29/10/2012 Inside Out London

This programme contains some scenes which some viewers may find

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

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

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

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

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

most disturbing abuse. Sadly, this is not specific to

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

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

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

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

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

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

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

Panorama asks, have we really learnt from the hospital that

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

prosecutions were based entirely on secret filming by an undercover

Panorama reporter. Evidence gathered during just 16 shifts with

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

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

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

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

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

she spoke to former patients, changing their names to protect

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

confirmed that had there been some some assistance for their daughters

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

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

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

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

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

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

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

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

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

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

home, Simon found himself being moved from locked hospital to

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

was being physically restrained regularly - at times for something

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

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

to understand how professional people actually never questioned

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

another where he was being restrained inappropriately with

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

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

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

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

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

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

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

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

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

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

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

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

Winterbourne View to try and deflect the investigation into

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

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

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

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

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

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

interview notes make particularly interesting reading for his mother.

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

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

Winterbourne View. Later, our secret filming would show Wayne

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

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

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

was being asked about possible abuse, with his current abuser

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

evidence of an offence. Both Wiltshire Council and Ridgeway

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

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

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

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

training was three days' instruction on how to cope with

patients when they're physically challenging. New recruits were

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Apology for the loss of subtitles for 46 seconds

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

only eight team, Simone was the patient our undercover reporters

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

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

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

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

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

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

She was left soaked with water outside in near-freezing

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

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

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

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

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

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

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

snapshot survey of every hospital patient with learning disabilities

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

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

lead to prosecution. Without these pictures, would anybody have

believed Simon or Simmone? The Panorama programme broadcast in May

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

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

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

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

shave, they should be properly criticised and had their homes

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

similar homes for people with learning disabilities have been

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

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

and voluntary organisations. The most exhaustive report into what

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

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

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

then you look at the commissioners that purchased the service.

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

professionals, every group of organisations fell down in some

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

review say that a lot of responsibility for failure at

Winterbourne View lies with Castlebeck. It promoted an

unworkable management structure. And it acknowledged that there was

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

chair melted away once the Panorama programme had been broadcast last

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

the organisation have learned the lessons other than to disappear.

Castlebeck insist that the board did not melt away but was

reconstituted to include more health and social care experts. It

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

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

turnaround programme. Financially Winterbourne View was one of

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

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

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

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

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

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

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

before patient welfare and says that investors have not taken money

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

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

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

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

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

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

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

as commercially sensitive rather suggests that profit did play a

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

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

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

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

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

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

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

probably got used to the environment. She was not being

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

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

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

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

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

letter arrived. There has been a safeguarding concern raised at

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

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

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

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

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

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

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

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

Ridgeway Partnership who run Postern says that disciplinary

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

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

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

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

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

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

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

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

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

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

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

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

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

been to Postern House again to collect the possessions that Simone

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

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

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

Partnership says that it deeply regrets that the family were not

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

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

patients have had further alerts over their safety since leaving.

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

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

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

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

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

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

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

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

reliably deliver. Most people with learning difficulties, like these

volunteers on a gardening project, lead busy lives in their

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

challenging behaviour are currently in hospitals. Campaigners say that

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

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

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

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

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

The Government says it is intolerable that people spend so

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

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