Response to BBC Panorama programme

A statement from Julie Layton – Chief Executive of Advance Housing and Support


“Like everyone who watched the BBC Panorama programme we were shocked and angered by the examples of abuse highlighted. We welcome the CQC recommendation to carry out an independent review of the care and discharge plan for each person in a segregation ward for people with a learning disability and/or autism. Government must do everything it can, and with the utmost urgency, to ensure that everyone in an Assessment and Treatment Unit has access to the expertise and funding to support a transition into the community.

As a not-for-profit housing and support provider we have a proud record of using Positive Behavioural Support and intensive 24/7 support to help people out of long-stay and secure settings to live well and successfully in their own homes.
We are not alone in the sector in this approach. The argument that `it’s too difficult’ to move people from long-stay units into the community just doesn’t wash. Transforming Care Partnerships made some progress – but more needs to be done. We believe that with the right amount of determination, collaboration and funding, it should be possible to give everyone the opportunity to move out of a setting which no longer meets their needs into their own home in the community.

Some of our customers come from a forensic mental health setting; others come from, what may have been, years spent in children’s homes, care homes, hostels, prison as well as long-stay hospital settings. Where other agencies or providers have given up or washed their hands of the issue, we have not. We cannot pretend it’s easy or that we have a magic formula that makes things work perfectly but what we have found is that our person-centred approach is successful when all parties and agencies work together to find a solution that preserves the dignity and level of independence that person deserves. What we know is that we are robust in Advance in the application and embedding of our core values including working in partnership with families and other agencies and respecting the people we support.

We have a long history of this type of work. For example, John – a young man of 24yrs old – had been at Winterbourne View. When we got involved with his support it was clear that a safe solution was needed to support John in the community – his behaviours were challenging and certainly exacerbated by the terrible experience he had in Winterbourne. Advance worked with the local council and NHS England to fund a shared ownership arrangement to enable him to purchase a bungalow in which he has lived in since 2015, with 2:1 support. Our home ownership for people with long term disabilities product enabled him to buy a stake in a home of his choosing. This gives him and his family the support of us providing the maintenance to the property and stability of us having a stake in the property. In his new home he receives additional support and input from two other local mental health charities.

We initiated a Multi-Disciplinary Team meeting with all partners to pull together the right support package. Our Regional Housing Officer pursued a disability facilities grant to adapt the property to meet his needs. Our Support team brought together a dedicated team to support him in his transition to independent living. While the work was being done to adapt his new home, and to minimise disruption, John was supported to go on holiday - the first in his life.

As well as a better quality of life, moving out of ATUs makes economic sense. The cost of a bed in an inpatient unit (such as an Adult Treatment Unit) is estimated by NHS England to cost on average £3,500 per week. The National Audit Office identifies the cost of inpatient admission for people with a learning disability in a mental health hospital as £180,000 per annum (£3,461 per week). In reality, however, the costs can vary hugely from one person to another, with packages in ATUs costing upwards of £10,000 per week not being unheard of.

Moving people out of ATUs and long-stay secure units is not simple – the slow but gradual progress with Transforming Care Programme shows us that – but transition is possible and is a reality for some. ATUs have their place and purpose in certain situations but for those families who want their sons and daughters to live in the community with dignity - shouldn’t that be an option open to all of them?

It will take a concerted effort on behalf of housing and support providers, charities, local authorities and government to work collaboratively to find the right `person-centred’ solution and provide a fully funded package of care and support that works for that individual. Living as independently as possible with dignity, free from fear and harm is a basic human right.
It is tragic that eight years on from Winterbourne View we are still hearing harrowing stories of people living in the most awful conditions while there are solutions available in the community. We can and must do better together.”