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Family of Guernsey abuse victim demand more transparency in care
Richard was physically abused by staff working for the States, an investigation found
A woman whose autistic brother was abused by care workers is calling for greater transparency from the States of Guernsey when investigating complaints.
Julia Le Pelley's brother Richard was physically abused by three staff working for the States last year, who were later sacked.
Health and Social Care Committee President Al Brouard said the care "fell well below" expected standards.
He said the case was "distressing" and he was "outraged" by what occurred.
The committee's investigation found three separate incidents of abuse in January 2023 against Richard by three separate staff members.
The report found:
One of Richard's carers, known as Staff B, "caused injury to his hand by bending his fingers backwards"
Staff D "pushed and shouted" at him
Staff E "hit him on the head and shouted at him"
Mrs Le Pelley said she had to battle to get information about the incidents and she questioned why there was no independent body to investigate allegations of abuse in care.
She said: "It wears you down, you think are you ever going to get anywhere with this?
"The States are the sort of department who can keep this info, so you feel like you're fighting a losing battle."
Mrs Le Pelley asked for her brother to be moved from where he is currently being cared for, but said she was told by the States there was nowhere else on the island.
She said too little was known about the backgrounds of agency staff.
"What worries us is what qualifications these agency staff had, who vets them?" she added.
"Is it Health and Social Care (HSC)? The agency? We don't know.
"We don't know whether these people are still working within care elsewhere."
Mrs Le Pelley asked for her brother to be moved from where is being cared for at the moment
HSC said agency staff at this level were vetted externally by the agency which employed them.
Mr Brouard said the care provided to Richard "fell well below the standards we seek to meet" and the three agency staff in question were "immediately removed".
He said information was also provided to the supply agencies for them to "consider whether they should be placed in any health or social care settings in future".
He added this case was, in his view, evidence of the committee having processes which meant incidents "could be effectively investigated".
"All our staff are employed in positions of trust, and we are frankly as outraged as service users, families, and the wider community if that trust is broken and behaviour falls below the high standards we all rightly expect," he said.
"What this case shows is that, as distressing as it was, our investigations found that abuse had occurred, the staff were immediately removed.
"The culture of continuous learning that we have sought to maintain was effective as work has been carried out with staff to ensure they are confident in raising any concerns about poor quality of care."
Mrs Le Pelley said the situation left her worried about her brother's future care and whether there had been other incidents despite receiving an apology from the States.
The investigation found a hand injury was observed on Richard on 5 January and was reviewed by a GP on 11 January and treated as unexplained.
It said a "safeguarding alert" was not raised at the time because there was no evidence of abuse or neglect.
'Unreasonably withheld information'
Concerns were subsequently raised by another staff member who said he witnessed physical abuse of Richard.
A safeguarding inquiry commenced on 24 January, the report said.
Mrs Le Pelley said one of her main areas of concern with the investigation was the level of redaction by HSC.
A police report was made into the incident, but Mrs Le Pelley has only been able to see it recently after working with the data protection authority to get it released by HSC.
Guernsey Police said it fully investigated but no further action was taken.
Mrs Le Pelley said: "I know we can't know the names of these people, but we need to know what they were doing and how often.
"It shouldn't have been a fight to get this info."
The Office of the Data Protection Authority (ODPA) said HSC breached two sections of the law relating to data subject rights.
"It unreasonably withheld information and resisted attempts by the family to obtain the full report," it said.
"Whilst a basic apology was provided by HSC initially and prior to the authority's involvement, the lack of the safeguarding report meant it was difficult for the family to be assured that what had happened would not happen again."
It said the report had now been released after an enforcement order but "without any recognition of the prolonged distress caused by the approach they adopted".
It added: "This was a very stressful experience for the family who wanted to make sure that their loved one was safe."
Mr Brouard said "the safeguarding report we produced was shared with the family, with redactions that we considered necessary to comply with the data protection law".
"The ODPA ruled that we had over-redacted the report, so a further version was supplied to the family with fewer redactions."
Liam McGenity: Ward not appropriate for man's care, inquest hears
Liam McGenity was found dead at St Mary's Hospital in Warrington
A clinical psychologist involved in the care of a man who took his own life at a private mental health unit has said the ward "was not appropriate for his care".
Liam McGenity was found dead on 2 March 2021 at St Mary's Hospital, run by Elysium Healthcare, in Warrington.
Cheshire Coroner's Court heard the 29-year-old believed he was being "unfairly detained".
Dr Lee Mulligan told the jury Mr McGenity had struggled in acute care.
He said he had provided psychological sessions for Mr McGenity while he was at the psychiatric intensive care unit at Atherleigh Park Hospital in Leigh, run by Greater Manchester Mental Health NHS Foundation Trust.
During this time, he said he had seen Mr McGenity for eight sessions, which was "more than any other patient he had worked with".
Mr McGenity was moved down from the psychiatric intensive care unit to an NHS bed on the Eve ward at St Mary's Hospital on 6 February.
The inquest heard the NHS was paying for private beds because of an increase in demand that arose during the pandemic.
Dr Mulligan replied "yes" when asked by coroner Victoria Davies if he thought Mr McGenity's mental state would worsen without psychological therapy and visits from his family.
He added Mr McGenity had "interpreted the actions of loved ones and care providers through the lens of delusional beliefs" and that he struggled in acute care when he was under restrictions.
Dr Mulligan told the jury it brought up "uncomfortable feelings about being controlled".
The inquest heard Mr McGenity was placed in seclusion shortly after he was admitted to St Mary's Hospital because "his behaviour indicated that he was a risk to himself and others".
