Care Reform? 136 Million to move LD/Autistic from public NHS Units to Private ‘Community Living ’

In our times of austerity, LA budgets so tight there isn’t support for family carers, beds, or equipment, benefits slashed to £62.50 per week for 24/7 care, and DLA reduced to £103.

Our government is providing 136 million to transfer 3000 LD/autistic, from NHS public hospitals to private increasingly venture capital monopoly corporation ‘ community living’ care, with no public only private hospital admissions of the autistic/LD and/or behaviour challenged

So this 136 million goes straight into USA Universal Health Services/Acadia and three monopoly providers. .

Such siphoning off  NHS/LA money to private profit had been planned for years, Laing and Bouisson, specialist consultants in care development, produced this report in 2011.

Commissioned by the Director of Learning Disabilities NHS under the ‘Valuing People now’ initiative.

http://laingbuisson.co.uk/portals/1/media_packs/Fact_Sheets/Illustrative_Costs_PLD.pdf

How is enforced removal for life from family friends and real community, to ever more profitable care in anyway Valuing The disabled ?

It is exactly the opposite as it writes them off behind the closed walls of an institution.

And in our days of austerity what is the huge cost of this not being considered ?

It is far far cheaper  for them to  remain at home in the real community.

This shows the whole purpose of ‘community living’ is to make as much profit out of the disabled as possible. As provider are paid  £4,500 + per week.

Learning Disability Today featured an article this month entitled,

Local Plans To Transform Care for People With Learning Disabilities Launched’.

https://www.learningdisabilitytoday.co.uk/local-plans-to-transform-care-for-people-with-learning-disabilities-and-or-autism-launched.aspx

And as always the National Media followed
https://www.theguardian.com/society/2016/jun/15/learning-disability-have-say-in-services-they-depend-on

A national implementation plan to develop ‘community services’ and close inpatient facilities was published in October 2015 by NHS England, the Local Government Association (LGA), and the Association of Directors of Adult Social Services (ADASS).

They say,
Building the right support set an ambition of empowering individuals and their families to have more say in their care’

But did not say how ‘community services’ empowered them.

The service users and their families still had no rights, or choice and any ‘community services’, which are owned  by monopoly corporations like USA Universal Health are enforced by the Court of Protection, and families gagged for life.

The article continues;
by developing and strengthening good quality support options in their communities.’

There are no ‘options’, as no choice is given, there is only one provider, one community placement.

Where has this ‘good quality’ support suddenly come from ?

Who and how has the quality been judged ?

If it does exist, why has it not been utilised before?

What is meant by ‘their communities’ ?

As residents are subject to 24/7 surveillance, and deprivation of liberty order, and in addition, now community deprivation of liberty orders, it can only be the disabled will live and go on accompanied outings to a planned venue in the area they originated from.

Which meant  the disabled, and where they originated from, had to be audited, so in 2013 the Health and Social Care Information Centre published a Learning Disability Census.

http://digital.nhs.uk/catalogue/PUB13149/ld-census-initial-eng-sep13-rep.pdfhttp://digital.nhs.uk/catalogue/PUB13149/ld-census-initial-eng-sep13-rep.pdf

Stating it was to deliver action 17 in ‘Transforming Care’.

A national response to Winterbourne View’.

How could this be a response to Winterbourne, when ‘community living’ is the same for profit living arrangement as Winterbourne View, owned by similar venture capital to Winterbourne’s Castlebeck.

The only reason for the move back to the disabled’s locality,was to appear to give the campaign the purpose of family involvement and living in their own community.

But neither parents or disabled are given any rights or say in this care or even guaranteed access to  their loved ones.

The real purpose was to devolve money to local Health and Social Care Trusts increasingly private companies who PROVIDE the care.

In fact, this was the first ever audit of inpatients in the NHS, or independent care and assessment Units.

Governments had not even counted the number of ‘Winterbourne type residents’, but had paid out millions of public money for their care for decades.

The audit was needed, to shear up the remaining public health provision between the chosen venture/private capital providers and to ascertain which Local Authority, NHS payments for past/present treatment could be reimbursed from- see Sunday Times 2014 http://www.thesundaytimes.co.uk/sto/news/uk_news/Health/article1478483.ece

And  to achieve the only change to care services- treating   inpatients in the area they originated from rebranded as ‘community living’.

