Abuse is prevalent in residential care settings, mental health wards and where vulnerable individuals require care in their homes. Vulnerable women don’t stand a chance in a system which enables predators and looks the other way. The problem of men using care careers in order to access and rape vulnerable women is so widespread that the UK Government recognises it specifically in sexual offences legislation. Sections 38 to 41 of the Sexual Offences Act 2003 outline how it is illegal for a carer to engage in sexual activity with a person who has a mental disorder, to incite a person with a mental disorder to engage in sexual activity and to cause a person with a mental disorder to watch a sexual act.¹ Penetration of a woman with a mental disorder, of her vagina, mouth or anus, with the carer’s penis carries a prison term of 14 years upon conviction. Continuing the practice of allowing male carers unsupervised access to female patients is being deliberately blind to evidence of a pattern of risk. Not all men, but it is enough, and we must safeguard vulnerable women. The alternative is to say the potential sexual abuse of women is acceptable to placate the feelings of men.

Statistics produced by the UK government show that males commit 98% of all sexual offences.² . In the UK Government figures for ‘the three years ending March 2018 [suggest] 3.7% of disabled adults aged 16 to 59 years experienced any sexual assault (including attempts), compared with 1.9% of non-disabled adults’³. The government extrapolated from this data that ‘in the three years ending March 2018, disabled women were almost twice as likely to have experienced any sexual assault in the last year (5.7%) than non-disabled women (3.0%)’.⁴ The United Nations Population Fund has highlighted how ‘In a study by the African Child Policy Forum of violence against children with disabilities, nearly every young person interviewed had been sexually abused at least once – and most more than once. Another study conducted in Australia found that as many as 62 per cent of women with disabilities under the age of 50 had experienced violence since the age of 15, and women with disabilities had experienced sexual violence at three times the rate of those without disabilities’.⁵ According to research by DAME ‘Eighty-three percent of disabled women experience rape or abuse, often at the hands of caretakers. And without a way to report their violations, the perps frequently go unpunished’.⁶ Victoria Brownworth argued regarding the situation in America that, as we know, ‘77 percent of rape and sexual assault were not reported to police. The enormity of that number suggests that within the context of disability, where so many victims may not even have access to language, or where the person they would report to is the same person perpetuating the assaults (and on whom they depend for their most basic care), the number may be perilously close to 100 percent’.⁷ Once again in America ‘NPR obtained unpublished Justice Department data on sex crimes… The results show that people with intellectual disabilities — women and men — are the victims of sexual assaults at rates more than seven times those for people without disabilities. It's one of the highest rates of sexual assault of any group in America, and it's hardly talked about at all’.⁸ Building on academic research, The People’s Law School, based in Vancouver, warn that ‘Most people with disabilities will experience some form of sexual assault or abuse (Sobsey & Varnhagen, 1989)’ and that ‘People who have some level of intellectual impairment are at the highest risk of abuse (Sobsey & Doe, 1991)’.⁹ Research has suggested that ‘among adults who have developmental disabilities, as many as 83% of the females and 32% of the males are the victims of sexual assault (Johnson & Sigler, 2000)’ while ‘for individuals with psychiatric disabilities, the rate of violent criminal victimization including sexual assault was two times greater than in the general population (8.2% vs. 3.1%) (Hidday, Swartz, Swanson, Borum, & Wagner, H.R. 1999)’.¹⁰ Abuse is underreported and only the worst instances might draw attention. People with disabilities are often forced to live in institutions away from public scrutiny without access to police, support services or advocates. These private institutions put profits over people and are financially incentivised to cover up abuse.

