Introduction

The BBC's Panorama television special, Undercover Care: The Abused Exposed, was first broadcast on 12 May 2011. This uncovered a regime of shocking abuse by care staff against residents of Winterbourne View, a private hospital near Bristol, England, providing healthcare and support for adults with learning disabilities, complex needs and challenging behaviour, including those liable to be detained under the Mental Health Act (1983). During five weeks spent filming undercover, Panorama's reporter captured footage of some of the hospital's patients being repeatedly pinned down, slapped, dragged into showers while fully clothed, taunted and teased. Methods of restraint and punishment were often dangerous and illegal. The programme decided to film secretly after being approached by a former senior nurse at the hospital who was deeply concerned about the behaviour of some of the support workers caring for patients.

In the immediate aftermath, politicians, the Care Quality Commission, professionals, and all segments of society were quick to express disgust and shock. The developments that unfolded exemplify how the influence of recent research may be detected, but also point simultaneously to areas where research has yet to have much impact on policy and practice.

In this chapter, what happened at Winterbourne View and the responses thereafter are used to frame a wider reflection on the impact that research has had on policy and practice in the area of disablist hate crime. By virtue of the sheer breadth of issues raised by this scandal, the discussion that follows is necessarily selective and is intended to highlight specific instances where research is perceived to have made an impact, and others where the evidence base has yet to make perceptible inroads into policy and practice. While the Winterbourne View case involved, specifically, people with learning disabilities and autism, the issues raised here go beyond the confines of impairment specificity.

A ‘layers of influence model’

In order to conceptualise how we interpret what happened at Winterbourne View, and its wider relevance for understanding disablist hate crime, the analysis that follows draws on a ‘layers of influence’ model. ‘Layers of influence’ was proposed by Göran Dahlgren and Margaret Whitehead in 1991 as a ‘social model of health’ for understanding the determinants of health.