who end up in hospital, to be there for between

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five and seven years. Critics call it warehousing. Simon's family felt

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they were left with no choice. The next stop for him would be a

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hospital. But before he arrived here at Winterbourne View, he was

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sent to two other hospitals first. This is the untold story of a

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journey that Simon never wanted to take. After 16 years in one care

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home, Simon found himself being moved from locked hospital to

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locked hospital. His behaviour deteriorated. For the first time he

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was being physically restrained regularly - at times for something

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like trying to hug. And doctors now described him as dangerous. What do

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you think about that shift in how Simon was viewed? It's really hard

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to understand how professional people actually never questioned

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whether it was something they were doing. It was always assumed that

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it was Simon's behaviour that was causing the problems. Sue Armstrong

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is an advocate who speaks on behalf of people who find it hard to

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communicate, like Simon. She now runs her own team of advocates, but

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in 2009, worked in Wiltshire. Sue was asked to see Simon by his

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mother. He thought he was being punished, he thought he'd been

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naughty, in his words. He thought that he'd been taken away from his

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family and his friends. He was leading a very solitary life.

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had now been away from his home for nine months. He was at his second

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Wiltshire hospital Postern House, run by the NHS. It's where Sue

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visited him. And he told her something worrying. He said he'd

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He told me straight away that he'd been hit and he was pointing to his

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head and pointing to his body. I said, "Simon, who's hit you?" And

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he told me the name of the staff member. And he said it wasn't the

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first time. Panorama has obtained records and notes that give us an

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extraordinary insight into Simon's journey through the system. And

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they reveal what happened at Postern. To our surprise, it also

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showed how little his family were told. We've been through some of

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Simon's papers at Postern House and we're aware of three allegations of

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mistreatment. And one worrying injury to Simon. One that Simon had

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been frogmarched with his arm behind his back to his room,

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another where he was being restrained inappropriately with

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someone lying across his chest, and a third incident. Then in addition

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to that, there was where he had the cut on his head - were you actually

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told about what happened? No, no - the only one that subsequently came

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to light after Sue, the advocate, made her investigations was the one

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where Simon was restrained on the floor. I had no idea about the

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others, absolutely none. So no-one told you? No-one told us nobody

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informed us, I did not realise it was that bad. Sue wanted an

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investigation into whether Simon had been hit and into the injury.

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There was a meeting at Postern House. Despite being Simon's

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advocate, she wasn't invited, neither was his family. And within

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days, Simon was moved to Winterbourne View. As I'm standing

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back here now, I feel choked. I felt that they whisked him away to

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Winterbourne View to try and deflect the investigation into

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Postern. And had that happened, then he may never have gone to

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Winterbourne View, and what must have been so frightening may not

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have happened. That was January 2010. His family may not have known,

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but Simon's notes show two people were disciplined over the first two

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incidents. Now, Wiltshire Council examined the third - and the cut to

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Simon's head. It meant questioning him at Winterbourne View. The

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interview notes make particularly interesting reading for his mother.

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I have got Simon Tovey and... you note who was supporting him?

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Yes - Wayne Rogers... ..who was one of the main ring leaders in

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Winterbourne View. Later, our secret filming would show Wayne

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Rogers targeting Simon, often. Wayne! For many people with

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learning disabilities, like Simon, telling a clear story can be hard.

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Simon... Yeah. Stand up, please. Others may not have known, but he

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was being asked about possible abuse, with his current abuser

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close-by. After the interview, it was decided there wasn't enough

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evidence of an offence. Both Wiltshire Council and Ridgeway

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Partnership, the NHS trust that runs Postern, say the incidents

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were investigated thoroughly, and can't be compared to Winterbourne

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View. A year after that meeting, our undercover reporter Joe Casey

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started at Winterbourne View as a support worker. Part of the

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training was three days' instruction on how to cope with

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patients when they're physically challenging. New recruits were

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taught by the company's own trainer. Andrew Norton was certified to

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teach a technique known as Maybo. The aim is to re-direct patients in

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a way that avoids physical restraint. But three former staff,

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who went to different sessions, told us he also gave advice not in