The statistics only scratch the surface as we know much sexual abuse is hidden and men often target nonverbal, or ‘unbelievable’, victims. Furthermore, if you need help from a carer to communicate or arrange a police visit do you think the carer who is raping you will assist in that? Sometimes men will target dying women who are incapacitated through end of life pain medication and the families are too traumatised to report the incidents. After a request for personal experiences of abuse, one woman disclosed how in 2015 her sister was on her death bed and ‘we stayed with her on Christmas Eve morning but on the night she had a Macmillan volunteer. He was male. When we got the call to come as death was imminent (Christmas Day Morning) I got there first and she was naked… I was puzzled. Later I rang the man to ask if he knew why she was naked and he said she begged him to remove her clothing because she was hot. Maybe it was entirely innocent but I can’t shake the memory. Another reason men should not be left alone with vulnerable women. She died that morning . I didn’t tell my sisters. I just covered her with the bedcovers and if they noticed they never said’.¹¹ This underscores one of the main issues which increases disabled women’s vulnerabilities: it is all so explainable. Even when you know something is wrong, not quite right, it can be rationalised why they had to strip the woman naked while no one else was around. In what other situation do we just nod along when vulnerable women are left alone with men who strip them naked? It is simply not safe to allow males access to vulnerable women. Safeguarding is based on trends and data rather than the individual.

Pregnancies in incapacitated or intellectually disabled cared for women bring much of the hidden abuse to light and make the problem undeniable. In February 2020 Edson Munyikwa was jailed for 15 years for raping and impregnating a severely disabled woman he was providing respite care to.¹² The woman was unable to communicate verbally and has the mental age of a toddler, she suffers from a range of serious disabilities, including brain damage, epilepsy and autism. Other care home staff tested her blood in order to try and ascertain why her epileptic fits were increasing and discovered she was pregnant. She then had to undergo a surgical abortion with a DNA test on the foetus proving that Munyikwa was the father.¹³ ‘In a statement, her family said: She was targeted because of her vulnerability and her inability to communicate. "We find it increasingly difficult to come to terms with the fact that another professional body has caused indescribable distress to a vulnerable young woman".¹⁴ They understood better than the judge who claimed that ‘This is not an ordinary case’.¹⁵ If this was not so frequent as to be ordinary why was it that on the 12 November 2020, only nine months later, the Court of Protection ruled that a 30-year-old intellectually disabled woman would have to undergo a Caesarean section without her consent as she could not undergo a natural birth due to her communication difficulties and inability to understand a midwife’s instructions.¹⁶ The Court of Protection recognised that she had been raped in a care facility and an investigation into the identity of the perpetrator was underway. Similarly, on the 4th December 2021 it was reported that, due to pressure from the victim’s family, the police were now probing how ‘a male hospital carer made a psychiatric patient pregnant’.¹⁷ Despite the birth of a baby girl, which is clear evidence that he had committed an offence under s.38 of the Sexual Offences Act 2003 by penetrating the vagina of a woman with a mental disorder, the Crown Prosecution Service were only considering whether he should face charges. Maybe the Crown Prosecution Service do not know how babies are made?

They could look to the American Courts for advice, who this week imprisoned Nathan Sutherland for ten years after he raped and impregnated a woman in a coma who was in his care.¹⁸ The convincing evidence in this case was that Sutherland’s DNA matched that of the baby born to the long-term unconscious woman. Sutherland should not have been caring for the woman. Indeed, it has led to a lawsuit from the victim’s parents that alleged Sutherland had cared for their daughter on hundreds of occasions from 2012 through 2018, despite promises from the state — which contracts with companies like Hacienda to provide services to people with developmental disabilities — that only women would tend to her. An expert on behalf of her family has said many of Sutherland’s encounters with the patient occurred overnight, when fewer staff members and visitors were around’.¹⁹

Families should not have to request single sex care for vulnerable women, it should be standard.²⁰

The four cases mentioned are frustratingly similar to one which happened in 2001. A 38-year-old woman who had suffered brain damage in a car crash and had lost her ability to communicate and care for herself was impregnated in a Warwickshire care home. A few weeks before she gave birth, other carers at her nursing home discovered she was pregnant and alerted her family. The woman’s family pursued the case and pressured for action. A DNA test of the child proved that one male carer, Ian Fraser McDonald, was the father. He was sentenced to life in prison with the judge ordering a minimum of 6 years to serve and the woman’s family sued the care home provider for facilitating the abuse of their daughter.²¹ Furthermore, ‘it was the second time the woman had been the victim of a sexual attack at the home. In June a man was jailed for an indecent assault on her unconnected to yesterday's ruling at Warwick Crown Court’.²² That is testament to the frequency of the abuse of particularly non-verbal disabled women: the same woman was sexually assaulted at the same care home by two different male carers. If those in power cared about disabled women this wouldn’t have happened multiple times and wouldn’t still be an ongoing problem. Treating it as an issue of ‘occasional bad apples’ is ignoring the pattern and the problem.

