Sunday, 5 June 2011

Devils Workshop of Winterbourne View

A feature of the Winterbourne View, Castlebeck (Panorama) appalling saga that lingers most with me brings to mind the cliche that idle hands are the devils workshop. The programme left more than a suggestion that the staff behaved as they did because they had nothing better to do. Jim Mansell of the Tizard Centre effectively said this in his comments. That they made entertainment by provoking residents into responses that would justify 'restraint'. Escalation of verbal and physical goading amounting to torture leading to some sort of misguided sense of 'job done' by the shift. Is this what people do when they are bored at work - I don't think so?

This is what happens when management allow unsuitable persons to do the wrong tasks with inadequate training and leadership. Incidents of neglect or cruelty almost always occur in these circumstances as found by J.P. Martin in Hospitals in Trouble 1984. At the beginning of the book he quotes Sir Keith Joseph who said in 1971: 'I must tell you that one day somebody will write a book about the part that scandal has to play in procuring reform.' This is the book, and those who do not know the history it contains may be doomed to repeat it. Management at Castlebeck clearly did not know and thus the circumstances conspired to allow 'Wayne' and his cohort of approval seeking and bored bullies to perpetrate vicious abuse.

So let us be clear bored people are not bad people but they are susceptible to bad leaders. 'Wayne ' was characterised in the programme as typical of a long serving, unqualified and very 'strong' leader - the tattoos adding emphasis for the programme maker. What Winterbourne View, as a private hospital, was crying out for was professional leadership from a qualified and experienced manager (equivalent to the registered manager in a care or nursing home - are they exempt from Outcome 24 of the Essential Standards of Quality and Safety?) backed up by a vigilant and informed responsible person from Castlebeck - all reinforced by effective regulation from CQC. What did they get - disinterested charge nurses, organisation managers who seemed to think that if they had suspended staff when the whistle was first blown all would have been OK and a regulator that has been denuded of professional expertise.

Scandals like this in residential care are not about size of the home, they are not about private versus public care and they are not even about resources for training or better pay. They are about having the right professional leaders of social care practice at every level - care worker, (registered) manager, responsible person, commissioner and regulator. The residents of Winterbourne View suffered in the devils workshop because of a multiple failure of leadership at every level. Castlebeck need not pay Price Waterhouse Cooper to find that out when they can buy J.P. Martins book for £17.50.


  1. Private hospitals do have registered managers - not sure where Winterbourne View's was - they also have to be providing medical treatment (not just nursing care) to fall into the hospital category. The psychiatrists involved should be added to your list of leaders required

  2. It is a mistake, I think, to play the game of trying to pin down the one true cause of abuse, ill-treatment and neglect. The point is (as I argued in Community Care recently) that these things have multiple causes. Having the 'right professional leaders' is part of the picture - but don't dismiss size, model of care, staff recruitment and training and the profit motive - they all have their part to play in understanding what happened.

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