Analysis of Winterbourne View: Legal, Policy, and Ethical Frameworks

This report provides a comprehensive analysis of the Winterbourne View case, focusing on the legal, policy, and ethical dimensions of healthcare practices in the UK. The report examines key legislation and national policies, including the Care Act 2014 and the Mental Capacity Act 2005, and assesses the policies that Winterbourne View should have adopted to ensure patient safety and well-being. It highlights the failures in compliance with CQC standards, such as inadequate staff training, poor complaint procedures, and improper medicine management. The report details the shortfalls in patient care, including compromised safety and lack of appropriate treatment, and discusses the outcomes of non-compliance, such as the closure of the facility. It explores methods for ensuring compliance, referencing CQC guidelines and various healthcare policies. Furthermore, the report addresses the impact of equality legislations, the relationship between law, policy, and ethics, and the influence of human rights law on fair treatment. The report concludes with a discussion on the practical implementation of legislation and policy in safe healthcare services and the impact of law and policy on the outcomes of real cases.

LAW, POLICY AND
ETHICAL PRACTICE IN
HEALTH AND SOCIAL
CARE

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Summarization of key policies and practices..............................................................................3
Policies that Winterbourne should have adopted.........................................................................4
Policies that were not adopted at Winterbourne..........................................................................4
Shortfalls in patient’s safety and care..........................................................................................5
Outcomes of non-compliance......................................................................................................6
Methods in which workers could have endured compliance.......................................................7
Impact of different equality legislations......................................................................................8
Relationship between law, policy and ethics...............................................................................8
CONCLUSION................................................................................................................................8
PART 2............................................................................................................................................9
INTRODUCTION...........................................................................................................................9
MAIN BODY..................................................................................................................................9
P1 How the legislature, the executive and the judiciary set out legal policy..............................9
P2 Summarize key feature of Statutory Guidance, Code of Practice, National Health Policy,
organizational policy.................................................................................................................10
P3 Relationship between key legislation and national policy...................................................11
P4: Compare national and organisational policy against national professional standards........12
P5 Explain human rights law influence and inform equal and fair treatment of others in Health,
Care and Support services.........................................................................................................13
P6 implement different legislations and policy in safe and health services..............................15
P7 describe the relationship between law, policy and ethical requirements..............................16
P8 Explaining the impact of law and policy on the outcomes of real case...............................17
CONCLUSION..............................................................................................................................18
REFERENCES................................................................................................................................1

INTRODUCTION
Winterbourne View, a hospital where patients expect safe and protected environment
turned onto a case study for studying institutional abuse due to the inhumane treatment of the
patients and also non-compliance by managers regarding various rules and assessment of the
quality of service provided to the patients in the healthcare unit. In this report, various legislative
and healthcare aspects of the Winterbourne View case study have been discussed and
recommendations will be made.
MAIN BODY
Summarization of key policies and practices
The key legislative and national policies that are applicable in healthcare sector in UK
are:
The Care Act, 2014 which states the role and importance of local authorities in prevention of
abuse and neglect of the patients and the duties of the local authorities have been reframed
making the safeguarding more regressive.
Mental Capacity Act, 2005 which identified certain categories of those people who were tasked
to take care of those patients who were mentally challenged i.e. those who could not take care of
themselves or take decisions for themselves.
Information sharing Guidance under which the management of a healthcare unit is required to
share particular information at particular time so that overall process can be improved (Waterson,
2018). This assists the medical practiotners in implementation of interventions on time and take
decisions regarding what information is to be shared or what is to be done while safeguarding the
patients.
Apart from these, there are certain codes of conduct and statutory guidelines that should
be complied with i.e. Care and Welfare of people using the services provided, safeguarding of
those people from any abuse who are using the services, managing the medicine, requirements of
the workers working in the healthcare unit, supporting the workers in the unit, assessment of the
quality of the services and care that are provided to the patient, complaints made by the users of
the services, notifying to the proper authority in case of absence or death of the user of service
under Mental Health Act, notifying other incidents as well, maintaining proper records etc. These
standards are prepared so that the management can identify what is expected of them and the
statutory compliance that they should follow in order to keep working.

