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Page last updated at 20:16 GMT, Tuesday, 31 May 2011 21:16 UK
Undercover reporter 'haunted' by abuse of patients

Joe Casey video diary
Joe Casey kept a video diary of his days spent secret filming

Joe Casey spent five weeks filming undercover in a private care hospital on the outskirts of Bristol after getting a job as a support worker. He was shocked by what he witnessed.

My experience at Winterbourne View will stay with me for a very long time.

The hitting, slapping, bullying, dousing with water, cruel and often pointless use of physical restraint on people - many with a child-like understanding of the world - all happened in front of my eyes.

On a near-daily basis, I watched as some of the very people entrusted with the care of society's most vulnerable targeted patients - often, it seemed, for their own amusement. They are scenes of torment that are not easily forgotten.

The targets had no way of defending themselves or speaking out. Anyone who questioned the abuse met a wall of silence.

They spent most of their days locked on the top floor of a three-story non-descript building in a business park on the outskirts of town.

'Suffocate on your fat'

The world of care was unfamiliar to me and going undercover as a support worker in a private hospital was a giant leap out of my comfort zone.

'Joe Casey said filming the abuse was the hardest thing he had done'

I was going in to try and collect evidence of ill treatment and abuse of people that we had been told about by Terry Bryan, a nurse with 35 years experience who had turned to Panorama after his official complaints about what he had witnessed at Winterbourne View went unheeded.

I would be working 12-hour days on weekly wage of just under £306.

After a few days, I started to see why Terry was worried enough to go to both management and government regulator - the Care Quality Commission.

On one of my early shifts, I saw a support worker poking a patient repeatedly in the eyes as if it were a game. A short time later, another worker pulled the same person across the floor telling her to "suffocate on your own fat".

Another patient, Simon, was one of the first to cross my path. He is 36 but has the mental age of a four-year-old.

Worker spaces foot over patients arm
Support worker training advises that physical restraint should be avoided

No one knows why, a cause has not been discovered.

He is very friendly and chatty, always wanting to give you a bear hug that you struggle to get out from. It could feel at times like he was getting out of hand and he would need to be told to calm down.

At Winterbourne View, Simon had become a plaything for some staff and a target for aggressive bullying and frequent abuse. I saw him being slapped, held down for no reason and threatened with having his head put down the toilet.

Before I went in undercover, the BBC sent me for private training in the best ways to care for people with learning disabilities and reduce the chance of them getting violent or posing a risk to themselves.

Patient at Winterbourne View private care hospital on the ground
Simone was the recipient of the worst of the abuse that I witnessed, including being doused in water fully clothed and being taken outside on a cold March day where she lay shivering on the ground

The message I came away with was that physical restraint should be avoided. All other options needed to be explored before resorting to holding someone down.

Some staff at Winterbourne View clearly did not feel this way and restraint was often used as the first resort at the hospital where patients include people with learning disabilities, autism, mental illness and personality disorders.

During my first days in the hospital I was struck by the sense of boredom that permeated the days.

With little to do, the patients were either watching television in the lounge or sleeping in their rooms. The smattering of activities were rarely inspired. At one point, staff resorted to reading to patients from a general knowledge textbook.

While some support workers seemed to genuinely enjoy their work, others seemed just as bored and frustrated as the patients.

The person who I had seen poked in the eye was called Simone, who suffers a genetic disorder.

'Horrific abuse'

She is 18 and had recently been taken into care after she began having violent outbursts. Like Simon, she was a popular target for bullying and abuse by staff.

She too can be a handful, but she has a sweet nature and an infectious laugh.

Simone was the recipient of the worst of the abuse that I witnessed, including being doused in water while fully clothed and later being taken outside on a cold March day where she lay shivering on the ground.

It was a day that ended with the water from the vase of flowers that her parents had given her on a visit being poured over her head as she screamed on her bedroom floor.

Support workers dragging patients across the floor
Patients often only have a child-like understanding of the world

She was then taken into the bathroom for a second shower fully clothed and had mouthwash poured over her.

It left me with my most haunting memory from my time undercover. At the end of that horrific day of abuse, I was the only one in the group of support workers who was not taking part.

I was watching on the sidelines, resisting putting a stop to this and blowing my cover. Simone was staring at me as she lay on the floor, staring at the only person not abusing her.

I could not save Simone on that day. I had to resist my instinct to step in. I was there to gather the evidence that could help save others from a similar fate - and Simone herself from future abuse.

The way we treat people like Simone and Simon is a measure of our common humanity. By that measure we have failed.

So where can the debate go now?

Do we need to pay higher wages to the people we hire to care for the vulnerable? Should support workers, like nurses, be listed on a national register? Should there be profit to be made in caring for these people? Should this be an industry or a public service?

I sincerely hope that what I witnessed Simon, Simone and others endure during my time undercover will help spark and inform a renewed debate on how we as a society treat our most at-risk.

Panorama's Undercover Care: The Abuse Exposed, BBC One, Tuesday, 31 May at 2100 BST and then available in the UK on the BBC iPlayer.

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Castlebeck statement to Panorama
Tuesday, 31 May 2011, 20:12 GMT |  Panorama

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