Councils ignore family’s requests for female only care and safety concerns and are willing to place vulnerable women in care homes rated ‘inadequate’. In one such case in Birmingham in 2019, 90-year-old Dorothy Close, who suffered from Parkinson’s Disease, was taken to Ivy House Care Home against her family’s wishes because council and NHS hospital staff wanted to free up her hospital bed. Within days of arriving, she became agitated and disclosed that a male care worker was sexually abusing her. ‘Police were called in to investigate but there was not enough evidence to go to court, and the NHS trust involved called off its own probe’.²³ Holly, Dorothy’s granddaughter, claims that ‘after they reported the incident, little was done by the care home or the council. “In the immediacy, absolutely nothing happened,” she said. “We informed the out of hours social work team and they advised the care home to suspend the staff. “What they actually did was move them onto another unit within the same home so they didn’t have contact with my Nan. [But] “I… found when I went to visit my Nan the following day that the same members of staff were actually on duty with her”.²⁴ Despite Dorothy’s family fighting for her and subsequently the other residents ‘the council decided to close the safeguarding enquiry, and said Ivy House should consider as part of its improvement plan what it should do when a resident did not want male carers for personal care. A manager from the council recorded that there was no evidence to confirm the abuse took place, so it could not determine that the male carers were a risk to anyone else’.²⁵ This is a common cycle of justification for ignoring the abuse of the vulnerable and disabled. Male perpetrators target the vulnerable who may not be believed or listened to, little physical evidence is left or collected, the police refuse to continue an inquiry, investigations are closed and the perpetrator moves to a new care home to continue to abuse. The lack of convictions is then cited to argue that male carers pose no risk to female patients or residents.

The rape and sexual abuse of vulnerable patients receiving care is rife. Between March and May 2018 ‘Hundreds of elderly and vulnerable social care residents have allegedly been sexually assaulted in just three months, a shock new report from the care regulator has revealed. According to the Care Quality Commission, there were 899 sexual incidents reported by social care homes between March and May 2018. Almost half were categorised as sexual assault. In 16 per cent of the cases members of staff or visiting workers were accused of carrying out the abuse’.²⁶ These are only the ones in which the patient is able to report or the perpetrator has been caught in the act. We know men target victims with limited to no communication. There have been cases where the presence of a sexually transmitted disease in the disabled and vulnerable woman has exposed sexual abuse and rape. In 2019 it was reported that a severely autistic woman in her 50s collapsed and was found to be HIV positive after being repeatedly raped by a night shift worker.²⁷ As the rape, or rapes, could have happened at any point during a ten-year period the police closed the investigation. Brent Council closed the home and promised not to use that private care provider again. What is reaching the press gives an insight into what many disabled and vulnerable women are suffering. In September 2018, Mark Cox was jailed for 5 months for attempting to masturbate on an elderly woman living in a care facility due to dementia.²⁸ Another female carer, suspicious of Cox’s late entry into the patient’s room disturbed him while he had his penis in his hand and had pulled the victim's nightdress up above her incontinence pad and undone the two straps that hold it in place to expose the victim’s genitals.²⁹ She reported what she found to the manager and the police leading to the conviction of Cox.

As well as other staff reporting patient abuse, hidden cameras are enabling more assaults to be detected and proven. For example, in November 2020 Benjamin Poole was recorded assaulting a woman in her 20s in a care home while she was having an epileptic seizure on a hidden camera that she had installed.³⁰ She had installed the hidden camera as she had been waking from epileptic fits and recalling being sexually touched. After one such fit ‘when she came round from the seizures, she viewed the footage from the camera via her phone and was horrified to see Poole committing a number of sexual assaults on her over a period of 23 minutes while she was having the seizures’.³¹ Poole was sentenced to 6 years in prison. In 2021, 21-year-old Dylan Birkett who worked in a Cumbrian care home was jailed for two years ‘after he was caught on a hidden camera sexually assaulting a vulnerable resident with dementia on Christmas Day.³² He had been repeatedly physically and sexually abusing the 69-year-old woman as the hidden camera had been set up by her husband in an attempt to understand why she was frequently agitated and distressed. Very little training and qualifications are involved in initially becoming a care assistant in a care home making the access to the vulnerable easier. One website advises that ‘You don’t necessarily need any qualifications or previous work experience to get a job in social care’.³³ Low pay, low status and difficult working conditions have meant that the care industry is struggling to attract and retain caring care staff. Bullying environments are developing as staff feel demoralised.

