Learning disability care 'dehumanising', as councils say care companies ripping off taxpayers
Local councils say they cannot afford “astronomical sums” being charged by private companies for the care of learning disabled and autistic people, as ITV News uncovers allegations of neglect at two providers.
Additional reporting by Investigations Producer Isabel Alderson-Blench
Josh Barr, 31, is meant to receive daily one-to-one help from private care company Precious Homes.
He needs support with daily tasks including communication, taking medication, cooking, and going outside. The local council pays Precious Homes £66,000 a year - not including accommodation costs - to provide him with six hours of daily support, as well as helping prepare meals.
Secret camera footage obtained by ITV News from inside Josh's supported living flat reveals he is not receiving the care the council is paying for. Across a ten-day period in June, it showed Josh received less than half of his paid support hours.
His support plan states a support worker should be with him five days a week from 10am to 4pm, supporting him to exercise, to go out, make meals and take his medication, but the footage shows Josh never left the flat with his carers; was never helped with meal preparation and on one occasion was given the wrong medication.
On one day where Josh should have received six hours of support, a staff member popped in for just ten minutes. He spent his days mostly alone, on his sofa or asleep. They never once showed up on time at 10am to support him.
“It’s just dehumanising,” Josh tells us.
“I just don’t know how I can keep doing it. I am a human being, and even though I can come across as able, that’s far from the truth. I wish I could be able.”
His mum Lisa contacted ITV News with serious concerns about her son’s welfare, after she says attempts to raise concerns with the care company have made little difference.
“Josh is now around 24 stone,” says Lisa. She believes Josh has put on around six stone since moving into his current placement with Precious Homes, less than two years ago.
“He has regressed into himself. If it carries on, Josh won’t be here. He won’t be with us at all.”
“I don’t like to use the word suicide, but I think Josh would go down that route because it’s a hopeless situation that he is in.”
Like the vast majority of care and support for adults up to 64 years old, Josh’s care is funded by his local authority.
Reacting to the findings, Patrick Harley, the leader of Dudley Council, said an investigation was now underway.
“I am really upset and horrified. Clearly, something has gone wrong here,” he said.
“There’s not a council in England that isn’t struggling with finances and a large portion of that is down to adult social care costs.”
Councils in England are spending on average more than a third of their budgets on adult social care, with more than £22 billion expected to be spent in 2024/25, according to the Association of Directors of Adult Social Services (ADASS).
It’s money that local authorities do not have - last year directors said they overspent by £774 million.
I asked Councillor Harley if there was a feeling local councils are being ripped off?
“I believe there is,” he said. “We are not going to pay these astronomical sums anymore.”
ITV News understands Dudley Council have suspended future commissions of care with Precious Homes until further notice.
New analysis for ITV News by Laing Buisson shows that private provision of specialist care for adults has increased from a fifth in 1990 to three-quarters today.
A Precious Homes spokesperson said: “We take the care and wellbeing of all individuals we support very seriously and are committed to transparency and continuous improvement.
“Our preliminary findings suggest your assertions are inaccurate and your portrayal of our dedicated staff is misleading. Mr Barr has full capacity which means he has the right to choose whether or not to engage with staff, and any refusal to interact must be respected.
“We record all interactions on Mr Barr’s care logs including all discussions with both Mr Barr and his mother. Our staff regularly attempt to involve him in exercise, community outings, and activities, as recorded in our logs, but participation is voluntary. In fact, he has previously complained of being pressured into activities.
“For the period in question, aside from one occasion when staff clocked in at 10.16am, records show that they were present from 10 am daily and engaged with him when he permits.
“We are confident our team provides the best possible care in the circumstances.”.
New analysis for ITV News by LaingBuisson shows the market for the care of working age adults in the UK, which includes people with learning disabilities and autism, is worth almost £19 billion, double what it was a decade ago.
Private companies dominate the social care market, providing three-quarters of care and support to working age adults. In 1990, it was just 21%.
Private provision does not necessarily equate to better care. 89% of not-for-profit care companies are rated ‘Good’ or ‘Outstanding’ by the sector’s regulator, the Care Quality Commission. This drops to 83% for private companies.
“I think there are important questions for us as a country to ask about the role of profit in the care market, particularly at a time when we are under such financial pressure,” said Jess McGregor, President of the Association of Directors of Adult Social Services.
“I think we should be assured as local government, but also as a country, that we are not seeing assets stripped from the social care system because of financial and profit arrangements.
“I don't think that there is a simple “profit is bad”. I think that the social care market is much more complicated than that. I have experience of working with a range of large care providers, and have experienced really good quality care.”
If you have been affected by any of the issues in this story, you can email investigations@itv.com
Andrew Dickens is only too aware of the tragic consequences of poor care and neglect of society’s most vulnerable. His brother Peter was autistic and had severe learning disabilities, requiring 24-hour care for his complex needs.
Peter was 31 years old when he died in January 2022, after choking on a sandwich. His carer left him to eat alone, despite his known risk of choking.
At an inquest in 2024, a coroner found that the eating and drinking guidelines that were supposedly in place to keep Peter safe, were not being followed.
In a Prevention of Future Deaths report issued to Cygnet, the multi-million pound company being paid to care for Peter, coroner Elizabeth Didcot wrote, “this guidance was not followed on the afternoon of his death, and this led directly to the choking incident that led to his death.”
“There was also non-compliance with the Eating and Drinking guidance many times prior to the day of Peter's death.”
Andrew and his family are still traumatised by the circumstances surrounding Peter’s death.
“On one of my last visits there, which was December 2021, it smelt of urine and there were massive, massive problems there with the cleanliness of the room,” Andrew told ITV News.
“It was clear that the staff were struggling to meet Peter’s needs.”
At the family’s request, it had been agreed that Peter should move to a more suitable placement. But he never got the chance.
“While [care] jobs are relatively low-paid, they are some of the most highly skilled jobs. You’re dealing with the most vulnerable people in the United Kingdom. This is the sort of thing that can happen,” Andrew says.
“People can die.”
A Cygnet spokesperson said: "We offer our deepest condolences to Peter’s family, loved ones, and all those who continue to be affected by his loss.
“We are committed to ensuring that the lessons learned from Peter’s death lead to meaningful, lasting change. We're dedicated to learning from every experience, sharing those insights, and making sure necessary improvements are always implemented.
“Following Peter’s death, we took extensive steps to improve the safety of those in our care including strengthening staff training and compliance with Eating and Drinking guidelines and sharing best practice in managing choking risks, dysphagia and nutrition and hydration.”
A government spokesperson said:
“These reports are shocking and distressing. Abuse or neglect of vulnerable people in care settings is appalling and represents a total dereliction of duty. We expect the CQC to investigate all instances of abuse or mistreatment and take appropriate action."
There is money being made in Britain’s adult care system, and more questions are now being asked about the cost to those who rely on it.
If you've been affected by any of the issues raised in this article, help is available
The charity Samaritans operates a 24/7 helpline (116 123) for anyone who needs somebody to talk to. Further resources can also be found on its website.