The last general audit of the total number of LD/Autism/CB  was in 2011.

This 2013 audit hyperboles that it per se,

‘marks a significant progression in enabling transformation of care’.

How could it ?

The Article continues
and, as a result, reducing the number of people with a learning disability and/or autism in England who are in hospitals ( public NHS )by up to half over 3 years’.

A third of the ATU 3000, have been there 5 years or more, and will be zomibified from their polypharmacy ‘treatment’, and in need of rehabilitation, so likely to be moved to the community living’s ‘specialist hospitals’, and be still medicated on release like Thomas Rawnsley.
http://www.dailymail.co.uk/news/article-3219060/Chemical-cosh-scandal-Thousands-patients-no-history-mental-illness-needlessly-given-cocktail-anti-psychotic-drugs.html

Read here, the huge amounts per week, being claimed by public NHS ATUs- up to £12,000 per week, this will be transferred by the Lamb campaigns, to private venture capital ‘specialist hospitals’ Priory Group, Cygnet, those like Cambian’s in ‘community living’ settings, and St Andrews Hospital.

https://www.sevendaysofaction.net/our-campaigns/autumn-2016-human/day-six-money-money-money/

The Article continues;

To this end, 48 local Transforming Care Partnerships (TCPs) – which are made up of people who use services, their families, ( without rights ) providers of services, clinical commissioning groups, local authorities and NHS England specialised commissioning hubs – are tasked with taking forward these intentions and designing new, high-quality, community-based services ( big player monopolies Dimensions/Cambian/Hesley   commissioned, and overseen by these TCPs, so a conflict of interests.) https://www.theguardian.com/social-care-network/2014/sep/05/personal-services-support-adviser-learning-disabilities

that reflect the wishes and circumstances of local residents.

(I assume this refers to local residents and not the vulnerable residents who have no choice).

The first awards from a £30 million, 3-year NHS England revenue fund to help TCPs where there is a need to speed up the delivery of new services have now been finalised.
Funding of almost £6.5 million has been designated to 23 TCPs on a match-funding basis to help get new services up and running while older models of care are still in place, ( unclear what these are) allowing for safe and effective transition between the two.

NHS England has also confirmed that £100 million of funding will be available over five years to support Transforming Care projects – up from the £15 million announced at the time of Building the right support. Investment of more than £20 million has already been provisionally earmarked for schemes across the country in 2016/17, including new housing and services.’

136 million of public money paid over to private, chosen, often venture capital backed service providers to establish ‘community living’ facilities .

These services are untested, monopolised and for profit,  and commissioned by the state with no effective input or choice from the service providers or their families.

The LGA’s community wellbeing portfolio holder, Cllr Izzi Seccombe, said:

Councils remain absolutely committed to supporting people with a learning disability and autism to live close to family and friends, in good quality accommodation with support from highly skilled staff. On occasions when a person’s mental health needs does require an admission to hospital, steps must be taken to ensure it is properly managed with the individual discharged in a safe and timely way.’

Public NHS Adult Treatment Units have merely been replaced by private for profit ‘specialist hospitals’, owned by the ‘community services’ provider.

No new beds are now commissioned in NHS public, replaced by ‘community living’ provision for life, enforced if necessary by the MCA..

In England, 24,000 people who have a learning disability and/or autism are classed as ‘being at risk of admission.’

It is unknown what ‘risk of admission’ means, or, how this figure was arrived at.

Admissions, can be triggered by meltdowns, inappropriate behaviour, violent outbursts, parents unable to cope, reaction to medication or its withdrawal, or assessments.
Or simply a call for help to police, GP , Social Services .

A family with an autistic/ mentally ill member, can only contact the police in a crisis, the intensive HSCT,  has no crisis facility call out system, and GPs will not come out, unless a physical problem, and even then will not examine, if impossible/ refused, as it will normally be if a patient has behavioural issues.

