‘Shocking’, ‘distressing’, ‘criminal’, ‘angry’, ‘disgusting’, ‘bullies’ – words and emotions that we’re sure will have crossed your minds and been experienced as you watched Panorama Undercover, broadcast last night (22nd May 2019).
8 years on from the Winterbourne View scandal, regretfully, concerningly and alarmingly, we again see the most vulnerable individuals in our society being abused by those who are there to provide support and care. As the programme suggested – questions must be asked of the Government – has it breached its promise to reform care for the most vulnerable?
It is our view that one of the fundamental lessons following Winterbourne, was to understand and by implication address the processes which lead to the development of corrupted cultures and abusive practices in care settings. Last nights programme would suggest that this lesson has not been learned.
Following Winterbourne View, the government set out policy documents advocating for approaches based on Positive Behaviour Support (PBS). Whilst there is a substantive body of research which suggests approaches underpinned by PBS can work, there is also a significant body of evidence of attempts at implementing PBS failing across sectors.
PBS is often presented as an approach which can be implemented by staff who have attended short duration courses, where the training is delivered as a script by trainers who themselves undertook scripted training. Training is not informed by a detailed organisational Training Needs Analysis and there is a significant lack of post training course support/mentorship.
This ‘reductionist’ approach to difficult behaviours fails to take into account the powerful external influences on service user and staff behaviour e.g. a lack of awareness of trauma, attachment and the impact of service cultures.
Services to individuals with complex issues continue to be provided by staff who are not valued, poorly trained, poorly supported, inadequately managed and led, and often overworked due to staff shortages and the casualisation of the workforce. Little attention is paid to how staff think and feel and how this is often a significant determinant of how they will respond to the behaviour of the individuals they support. Concentration in training is on staff skills and not the influence of the culture and practices of the service in which they work.
The Serious Case Review (SCR) following Winterbourne View identified serious management failings which:
‘allowed a closed and punitive culture to develop on the top floor of the hospital.’ (DH 2012).
It is likely that should a SCR be undertaken following last nights programme – this issue will again form one of the outcomes.
What we need to prevent future events such as those presented by Panorama Undercover are intelligent compassionate integrated approaches that help staff understand and deal with their own emotional challenges and to see the behaviours presented by the individuals they support as a presentation of the persons distress.
This is not just about training staff, its about providing ongoing supervision and support, accountability, management oversight and an effective inspection regime. Unless and until such approaches are embedded in services, then the risk of poor practice becomes a tragic reality for the many vulnerable people supported in services across the UK.
The Care Quality Commission today published an Interim report:
“Review of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability and or autism.”
The report focuses exclusively on the experience of those people cared for in segregation on a mental health ward for children and young people or on a ward for people with a learning disability or autism. It follows visits to 35 wards and looking at the care provided to 39 individuals. It makes a number of recommendations for the health and care system.
Click on the link to go directly to the report.
Preliminary Findings include
CQC intend to continue this review looking at a wider group of settings including adult social care and working with Ofsted to consider the use of restrictive practices in residential childcare and secure children’s homes.
CALM offers some observations on the response of the Scottish Government to the issues raised in No Safe Place; the report arising from the investigation into the use of restraint and seclusion in Scotland’s schools authored by the Children’s and Young Peoples Commissioner for Scotland (CYPCS)
he Scottish Government response of 1st of February is not definitive, rather it offers a series of opinions and observations, stating that any future actions will be informed by the results of an ongoing consultation exercise, limiting its response to the 9 recommendations the minister views as applying to them.
A number of significant commitments are however made:
However, notable for their absence, are any commitments to a number of areas which CALM believe continue to require urgent action. These include:
CALM will continue to lobby both the CYPCS and the Scottish Government for full implementation of the CYPCS report and the further action CALM consider necessary to achieve the following outcomes:
Learn to nourish your own wellbeing.
Cultivate your mindfulness and compassion.
Respond more wisely, and sensitively, to the people you work with.
Interested in joining us on the 28th & 29th March 2019 for this unique 2 day training experience?