Policies that Winterbourne should have adopted
There is a list of policies that Winterbourne View healthcare facility, being an institution
in UK, should have adopted in order to provide safe and secure environment to its patients
(Griffiths, 2017). There are a certain set of standards formulated by CQC, which the healthcare
units of UK are required to comply with and those standards that Winterbourne should have
adopted are:
Welfare of people using the services i.e. the patients: Since it was a healthcare unit, safety and
protection of the patients in the healthcare unit should have been the primary responsibility but
this was not the case where those responsible for the safety themselves were the ones
compromising it (Hannah, 2019).
Working staff: The staff that was employed at the healthcare unit did not have sufficient and
adequate skills and also lacked the training that is necessary for such medical practiotners. This
carelessness in the hiring process led to non-compliance of the standard which should have been
avoided at every cost.
Complaint Procedure: The process for filing and taking action for any complaints that were filed
by the patients at Winterbourne was extremely poor and despite repeated filing, no action was
taken. This is an extremely ill formulated policy which should have been rectified and in
compliance with the standard set by CQC.
Medicines: This was another policy i.e. standard that Winterbourne did not comply with and the
management was extremely irresponsible regarding where they were store, their stock levels, the
supply and requirement of mandatory authorization before issuing (McGeown, Heffernan and
Gibson, 2018). All these aspects were not considered which should have been followed.
Regular update from the management: This is another aspect which should have been
complied with where the management of Winterbourne hospital currently was not giving any
proper and regular updates regarding their various policies and practices to the regulatory bodies
like CQC etc.
Policies that were not adopted at Winterbourne
Despite a detailed and comprehensive policy formulation, there were many policies that
were not adopted by the Winterbourne View Institution:
Non-compliance of giving safe environment to the patients: Patients at Winterbourne View
were not getting a safe environment and relevant care or support tin their treatment because the

care plane that were formulated for every patient were not specific and detailed and rather than
understating the complex needs of individual patients, they formulated a standard or generalised
treatment without maintaining of adequate or sufficient records (Enston, 2019).
Failure in compliance with safety of patient standard: Instead of protecting their patients from
the abuse or maltreatment, they themselves were not giving adequate care to the patients and
when there were allegations against the hospital regarding abuse of the patients by the caretakers,
no proper statements or evidences were presented.
Non-compliance of the Medicine management standard: Patients at Winterbourne View
Institution were not given the required medicines in the required quantity and further the
management was not working in a responsible manner for proper storage or disposal of the
medicines.
Lack of trained and competent staff: Winterbourne healthcare institute failed to provide trained
care takers who could not comply with the duties and responsibilities that they are required to
perform (Rose and Farrer, 2016). The skills that the caretakers should possess in a healthcare
institute was lacking amongst the caretakers of Winterbourne Institute.
Poor Quality check systems: the quality of the care and treatment that the patients at
Winterbourne Healthcare institute received was not at par with the standards that were set by the
regulatory bodies and authorities depicting lack of any effective leadership or management in the
institution.
Shortfalls in patient’s safety and care
While reviewing the healthcare institute, CQC found that following were the major
shortfalls in the facilities and treatment provided top the patients:
 The registered provider i.e. Castlebeck Care Ltd did not given enough importance to the
quality of staff that it hired which led to exposure of the patients that were admitted in the
facility towards a risk in the treatment or care that they received.
 There were no proper technologies or systems like RIFD etc. to track the movement of
the patients and ineffective or redundant technologies were being implemented on the
patients to treat them which were compromising with the wellbeing of the patients and
thus questions were raised on the quality of the healthcare services provided to the
patients (Atkinson, Crozier and Lucas, 2018).

 There was no proper assessment of the risk that the healthcare unit was facing and
therefore, those possible scenarios in which the patient might be exposed to a certain
threat or risk were being overlooked by the staff at Winterbourne Healthcare Unit which
led to compromise on the safety and protection of the patients.
 There was no adequate training or supervision given to the care takers and medical
practiotners employed in the firm. The recruitment process through which the caretakers
are hired in the Winterbourne healthcare facility was not upgraded and was not
differentiating clearly between the efficient and inefficient employees.
 The feedback mechanisms and the monitoring and evaluation mechanisms adopted at the
Winterbourne Facility for the evaluation of the caretakers were not effective enough and
even if they were implemented, which was with irregular consistency and therefore the
safety of the caretakers was compromised with.
Outcomes of non-compliance
Due to their non-compliance, the Winterbourne View healthcare institute was ultimately
shut down by the appropriate authorities leading to complete collapse of the institute. Care
Quality Commission, which was tasked with conducting a review on the Winterbourne institute
when they were charged with abuse of the patients determined following outcomes due to non-
compliance of the standards set by them for such healthcare institutes in UK:
 CQC restricted further entry of all the people in Winterbourne Institute restraining
anybody from getting admitted there or getting their treatment done (Ellis and Abbott,
2016). This stopped any more patients from getting admitted in the healthcare facility
which was the first step towards closing down of the institute.
 CQC collaborated with the National Health Service and the local council so that they
could collectively ensure the safety of the patients that were currently admitted in the
healthcare facility and ensure that during the time taken to shift them to another
healthcare institute, they were safe and were not harmed in any manner.
 Along with NHS and South Gloucestershire Council, patients who were still admitted in
the Winterbourne facility were closely guarded and the activities of the care takers were
carefully monitored so that their health and safety could be protected at any cost.
 CQC along with other prominent healthcare societies in UK were extremely concerned
and alarmed with whatever they had found while evaluating the practices adopted at the

