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Firshill Rise: Sheffield’s learning disability community speaks up against service failings

Shocking discoveries at Sheffield service for people with learning disabilities and autism lead to ‘inadequate’ ratings and a closure to new admissions.

Firshill Rise Google Maps

Firshill Rise, a service in Sheffield for adults with learning disabilities and autistic adults who are experiencing mental health or behavioural difficulties, has been rated inadequate by the Care Quality Commission (CQC). The seven-bed unit was inspected without warning following reports of safeguarding concerns.

The NHS website for the service describes its ethos:

At Firshill Rise we support our service users to achieve the best quality of life they can by helping them learn new skills, get involved in the local community and ultimately lead fun and interesting lives.

We plan for discharge from day one. We understand that a hospital is not a home and that everything we do is aimed at supporting a positive community-based outcome for the people we serve.

We believe in positive and proactive support. Our care plans focus on actively supporting service users and their care team to develop strategies that increase their wellbeing and decrease risk.

Despite Firshill Rise, which is an Assessment and Treatment Service, receiving a ‘good’ rating in October 2018, the latest report means that the service is barred from admitting new patients without written permission from the CQC.

Debbie Ivanova, CQC’s deputy chief inspector for people with a learning disability and autistic people, said “People were not being looked after in a way that was safe, effective, or caring. We saw staff ignoring a person for basic needs like food and drink, and staff were seen talking amongst themselves rather than engaging with people using this service.”

Assessment and Treatment Services (also known as Assessment and Treatment Units, or ATUs) should be short-term measures that help a learning disabled person to recover sufficiently to move back to the community. However, Firshill Rise has been keeping some patients for so long that they risk becoming institutionalised.

The CQC heard that patients had had requests for food and drink ignored, that restraint had been overused, and that people had been put into isolation; dehumanising approaches that are not conducive to good mental health care.

The service was judged not to be safe, not to be caring, not to be effective, not to be responsive and not to be well led.

Sheffield Voices is a self-advocacy group for people with learning disabilities and autism. In response to the report, the group made a video.

I was invited to attend their next meeting and spoke with Kathryn Littlewood, the group’s manager, and the group members about how they feel about what they have learned.

Members of the group are all concerned that this is just one in a long line of scandals about the treatment of learning disabled people in Britain. Following on from Winterbourne View and Whorlton Hall, another Assessment and Treatment Unit, Firshill Rise is further proof that institutionalising people rather than offering individualised care and support is letting disabled people down.

Becca believes that people should live in “a home where they feel safe, in the community that’s helping them to get some of their goals”. And group member Michael shares the feelings of many when he says “It’s disgusting. They need to close it down”.

One member of the group is experiencing problems within her own living situation and says that reports she has made to safeguarding teams over the last two and a half years have gone unaddressed.

There is scepticism among group members about the effectiveness of services like this and the group is keen for managers and services to be held accountable. When somebody is disempowered and does not necessarily have control over where they live, they have few options to escape abusive or unsuitable situations. When some of those people are unable to vocalise their complaints, or their methods of communication are not understood by those around them, as is often the case, they are even more vulnerable to abuse. The group also noted that only care homes are inspected by the CQC, while supported housing is not.

The fact that somebody has a learning disability or is autistic is not an excuse to treat them with any less kindness or respect than anybody else. “People like us are human”, Darren said. "We've got a heart. We breathe. You know, we've got lungs. We’re just, you know, slightly different.”

Marie points out that “what the general public ought to realise is that everybody's totally different as an individual. And there are different levels of learning disabilities, and a lot of it is a one-size-fits-all regime.”

Other group members like Craig and Andrew are keen for a more visible, easily accessible rating or league table system, based on feedback by residents. For instance, plaques outside a home could include a star system so that people and their families can choose to live somewhere based on these ratings.

All agree that staff at such services should be trained by experts with experience, i.e. those with learning disabilities and autism themselves. Now Then can reveal that Firshill Rise asked Sheffield Voices to attend to offer self-advocacy in April this year, but they requested urgent help, which Sheffield Voices does not offer.

Kathryn says that she explained that Sheffield Voices is not a crisis or emergency service.

We need to train people to properly go into Firshill to help do peer advocacy, and we agreed with them that they would pay us to do that. And then, just four days before we were meant to go, they clearly forgot that they‘d agreed that we were going in, and I asked them what the setup was and they said "Oh sorry, there's nobody living here anymore". So clearly one hand didn't know what the other hand was doing.

Sheffield Voices has been running for eight or nine years. Why suddenly approach us when the CQC have gone in?

“It stopped people from having a voice”, Marie, who was supposed to be on that team to go into the service, says.

Sheffield Voices members are interested to see whether any staff members who had carried out acts of abuse would be criminally charged or whether they would be safe to “just walk away and go and get another job”. Now Then approached South Yorkshire Police but did not receive an answer to this question.

Silence is violence placard
Jason Leung

ATSs and ATUs have long been a thorn in disability activists’ sides. Campaigns have called for their closure and the Equality and Human Rights Commission has said that the government’s failure to move disabled people out of them is “a systemic failure to protect the right to a private and family life, and the right to live free from inhuman or degrading treatment or punishment, under the European Convention on Human Rights”.

In response to the CQC report, Mike Hunter, Medical Director at Sheffield Health and Social Care NHS Foundation Trust, said, "We are very sorry that we have not delivered good care consistently in our unit at Firshill Rise and we will improve the care we provide there.

"We have now temporarily closed the unit to admissions to give us time to make the required changes including training for staff and thinking carefully about how we provide services in the future. The service users who are still in the unit have more activities and extra support to help them have a better experience in our care.

"We will work with service users, their families and carers, and our health and care partners to make these changes. We will ensure that Sheffield and South Yorkshire have an Assessment and Treatment unit that we can all be proud of, because it supports the needs of some of the most vulnerable people in our communities."

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