so, currently, the longest delay we've had is 524 days, but that's just on our current records. for the next half an hour, it varies over time. we'll bring you some and of course, the reasons of the exclusive and original for delays are complex, journalism we've broadcast they're not straightforward. over the last week. on tuesday, we heard this isn't someone just sitting first—hand the shocking, on something and not doing theirjob properly. brutal impact that rape can have so, what is it like for patients on an individual. arriving for the first time sarah — which is not her real name — at a hospital like this? is the 23—year—old graduate raped it's like being thrown by the former worcestershire county in the deep end. cricketer alex hepburn. you have to learn to cope quite last month, he was sentenced to five years in prison and will be on the sex offenders‘ register for life. quickly and adapt quite quickly, in the interview you're about to hear, sarah — speaking in herfirst broadcast because you're surrounded by people interview — describes the shocking, who are going through the same thing. dramatic and debilitating when i first got here, it was hard because it's effect it had on her. so restrictive and you have to be observed on the toilet and observed with a pen, and all those things that i would like you to tell our are really, like, you don't think audience about the impact you need, but they put in place for your safety. on both your body and your mind, as the days turned into weeks, amy and sarah were the only two patients the hospital turned into months, allowed me to meet. because you were raped. erm... sarah arrived on this 23—bed ward so, when it first sort of happened, for women with borderline personality disorder a year ago.

i was, i guess, in denial. like all the patients, she had to be sectioned under so, the people that the mental health act to protect herfrom harming herself. sort of like know — i think people think that if you're in hospital, my family and my friends you're crazy and there's and what not — they said to me, no hope for you. and i remember, it's a piece because a lot of people of advice that literally everyone are in hospital for a long time gave to me was, don't and some people don't get out. let this define you. it's kind of hard because i really i had this view that you'd be didn't have an understanding in therapy all the time whereas, of rape, or the implications of rape actually, it's really different to that. and the effect, the impact it would you don't... you don't have padded cells, have on a person that was raped. i just remember, right, you have seclusion, don't let this define you. you're going to carry which i've never been in, on and you'll be fine. and for the first two but i know it's not very nice. if a patient is in extreme distress months, i was fine. i didn't want to leave... or is a risk to themselves or members of staff, this, the seclusion room, is always used as a last resort. i was at university in the city where it happened in a damning report published this at the time and i didn't... week, the care quality commission you know, my parents begged me has called for a review of every to come home and i said, no, like, why should i have to miss patient in long—term out on this? seclusion, or segregation, it was the last few months in mental health hospitals. of my university sort of experience, my studying, and i said, and this is a glimpse

no, why should i? you know, this is like my final of what seclusion looks like. year, why should i have to go home? i didn't want anything to change. the teenager behind this door, we have been told, was held inside this room on a ward and i didn't want to let it at st andrew's for months. define me, whatever that meant. the parents, who have asked not to be identified, so ijust... say their only contact i'm fine, i carried on as normal. with their child when they came in hindsight, i wasn't normal. far from. erm, and ijust carried on. to visit was through the hatch in this door. a recent inspection into the use i still went to my lectures. of seclusion at st andrew's hospital erm, i told my personal academic in northampton found that a patient tutor what had happened. was subjected to repeated and again, i thank her so much. and prolonged periods of seclusion and segregation for 18 months prior to the cqc‘s inspection visit. we were also told allegations she was able to extend my dissertation deadlines, of a patient being locked because this was a month in isolation and fed through a hatch at this hospital, a question before my dissertation was due. such a crucial part of my education, which i put to the chief executive. of my future, of my life. and ifeel that that's had a great impact on that. in terms of a physical environment, on padded cells, or metal hatches, erm, and so i didn't. or people being kept inappropriately in longer term segregation, actually, i think some of the cases we went on a university trip you're referring to there are in our to italy, which is then where i met my boyfriend to there are in our child and adolescence services. at the time. if you look at the cqc focused inspection report, it doesn't

and i got so wrapped up in him, support those allegations. actually, it talks about many, i guess it was sort of my escape. many examples of good practice. he made me happy, and that's what i wanted to feel. i didn't want to acknowledge the cqc‘s report also said staff decided it was necessary to reduce anything else in my life. the risk to the patient by locking you know, i've met this them in segregation. wonderful guy, so i'm just in some seclusion rooms, going to be so absorbed for certain types of patients, in him, which was great. it was fine. there is the opportunity for food, or other things that patients might erm, he then went travelling, and so it left me then. patients might need, to be given to them that wasjune and all of my through an opening in the door, which means that the door itself friends had finished their dissertation at this point. doesn't have to be opened. you know, everyone was moving home, the use of seclusion rooms is only university was over now. and so i was back ever used as an emergency response. with my parents, who... a care quality inspection report the rape doesn't only affect me, it affects my mum, it affects my dad, published in september 2016 found my sister, everyone. my grandparents, my aunties, that a technique called prone my uncles, my cousins. restrain, orface—down restraint, everyone that knows me and cares was widely being used across wards about me and loves me, here at the hospital. it hurts them just as much prone restraint is when someone as it hurts me. is pinned on a surface mmm. and is physically prevented from moving out of this position. so, i'm back with my family since 2016, its use has reduced, and i can see the effect it has but there are still over on my mum, and i can't escape. 1,000 recorded incidents. you know, my boyfriend,

