Campaigners say many with learning disabilities miss out on the best care

An inspection found "widespread institutional abuse" of patients at Budock Hospital, run by Cornwall Partnership NHS Trust.

But the agencies which inspected the trust - the Healthcare Commission and the Commission for Social Care Inspection - say their investigation raises broad, and very worrying, concerns about the way the care of people with learning disabilities is addressed.

During the investigation, evidence was found of staff hitting, pushing, and dragging people who were supposed to be in their care.

It is essential that services for people with a learning disability are given the priority they deserve across the whole of the UK David Congdon, Mencap

There were also reports of staff withholding food and forcing patients to take cold showers.

The inspection team also heard allegations of sexual abuse by fellow residents and one man had his skull fractured in an attack by another with learning disabilities

This is an extreme case, but both those who investigated Cornwall and campaigners say many in this group are being failed, not through outright abuse, but because they are not given the highest standards of care.

They may be unable to champion their own rights, but more often their needs are simply not given adequate attention.

Cornwall 'not alone'

It is estimated that more than a million people in England - 2% of the population - have learning disabilities.

The national charity Mencap said what had happened in Cornwall was "truly appalling".

David Congdon, head of campaigns and policy, said: "This was an unusual case. You do get isolated instances of abuse, which usually do get dealt with properly.

"But there are some very simple lessons from this case.

"If you have an institution that is very inward-looking then things can go unnoticed. It's much better if there is an open climate, with lots of visitors .

"Its also preferable for people to live close to their friends and family, so that there are people who care around them."

Support and protection

Mr Congdon said there was a move to "ordinary houses in ordinary streets" rather than 24-hour residential care.

But he stressed that, while this gave people with learning disabilities more independence and control over the care and support they received, agencies must ensure adequate support was available and not see it as an opportunity to cut costs.

"Agencies need to ensure people get the support they need to live their lives and protect them from abuse.

But he added that, wherever they lived: "It is essential that services for people with a learning disability are given the priority they deserve across the whole of the UK."

In a joint statement, the heads of the services who carried out the inspections said they have concerns that "the quality of care is not always what it should be".

Shut down

Anna Walker, chief executive of the Healthcare Commission and David Behan, chief inspector of the CSHI, added: "We are not saying the abusive behaviour we saw in Cornwall is happening everywhere."

We detect a widespread lack of understanding about the rights and needs of people with learning disabilities Healthcare Commission and Commission for Social Care Inspection

"But sadly, Cornwall is not the only service where serious allegations have been made in recent months."

Sutton and Merton Primary Care Trust in south London has asked the commission to investigate allegations of abuse of patients.

And it has had to intervene at a private unit for teenagers with learning disabilities in Norfolk.

The unit was subsequently closed down.

Ms Walker and Mr Behan added: "Instances of abuse can be symptomatic of services that have been neglected for too long.

"They are the most serious sign of a problem, but our concerns are much broader.

"We detect a widespread lack of understanding about the rights and needs of people with learning disabilities."

Following on from the Cornish investigation, the Healthcare Commission and the CSHI are to investigate all NHS and independent provides of care for this group.

The findings of their investigations will be published next year.

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