On contacting the police, the autistic/LD/mentally ill is taken to an assessment centre and detained under the MHA he is unlikely to be returned home for life and can earn on average over £4,000 per week for private profit.

profit.http://www.cqc.org.uk/sites/default/files/tah_coreservice_crisis_services_and_health-based_places_of_safety_sheffield_health_and_social_care_nhs_foundation_trust.pdf

Now it triggers ‘community living’, and this, unlike hospital admission under the MHA, is under the MCA for life and held in secret with parents gagged, and prevented from even seeing their adult children ‘in the community’, if in their childrens ‘best interests’.

These projected 24,000 a year will now be fed into the ‘community living’ industry, and be made a  valuable commodity with an increasing income potential of at least £4000 per week, guaranteed for life.

Plans for a large autistic village community living has already caused concern.

Alarm over huge new ‘care village’ for autistic adults

And  those at ‘risk of admission’, and the 3000 ATU, are in addition to all other LD/Autistic, whose only adult support service is now ‘community living’ .

So this is the rounding up of lifetime captive cash cows.

So, other than the financing and setting up of local bodies, and chosen, private monopoly providers, receiving millions of public money, and billions of future guaranteed income, and the LD/ autistic/CB living being incarcerated in the area they originated from, how else has this transformed care ?

Already cottage style care villages built in eighties are being demolished to build cheaper smaller units to factory farm the disabled for ever  more profit.

http://www.thejournal.co.uk/news/local-news/ponteland-care-village-could-demolished-4445220

 

 

 

 

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Winterbourne View- vital questions that remain unanswered.

Staff WinterbourWhy did the NHS pay Winterbourne View providers at least £4,000 per week to drug and baby sit the autistic and so called ‘learning disabled’ ?

Where else could a company charge £4,000 +, and be commissioned privately, to employ workers on 12 hour shifts to drug, torture, and abuse very vulnerable adults?

Where were all the psychiatrists, nurses ,social workers, NHS managers who commissioned the services, and prescribed the risperidol  administered to the lady under the chair by pinching her nose?

Why were they not held responsible ?

Why were only care workers prosecuted and sacked ?

How and  why was this deemed ‘assessment and treatment’ under the Mental Health Act?

How and why were the residents legally detained under MHA per se, and for so long ?

Why have successive governments allowed billions of profit to be made out of public money, at the expense of our most vulnerable ?

Why was insufficient support at home given to the Winterbourne parents, some becoming so desperate they attempted suicide.?

Why did the CQC, after being alerted by managers of the numerous allegations of abuse in Winterbourne, wait for over 3 years from February 2008, and a national scandal revealed by BBC , particularly as, ‘The recorded events between 2008-11 [were} fragmentary’ according to the  SCR, to do anything about the abuse ?

Why did the managers, and the police the abuse was reported to, do nothing ?

Why was a BBC Programme only then commissioned, and used to reveal abuse, already known to the regulators, the managers, and the police ?

Why were no managers/executives sacked or prosecuted, just poorly paid, working 12 hour shifts care workers ?

Nothing has been done about, as CQC described,‘the systemic failure to investigate claims of abuse’ in all present and future residential care providers.

It did  not stop the abuse that Thomas Rawnsley suffered, only two years later in Homeleigh House, and then his further abuse in Kingdom House where he died.

Why was Winterbourne View, a private venture capital institution, merely as dramatic propaganda, to convert and rebrand NHS publically managed ‘treatment and assessment’ Units, to privately owned ‘community living’ and ‘specialist hospitals’, with the same inadequate safeguards, commissioning, staffing and oversight and run for profit ?

What has changed to stop Winterbourne abuse happening today, or, in future similar institutions rebranded ‘ community living ?

How much profit has been made by investors, managers, banks, accountants. experts, lawyers, consultants, campaigners, PR gurus, pharmacies, care agencies, private company providers?

Billions.

Read the serious case review here, my blogs and decide for yourself, if anything has changed, or will change, in the long awaited expensive solution to Winterbourne View abuse,- the use of similar for profit institutions as Winterbourne only more of them, nearer their original local community/parents.

http://hosted.southglos.gov.uk/wv/report.pdf

And read the only plans for all disabled- ‘Community Living for Profit’.

https://www.learningdisabilitytoday.co.uk/local-plans-to-transform-care-for-people-with-learning-disabilities-and-or-autism-launched.aspx

 

 

 

 

MCA illegality of removal LD/Autistic to ‘Community Living’ and professionals involved.