he's now travelling. erm, i have to face this. figures show within the last three years, the technique was used and it was then that by staff on patients i sort of realised that a total of 5,597 times. i couldn't hide from this prone restraint should not be used. and that it was going to affect me, whether i liked it or not. you... i feel i should say... it is something which is associated and this is obviously really hard with death, in some circumstances. for you to talk about this, and you want to tell our audience about this. certainly, within the charity, mm—hmm. why do you want to speak about this? we have reduced the amount of prone restraint that we use drastically over many years, because we know that it can be associated with, you know, very poor because hepburn has no idea, outcomes for people. i believe, the extent of what his stupid actions sometimes, when somebody that night caused. is restrained, they will move into the restraint position there are no winners here, ina prone. in terms of his composition, and when we talk about prone, in terms of both of our futures, there are no winners here. we mean face—down. he has no idea the... if that happens, we immediately move them to supine, which is face—up, he just disregarded rape for all of its meaning. he joked about it. which is a much safer and then he did it. way to restrain. he's got no idea of the rippling

effect that it has on someone. 0k, he can cry in court because, we try to do lots of different look what he's lost — events that goes on. he's lost his good character, he's lost his career, blah, blah, blah, blah, blah — so, there's hallowe'en. but this was his choice, it's interesting to see this was his decision. what life is like on this ward from your perspective. there was no thought for me as we can see, patients look as though they're at all through all of this. having a lot of fun, so, i wanted to come here and let they're enjoying themselves. but at the same time, everyone know exactly how it makes people think, there are concerns from the outside in hopes to educate, that, you know, places like these to prevent this from happening. that's why i'm here. are very secretive and a lot goes on behind closed doors. well, i don't... i think we're as well, we are grateful that you chose transparent as possible. all hospitals have inspections. us to speak about this. there are people like nhs england, mm—hmm. people that have, you know, you suffered a partial paralysis a say on the people that are here. there's no... on one side of your face. there's nothing to hide. yeah. more than 900 children and adults you had recurrent are treated by st andrew's nightmares, i think. across their four hospitals. mmm. you have been diagnosed with ptsd. yes. those are some of the other huge things that have happened in february of this year, to you as a result of being raped. the cqc rated a charities hospital in nottinghamshire as "inadequate", mm—hmm. yeah. saying there had been a real you've also had to go "deterioration in services" and that to court twice. "significant and urgent

there were two trials. improvements were needed". what was the most challenging time how can the public have confidence that you have the capacity to look after such vulnerable people, for you in court, would you say? if your services are poor? in court, i would say the most not only was it rated inadequate, difficult thing isjust it was put into special measures, and that is wholly unacceptable being made out a liar. at every single level. and it's one of the hardest cqc you know, that what you're saying reports i've ever had to read, and i absolutely will not rest — isn't true, when you know it is. and my colleagues will not rest — and it's evident in my behaviour, how i talk. until we make sure that we're that's difficult in itself. providing standards of care in that unit consistently that they have a right to expect, every single day. erm, when i went into court, i was given this folder, a hefty sort of folder. the cqc‘s findings show how poorly managed the hospital was. inspectors found that staff did not protect patients from avoidable harm or abuse, and unbeknown to me at the time, patients' privacy and dignity it was just the stack of evidence were not respected, and their basic needs were not always met. that the cps had got, it goes on to say, "staff did not and i was told to sort of refer to, follow the mental health act code you know, page whatever, to view of practice when using seclusion" for longer than required. the texts between you and joe. i'm not making excuses. i don't want to give any and so, you know, i did that. sense of justification. it was unacceptable.

