Marie-Louise Connolly
BBC News NI Health Correspondent

Muckamore Abbey Hospital was meant to be a home, a place of safety for people with severe learning disabilities and mental health needs in Northern Ireland.

But some patients were abused.

Central to those investigating what went on at Muckamore was hundreds of thousands of hours of CCTV footage. Staff believed the cameras were not switched on. But they were. The footage revealed 1,500 crimes on one ward alone.

One person whose job it was to trawl through the recordings told BBC News he watched vulnerable adults "kicked, trailed by their legs down corridors and thrown into a seclusion room".

Read the rest of this article here.

Click the play button at the top of the page to watch Minister of Health Mike Nesbitt react to the inquiry findings.

Northern Ireland's health minister the report was a watershed moment or how the health and social care system cares for the most vulnerable members of society.

“The system, which should have ensured that the most vulnerable in our society were protected, nurtured and cared for, failed you in that core duty.

"You were let down and for that I am truly sorry."

Image source, PA Media

He adds: "I can assure you that my department views the safeguarding of those who are most vulnerable in our society as a key priority."

He says time will be taken to look at recommendations to ensure "we never find ourselves in this position again".

Mike Nesbitt will update the Northern Ireland Assembly next week.

The leaders of the Health and Social Care system have released a joint statement saying that the inquiry marks "a dark and significant moment" for the system.

They said they recognised the seriousness of what has been identified and the profound impact on patients, families, staff and the wider public.

"We would like to assure the public and staff that we are committed, as a system, to learning from these findings and to strengthening leadership, governance and safeguarding arrangements across all services to reduce the risk of such failings occurring again."

They added that significant work has already begun and said they acknowledge the further distress this report will cause for patients and families.

Image source, Liam McBurney/ PA

Assistant Chief Constable Davy Beck of the Police Service of Northern Ireland (PSNI) says that the protection of the most vulnerable is a priority. He adds the PSNI accepted the inquiry's recommendation.

"We will work hard to improve the process for the review of live investigations and escalation where required."

He said this is the largest adult safeguarding investigation in the UK and is the subject of ongoing criminal proceedings.

"The public inquiry has been running parallel to our police investigation. To date, we have reported 124 people to the Public Prosecution Service with the first file submitted in April 2020."

He said the investigation has been a very detailed and complex one.

The Commissioner Designate for Victims of Crime Northern Ireland Geraldine Hanna says today's report is "a monument to the courage and perseverance of the families of the victims of Muckamore Abbey".

“It is painful to hear about the cruelty these victims suffered at the hands of those who were supposed to care for them.

She says they were harmed and then failed by the institutions that were supposed to protect them.

“This has clearly been a systemic issue and there must be change. .”

Mencap, a charity that supports people with learning disabilities, said the legacy of this inquiry would be in the actions that follow.

“People with a learning disability and autistic people have the right to safe, person-led support, dignity, respect and protection from harm," said Jon Sparkes, the charity's chief executive.

"We call on the Department of Health, Trusts and the wider health and social care system to commit to implementing recommendations in full and to work with people with a learning disability and their families in shaping future services."

The SDLP's Colin McGrath says what happened at Muckamore was a "shocking dereliction of duty".

“While work to hold individuals accountable is ongoing, it has always been clear that patients were also failed by the wider system," he adds.

"Concerns were raised, warning signs were present and opportunities to intervene existed, yet action was not taken. That raises serious questions about leadership, oversight and safeguarding across our health service."

People Before Profit assembly member Gerry Carroll says the report can not be allowed to gather dust.

"This can never be allowed to happen again.

"The health minister must act immediately, and those responsible in positions of power and authority must be held fully to account."

Sinn Féin MLA Phillip McGuigan says it's a "shameful" chapter in the history of health and social care.

He thanks Tom Kark KC for his work and report and now says that it's the time for politicians to look at the 106 recommendations in the report to ensure this will not happen again.