Chronic understaffing is putting patients at risk of abuse. The industry has been in crisis for years, in fact since it was turned into an industry through privatisation.

Still, a large amount of training and many qualifications don’t stop the danger which men as a class pose to women, particularly vulnerable women. Males build careers around access to vulnerable women and girls. For example, in July 2020 Emmanuel Adeniji, who was a trained healthcare professional with 15 years experience was jailed for 11 years at Ireland’s Central Criminal Court for raping a 73-year-old woman with Alzheimer's in her nursing home bed during the Covid-19 lockdown.³⁴ CCTV showed him entering and leaving the victim’s room at 3am on the 3rd April while DNA on the victim matched his.³⁵ On 29th May 2021 it was revealed that Graham Davis, ‘a former Greenock psychiatric nurse facing a catalogue of allegations of sexual assaults against his vulnerable patients may never stand trial’ as ‘his lawyer won a last-minute adjournment amid concerns over his health’.³⁶ On 30th November 2021 it was reported that ‘A student nurse from Waltham Forest is accused of raping a vulnerable patient in an east London mental health hospital. Ige Apata, 42, will stand trial in March, charged with three counts of rape and two counts of sexual touching at Goodmayes Hospital in Redbridge earlier this year. The alleged crimes are said to have taken place in a part of the hospital that deals with the most vulnerable patients, such as those that present an acute risk to themselves or have had a stroke’.³⁷ In December 2021 it was reported that the risk posed to female patients at a Redbridge mental hospital was so severe that the hospital is now ‘making staff wear body-worn cameras’.³⁸ But this is a sticking plaster because, as Rachel Rowan Olive has argued, ‘Where cameras have been trialled, staff control when they are turned on’.³⁹

An Ongoing Failure

None of what I am saying is new. In 2001 Amelia Hill reported for The Guardian on the ‘Hidden plague of sexual abuse [which] grips care homes’.⁴⁰ Hill related how ‘when 84-year-old Katherine Barnes stopped talking, her family assumed it was simply an inevitable stage in the slide towards Alzheimer's…Soon afterwards, she became transfixed with terror every time her formerly beloved son-in-law entered the room of her nursing home… [but] It was only when John Tiplady, owner of the £350-a-week Denison House nursing home in North Yorkshire, was arrested for sexual attacks on the elderly women in his care that the family began to piece together a number of strange incidents that had slipped their notice at the time’.⁴¹ That was in 1997 but is strikingly similar to what is still happening in care facilities across the country. “Anyone who bothers to look into it cannot fail to realise that the sexual abuse of elderly people in care homes is horribly prevalent,” said Ginny Jenkin, director of Action for Elder Abuse, whose helpline has received around 160 calls from frantic families and care homes since 1997 concerning extreme sexual abuse in care homes, a figure she says grossly underrepresents the true level of the abuse taking place’.⁴² As Jenkin stated, 'People find it hard to understand why anyone would want to abuse an old person, but someone suffering some mental and physical frailty is the perfect victim: they can't defend themselves, they can't get away, and if they're able to communicate they're probably not believed. What more could any abuser want?'.⁴³ As early as 2001 Jackie Pritchard, a specialist in this kind of abuse, had already ‘been battling against scepticism and apathy for more than 15 years’.⁴⁴ ‘This sort of abuse is endemic in all but the best care homes,' she said. 'The whole spectrum of abuse, from inappropriate touching to rape, takes place in exactly the same way as child abuse took place in days gone past: there is exactly the same targeting of homes, the same grooming of particularly vulnerable victims, and the same patterns of mobility and planning in the abusers. It's a massive scandal just waiting to break. All we need is the government funding to prove it's as bad as we know it is’.⁴⁵ The funding and desire for change never really materialised. However, the Care Quality Commission, the official body which regulates England’s 16,000 care homes and mental health units for example, can now prosecute Homes which fail to meet safeguarding standards under Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 13.⁴⁶