Thomas7

Thomas Rawnsley escorted to his ‘community  living’.

Thomas11

Thomas’ Independence

article-1392892-0C588EA100000578-553_468x286

A young lady living independently in Winterbourne View.

Far from giving carers rights and support, the Care Act conspires to break family carers, and gain evidence it is not in a vulnerable person’s ‘ best interests’ to remain at home.

The removal from the family home to extremely lucrative- £6,000 + a week private provision is euphemistically termed ‘independent’ and now rebranded ‘community living.

It is anything but as every move of this ‘living’ is controlled in secret, and away from public and relatives’ eyes.

Family are often excluded on the grounds visits upset and are  therefore not in the ‘best interests’ of those living in the ‘community’.

It is still termed ‘independent ‘ and ‘living in the community’ despite courts deeming it a deprivation of liberty with its 24/7 supervision with no choice given.

Is there any evidence, that residential living for life is actually in a persons ‘best interests’?

No, it is,  because the states says so.

But no one measures the outcomes of those who live there, as individuals, or, as a group.

So there is no effective monitoring of this deemed ‘best interests’

An Adult Services Manager, reviews the Care Provider’s, his employer commissioned Care Plan.

The Care Quality Commission may make announced inspections of documentation and placement.

A CQC whose regulation has been critised, as not fit for purpose, and who ignored the Winterbourne View and Thomas Rawnsley.

Inspecting Cambian’s Kingdom House for the first time on announcement, only after Paula Rawnsley’s complained of her son’s abuse and found none and rated it ‘good.’

And then 10 months after Thomas unexplained death the CQC merely did a second announced inspection rating it again ‘good’.

The state does not inspect and assess the kind of life, they decide is in a person’s ‘ best interests’, nor, review their situation, once a person has been removed there.

So they cannot, and do not bother to explain, how such a life can be in anyone’s let alone the vulnerables ‘best interests’.

And the vulnerable, his IMCA, or parents are not allowed to decide what is in their adult child’s ‘best interests’.

And, a family have no enforceable rights, so cannot protect their loved ones, no matter how serious the abuse, or, inadequate the care as Paula Rawnsley found out when she was even gagged from going to the press etc weeks before he died.

The government’s plan is enforced, unaccountable ‘community living’ and medication for maximum profit, claimable for life.

And, it has ensured, the captive consumers, have no voice, rights, choice, or means of escape.

The assessors of ‘best interests’ are jointly managed by the Adult Social Services and Health and Social Care Trusts.

And their decision enforced by the Court of Protection.

Their weapons  Care Act safeguarding, wellbeing and ‘best interests’ and 433 million public aid.

All are part of a multiagency safeguarding hub- MASH, which includes GP practices.

Here they share unchallenged ‘information’ illegally, without check on its accuracy or reliability.

All are charged and paid, to collaborate to implement government policy, and so potential/future and/ or existing neglect, abuse and safeguarding issues will be found.

GPs, and home nurses monitor and assess, the cared for and carers’ health and wellbeing.

But only as this relates to actual, or risk of, neglect ,abuse and/or safe guarding.

Occupational Therapists are part of the team, and are now treated as appropriate trained professionals, thanks to lobbying by the College of Occupational Therapists (COT).

They assess wellbeing through day to day activities.

https://www.theguardian.com/social-care-network/2016/aug/08/four-things-occupational-therapists-need-to-know-about-the-care-act?CMP=share_btn_tw

If there is no support , day centres closed, and schools SEN funding ending at 16, such activities are limited.

And family Carers will find it financially and physically, impossible to continually provide activities and 24/7 support, particularly without respite, again no longer provided.

Occupational Therapists also assess the ‘suitability’ of a person’s living arrangements, and, as housing, equipment, beds, etc, are not funded, this is likely to be inadequate.

Person Centred Planners are funded by the Local Authority.

They assess interests, desires and activities, past and present.

And as stated these are now likely to be limited.

The PCP then writes a statement in the first person, purporting to be the disabled person, describing all they previously did and/or want to do, but no longer can. But may ignore their wish to remain at home, and that they love their family.