Winterbourne View Institute they decided that the environment and practices that are
currently being adopted are not fit for any healthcare institute to continue operating and
ultimately decision was taken to shut down the healthcare facility altogether.
 Further, CQC even took away the authority of the registered provider of the
Winterbourne Healthcare unit; Castlebeck Care Ltd (Jones and Lupari, 2016). From
opening any healthcare institute in future in the current location at which Winterbourne
was located.
Methods in which workers could have endured compliance
As per CQC, healthcare units are required to send regular reports to CQC so that they can
review the action plan that is being implemented by them and these are then evaluated by the
designated authority in order to ensure whether the policies that are being adopted are in
compliance with the standards set or not. There are various policies procedures and compulsory
standards that the care takers and managers of Winterbourne Hospital should have followed in
order to gain compliance with the legislative and regulatory bodies of UK like CQC such as:
 Outcome 4: Care and welfare of people using services: Providing a safe environment to
the patients who get admitted in the healthcare facility.
 Outcome 7: Safeguarding the people using services from abuse: The patients should be
respected and workers should ensure that their human rights are protected.
 Outcome 9: Managing the medicines: Stocks of the medicine should be properly
accounted and maintained and their disposal should be under strict authority and
supervision.
 Outcome 12: Meeting requirement relating to workers: Recruitment procedures should be
appropriate so that personnel hired are qualified and competent.
 Outcome 14: Supporting the workers: Training and development process of the staff
should be carried out defining proper structures (Rowson and McSherry, 2018).
 Outcome 16: Assessment and monitoring of the quality of service provided: The decision
making and the quality of care provided to the patients should be manager properly and
regularly evaluated.
 Outcome 17: Complaints: The procedure for receiving and addressing the complaints
should be appropriate.

 Outcome 19: Notifying the deaths or unauthorised absence of the person who is detained
as per Mental Health Act, 1983: Any missing person or in case of death of a person, it
should be reported to the CQC immediately.
 Outcome 20: Notifying the other incidents: All major incidents should be notified to
CQC.
 Outcome 21: Records: Record maintained should be accurate and privacy as well as
safety of these records should be maintained.
Impact of different equality legislations
There are various aspects that have been used by CQC in order to ensure that the equality
in the treatments given to the patients is maintained and these included factors like age, sex,
religion, identity, carers, fairness, respect, dignity, autonomy etc. these collectively have a major
impact on the treatment of patients. This has emphasized on selection and recruitment on the
basis of experience rather than by gender or sex or any other factor. Integration of the protection
of various aspects of human rights in the treatment that is provided to them is another major
aspect that has been included in the entire process.
Relationship between law, policy and ethics
When talking about healthcare sector, the three major aspects i.e. law and legislation,
policies formulated, ethics in the healthcare sector are some of the key aspect and ion order to
operate the healthcare industry successful, and all three of these need to be integrated (Bennett-
Britton and Salisbury, 2019). Ethics help in determining what is good and bad making an
individual decide what should be done i.e. the correct path that should be chosen in difficult
situations and laws are basically based in these ethics and morals. Laws ensure that people
follow these ethics and morals and work on their basis. Policies are similar to law and these are
also used to regulate the actions of the people. In Winterbourne Healthcare facility as well if
compliance of Law and statute had been done, then the healthcare unit would not have been shut
down and patients would not have been abused.
CONCLUSION
It can be concluded from the above report that Winterbourne Healthcare facility was a big
failure in the healthcare sector due to lack of compliance of the various standards and laws that
were set by the different regulatory bodies of UK. It was also found that these are not the only
aspects since adoption of those policies that protected and safeguarded the rights of the patients