Nevertheless, the Care Quality Commission has a history of failing to investigate reports and subsequently not using the legislation at its disposal. The 2011 Winterbourne View Scandal highlighted this to national outrage. Undercover filming by a Panorama journalist at the private hospital run by Castlebeck Ltd to provide care for adults with learning disabilities and autism exposed what experts described as abuse amounting to torture.⁴⁷ 11 staff members were convicted of the abuse of learning disabled patients which included patients being ‘violently restrained, pinned under chairs, forced under cold showers as punishment, and even one woman [having] mouthwash poured into her eyes’.⁴⁸ The whistleblower, Terry Bryan, approached Panorama after the CQC ignored his pleas and failed to inspect the home.⁴⁹ Even after the exposure the CQC wouldn’t admit any fault. In 2011 Martin Green, Chief Executive of The English Community Care Association, said that ‘The CQC has failed to take due responsibility for their own failings in the Winterbourne View case. CQC has talked about failures by the provider and by local health and social care services, but has not fully acknowledged that cases like this also show a fundamental flaw in its own performance’.⁵⁰ Since then the Care Quality Commission is alleged to have covered up sexual abuse. Andrew Norfolk reported for The Times in 2017 that ‘the suspected rape of a helpless autistic man by a high-risk sex offender was kept secret by the official body responsible for his safety… [and] the incident was among a cluster of sex alerts at residential homes owned by a private company that specialised in the care of young adults with learning disabilities’.⁵¹ Norfolk claimed that ‘All were kept hidden from the public by the Care Quality Commission (CQC)’.⁵² Norfolk stated that ‘The Times has seen confidential police documents and agency reports linked to the suspected rape and other incidents at three homes run by Hillgreen Care. They reveal that ‘The deputy manager of one home was a convicted sex offender working in Britain illegally. Concerns were raised at other homes over “sexual grooming” of residents and staff having sex while on duty. Care workers were initially told not to inform police of the suspected rape. Potential DNA evidence linked to the incident was destroyed.’⁵³ When the CQC does act it is inadequate. In January 2020 it fined Kinross care home in Portsmouth a meagre £1,200 after an inspection found at least 15 allegations of sexual abuse, with 12 not having been investigated or referred to safeguarding.⁵⁴ The CQC inspector Steve Evans stated about the alleged sexual abuse of residents that ‘the seriousness of the matter in this instance did not justify prosecution, but the threshold of evidence is the same for a fine’.⁵⁵ In black and white, the CQC does not deem the sexual abuse of disabled people serious enough to prosecute.

Conclusion

The sexual abuse of these women, and sometimes vulnerable men, is only getting attention and addressed when family members fight for them or good people in the care sector whistleblow. Imagine all the vulnerable women who don’t have relatives who will champion their cause, or all the rapes and sexual assaults that don’t result in pregnancy to provide clear evidence of a crime. All the incidents which haven’t been stopped by a good carer who happened to be suspicious of their colleague. All the abuse that isn’t captured on hidden cameras. Male perpetrators, if suspicion is raised, are often not convicted and just move to a new home to continue their abuse. The problem is shuffled around and never addressed. A member of the CQC publicly stated that he didn’t find the sexual abuse of vulnerable residents serious enough to prosecute. Without a change in culture, policy change and proper oversight from the CQC, then good carers, nurses, doctors and families of vulnerable and disabled adults are fighting an uphill and losing battle.