And anything suggesting neglect/abuse/ safeguarding may also be mentioned- ”I wish I could see more of Daddy’, ‘I don’t like it when Mummy cries’. ‘I like to help Mummy cook’.

The Developmental Officer, a care worker paid at a higher rate, will assess how the cared for are being ‘developed’ within the family home.

A clinical psychologist assesses the effect of living at home, any emotional abuse and the general psychological wellbeing of carers and cared for.

A psychiatrist looks for signs, or risk of mental disorders of carer and cared for, and the effect of caring on them both.

If any care support is funded, this must, under the Care Act be chosen by the LA.

And it will be briefed to assess family carers’ care, and look for safeguarding, neglect and abuse risks.

The team will have regular secret meetings, but concerns, and assessments will not be mentioned to family carers, until disclosed in reports just before a court hearing to decide ‘best interests’.

The LA and HSCT lawyers and the Official Solicitor, will agree these assessments, as will the Judge.

The Emperors Clothes of ‘expert’ corroboration, will appear over whelming, but lack any substance, and remain unchecked and unchallenged , but decides a family’s fate.

In breach of the disabled, and their family’s human rights to privacy, family life and a fair hearing.

And of the Equality Act, and Discrimination Act, as the disabled are being discriminated against.

If an autistic, add the Autism Act, as their autism is not considered .

It is also in breach of the MCA, as blanket capacity assessments are used, the wishes ( to stay at home ) of the incapacitated  ignored, and the most, ( removal) ,rather than the least restrictive option is ordered.

But systemically, these rights cannot be enforced, and are ignored.

And at best 1 family representative must fight 3 lawyers and an army of ‘experts’.

We need actual figures of those incarcerated, drugged, isolated, in misery barely existing and dying in unknown numbers of ‘natural causes’ with no investigation.

All earning millions for their jailers, experts, managers, courts, lawyers and venture capital investors.

And the situation is getting far worse, as numbers are increasing and ever larger Units are being built and the government has fed 433 million to LAs, and HSCTs to encage via safeguarding and MCA ‘best interests’.

https://finolamoss.wordpress.com/2016/05/19/how-will-433-million-carers-act-implementation-money-be-spent/

We can only glean by comments of care workers, what is happening in these places, the CQC are doing nothing about the chosen venture capital backed monopolies like Cambian/Lifeways.

https://finolamoss.wordpress.com/2016/04/14/workers-expose-life-in-lifeways-supported-living/

Our most vulnerable will become audit statistics, to make ever greater profits in ever larger more profitable settings, the bungalows replaced by wards, and families will not even be allowed to know where they are housed, let alone worry about their distance from them.

Justice Munby in Re:S, sums it up for me perfectly:

“115] I am not saying that there is in law any presumption that mentally incapacitated adults are better off with their families: often they will be; sometimes they will not be. But respect for our human condition, regard for the realities of our society and the common sense to which Lord Oliver of Aylmerton referred in In re KD
…, surely indicate that the starting point should be the normal assumption that mentally incapacitated adults will be better off if they live with a family rather than in an institution – however benign and enlightened the institution may be, and however well integrated into the community – and that mentally incapacitated adults who have been looked after within their family will be better off if they continue to be looked after within the family rather than by the State.

[116] We have to be conscious of the limited ability of public authorities to improve on nature. We need to be careful not to embark upon ‘social engineering’. And we should not lightly interfere with family life. If the State – typically, as here, in the guise of a local authority – is to say that it is the more appropriate person to look after a mentally incapacitated adult than her own partner or family, it assumes, as it seems to me, the burden – not the legal burden but the practical and evidential burden – of establishing that this is indeed so. And common sense surely indicates that the longer a vulnerable adult’s partner, family or carer have looked after her without the State having perceived the need for its intervention, the more carefully must any proposals for intervention be scrutinised and the more cautious the court should be before accepting too readily the assertion that the State can do better than the partner, family or carer.

But, as now, if no support provided by LA, as required by Chronically Sick and Disabled Act 1970, but if sued they defend, that support is residential, then likely to be held a proportionate interference by state under HRA, and the lack of available care at home would rebut the presumption.

So Munby’s statements of humanity, and obvious ‘best interests’ can be subverted by LA policy, as can MCA.