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any handbook. One was Terry Bryan, the nurse who blew the whistle on

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the abuse at Winterbourne View. Andy said that, if a person was too

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big to put on the floor to restrain, to kick them in the balls to get

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them there. I was shocked. No, I've been doing this job for 30-odd

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years, and first time I ever heard anything like that. Our undercover

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reporter wasn't told to kick patients in the groin. But we

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played an audio recording of the advice he was given to Margaret

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Flynn. If you do resort to using reasonable force, be honest about

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it. You've got to justify it - he was a lot bigger than me, I could

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not get his hands off my throat, I thought I was going to die... I

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tried the Maybo technique and it didn't work, and if I did nothing,

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I would have died. So I did this and I'll leave it up to your

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imagination... But you see how that covers everything? It wouldn't be

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just enough to write, "He had me up against the wall by my throat so I

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kneed him in the balls." it is almost a recipe for thuggery.

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know from some of the injuries sustained by patients that they had

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been head-butted. So, it is profoundly shocking to hear that

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whatever it takes his fine, and that people were trained in such

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Apology for the loss of subtitles for 46 seconds

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The company says, it has revised its training in the last year. Then,

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only eight team, Simone was the patient our undercover reporters

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saw being abused most frequently. As with Simon, her records tell a

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story of someone who is not being heard. A report written at

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Winterbourne View says she has a good relationship with this man,

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Wayne Rogers, who we now know Simone picks up a telephone and

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asks for 999. She is giggling and it is taken as a joke. She asks for

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Wayne to be arrested and with good reason, because this happen six

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She was left soaked with water outside in near-freezing

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temperatures. That day she was subjected to abuse over 11 hours,

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We do not know what the Daily care notes written by staff said about

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Simone that day. But we do know how are the days were described. This

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is Simon on March 7th, 2011. On this day, his care notes so that he

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has been re- directed a couple of times. -- his care notes say. And

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there are no management problems. It is a false record that helped to

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hide the abuse. The notes say that this was a good day for Simon. The

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snapshot survey of every hospital patient with learning disabilities

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in England and Wales showed one in 20, 5%, claimed they had been

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assaulted at least 10 times in the previous three months. Few assaults

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lead to prosecution. Without these pictures, would anybody have

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believed Simon or Simmone? The Panorama programme broadcast in May

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last year horrified anyone who watched. The Government says it is

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a shock. NHS South West says it is appalled at the secret filming.

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Horrendous and horrible. They were dragged by the hair, sat on, soaked

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in water... Change was promised. care home providers are not up to

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shave, they should be properly criticised and had their homes

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taken away from them. Winterbourne View was closed quickly and now

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similar homes for people with learning disabilities have been

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inspected. Nearly half a failed to meet necessary standards for care

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and safety and more problems were found in those run by private firms

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and voluntary organisations. The most exhaustive report into what

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happened was a serious case review. Vic Citarella worked on it

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alongside Margaret Flynn. Whichever way you look, the professionals at

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Winterbourne View, the nurses, the psychiatrists, let people down, and

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then you look at the commissioners that purchased the service.

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Safeguarding, they missed things and the police. Every group of

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professionals, every group of organisations fell down in some

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shape or form. That is a pretty sorry story. But the authors of the

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review say that a lot of responsibility for failure at

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Winterbourne View lies with Castlebeck. It promoted an

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unworkable management structure. And it acknowledged that there was

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limited executive oversight. We know that Castlebeck's board and

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chair melted away once the Panorama programme had been broadcast last

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year. And I am not confident that the individual's who was steering

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the organisation have learned the lessons other than to disappear.

