Channel 4’s Dispatches ‘Under Lock and Key’ brings cross-sector response


Providers of learning disability services expressed shock and disappointment at the scenes depicted in Channel 4’s ‘Under Lock and Key’ aired on Wednesday 1st March.


The Dispatches documentary prompted organisations representing the sector – including CMG, Voyage Care, United Response, Lifeways, The Wilf Ward Family Trust, Mencap, Choice Care Group, the Voluntary Organisations Disabilities Group (VODG), ARC England, Encompass (Dorset), Homes Caring for Autism, 7Days of Action Steering Group, Bringing Us Together and Dimensions – to deliver a unified response to the footage of services at St Andrew’s Healthcare.


Peter Kinsey, Chief Executive of CMG said:

“I was shocked and appalled and felt physically sick when I watched the documentary.

“It is inappropriate for so many people with learning disabilities to be living in large hospitals where it is very difficult to provide personalised support. As we have seen all too often, the standards of care in hospital can be extremely poor and unacceptable in a modern society.”

“However, this documentary also clearly shows that people with learning disabilities who have complex needs can live successfully in the community, with the right support.”

Tim Cooper, Chief Executive of United Response said:

“This terrible footage is immensely worrying to providers in the learning disability sector that provide quality services at a high intensity to some of the most vulnerable people in the country.

“There are still far too many people living in institutions and inpatient settings that do not benefit from small-scale personalised social care services delivered in the community. We want individuals to exercise more independence and control over their own lives.

“The Government set out the right direction of travel with its Transforming Care Services policy initiative; however that agenda must now be turned into a reality through giving people access to sufficiently funded community based services.”

Professor Martin Green OBE Chief Executive for Care England said:

Community settings will be social care registered services, but we are clear that this is a sector under immense financial strain. In order to meet the demand for personalised care for people with complex learning disabilities in the community, and which allows a safe transfer from hospital settings to be achieved, then we must address urgently the crisis facing social care due to chronic underfunding over many years. Learning disability services are closing at an alarming rate and providers are reluctantly handing back contracts to local authorities. The situation is exacerbated by a lack of funding to meet the rising cost of paying staff for sleep in services at night time to provide essential back up in order to keep people safe.”

Care England wants to see the upcoming budget put social care funding on a proper safe footing and ensure that providers continue to provide and develop services in the community for people with learning disabilities.


  1. The public do not understand that there are people in our society that are phychotic .The victorians build mental hospitals to protect them .Thatcher closed them down.They are now cared for in private care and no longer the NHS .there are mad people that you cannot reason with during phychotic episodes ,Its not right to label some mad neither is it right to let them remain in distress when medication can calm them along with kindness .We have to be realistic that during disturbed episodes they need sometimes restant .Its not right to victomise those that work and care for these people .Neither is it right for these private companies to get rich from caring for these people .The care system is in a mess.very few wanting to care for the mentally ill as qualified nurses .so we have care staff with very little training being put in dificult circumstances .Thatcher should never have closed hospitals and given the care to the private sector

  2. When patients are prescibed psychiatric drugs such as antidepressants, antipsychotics or benozodiazepines and are not able to metabolise these medications efficiently, the resultant toxicities which build up in the body and shown up as behavioural side effects. These include akathisia which makes the patient physically restless, but not always, irritable, jittery and crying one minute and laughing the next minute (dysphoria).

    Patients with akathisia are vulnerale to disrespect from care-givers and may percive a comment as an insulting, and behave un- characteristically in an agressive manner.

    Furthermore akathisa often preceedes worsening behaviour, such as violence, aggression, psychosis, suicide and homicide. All these behaviours can be predicted by taking a test for genetic profile prior to taking psychaitric medication.

    There are other ways to ameliorate ‘diffiult behaviour’ in cases where patients are inefficent metabolisers without having to resort to psychaitric medications, which only makes matters worse. Pre- Therapy/Contact work is practised on the continent and needs to be introduced in the UK to psychiatrists, social workers and psychiatric nurses. This way is far more humane than patients being forced to take psychiatric medications, which for inefficent metabolisers will never ever be therapeutic.


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