Just click on the link below to book your place.
We look forward to welcoming you!
Who is CALM Presence for?
CALM Presence is a 2 day course for teams or individuals who are working with or supporting people who may experience distress. Often people who work in the fields of social care, education, or health can experience stress and burnout. Mindfulness and compassion training can support people to nourish their own wellbeing as well as becoming more attuned to the people they’re working with.
CALM offers some observations on the response of the Scottish Government to the issues raised in No Safe Place; the report arising from the investigation into the use of restraint and seclusion in Scotland’s schools authored by the Children’s and Young Peoples Commissioner for Scotland (CYPCS)
The Scottish Government response of 1st of February is not definitive, rather it offers a series of opinions and observations, stating that any future actions will be informed by the results of an ongoing consultation exercise, limiting its response to the 9 recommendations the minister views as applying to them.
A number of significant commitments are however made:
However, notable for their absence, are any commitments to a number of areas which CALM believe continue to require urgent action. These include:
CALM will continue to lobby both the CYPCS and the Scottish Government for full implementation of the CYPCS report and the further action CALM consider necessary to achieve the following outcomes:
CALM are really excited to promote our collaboration with Youth Mindfulness. To get the ball rolling we met up yesterday to discuss our first joint venture. Our meeting was hugely successful, with all involved leaving even more committed to making CALM Presence essential for all providers who are interested in promoting well-being across services.
The first CALM Presence Course will be delivered in Glasgow on the 28th and 29th March 2019.
Watch this space for more information about the event and how to book your place.
We look forward to seeing you there.
The Children and Young Peoples Commissioner for Human Rights (CYPCS 2018) published the results of their investigation into the use of restraint and seclusion in Scotland’s schools on 15.12.18. Their investigation focused on the reporting and recording of restraint and seclusion reflecting concerns raised by the UN CRC and by parents regarding the use of such interventions.
Attached below is CALM’s formal response to the report and has been sent to both the Commissioner and to the Scottish Government. We await their response.
As ever CALM will endeavour to support all service providers in their efforts to promote best practice. If we can be of any help, please do not hesitate to contact us through the web contact page or directly at 01259 76368
Have a listen to Dr. Brodie Paterson’s, Clinical Director at CALM, discussion on Trauma Informed Care as part of the Restraint Reduction Networks, Wednesday Webinar Series.
Why not share your thoughts regarding the points made, on our social media platforms…. we look forward to continuing the conversation.
The Children and Young Peoples Commissioner for Human Rights (CYPCS 2018) published the results of their investigation into the use of restraint and seclusion in Scotland’s schools on 15.12.18. Their investigation focused on the reporting and recording of restraint and seclusion reflecting concerns raised by the UN CRC and by parents regarding the use of such interventions. CALM will respond directly to the CYPCS whose full report can be accessed via the CYPCS website www.cypcs.org.uk but felt that urgent guidance for CALM using schools and Local Authorities was necessary as the report’s recommendations in one area caused us some concern in relation to the potential short term implications for some vulnerable children in some schools and authorities.
Attached below is CALM’s initial response to the report to support CALM using organisations. We welcome your comments on the document and are keen to stress CALM’s willingness to support you in your efforts to promote and achieve best practice for the Young People you support.
Everybody at CALM would like to extend our best wishes for Christmas and the holidays to all CALM using organisations, their staff and the people they support.
The CALM program has been taken to Australia (and Airdrie) the Falkland islands (and Falkirk), Canada ( and Cheltenham) America ( and Alnwick) this year.
We have published, presented and trained relentlessly with some real milestones reached.
It’s been a fabulous journey involving trains, planes, automobiles, and ferries (sometimes even on time) and some very late nights and very early mornings. It’s been a privilege to work with some fantastic teams sharing our messages of values led, evidence based and relationship delivered practice.
We are now resting, preparing to do it all again next year. We know some of you will be working over the holiday season and our thoughts are with you.
We hope you manage to spend time with those you love and we look forward to working with you in 2019.