1 Sexual Offences Act 2003, c. 42, Part 1, ‘Care Workers for Persons with a Mental Disorder’, Sections 38 – 41, https://www.legislation.gov.uk/ukpga/2003/42/part/1/crossheading/care-workers-for-persons-with-a-mental-disorder 2Ministry of Justice, ‘Statistics: Women and the Criminal Justice System’ (26 November 2020), https://www.gov.uk/government/statistics/women-and-the-criminal-justice-system-2019/women-and-the-criminal-justice-system-2019

3 ‘Disability and crime, UK: 2019’, Office for National Statistics 2 December 2019), https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/bulletins/disabilityandcrimeuk/2019 4 ‘Disability and crime, UK: 2019’, Office for National Statistics 2 December 2019), https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/bulletins/disabilityandcrimeuk/2019 5 United Nations Population Fund, ‘Five things you didn’t know about disability and sexual violence’, UNFPA (30 October 2018), https://www.unfpa.org/news/five-things-you-didnt-know-about-disability-and-sexual-violence

6 V. Brownworth, ‘Raped, Abused, and Ignored: Disabled Women Are Invisible Victims’, DAME (31 January 2019), https://www.damemagazine.com/2019/01/31/raped-abused-and-ignored-disabled-women-are-invisible-victims/

7 V. Brownworth, ‘Raped, Abused, and Ignored: Disabled Women Are Invisible Victims’, DAME (31 January 2019), https://www.damemagazine.com/2019/01/31/raped-abused-and-ignored-disabled-women-are-invisible-victims/

8 J. Shapiro, ‘The Sexual Assault Epidemic No One Talks About’, NPR (8 January 2018), https://www.npr.org/2018/01/08/570224090/the-sexual-assault-epidemic-no-one-talks-about?t=1639128467212 9 The People’s Law Project, ‘Abuse of People with Disabilities’, College of Direct Support, p. 3. http://www.collegeofdirectsupport.com/Content/Sertoma/images/Abuse_Disabil%20_Information.pdf 10 The People’s Law Project, ‘Abuse of People with Disabilities’, College of Direct Support, p. 3. http://www.collegeofdirectsupport.com/Content/Sertoma/images/Abuse_Disabil%20_Information.pdf 11 Anonymous disclosure, 5th December 2021.

12 S. Finnegan, ‘Severely disabled woman needed surgical abortion after being raped by carer in her Leeds home’, Leeds Live (18 February 2020), https://www.leeds-live.co.uk/news/leeds-news/severely-disabled-woman-needed-surgical-17765235

13 S. Finnegan, ‘Severely disabled woman needed surgical abortion after being raped by carer in her Leeds home’, Leeds Live (18 February 2020), https://www.leeds-live.co.uk/news/leeds-news/severely-disabled-woman-needed-surgical-17765235 14 S. Finnegan, ‘Severely disabled woman needed surgical abortion after being raped by carer in her Leeds home’, Leeds Live (18 February 2020), https://www.leeds-live.co.uk/news/leeds-news/severely-disabled-woman-needed-surgical-17765235

15 S. Finnegan, ‘Severely disabled woman needed surgical abortion after being raped by carer in her Leeds home’, Leeds Live (18 February 2020), https://www.leeds-live.co.uk/news/leeds-news/severely-disabled-woman-needed-surgical-17765235 16 ‘Woman with learning disabilities pregnant after rape’, BBC News (12 November 2020), https://www.bbc.co.uk/news/uk-england-54921390 17 I. Gallagher, ‘Police probe psychiatric hospital carer who got his patient pregnant... so why is the baby being sent to live with HIS family in Ghana? And why, asks the maternal grandmother, is she being frozen out by social services?’, Daily Mail (4 December 2021), https://www.dailymail.co.uk/news/article-10275347/Police-pro'be-hospital-carer-impregnated-patient-baby-sent-family-Ghana.html

18Associated Press, ‘Former Arizona nurse who raped, impregnated incapacitated woman sentenced to 10 years in prison’, 7 News Miami (3 December 2021), https://wsvn.com/news/us-world/former-arizona-nurse-who-raped-impregnated-incapacitated-woman-sentenced-to-10-years-in-prison/

19Associated Press, ‘Former Arizona nurse who raped, impregnated incapacitated woman sentenced to 10 years in prison’, 7 News Miami (3 December 2021), https://wsvn.com/news/us-world/former-arizona-nurse-who-raped-impregnated-incapacitated-woman-sentenced-to-10-years-in-prison/