are important in operation of any hospital or healthcare facility. In this report, various legislative
and national policies to be followed in healthcare sector were discussed and various laws and
policies that should have been followed have been detailed. Outcomes of different laws and
policies not adopted by the Winterbourne Hospital were discussed and finally equalisation and
its impact was analysed.
PART 2
INTRODUCTION
Law, ethics and policies are playing an important role in the social and health care sector.
Those are frequently featured in the media report meanings patients, client and families are more
issued for their rights for effective work. The present report is based on the law, policies and
ethics in the home care or company. The report will explain the judiciary set out legal and policy
for health as well as summarized the key features of legislation and code of practices. This will
show relationship between key legislation and national policy to direct health care practices. This
will compare by the specific national and international human rights in services. This will be
explaining by the national and international human rights law influence and inform equal and fair
treatment as well as implement different legislation in own practices. This will describe laws,
policy and ethical requirements in real case scenario and related laws and legislation.
MAIN BODY
P1 How the legislature, the executive and the judiciary set out legal policy
Modern health policy
includes many complex
legal, ethical and social
question which need to be
answered by the
government with the sole
motive of improving the
health in the nation.
legislature, the executive
UK legislative used to have the
special authority to develop the
policy and pass on the rule making
and regulating power to department
in branch. There are major
determent of legislative policy
making. One used to belong to
political party, other used to belong
to individual people, third used to
Executive used to bring
the evidence, data and
reasoning necessary for
the formulation of sound
health policies. As the
U.K. Department of the
health has an capacity to
obtain data in area of
clinical and policy
legislature, the executive and the judiciary

and the judiciary used to
set out the legal and policy
landscape for Health and
Social Practitioner in the
UK (Glasby, 2017).The
legislature is one of the
best suited branch of the
government which helps
the government in the
development of the health
policy in the country. As
Legislative have the power
to collect the variety of the
information from the
relatively wider range of
the source; part of its
mandate is to protect and
promote the health of the
public; and it has the
power to engage in a
lengthy and deliberative
process in enacting
legislation.
belong to interested group and
fourth one are the temporary basis.
The Executive is also used to bring
the variety of the contribution to the
healthcare policy of the UK.
Executive branch of the government
used to be objective as well as
accountable.
research. Judiciary are the
one who used to provide
the least amount of the
support in development of
the Health policy in the
UK. As the information
which are possess by the
Judiciary are always
partial or incomplete
which does not help in
formulation of the policy.
Generally Legislature and
Executive branch used to
take the information of
Judiciary as a basis and
source the information
regarding policy (Costa-
Font and Greer, 2016)
P2 Summarize key feature of Statutory Guidance, Code of Practice, National Health Policy,
organizational policy
Statutory Guidance, Code of Practice, National Health Policy, organizational
policy

Care and Support
Statutory Guidance
Key summary of the
Statutory guidance is that it
defines the general
responsibility and universal
service which promotes the
well-being among the UK
people and reducing needs
among the same. After that
guidance covers the contract
and identify the need of the
care and support. Statutory
guidance then covers the
person-centered care and
support planning.
Code of Practice
The Act is supported by the
Code of the practice which
provides with the guidance and
the information about how the
act works in practice. Code of
practice defines that there is a
statutory force,
which in simple words means
that certain level of the people
has a legal duty to have regard
to it when working with or
caring for adults who may
lack capacity to make
decisions for themselves.
National Health Policy:
National health policy is
formulated in the year 2017,
which was formulated to
provide the best level of the
health and well-being through
a preventive and pro motive
health care orientation in all
developmental
policies.organizational policy:
Organization policy are the
policy which are made and
implemented by organization
to safe their employee from
the health and social care.
P3 Relationship between key legislation and national policy
Legislation and national
policy of Health and social
care used to share the mix
National policy is made by the
government to enhance the
performance of the existing Law
In general words it can be
highlighted that national
policy of the Health and
key legislation and national policy

relationship among them as
they are having many
differences among them but
at the same time also
supports each other in the
processing. National Policy
of the Health and social
care generally used to
define the aim and objective
which is set up by the
government to regarding the
health and social care of the
consumer in the country but
at the same time the
Legislation used to define
the different law which
used to follow by the people
in the country to have a
good health and social care
(Curtis and Burns, 2015)
National policy of the UK is
generally developed with
the help of the country legal
regime.
in the UK. This policy of the
government also identifies the
who and what will be governed
by the Law of the UK.
Legislation of the country
generally used to regard as a
consequence which can be used
by the government to make the
policy in the organization and
implementing the same in the
country.
social care in the UK was
passed by the Legislature of
the country which has bind
all the people of the country
to follow the same and this
cannot be changed without
going through all the
process again. As explained
above also that the policy is
set up by the branch of the
government in accordance
with particular branch. This
shows that the supportive
relation is shared by the
both.
P4: Compare national and organisational policy against national professional standards
National Policy is the At the same time the At the same time the
National and organizational policy