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Castlebeck insist that the board did not melt away but was

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reconstituted to include more health and social care experts. It

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also says that once alerted, it moved swiftly to protect patients

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and apologise. Since then, �8 million has been put into a

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turnaround programme. Financially Winterbourne View was one of

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Castlebeck's best performers. Turnover at the 24 bed hospital was

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�3.7 million a year. There was an average weekly fee for patients of

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�3,500. At Bristol Crown Court last week, the judge described to a

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hospital run with profit in mind. He called it a scandalous lack of

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regard for residents and staff. would like you to remember that our

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children have suffered greatly and it will take a long time for their

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physical and mental scars to heal. Castlebeck denies that profit came

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before patient welfare and says that investors have not taken money

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out of the business. It also says that where possible it has provided

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information to the serious case review. The author is still found

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it difficult to discover how the public money paying the bills was

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We can probably best described it as no response. We thought we would

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explore help for areas, like how they were investing in activities

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and staff development and a whole raft of areas, but the door was

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closed on us, basically. The fact that they described the information

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as commercially sensitive rather suggests that profit did play a

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considerable part. After Panorama exposed the abuse here, Simone did

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not go home. She was not ready. Instead she went to another

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hospital. Austen house, the place that Simon and left after three

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complaints about his treatment and one worrying injury. -- Costa and

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house. For Simone's parents, it was still a 40 minute drive away but

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closer to home than Winterbourne View. They were pleased with some

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of the care. Someone was very calm, nothing. -- Simone. Then she

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probably got used to the environment. She was not being

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nasty like she was at Winterbourne View. She was quite calm. If she

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sat on the floor, the manager or somebody would sit on the floor

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with her. They would stroke her. But Simone's notes also detail the

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difficult days. Over four hours one morning, she was restrained in a

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chair 10 times and twice on the floor. Then four months ago, this

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letter arrived. There has been a safeguarding concern raised at

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Postern House. Simone is mentioned and we are in the process of

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looking into this to see what has happened. She continues to be safe

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and the concern talks about the way she was supported by staff when she

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was upset and agitated. We were not told what they had done wrong. We

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just assumed that somebody had made a wrong move. You have been left to

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knowing that something has happened to Simone but to do not know what

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It is not the same as Winterbourne View but it is still wrong.

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Although were told was that four members of staff had been suspended.

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Ridgeway Partnership who run Postern says that disciplinary

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action has been taken and accepts that the family should have been

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told more. Not a council says it has no reason to doubt that postion

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house provides good care. -- Postern House. Within a matter of

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weeks, Simone was moved and her parents were not told when she was

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moving even though they asked. you have any idea why the decision

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was made suddenly? Probably because she attacked two staff, on Monday

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and on the Wednesday. This time she was taken 200 miles away to her for

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a hospital in two years. -- 4th hospital. We were mad because we

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did not get to see our daughter or say goodbye before she left.

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the journey her parents are making now is not to see her. The AA Tower

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round trip is too much for them. -- the eight hour round trip. They

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cannot see her. We used to visit three times a week. Now we do not

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see her. It is not very nice not to see your child. Instead they have

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been to Postern House again to collect the possessions that Simone

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left behind. We always thought that one day we would pick her up and

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her staff. Now we have ended up picking up her things and not her.

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All they have been able to bring home, boxes and bags. Ridgeway

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Partnership says that it deeply regrets that the family were not

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able to say goodbye to their daughter. Panorama has learnt that

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including Simone, at least 19 of the 51 former Winterbourne View

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patients have had further alerts over their safety since leaving.

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Not all alerts will mean that somebody has been harmed, but we

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know at least one patient has been assaulted and in the second case

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there is a criminal investigation. Also like Simone, just under half

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of the patients remain in hospital. If nothing else results from the

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scandal of Winterbourne View Hospital, I very much hope that it

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is scrutiny of a practice that moves people around as though they

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are pawns. We can and should be doing something so much better than

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placing people in units that we do not know what it is that they can

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reliably deliver. Most people with learning difficulties, like these

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volunteers on a gardening project, lead busy lives in their

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communities. But it is estimated that 1500 people in England with

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challenging behaviour are currently in hospitals. Campaigners say that

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if there is to be real change after Winterbourne View, then the

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Government needs to do more than give guidance. What we need is the

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Department of Health to say thou shalt not. We will close these over

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a period of time and each local authority will look at how it can

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make its local provision work, together with local health services.

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The Government says it is intolerable that people spend so

:28:36.:28:40.

long in such hospitals and it will publish its plans for change

:28:40.:28:48.

shortly. For now, Simone is a long way from her family home. Her only

:28:48.:28:54.

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