20 Dr Em., ‘Why Disabled Women Requesting Female Only Intimate Care is Not ‘Disgusting’, Uncommon Ground Media (9 August 2019), https://uncommongroundmedia.com/why-disabled-women-requesting-female-only-intimate-care-is-not-disgusting/ 21 Coventry Live, ‘Family to sue over care home rape’, Coventry Live (18 August 2001), https://www.coventrytelegraph.net/news/coventry-news/family-sue-over-care-home-3177826 22 Coventry Live, ‘Family to sue over care home rape’, Coventry Live (18 August 2001), https://www.coventrytelegraph.net/news/coventry-news/family-sue-over-care-home-3177826 23 A. Stacey, ‘Gran ‘sexually abused’ in care home family had warned against’, Birmingham Live (27 August 2019),

https://www.birminghammail.co.uk/news/midlands-news/gran-sexually-abused-care-home-16766900 24 A. Stacey, ‘Gran ‘sexually abused’ in care home family had warned against’, Birmingham Live (27 August 2019), https://www.birminghammail.co.uk/news/midlands-news/gran-sexually-abused-care-home-16766900

25 A. Stacey, ‘Gran ‘sexually abused’ in care home family had warned against’, Birmingham Live (27 August 2019), https://www.birminghammail.co.uk/news/midlands-news/gran-sexually-abused-care-home-16766900 26 S. Lintern, ‘Hundreds of social care residents allegedly sexually assaulted, watchdog reveals’, Independent (27 February

2020), https://www.independent.co.uk/news/health/social-care-sexual-assault-rape-cqc-a9361401.html

27 C. Dyer, ‘Autistic woman raped at a care home 'by night shift worker' is diagnosed with HIV’, Daily Mail (27 January

2019),

https://www.dailymail.co.uk/news/article-6636853/Autistic-woman-raped-care-home-diagnosed-HIV-five-feared- infected.html 28 N. Docking, ‘Carer caught masturbating in dementia-sufferer's room claimed he had an itch’, Liverpool Echo (17

September 2018), https://www.liverpoolecho.co.uk/news/liverpool-news/carer-caught-masturbating-dementia-sufferers-15164832

29 N. Docking, ‘Carer caught masturbating in dementia-sufferer's room claimed he had an itch’, Liverpool Echo (17

September 2018), https://www.liverpoolecho.co.uk/news/liverpool-news/carer-caught-masturbating-dementia-sufferers-15164832 30 CPS, ‘Carer jailed for sexually assaulting a resident while she was having seizures’, CPS News Centre, https://www.cps.gov.uk/mersey-cheshire/news/carer-jailed-sexually-assaulting-resident -while-she- was-having-seizures 31 CPS, ‘Carer jailed for sexually assaulting a resident while she was having seizures’, CPS News Centre, https://www.cps.gov.uk/mersey-cheshire/news/carer-jailed-sexually-assaulting-resident-while-she-was-having-seizures

32 T. Earnshaw, ‘Barrow care home worker caught sexually abusing resident on family's hidden camera’, LancsLive (9 January 2021), https://www.lancs.live/news/local-news/barrow-care-home-worker-caught-19593712 33 ‘Starting your career’, Think Care Careers,

https://www.skillsforcare.org.uk/Careers-in-care/Starting-your-career/Starting-your-career.aspx 34 P. Reynolds, ‘Healthcare assistant jailed for 11 years for rape of woman with Alzheimer's’, RTE (30 July 2020), https://www.rte.ie/news/2020/0730/1156453-courts-rape/ 35 P. Reynolds, ‘Healthcare assistant jailed for 11 years for rape of woman with Alzheimer's’, RTE (30 July 2020), https://www.rte.ie/news/2020/0730/1156453-courts-rape/

36 D. Goodwin, ‘Former nurse 'may never stand trial' over sex assault allegations’, https://www.greenocktelegraph.co.uk/news/19332051.former-psychiatric-nurse-may-never-stand-trial-sexual-assault-allegations/

37 J. Mellor, ‘Student nurse accused of raping patient at Goodmayes Hospital’, East London & West Sussex Guardian (30

November 2021), https://www.guardian-series.co.uk/news/19751898.student-nurse-accused-raping-patient-goodmayes-hospital/

38 J. Mellor, ‘Body cams for Ilford mental hospital staff after ‘culture of secrecy’ over allegations of serious assault’, Yellow

