Worse than Broadmoor for autistic children, reveals whistleblower nurse
Published by The Mail on Sunday (6th January, 2019)
Ian Summers spent eight years as a mental health nurse at Broadmoor, the high-security psychiatric hospital holding some of the most dangerous criminals in Britain. So it is chilling to hear him reveal that he saw patients more often violently held down, forcibly drugged and attempting suicide while working in a hospital unit holding vulnerable teenage girls – some of them autistic – than when he looked after serial killers, child abusers and psychopaths.
‘I am ashamed by what I have witnessed,’ he says. ‘It is simply barbaric – worse than Broadmoor. I’ve never seen anything like it. They are destroying the lives of young people in the most desperate need of help.’
Now he and two senior colleagues have blown the lid on what they call ‘shameful institutionalised abuse’ taking place behind the locked doors of Meadow Lodge, a unit in Devon funded by the NHS.
Their shocking claims – corroborated by other staff, patients and families – follow a series of reports by The Mail on Sunday exposing the shameful treatment of children and young adults with autism and learning disabilities. They are taken from their families and held against their will in secretive secure health units and Assessment Treatment Centres (ATUs).
Our reports have led to three official inquiries as more and more families have come forward – some of them breaking gagging orders – to tell how their children have been locked in solitary confinement, fed through hatches like animals, and forcibly medicated. One man, to the dismay of his distraught parents, has been held for 18 years.
Mr Summers, 56, and his fellow whistleblowers say places such as Meadow Lodge show how ‘the whole system is failing people with autism’ when adolescents with serious problems are simply seen as ‘cash machines’ for private firms which can charge up to £730,000 a year for each patient.
Meadow Lodge is operated by Huntercombe, a controversial group whose parent company the Four Seasons Health Care group is nominally owned by the private equity firm Terra Firma Partners III which is run by Guy Hands, one of Britain’s richest men. Huntercombe has handed its best-paid director more than £1 million over the past two years.
Among the allegations made to this newspaper are that:
– Teenage girls were left bruised and distressed after being held down by teams of adults for up to one hour 45 minutes;
– Adolescents were forcibly injected in the buttocks and made to take cocktails of powerful drugs to sedate them;
– Agency staff slept when they were supposed to be monitoring teenagers at high risk of suicide and self-harm;
– Staff were told not to take young patients to hospital after incidents of self-inflicted injuries and a drug overdose;
– Records of restraint and the use of ligatures by patients to hurt themselves were not filled in properly and falsified;
– Unsafe practices included failure to monitor keys properly, inadequate training in life-saving techniques and staff shortfalls;
– A senior carer was suspended over bullying and harassment charges, including the use of sexually suggestive language in a unit holding victims of child abuse.
– Meadow Lodge staff were transferred from a nearby unit under ‘special measures’, which was then closed amid concerns over dehydration, malnutrition and poor care.
Patients at Meadow Lodge were deeply traumatised by their experiences. One of them, a girl aged 14 when she was locked up there last year, told the MoS: ‘It was horrible. I saw things that really disturb me to this day. Some of the other girls who had been in different units said it was really bad compared to others.’
Her father said she left the unit in a significantly worse mental state than when she entered and became so stressed she attempted suicide. ‘It felt out of control and definitely under-resourced. It was like a prison – there was no help,’ he says.
The whistleblowers raised their concerns with Huntercombe directors, police and the Care Quality Commission (CQC) in August last year. Commission inspectors paid a surprise visit three months later and issued a safety warning notice.
Meanwhile, the whistleblowers were dismissed, and on Christmas Eve received their P45s. The company denies many of their allegations and insists that they were not dismissed for raising concerns.
Huntercombe opened the ten-bed Meadow Lodge in the village of Chudleigh in July 2017, just weeks before the closure of a similar ten-bed unit, Watcombe Hall, in nearby Torquay. It had been placed in special measures after a local hospital raised the alarm over the number of admissions and the state of patients turning up from Watcombe Hall. CQC inspectors discovered one patient had not eaten or had a drink for four days.
There were also concerns over high staff turnover, inadequate training, poor health assessments, overuse of restraints, failure to record incidents and a lack of activities. Inspectors saw one young person abscond over a fence while another had bruises on their upper arm from being held down. The injuries were ignored by staff, some of whom found new jobs at Meadow Lodge.
One of the whistleblowers, Jane, 50, a former prison officer who became a senior support worker at Meadow Lodge, says: ‘I would not have joined if I had known any staff came from there [Watcombe Hall]. I don’t put up with abuse of children.’
She and fellow whistleblower Joanne, a mental health nurse with 20 years’ experience, joined Meadow Lodge last January, and soon found that safeguarding concerns similar to those raised at Watcombe Hall were happening again, with children routinely held down by teams of up to three adults.
‘There was one girl with her arm in plaster who was always being restrained,’ says Joanne. ‘When I worked in adult units, there were maybe one or two restraints a month because we de-escalated situations, but this was going on all day long.’
Mr Summers, who joined in April, was also dismayed at seeing how troubled teenagers, bored by the lack of facilities or adequate therapy for traumas such as sexual abuse, were sedated with powerful drug cocktails and routinely restrained.
