Regulation of intellectual disability services
| Date | 05 May 2015 |
| Published date | 05 May 2015 |
| DOI | https://doi.org/10.1108/AMHID-01-2015-0005 |
| Pages | 101-107 |
| Author | Afra Kelsall,John Devapriam |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Regulation of intellectual disability
services
Afra Kelsall and John Devapriam
Afra Kelsall is Winterbourne
View Strategic Case Manager
at NHS England (seconded
from the Care Quality
Commission), Leicester, UK.
Dr John Devapriam is
Consultant Psychiatrist at
Leicestershire Partnership
Trust, and National
Professional Advisor for ID at
Care Quality Commission,
Leicester, UK.
Abstract
Purpose –Winterbourne and Mid-Staffordshire scandals have had a significant impact on how Care Quality
Commission inspects and regulates intellectual disability services (IDS). The purpose of this paper is to
describe the changes and development of regulation of these services and future work.
Design/methodology/approach –The paper is a descriptive paper.
Findings –A new regulatory model is currently implemented for IDS. It has been developed in consultation
with patients, carers, providers and other stakeholders. There will be ongoing developmentand refinement of
the inspection methodology.
Originality/value –This is an original descriptive paper which will provide useful information to readers on
how the regulatory process works in IDS.
Keywords Learningdisability, Regulation, Intellectual disability, Inspection,Assessment and treatment units,
Winterbourne
Paper type Viewpoint
Background
Services for people with intellectual disability
Historically, most people with intellectual disabilities were cared for in hospitals. Following the
normalisation movement of the 1980s, these long-stay hospitals were closed. The number of
hospital beds fell from around 64,000 in 1970, to well under 10,000 by 2001 (NHS England,
2013) and around 3,954 by 2012/2013 (Royal College of Psychiatrists, 2013). The closure of
long-stay hospitals was accompanied by an increasing focus on community intellectual disability
teams providing a range of services, including those for mental health and behavioural difficulties
(Lindsey, 2000). Current provision of specialist intellectual disability services (IDS) can be best
described by the Tiered model of care with Tiers 1-3 constituting community services and
Tier 4 constituting in-patient services (Royal College of Psychiatrists, 2011). Within this model, the
purpose of in-patient beds changed from one that provided long-term residential accommodation,
to one that was accessed for assessment and treatment of severe mental health and/or behavioural
difficulties across a six different categories of bed types (Royal College of Psychiatrists, 2013).
Winterbourne and Mid-Staffordshire
Tier 4 (in-patient services) for people with intellectual disabilities came under scrutiny following the
broadcast of the BBC Panorama programme “Undercover Care: the Abuse Exposed”.Following
this abuse scandal, a number of reports (Department of Health, 2012a, b) were published
describing these units as a new form of institutional care which had no place in the twenty-first
century and concluded that there were too many people staying for too long within these units.
In 2009, an independent inquiry into Mid-Staffordshire NHS Foundation Trust found widespread
and system deficiencies in care and lack of clinical governance arrangements. The failings at
Received 31 January 2015
Revised 31 January 2015
Accepted 13 March 2015
DOI10.1108/AMHID-01-2015-0005 VOL. 9 NO. 3 2015, pp. 101-107, © Emerald GroupPublishingLimited, ISSN2044-1282
j
ADVANCESIN MENTAL HEALTHAND INTELLECTUAL DISABILITIES
j
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