Advertiser (1 December 2021),

https://www.yellowad.co.uk/body-cam-rule-for-ilford-mental-hospital-staff-after-culture-of-secrecy-over-allegations-of- serious-assault/

39 R. Rowan Olive, ‘If anyone is to be wearing recording equipment on psychiatric wards, it should be the patients’, Mental

Health Today (20 May 2019),

https://www.mentalhealthtoday.co.uk/innovations/if-anyone-is-to-be-wearing-recording-equipment-on-psychiatric-wards-it- should-be-the-patients

40 A. Hill, ‘Hidden plague of sexual abuse grips care homes’, The Guardian (25 February 2001), https://www.theguardian.com/society/2001/feb/25/socialcare.longtermcare 41 A. Hill, ‘Hidden plague of sexual abuse grips care homes’, The Guardian (25 February 2001), https://www.theguardian.com/society/2001/feb/25/socialcare.longtermcare 42 A. Hill, ‘Hidden plague of sexual abuse grips care homes’, The Guardian (25 February 2001), https://www.theguardian.com/society/2001/feb/25/socialcare.longtermcare 43 A. Hill, ‘Hidden plague of sexual abuse grips care homes’, The Guardian (25 February 2001), https://www.theguardian.com/society/2001/feb/25/socialcare.longtermcare 44 A. Hill, ‘Hidden plague of sexual abuse grips care homes’, The Guardian (25 February 2001), https://www.theguardian.com/society/2001/feb/25/socialcare.longtermcare 45 A. Hill, ‘Hidden plague of sexual abuse grips care homes’, The Guardian (25 February 2001), https://www.theguardian.com/society/2001/feb/25/socialcare.longtermcare

46 ‘Guidance for providers Regulations for service providers and managers Regulation 13: Safeguarding service users from abuse and improper treatment’, Care Quality Commission: The independent regulator of health and social care in England, https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-13-safeguarding-service-users-abuse-improper

47 P. Curtis & Hélène Mulholland, ‘Panorama care home abuse investigation prompts government review’, The Guardian

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48 K. Robertson, ‘Wiltshire mother condemns 'false promises' a decade on from Winterbourne View abuse scandal’, Gazette

& Herald (27 May 2021),

https://www.gazetteandherald.co.uk/news/19331738.wiltshire-mother-demands-change-decade-winterbourne-view-abuse-scandal/ 49 MENCAP & Challenging Behaviour Foundation, ‘Out of Sight: Stopping the neglect and abuse of people with a learning disability’, p.11 https://www.mencap.org.uk/sites/default/files/2016-08/Out-of-Sight-Report.pdf

50 ECCA, ‘CQC refuses to acknowledge their failings in Winterbourne View report’, Carehome.co.uk (18 July 2011), https://www.carehome.co.uk/news/article.cfm/id/1553671/cqc-refuses-to-acknowledge-their-failings-in-winterbourne-view-report 51 A. Norfolk, ‘CQC covered up suspected rape in care home’, Times Investigation (27 July 2017), p.1. https://minhalexander.files.wordpress.com/2017/09/cqc-covered-up-suspected-rape-in-care-home.pdf

52 A. Norfolk, ‘CQC covered up suspected rape in care home’, Times Investigation (27 July 2017), p.2. https://minhalexander.files.wordpress.com/2017/09/cqc-covered-up-suspected-rape-in-care-home.pdf

53 A. Norfolk, ‘CQC covered up suspected rape in care home’, Times Investigation (27 July 2017), p.2. https://minhalexander.files.wordpress.com/2017/09/cqc-covered-up-suspected-rape-in-care-home.pdf

54 R. Lemmer & M. Salkeld, ‘'Inadequate'-rated Kinross care home in Portsmouth fined £1,200 after not reporting sexual

abuse claims properly’, The News (3 January 2020), https://www.portsmouth.co.uk/health/inadequate-rated-kinross-care-home-portsmouth-fined-ps1200-after-not-reporting-

sexual-abuse-claims-properly-1353952 55 R. Lemmer & M. Salkeld, ‘'Inadequate'-rated Kinross care home in Portsmouth fined £1,200 after not reporting sexual

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