‘I would compare one week in Meadow Lodge to a year in Broadmoor when it came to restraint, and there was much more use of medication,’ he says. He alleges that teenage girls, some the victims of child abuse, were disturbed when held down violently in bedrooms by teams of four, including men.
Last year a CQC inspection highlighted increasing use of restraint and ‘physical intervention’, with 118 reported incidents in one month alone.
Yet the whistleblowers say they were not given training in specialist child mental health. The CQC found just 66 per cent compliance for basic life-support training, despite it being compulsory, and that ‘few’ agency staff completed mandatory training.
Joanne says that on her third night at Meadow Lodge, five staff had to deal with six girls self-harming. ‘One was head-banging, another throwing herself at the wall, then another started off in the corridor. I’d never seen anything like this and I still feel devastated since we had to leave the one in the corridor.’
Some patients entered the unit voluntarily but ended up being sectioned as their problems escalated. Yet the three whistleblowers say there were often no previous recorded issues of self-harm. ‘It was learned behaviour,’ says Joanne.
Campaigners warn that autism is often detected late in girls and that they mimic others in an effort to fit in, leading to eating disorders and self-harm when locked in psychiatric units instead of getting far cheaper and more effective support in the community.
‘There was one autistic girl who definitely should not have been there,’ says Jane. ‘All we did was restrain her. Autism is not a mental health condition and she could not cope with the screaming, the head-banging, the things she was seeing.’
The whistleblowers say two patients absconded one night while a third banged her head against a wall so badly that the teenager could not open her eyes the next day. ‘Her head was so swollen she looked like the Elephant Man,’ says Joanne.
Yet the whistleblowers claim a senior staff member ordered them not to take the girl to hospital on the bizarre grounds that his own face once swelled up after falling off his bike. The girl was later rushed into hospital, where she suffered a seizure.
Mr Summers, whose son has autism, says on one occasion he tried to take a 16-year-old who claimed to have overdosed to hospital, but was accused of overreacting. He also had to persuade bosses to let him rush a 15-year-old to A&E after she sliced her leg open with glass.
‘Parents would be really angry and shocked if they could see what was going on. They think these are safe places, but their children would be better at home,’ he says.
One support worker was found guilty of misconduct for being sexually explicit – yet was reportedly only briefly suspended.
Huntercombe told this newspaper: ‘The alleged incident of inappropriate language was between colleagues and not directed to young people.’
The whistleblowers also allege that legally binding records of restraint and other incidents were altered or not always filled in properly – claims confirmed to the MoS by staff still working at the unit. This is strongly denied by Huntercombe, which insists it tracks the reports for accuracy.
‘It’s the worst unit I have ever worked in,’ says one veteran care worker, who also complained of ‘liquid coshes’ used to sedate patients. ‘I’m always concerned about the welfare of the children, expecting to hear a coroner has been called. It’s scary.’
A therapist told how he quit after a few months because there were ‘no facilities, no budget, no support, no supervision and no infrastructure. It was difficult to attempt therapy in a room being used by staff for coffee.’
One former patient says she was attacked and bitten by another girl who was supposed to have two carers with her at all times: ‘They were just sitting in the lounge chatting, so I had to restrain her myself.’
Some teenagers were seen as posing a high risk of suicide so needed constant monitoring to stop them swallowing toxic items or tying ligatures made from torn-up clothing or sheets around their necks. Yet the whistleblowers say some untrained agency staff slept while they were supposed to be on duty at night.
Huntercombe says: ‘An incident where some agency staff were alleged to be asleep was investigated and appropriate action taken.’
Jane says that on one occasion, as she fought to save a teenage girl hanging from a shower rail, an agency worker bought a screwdriver rather than a specialist cutter to sever the ligature, saying he had never seen such an incident before.
Yet having raised concerns about the centre, Jane says she was suspended, then fired, for allegedly swearing during the life-saving rescue – something she denies: ‘I was told by one manager to keep my mouth shut or I would be sacked.’
Joanne and Mr Summers say they were dismissed for allegedly stealing documents after they gave patient observation sheets to a manager investigating their claims. ‘This system is all about money,’ says Joanne. ‘But I’m ashamed – these children are like caged animals.’
The CQC says it placed Meadow Lodge under ‘enhanced multi-agency surveillance’ after being ‘made aware of ongoing concerns’, then carried out an unannounced inspection in late November that prompted a patient safety warning notice. ‘Our priority is always the care and wellbeing of people using services.’
Huntercombe, which cares for about 700 patients in 23 units around the country, is part of a care home business that is no stranger to controversy. Stephanie Bincliffe, a 25-year-old with severe autism, died in one of its secure hospitals after staff allowed her weight to balloon to 25st as she spent years in a padded room.
A Huntercombe spokesman said: ‘Certain employees who were dismissed for gross misconduct are presenting themselves as whistleblowers. The reasons for their dismissal were categorically not for whistleblowing.’
He said a previous CQC inspection six months ago found patients and staff to be positive about services and did not raise concerns over ‘excessive’ use of restraint or medication. Potential ligature points had been identified and observations stepped up ‘as a precaution,’ while keys were never in the possession of patients.
He added that the recent CQC surprise inspection ‘was not related’ to the issues highlighted by the MoS: ‘All relevant external authorities have been satisfied the management team acted properly throughout.’