Liam McGenity's father previously said he had been "consumed with a dreadful illness"
While he was in seclusion, Mr McGenity harmed himself and required emergency medical treatment at Warrington General Hospital.
The court heard Mr McGenity was required to isolate in his room for 10 days from 9 February when he returned to the Eve ward, in accordance with Covid guidelines.
The doctor with overall responsibility for his care while at St Mary's Hospital said he first met Mr McGenity on 9 February.
Dr Obiajulu Okaye told the inquest he did not recall the decisions around isolation but said the fact Mr Genity was put on two-to-one care indicated he needed round the clock attention.
The jury heard Mr McGenity's mobile phone and laptop were confiscated under restraint while in the unit because he was "accessing distressing images" and syringes, cannabis and cannabis oil were later found in his room.
Dr Okoye said the 29-year-old "would and should have been searched" before coming into the unit but the items "may have been secreted" on his person.
ME Action estimates the number of people with ME/CFS in Scotland has more than doubled from about 22,000 since 2019 to over 50,000 now.
Since the Covid pandemic there has been a rise in cases of post-viral illnesses, such as ME, with similar symptoms.
Keith Anderson had been Scotland's only specialist ME nurse, based in Fife. The service has been paused since he died last year.
Stella, from Tayport, says his help made her day-to-day life more manageable.
The 72-year-old was a fit grandmother who enjoyed yoga and looking after her grandchildren, but began showing ME symptoms in 2020.
Keith Anderson, who was based in Fufe, was Scotland's only specialist nurse
Her self-diagnosis was confirmed by Mr Anderson after she had been bedbound for more than a year, receiving "absolutely no help".
"I couldn't even lift my head off the pillow, lift a kettle, or go to the bathroom unassisted," she said.
Stella had appointments with Mr Anderson every three months and could contact him by telephone more frequently.
"Now Keith has died there's absolutely nothing," she said.
Paula Notman, 60, was a keen gym-goer who loved to exercise before her ME diagnosis.
It led to her giving up full-time work, the break-up of her relationship and left her unable to take her dog for walks.
"You mourn the person that you were, it's almost like a bereavement… I went through dark times," she said.
Paula Notman says there is no-one to turn to for help
She started fortnightly appointments with Mr Anderson in 2020, describing him as "the best help… somebody who understood, made you feel validated and really went through everything".
He advised her on diet, medication and other ways to manage her symptoms - but now Paula says there is no-one to turn to.
"There's no help and no way forward, you're left to deal with it," she said.
"In this day and age Scotland should have something."
Karima Rahman, from ME Action, said Mr Anderson's death had left Scotland without any specialist doctors or consultants.
She said there were just "pockets of provision" that were based on "outdated models that don't meet the standard of care and treatment that patients should have access to".
'Failure of duty'
Dr Charles Shepherd, an expert on the condition who also works with the ME Association, said the number of specialist practitioners in Scotland had steadily declined over the years.
He said the death of Mr Anderson had left provision "at rock bottom".
"The ME Association receives regular reports from people in Scotland who are unable to be referred by their GP to a specialist ME/CFS service where they or their GP can obtain with help with diagnosis or management," he said.
"This represents a serious failure of duty by NHS Scotland to provide specialist help for people with ME/CFS."
He said GPs were being relied upon more heavily in Scotland than in England, where there are 57 clinics which follow National Institute for Health and Care Excellence (NICE) guidelines on referral and diagnosis.
Dr Charles Shepherd said services were at rock bottom
While GPs are able to diagnose the condition, they often lack training - which can lead to delays.
In 2022, a Scottish government report acknowledged that "despite a growing recognition of the need for specialist ME/CFS services, actual implementation has been minimal".
The government said it was considering a recent analysis of provision across Scotland and was committed to creating a more equitable service.
It said specialist provision did currently exist within NHS Lothian at the Astley Ainsley Hospital in Edinburgh, and that a service was being offered by NHS Greater Glasgow and Clyde.
However, a recent government survey of NHS boards said this was not a specific ME/CFS service. Neither service has a specialist clinician on site nor acts as a point of referral for formal diagnosis.
Dr Shepherd said the Lothian Service was more focused on pain management and that there had been "very mixed reports" about the Glasgow service.
He said they did not provide the level of care recommended in the new in the new NICE guidelines.
These UK-wide guideline are followed in Scotland because the country does not have its own version through the Scottish Intercollegiate Guidelines Network (SIGN).
NHS Lothian says it was operating within the NICE guidelines, with a team of psychologists, physiotherapists and occupational therapists on site.
NHS Greater Glasgow and Clyde said the NHS Centre for Integrative Care sees people referred with a wide range of long term conditions and complex co-morbidity, including people with ME/CFS.
A spokesman said: "Each person is assessed individually and a person-centred approach is followed rather than focus on a specific condition or diagnosis."
Other Scottish NHS boards told the BBC they offered a range of primary care services, holistic and psychological support - but had no plans to introduce specialist services.
Dr Gregor Purdie, a retired ME specialist physician, said there was a lack of specialist training across the UK.
He said a historical perception that the condition had a psychological rather than a physiological basis had led to many doctors "shying away" from it.
This led to "a dearth of support and interest by the medical profession and health services in general", he said.
"We need to train clinicians that have a specific interest in ME/CFS."
NHS Fife said the "valuable" service which had been provided by Keith Anderson was currently paused because no suitably experienced specialist nurse was available.
"New temporary arrangements were put in place to enable GPs to refer patients with ME/CFS to other services for those with long-term conditions," it said.
NHS Fife said it did not intend to close the service, but could not say when a replacement would be hired given the shortage of specialists across the UK.