that inspection happened in october. we have put in an entirely yes, i can see the text. fine, 0k. and then i was told, new leadership team. turn to page whatever. and i did. and there was a picture as i say, we're of the mattress that it happened on. closed to admissions. we've done a comprehensive medical andjust, boom, panic attack. review for every single patient. no forewarning. families whose loved in the court room, ones are in your care you had a panic attack? have every right to be concerned, haven't they? yeah, yeah. absolutely, yes. each and every one of us has every thejudge — again, amazing right to be concerned. person, can't fault him — i talk to colleagues about it cleared the court room instantly all the time and say, and gave me a break. if it's not good enough there was no forewarning for your mum, then it's not good enough for any one person in our care. for what i was about to see. sandy howse is visiting in such a sensitive case, it's shocking. yeah. her 30—year—old son, sarah, speaking to us in an exclusive interview. who was admitted on a secure ward after a mental health crisis. and if you're affected by any of the issues sarah spoke there are, for a number about, do go to the bbc of reasons, nowhere... action line — bbc.co.uk/actionline. no institution, nothing anywhere, ever, is perfect, and there will always be people next, a follow—up to an exclusive who for one reason or another have story we brought you in april. had a less than positive experience. last month, we heard but there are also people who look out for every small negative about the way some patients experience and blow it out of all proportion.

but some parents do have a right to be concerned. were being treated in assessment because the implications for those and treatment units, atus. who should be released they're places where patients back into the community, but are being held because there with autism and learning is a lack of suitable places to send them, can have an impact disabilities can be assessed and treated, before being integrated on their mental health. back into communities. this week, we got rare access to one atu where up isn't it unacceptable that you have to 50 patients are stuck, patients here who shouldn't be here, simply because there is a lack of suitable places they should be in the community getting tailored care for them in the community. and that's not happening? our reporter, noel phillips, if they don't need to be here, has this exclusive film. then of course the answer is no, when i first got here, it was hard because it's absolutely, it is not acceptable so restrictive and you have to be to do that. observed on the toilet but actually, people's mental and observed with a pen. it's like being thrown health, their well—being can fluctuate over time, in the deep end. so it's not as simple as just saying you have to learn to cope quite someone either does need to be quickly and adapt quite quickly. here or doesn't need to be here. cameras are rarely allowed but actually, the point is, at the point where there inside secure units, is a clinical view that someone's needs and their health outcomes can but this programme has been given rare access inside this be better served outside mental health hospital, of an inpatient hospital setting, where children and adults are held then more needs to be done to make under lock and key. sure those patients can move on more quickly. there are some tranquil places in any situation, in any incidence

where a staff member is not inside st andrew's — treating our patients like this art workshop, with the utmost of dignity a form of therapy for and respect, that is patients with autism. are you scared of completely unacceptable. leaving here one day? there's part of me that worries how st andrew's healthcare runs a number of private i'll cope again in the community. hospitals across the country. will i go back into my old ways? some of its services are rated good by the care quality commission, but many wards with people with learning disabilities i think there should be a lot require improvement. we're treating a very small more support in place, subsection of society, and i think a lot of it should be with often considerable risk as well. based around the community. not only to other people, because your best chance of getting better is around your family and friends. but to themselves. st andrew's healthcare has doubled this hospital here in northampton in size in the last ten years. is one of st andrew's biggest sites, and in 2016, it opened a £115 million providing specialist psychiatric unit for young people care to up to a50 people. with mental illnesses. but some campaigners funded by you, the taxpayer, have accused the charity of profiteering from taxpayers. through nhs england. but the chief executive 90% of st andrew's says that she intends referrals are from the nhs. to reduce facilities, the annual cost of looking after a patient with autism can be as high as £245,000. closing a number of wards. we would expect to see a reduction of beds for specialism for people this footage we've been shown with autism and learning

disabilities to be reduced by the parents of a patient locked by about 100, just over the next two years. the issue of children and adults behind a door at a st andrew's facility raises questions with autism and learning about the controversial practice of seclusion, where patients can be locked disabilities being held in high—dependency mental health away for long hours. units like st andrew's has in this particular inquiry, in relation to the detention become a pressing issue. of children and young people there remain questions, though, with learning disabilities about whether enough is being done by the government to fix a system and autism... that is causing a crisis in parliament, politicians have for thousands of people and their families. launched a major inquiry into claims that's it for this week. that the rights of people with autism and learning disabilities are being violated remember, if you want to get in touch with a story for us to look in secure hospitals across britain. at, do e—mail victoria@bbc.co.uk. after weeks of negotiations, st we're back live on tuesday morning at ten o'clock on bbc two, andrew's has allowed me in to meet the bbc news channel and online. some of the patients thanks for watching. who live behind these doors. hello. it's the first time a journalist has weather changes are under way this been given this sort of access. bank holiday weekend. we've only been allowed some of us have started it with warm sunshine. onto one ward, mackaness, others may have seen more cloud. a is—bed medium—secure unit for men with a range of conditions such some of us have had as autism, learning disabilities a bit of rain as well, and acute mental health disorders. those who live on this ward a sign of things to come. are all violent offenders.

