The scandal of how Britain cares for its most vulnerable people - the mentally disabled

Every home for people with learning disabilities in England is to be inspected by the Government's NHS watchdog after an inquiry revealed shocking evidence of "widespread institutional abuse".

Vulnerable people suffering from such conditions as autism and cerebral palsy endured years of bullying, harassment and physical ill-treatment at the hands of NHS staff, the inquiry into services in Cornwall found.

One severely disabled man was tied to his bed or wheelchair for 16 hours a day. Others were given cold showers, had food withheld and spent hours locked in their rooms. A number were drugged to control their behaviour.

The Healthcare Commission, the NHS inspectorate, which conducted the inquiry jointly with the Commission for Social Care Inspection (CSCI), said it is feared the abuse uncovered in Cornwall could be widespread.

During the investigation, 40 residents were referred to Cornwall County Council under the procedure for the protection of vulnerable adults. But the report says "despite the seriousness of the evidence" neither the Cornwall Partnership NHS Trust, which ran the homes, nor the council took adequate action to ensure there was no abuse elsewhere. Five staff were dismissed.

There are more than one million people with learning disabilities in the UK. More than 100,000 are in homes supported by social services, voluntary organisations and the NHS.

The revelation of the abuse in Cornwall follows the closure last year of a private home for adolescents in Norfolk after an inspection by the commission. The commission is investigating allegations of physical and sexual abuse in homes in south London.

In a joint statement, Anna Walker, chief executive of the commission, and David Behan, chief inspector of the CSCI, said: "Our Cornwall investigation highlights unacceptable standards of care. In the light of these events, it is right to ask about the state of services around the country. Sadly, Cornwall is not the only service where serious allegations have been made. Instances of abuse can be symptomatic of services that have been neglected for too long."

The inquiry into services run by Cornwall Partnership NHS Trust began after five families complained to the charity Mencap. The trust runs services for 200 people with learning disabilities at Budock Hospital, near Falmouth, with 18 beds, and in four treatment centres and 46 homes in the community.

The commission clashed early on with the trust, over what it said was its slow and inadequate response. Yesterday, the commission wrote to the Health Secretary, Patricia Hewitt, requesting the trust be placed on special measures after it found senior managers had "failed to identify and correct situations involving physical, emotional and environmental abuse".

At one home, staff removed all taps because of misbehaviour by a resident - leaving the rest with access to a single shower. People were unable to wash their hands despite the presence of a resident who habitually smeared faeces. At another home, light fittings were removed. In more than two thirds of the 46 "supported living" houses, people had their movements too heavily restricted, with staff locking internal and external doors.

Between 2002 and 2005, there were more than 3,000 incidents recorded each year involving the 200 residents looked after by the trust. The report says the high number was a cause for concern and many involved "extreme violence between residents". Residents' money was also misused. The family of one man planned a two-night holiday for him for which the cost on the application form was £260. But when they received the bill, the cost was £751.40. The explanation given was that the extra was to cover staff costs. The commission has referred those cases to the NHS Counter Fraud and Security Management Service.

In a statement, Lezi Boswell, who took over as chief executive of Cornwall Partnership Trust in May, said she had apologised in writing to those involved .She said: "The failings which have been brought to light are shocking and shameful. There are no excuses. I cannot and will not attempt to justify what has happened as it is inexcusable. My job now, as the new chief executive, is to turn the services around.

"The trust fully accepts the recommendations in the report and we are determined to work together with partners to quickly and effectively address the problems raised and to implement all its recommendations."

David Congdon, head of campaigns and policy at Mencap, said: "The extent of abuse of people with a learning disability in Cornwall has been truly appalling. It is quite horrific that this has been allowed to continue for as long as it has."

Pauline and Gerald Bevan, whose son Russell used to be a resident at a care home in Cornwall, welcomed yesterday's report. They now care for their son, 37, at their home in Newquay.

'He was crying and saying he didn't like it there'

The mother of one resident described how she removed her son from the care of the Cornwall Partnership Trust after he returned home for Christmas in 2004 and begged not to be sent back. "He was crying and saying he was unhappy and didn't like it there. He was afraid of going back. It wasn't like him."

Her son, referred to as Y in the Healthcare Commission's report, had spent a year in Budock Hospital before moving to one of the 46 homes in the community, where he lived for seven years. He is described as "moderately disabled".

According to the report, after he had been living there for some time, a member of staff told his mother he had been sexually assaulted on two occasions while at Budock Hospital. It was also alleged that while he was living in the home a member of staff struck him. His parents had earlier complained that their son was frightened of the member of staff who had allegedly struck him and asked that he be moved from the house but the request was turned down.

After his parents, who are both in poor health, decided to have him at home they lodged a formal complaint. The trust said there was no evidence to support either allegation. In its investigation, the Healthcare Commission found that the member of staff alleged to have physically assaulted him had received a formal warning and was moved to another job. An independent review found no evidence that he had been bullied or assaulted but said there was evidence that his clinical care had "fallen below the required standard".