Introduction

Two stories dominated the British news media in the early summer of 2011. The first concerned Winterbourne View, a private hospital for adults with learning disabilities near Bristol. Undercover filming for the BBC Panorama programme in late May 2011 showed staff there involved in appalling abuse of vulnerable residents, some of it verging on torture. Residents were seen being pinned down by staff members, slapped, dragged out of bed and, in one case, doused in water and left outside in cold weather. The programme caused public outrage and some weeks later, the home, owned by the private care company Castlebeck, was closed by the Department of Health and a group of eleven carers subsequently charged with some 45 counts alleging illtreatment against or neglect of five victims.

Hard on the heels of the Winterbourne scandal came the announcement of the closure of Southern Cross, with 37,000 residents in over 750 care homes, the biggest provider of residential care for older people in the UK. The announcement caused huge anxiety among the residents of its care homes, their relatives and Southern Cross workers, 3, 000 of whom lost their jobs. In echoes of the banking crisis of 2008, the state was forced to step in, with the Conservative– Liberal Democrat Coalition Government announcing that no resident would be turned out onto the street. In the event, many of the homes were subsequently bought out by Four Seasons, the second largest care provider (the financial stability of which was also the subject of considerable speculation in the financial press during 2011: Bowers, 2012; Scourfield, 2012).

Any suggestion that Winterbourne and Southern Cross were simply ‘bad apples’, anomalies in an otherwise high-quality social care sector, was quickly dispelled by a second Panorama investigation in October of the same year. That programme gave examples of four former Winterbourne residents being assaulted in their new homes, the homes to which they had been moved.

More systematic evidence came in a Care Quality Commission Review of Learning Disability Services in 2012 (CQC, 2012). That report was based on unannounced visits to 145 establishments: 68 NHS Trusts providing assessment and secure services; 45 independent health-care services providing assessment and treatment; and 32 adult treatment and secure services.