Following a shocking catalogue of abuse, a young man with autism has been awarded out-of-court damages following failures in his care by a private autism hospital in Birmingham and the West Mercia Police.
23-year-old Adam Nasralla, who was diagnosed with autistic spectrum disorder aged nine, has been left suffering severe PTSD following months of mistreatment at the Wast Hills hospital, which culminated in March 2014 with him being handcuffed, placed in a spit hood and detained in a police cell where restraints continued to be used, with no solicitor or appropriate adult allowed to visit him. Spit hoods have recently been criticised for breaching individual human rights.
At the time of his arrest, Adam had been frequently restrained on the floor and on his bed by as many as nine hospital staff for up to 11 hours, including using the ‘Supine T’ restraint technique, had been injured by hospital staff and, at times, had been so heavily medicated he could hardly speak.
An independent social worker and expert in autism appointed as an advocate by Adam’s family said that he was concerned from the outset that hospital staff lacked understanding of autism, frequently used physical restraint and lacked a clear plan for Adam’s daily care. The social worker’s concerns were never addressed.
A medical expert said that Adam’s autism would have made him even more sensitive to physical restraint and that not understanding why he was being restrained would have been traumatic for Adam.
The local authority Serious Case Review conducted on the insistence of Adam’s lawyers, Hodge Jones & Allen, described serious and multiple failings across the agencies involved and concluded that Adam’s placement at Wast Hills had ‘completely failed’. It also reported that the hospital relied too heavily on restraining its patients, that investigations into allegations of mistreatment were ‘seriously flawed’, and the decision to arrest Adam for assaulting staff members was ‘a very bad decision’.
Up until the age of 15, Adam was in mainstream schools with specialist care. He was a loving, happy child who enjoyed school. With the onset of adolescence his behaviour changed. With little support from adult services, Adam was detained under the Mental Health Act at 18.
Adam’s first placement was at Greenways Assessment and Treatment Unit in Macclesfield and included the use of regular, multiple full prone restraints involving up to 10 members of staff and the introduction of seclusion. Adam’s presentation declined dramatically and he was sent to Wast Hills.
Initially, he was described as making ‘considerable progress’ at Wast Hills and as a ‘very able individual, able to engage in meaningful activities’ but as time went on, he was separated from other patients, denied social activities and his medication was increased. Within eight months, Adam’s anti-psychotic medication was tripled in dose without his family’s consent, despite their concerns about the side effects.
Adam’s progress further declined and after restraining Adam over a period of 11 hours, the police were called. They were told that Adam’s diagnosis of autism had been removed, and that he had capacity and so was responsible for his actions.
Adam was handcuffed by the police, placed in a spit hood and restrained with a belt in police custody. The doctor who assessed Adam, however, reported that he was not fit to be charged and should not be held in police custody. Eventually Adam was transferred to Recovery First, where, according to the family, staff were extremely distressed by his former treatment.
When questioned during the serious case review, the hospital, run by Danshell Healthcare Limited, said it had removed the diagnosis because Adam failed to respond to treatment. An expert on the case said that it was highly unusual for a diagnosis of autism to be removed, since it is considered a lifelong condition. He also said that the diagnosis was removed exactly when Adam was ‘in crisis’.
When Adam’s parents finally got to visit their son after his arrest, he was clearly extremely disturbed and could not stop crying. He continues to suffer trauma as a result of his arrest and police detention.
Recovery First, which assessed Adam immediately following the arrest, said that his treatment demonstrated ‘an extremely troubling lack of care’, with safeguarding concerns being ignored. Adam subsequently made excellent progress at Recovery First with staff engaging with him appropriately. Adam’s autism diagnosis was reinstated shortly after his arrival and his medication was dramatically decreased. Throughout his time at Recovery First, Adam was not subject to any floor restraint.
Later it emerged that at the time of Adam’s placement at Wast Hills, Worcester Council had begun a large-scale investigation into standards of care and treatment at the hospital, suspending any new placements. The family were not aware of this and had they known about the allegations, they would never have allowed him to live there.
London law firm Hodge Jones Allen acted for the Adam in his civil claim for negligence, assault, breach of human rights and wrongful arrest. Both Wast Hills and West Mercia Police settled out of court.
Civil liberties partner Nancy Collins said: “It defies belief that such a vulnerable young man could be subject to such appalling treatment. Clearly, he and his family have been deeply traumatised by this horrific experience.
“Adam was wholly failed by those who were responsible for his care. Even when very serious concerns were raised, the infringement of his human’s rights continued unchecked. The police were also seriously negligent in their treatment of Adam, an extremely vulnerable young adult. Sadly, the case exemplifies the poor treatment frequently suffered by people with autism, learning disabilities and complex needs. There is a sense that this treatment is somehow acceptable and there is a lack of public scrutiny into the care afforded to those with learning disabilities. The abuse in this case came to light only because of the determination of Adam’s family, who acted as Adam’s voice to ensure that his story was heard. It is deeply regrettable that they had to resort to legal proceedings to seek redress for the difficulties Adam and they had experienced.”
Adam’s parents said: “We have fought a long, personally and financially draining battle to try to ensure what has happened to our beloved son does not happen to any other family. The “drugging them up and pinning them down” regime in hospital settings is barbaric and inhumane, this treatment belongs in a different century.
“We are incredulous that there has never been an apology. How can we believe “lessons have been learnt”?
“Nothing can ever compensate for our lost years as a family. Our son has been severely harmed by those who were supposed to care. We will never be the same again.
“Thankfully, with the support of some fantastic people, Adam is now living successfully in the community. His entire team left their jobs at Recovery First to continue to support him in his own house. Our son is loved once more and is now, in his own words, “as free as a bird”.
“To date, there has been zero accountability. The SCR recommended that the Wast Hills doctor be referred to the GMC. Without consulting the family, it concluded that the doctor had no case to answer.
“The only way to stop the horrific practice of floor restraint being used on autistic people is for legislation to be introduced to ban it.”
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Notes for Editors
Hodge Jones and Allen
- Hodge Jones and Allen is one of the UK’s most progressive law firms, renowned for doing things differently and fighting injustice. Its managing partner is Patrick Allen, recently awarded a lifetime achievement award by Solicitors Journal.
- For 40 years’ the firm has been at the centre of many of the UK’s landmark legal cases that have changed the lives and rights of many people.
- The firm’s team of specialists have been operating across: Personal Injury, Medical Negligence, Industrial Disease, Civil Liberties, Criminal Defence, Court of Protection, Dispute Resolution, Employment, Family Law, Military Claims, Serious Fraud, Social Housing, Wills & Probate and Property Disputes.
- In 2016, the firm launched Hearing their voices – a campaign to raise awareness and build conversations around the issues and the injustices we might all face.