The CQC has taken action to tighten up on homes with ‘closed cultures’.
According to the CQC, these are more likely to be homes where residents are highly dependent on staff to meet their basic needs, where there is poor management and leadership and where there are concerns about the numbers, skills and level of training for staff.
In new guidance, inspectors have been told to operate a “low threshold for deciding to carry out a responsive inspection” in homes that they consider to be at high inherent risk of having a closed culture.
Warning signs will include:
- concerns raised by staff working in the service, by families or others that relate to how people are being treated, incidents involving violence or how complaints are handled
- whether managers know what is happening in the service day-to-day
- whether manager acknowledge potential signs of poor culture or potential abuse
- a high proportion of people being cared for in some form of isolation, away from other people using the service
- people using the service being restricted without proper consideration of their human rights. As well as restraint, this includes restrictions on access to food and drink, to using the toilet, to going outside, to visitors and to their own clothes and possessions.
In May 2019, BBC Panorama exposed the culture of abuse and human rights breaches of people with a learning disability at Whorlton Hall. It reinforced how important it is for everyone involved in the care of people with a learning disability or autistic people to identify closed cultures, where abuse and human rights breaches may be taking place.
In addition to publishing the guidance, the CQC has commissioned two independent reviews into the regulation of Whorlton Hall.