Please note that this article may be distressing and contains details of the alleged abuse.
On Wednesday 9th June 2021, it was reported by the BBC that four former employees have claimed that residents – Autistic children – are abused by staff.
Ty Coryton, based in Whitchurch, Cardiff in South Wales, is a facility providing both residential care and specialist schooling for Autistic children. The children attending – either as residents or as day school pupils – have extremely high support needs, most have co-occurring learning disabilities, and many have been failed by previous education establishments who were unable to accommodate their needs. These are children who are extremely vulnerable, are likely to be experiencing educational trauma, and who deserve to be treated with dignity, support, and respect.
Ten years have passed since the Winterbourne View scandal, it’s been five years since abuse at Mendip House was exposed, yet lessons are still not being learned. Autistic people – particularly those who also have a learning disability – are subjected to humiliation, physical and verbal abuse, and neglect. Restraint, including highly dangerous prone restraint, are being used regularly, often as a first response. Following evidence provided during the Winterbourne View review, both the National Institute of Clinical Excellence (NICE) and the UK government responded by updating guidance regarding the use of prone restraint in hospital and care settings. These advised that it should only be used if other de-escalation methods have failed (though at Autistic UK we do not condone any use of prone restraint), that there should be on-site access to lifesaving equipment such as defibrillators and oxygen, and it should be used for the shortest possible time – Autistic UK places this at zero seconds.
Despite these already conservative reformation attempts, prone restraint is often used as first response, and as mentioned in the Ty Coryton article, children are being restrained in this manner for prolonged periods of time, in this example 20 minutes. Prone restraint can kill. While this should be reason enough to ban its use, it also does nothing to de-escalate a situation; it provokes a fear response, either fight, (attempted) flight, freeze, or submit.
In addition to dangerous restraint, Ty Coryton, like with other institutions, have been accused of abuses such as secluding residents by locking them in their rooms, staff being verbally abusive, restricting access to food, and withholding money from the residents. While it’s easy – and typical – for individual staff members to be held accountable, these people are scapegoats for a wider issue. If it were simply a case of ‘a few bad people in the wrong job’ these horrific abuses wouldn’t be as widespread, nor would they span decades. Yes, individuals should report safeguarding concerns, but those who do are often managed out of their positions, or leave because no changes are made.
We spoke with a person who worked at Ty Coryton on a temporary basis in 2019 in the school. They have asked to remain anonymous, but informed us that they submitted a safeguarding report to their agency following their time at the school. While they stress that the staff they worked with genuinely seemed to care for the pupils, they were overworked, underpaid, and – due the environment being distressing to the pupils – often injured.
They told us that there are no safe areas for pupils in meltdown to de-escalate, and that the garden is used in lieu of breakout rooms, meaning “Regular disruption to the pupils’ routines, which can lead to meltdowns.” When speaking further of the unsuitable premises, they told us, “They bring in builders during school hours to carry out essential repairs (meaning workmen and tools all over the place),” adding that a pupil they were working with “Repeatedly tried to enter the construction areas and touch dangerous equipment including drills and nails. … He even managed to pick up an electric drill, but thankfully I was able to swiftly remove it from him.”
Alongside this unsuitable physical environment, the school was missing one-page profiles (documents containing essential information about pupils’ support needs), plans change without warning (including taking pupils on trips or swimming at short notice), and the staff are regularly burned out and distressed. Such a changeable environment would be damaging to anyone, and this is where children with some of the highest support needs are educated. There’s no wonder that meltdowns are prevalent. With prone and supine restraint being the go-to ‘solution’, our source added, “There was a boy who was restrained like that so regularly that, when he could feel himself getting agitated, he would lie on the floor because he knew it was coming.”
In order to prevent future incidents, there needs to be an immediate shift in societal attitudes towards disabled people, in conjunction with a change in ethos from care providers. While those who control these homes still fail to provide adequate training, policies, staff renumeration, facilities, and support, these incidents will keep happening.
Autistic UK believes that a trauma informed approach should be adopted by all facilities, together with a strengths-based attitude towards their residents. In order to provide the care that vulnerable members of society deserve, as a minimum care homes and specialist schools should:
Use the trauma informed principles of safety, trust, collaboration, empowerment and choice
Provide appropriate communication tools to all residents/pupils, including AAC where needed – this should never be removed for any reason
Ensure that the sensory needs of residents/pupils are met
Ensure that residents/pupils are treated with dignity and respect – this is particularly important when working with residents/pupils with personal care needs
Recognise that disability (including learning disabilities) does not mean a person is a ‘younger person/baby trapped in an older person’s body’ – this is ableist, infantilising, and unacceptable – provide access to age-appropriate information in a stage-appropriate format
Reject and ban the use of prone restraint
Use person-centred planning, and ensure the needs of all residents/pupils are met
A change to the management culture to one that encourages and supports an easy to use, transparent and robust complaints process based on risk management principles. It should be designed to prevent repeated incidents together with protection for whistle-blowers, whether they be family members, residents, pupils or staff.
These points are not unreasonable. Many people reading them may wonder why we’re ‘pointing out the obvious’, yet care providers regularly fail to meet any of these points, then label their residents as having ‘challenging behaviour’ rather than acknowledging they’re failing their duty of care. It is worth remembering that placements are funded by local authorities; the state is footing the bill for this level of abuse. Would a ‘one strike and you’re out’ policy for company misdemeanours ensure that the owners ensure they protect the human rights of their residents? Perhaps the knowledge that they will be ‘hit in the pocket’ will be more successful than appealing to their humanity.
We contacted the Care Inspectorate for Wales for comment, as yet this has not been forthcoming.
Glossary
AAC – Augmentative and Alternative Communication. This can be in the form of letter boards, picture systems, or computerised software to aid communication for those who struggle with speech.
Prone/Supine Restraint – The restraint of a person in a lying position (face down and face up respectively), often on a floor, with one or two people on top of them. This has been the cause of death of care home residents, school students, and people detained by the police. More information and an image can be found in this article. An article in the Nursing Times contains information in standard English as to why floor restraint is dangerous, providing academic references for further reading.