An inquiry into abuse at Muckamore Abbey Hospital has found ‘profound and deeply troubling’ failures in care.

The inquiry report, published on Thursday, found that restrictive practices were used inappropriately and that ‘as needed’ medication was overused and ‘left some patients zombified’.

Chairman of the inquiry Tom Kark KC said the people who lived at Muckamore and their families ‘deserved better’.

Muckamore Abbey, run by the Belfast Health and Social Care Trust, was a hospital in Co Antrim for adults with severe learning disabilities and mental health needs.The inquiry examined allegations of abuse of patients at the facility.

It was initially set up by former Health Minister Robin Swann and began hearing evidence in June 2022.The hospital has also been at the centre of the UK’s largest-ever police investigation into the alleged abuse of vulnerable adults and a number of prosecutions are continuing.

Police seized 300,000 hours of CCTV footage, revealing what the inquiry heard was ‘shocking abuse of vulnerable patients’.

The inquiry’s central finding was that a policy shift to move patients with learning disabilities and autism from hospital into community care was not matched with investment.As a result, many patients could not be safely discharged due to a lack of capacity in the community leading to delays in resettlement, heightened distress, and in some cases readmission. The inquiry also found that there was “insufficient” staffing at all levels, leading to unsafe wards, and restrictive practices were used inappropriately.Staff instability, increased violence, high use of restrictive practices and repeated complaints were “visible and known”.It also found that “as needed” medication was overused as a tool of restraint which left some patients “zombified”.It found that seclusion was misused as punishment for so-called “bad behaviour” and was not properly monitored.There was a “closed culture” among staff which discouraged reporting of poor behaviour and many families said they were frightened to complain in case it impacted on the care their relatives received.

The inquiry has made 106 recommendations and proposes reforms in response to the “profound catalogue of failures”, including “ineffective” external inspection regimes, and serious failures in governance within the Belfast Health and Social Care Trust which led to the erosion of oversight at the care facility over many years.

It said the BHSCT treated each complaint in isolation, preventing any recognition of wider patterns emerging over time.

Jennifer Welsh, Chief Executive of Belfast Health and Social Care Trust said: “Today’s inquiry report makes for very difficult reading. The failings are widespread and they go to the core of operational, strategic and policy failings. “The report also notes concerns about the Trust’s approach to the inquiry itself, which we take very seriously and will reflect upon. “I’m truly sorry for the distress, the anger and the anxiety that this Trust has caused you and continues to cause some of you. The mark of a civilized society is how we treat the most vulnerable members of that society. “I am sorry to say that your loved ones were treated by many staff in the most uncivilised way.”Health Minister Mike Nesbitt said: “A system which should have ensured the most vulnerable were protected, nurtured and cared for, failed in that core duty. “They were let down and for that I am truly sorry. I believe some recommendations can be progressed immediately. Others will need more working out, none should take until Christmas to figure out. “I had taken advice from officials and they said you really need to wait until Mr Kark reports until you meet the families. “Well now he’s reported, so there’s nothing to stop me meeting them. I will meet them as a matter of urgency.”

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