an atlantic weather system is moving this is one of the rooms. in, where we've seen most of the sunshine earlier today, and where the cloud has been how often are patients allowed spilling in from the atlantic, with a bit of rain around. to leave their bedrooms? still some of that rain as and when, really. into the evening and overnight they can come out of their bedrooms as well, particularly in scotland. whenever they want. some heavier bursts developing here. johnny kheir is the nurse manager wettest towards the west and north west. in charge of this ward. northern ireland sees outbreaks of rain overnight, the man who lives in this room pushing in towards western parts of england and wales later into the day. is a convicted offender, who's been detained and sent dry in central and eastern england, with clear spells and mist and fog patches. here by the ministry ofjustice temperatures are staying up. mild going into sunday morning. because of the risk he poses to himself and others. are parents allowed a wet start in scotland, to come to the bedrooms? although the heavier rain will ease for many. so... still outbreaks of rain in northern scotland. showery rain spreading further south in england and wales. not much rain reaching southern england, and it's no, so, visitors wouldn't be weakening moving south. elsewhere — drier, brighter, allowed into the room. sunny spells, cooler and fresher. still some spots towards the south it's not really appropriate east, into the low 20s here. because we can't control making sure just single figures, in the rain, of the safety of everyone else. in northern scotland. because these men have been sent another cool and wet day here by the criminaljustice system,

only the ministry ofjustice can on bank holiday monday here. approve their release. elsewhere, some sunshine we've been told we're not allowed around, cloud building. showers break out, some heavy ones to speak to any of them, due across the western side of the uk. to the offences they've committed, the arrows indicating the breeze. which gives you a sense as to why some showers spread further they have to be kept in a secure east during the day, but not many at all towards the east environment like this. and south east. it's really about the risk. but when it comes to nhs patients, but starting the weekend, dr paul wallang oversees into the low 20s and into the high their discharge from the hospital teens in the warmer spots. back into the community. what you find in this ward is that looking at the picture into tuesday a lot of the patients have moved from prison to this ward, and they've moved from prison because prison — it feels much cooler and fresher, is deemed to be completely inappropriate and unsuitable for them. all of the patients have autism on this ward too, because the wind is switching so you can imagine what it's to a northerly. like for someone with a lot of dry weather around, autism to be in prison. but building cloud brings the chance that's not a conducive environment. of catching showers, and not therapeutic. and temperatures for many a bit below average for the time of year. and often, the patients we've moved so, entering a spell of cooler to the ward need a lot of intensive and more unsettled weather therapy and treatment, for the rest of the weekend. temperatures gradually coming down, the breeze picks which we can provide on this up, some rain around. maybe not as much as you would like across gardens in the southern ward and within the charity, st andrew's charity. parts of the uk, though. during our time on mackaness into next weekend... ward, we saw how closely and by next weekend, high pressure building from the south, monitored these men were. as it starts to turn a risk assessment has to be completed every time a patient uses the kitchen or laundry facilities. warmer once again.

but when inspectors from the care quality commission visited mackaness in march 2018, concerns were raised about staffing and a lack of leadership. do you think there are shortcomings in some of the care you provide? of course, there are shortcomings in every service. it would be extremely arrogant and just wrong to sit here and say, no, i'm really happy with the services that we provide all of the time. i think even if we were outstanding rated in every single one of our services by the cqc, on an ongoing basis, i would never be satisfied. you know, our patients have an absolute right to expect the very best possible care from us every single day, in every single service, and we'll never finish that. we'll always continue to focus on improving the quality of care. the woman now in charge of all of st andrew's hospitals spent a number of years in the public sector, running an nhs trust. her predecessor, who resigned injanuary 2018, was paid almost £500,000 when he left the job.

the charity recognised they needed a very different type of chief executive to take st andrew's healthcare in a different direction, moving forward. they looked for a very different chief executive. i'm paid considerably less than any of my predecessors. and my focus, having come from the nhs, is absolutely on health and healthcare. st andrew's is no stranger to controversy. she's so desperate to end it all really. she currently has a toothbrush this is bbc news. inside her because she the headlines at 5pm. swallowed a toothbrush. an actual toothbrush? just last month, this programme the race to become found out one of the patients here, the new conservative leader and prime minister is under way — 26—year—old ayla haines, has spent the past seven years on a ward. matt hancock is the latest to enter the contest. she tried to end her life by swallowing a toothbrush, which is still inside her. delivering brexit is absolutely mission—critical, and it must be done, the goal, as you say, scott, and done as soon as possible, and it was to get that number down. 00:14:49,525 --> 2147483051:44:09,478 patients like ayla are supposed 2147483051:44:09,478 --> 4294966103:13:29,430 to be admitted for nine to 18 months has to be done in this parliament. a british climber dies on mount everest. robin haynes fisher is the tenth person to die

on the mountain this season. president trump is injapan for the start of a historic four—day state visit. universities in england are told not to ‘scaremonger‘ over finances as a review is expected to call for them to reduce their tuition fees by nearly two thousand pounds per year. and in sport, a historic victory