An incident between a resident and a care worker at Winterbourne View, in Bristol, filmed by the BBC in its investigation into Castlebeck. Photograph: BBC/PAA private care company that was forced to close one of its hospitals following horrifying allegations of abuse has been ordered by the social care watchdog to make "root and branch improvements" after inspectors raised "serious concerns" over the treatment of people with learning disabilities at a further three hospitals and one care home.
The Care Quality Commission (CQC) initially investigated Castlebeck after an undercover BBC reporter secretly filmed vulnerable residents with learning disabilities at Winterbourne View hospital near Bristol being pinned down, slapped, doused in cold water and repeatedly taunted and teased. Twelve people who worked at the hospital were arrested and are currently on police bail. Four other employees were suspended from Castlebeck's Rose Villa care home in Bristol amid claims of misconduct.
The CQC has since inspected 23 properties and services owned by Doncaster-based Castlebeck and nearly half were "judged by inspectors to be non-compliant with the essential standards of quality and safety". Of these, patients in four – Arden Vale, near Coventry; Rose Villa, in Bristol; Croxton Lodge, in Melton Mowbray, Leics; and Cedar Vale, in Nottingham – suffered ill-treatment.
Among the failings, inspectors found that patients were not safeguarded from "physical and emotional harm", "restraint was [not] always appropriate, reasonable, proportionate and justifiable to that individual", "people … are not safe" and there were not enough staff. As a result of the findings, the Nursing and Midwifery Council launched an investigation into the conduct of registered nurses employed by Castlebeck.
The stakes are high, as the CQC has the power to strip Castlebeck of the right to provide services.
CQC chief executive Cynthia Bower said the problems were not on the same scale as Winterbourne View. "Our inspections have found a range of problems, many of which are found in a number of different services. This clearly suggests that there are problems that Castlebeck needs to address at a corporate level – the company needs to make root and branch improvements to its services and processes," said Bower.
The other non-compliant sites are: Acrefield House in Wirral, Briar Court nursing home in Hartlepool, Chesterholme in Hexham, the East Midlands centre for neurobehavioural rehabilitation in Melton Mowbray, Hollyhurst in Darlington, Oaklands in Hexham and Willow House in Edgbaston.
The CQC is following up its Castlebeck inquiry with a major review of learning disability services. "We will carry out unannounced inspections of 150 of these services," said Bower.
Paul Burstow, the care minister, said that "what went on was unacceptable" and "commissioners in local authorities and the NHS need to ask themselves whether [Castlebeck] are the right people to be taking services from".
Castlebeck is owned by Lydian Capital Partners, a Geneva-based investment fund backed by a consortium of investors including Irish billionaires Denis Brosnan, Dermot Desmond, JP McManus and John Magnier, the racehorse breeder. The NHS and local authorities pay Castlebeck an average of ?3,500 a week to care for each patient. Since 2006, when Lydian Capital bought the company, yearly receipts have risen by 80% to ?55m.
Paul Brosnan, the 35-year-old chairman of Castlebeck and son of Denis Brosnan, resigned earlier this month in the wake of the closure of Winterbourne View. Dick Stockford, a veteran NHS adviser, was brought in to turn the company around.
Castlebeck chief executive Lee Reed said the company identified the areas for improvement when he took the job in January. It then spent several months on "the subject of internal reviews and recommendations".
He said: "The safety and wellbeing of people in our care will always be of paramount importance to us and we will have a zero tolerance policy towards inappropriate behaviour directed against those who use our services. We remain deeply sorry for all that happened at Winterbourne View and also apologise for any incidents where our services have in the past not met the high standards that we, those we support and their families, expect and deserve."
The Department of Health announced a new review of quality and regulation in social care, led by Imelda Redmond, chief executive of the charity Carers UK. She will look at the standards of care homes, staff training and the way in which they are monitored.
Burstow said her recommendations would form part of a white paper on adult social care due next year, which is also expected to disclose future funding options for elderly care.
However Labour were critical of the government, saying that data showed nearly one in five people in learning disability hospitals such as Winterbourne View had been there for more than five years. "You have NHS cash being used by councils to fund places where people with learning disabilities are left for years. We need to get them out into the community," said the shadow health minister, Emily Thornberry.
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