"I don't think anyone can deny the level of abuse in Muckamore.

"There must be accountability within the trust, the department of health and regulatory body."

The Trust’s response to the 33 areas of criticism from the inquiry encapsulated in a 57-page schedule of criticism was 479 pages long., external

Jennifer Dawson, whose brother Matthew McPeake, was in Muckamore for 17 years says families have had to fight for the inquiry "so today has been such a traumatic, but monumental day for us".

She said while families will have to go away and look at the recommendations "really the story will be whether they will be implemented".

She says change is needed so that "anything like this never happens again".

The Chairman of the Belfast Trust says a new leadership team is in place which is “committed to rebuilding trust within the community”.

“We are taking organisational responsibility,” he says.

Professor Stuart Elborn says they are “ensuring failings are addressed and never repeated”.

Elborn says they will “embrace and implement the recommendations” and are “already creating a culture where concerns are acted upon immediately”.

Welsh says the trusts is facing up to its failings.

"It took the persistence of a parent, Mr Brown, to relentlessly challenge the system and to push hard for his son which uncovered so many failings at Muckamore and which has led us to where we are today.

"I must recognise and applaud Mr Brown’s perseverance, dedication, and unrelenting challenge on behalf of his son.

"I know he is not alone in this, and many families have been very vocal in their pursuit of justice for their loved ones."

She adds that the trust will reflect on its approach to the inquiry, concern over which was mentioned in the report.

Welsh says she hopes that patients will eventually be able to heal and says there are owed nothing less.

“The CCTV footage which captured the behaviours of many staff while at times deeply shocking and distressing has given a voice to those who had no voice.

“Some of this footage is harrowing but it speaks to a truth that cannot be denied."

Chief Executive Jennifer Welsh says that she is deeply sorry for everything that patients suffered and for the lasting impact of "such appalling behaviour."

"You did nothing wrong, you did not deserve to be treated in this way, you deserved safety, dignity and compassion.

“On behalf of this trust and the senior team gathered today, I as chief executive take full responsibility for the wrongs committed against you and I offer you my unreserved apology.”

Professor Stuart Elborn, Chair of Belfast Trust, says this is a “deeply distressing” report.

Elborn says the Trust offers "an unreserved apology" to all patients and families that were harmed.

He says he is "truly sorry to anyone affected".

"We failed them on many levels and over many years".

"We take full responsibility for these failures," he says.

"Leadership, culture and governance failed.

"Together they did not prevent harm, did not detect it when it occurred and did not ensure concerns were escalated," he says.

If you click play at the top of the page you can watch the press conference with both the chairman of the Belfast Trust Professor Stuart Elborn and chief executive of the Belfast Trust Jennifer Welsh.

Politicians in Northern Ireland are beginning to react.

DUP Leader Gavin Robinson and DUP Health Spokesperson Diane Dodds said the findings "must mark a turning point for health and social care services in Northern Ireland".

Robinson said: "Vulnerable individuals who should have been protected and cared for were failed".

Dodds said the recommendations "must now be implemented in full" and "must mark the beginning of meaningful and lasting reform."

Alliance's Nuala McAllister says she won't accept a "slow pace" when it comes to action.

Some of the patient experiences are intense and graphic," she tells BBC Radio Ulster's Talkback programme, added that the 700 page report is hard and important reading.

Glynn Brown went on to say that without accountability "this is all a waste of time".

"The people in senior positions do not recognise accountability," he says.

"It's something they talk about, but they don't believe in it, it's not for them it's for the plebs at the bottom. That's the problem "

Claire McKeegan of Phoenix Law, who represents some of the families, says implementation of the report must happen immediately.

"We have seen too many reports welcomed in principle and quietly shelved."

Margaret McGuckin, whose brother Kevin was in Muckamore, says she was "shocked" as well as "pleased and elated" at the report.

"There was systemic abuse, that’s what I needed to hear.

"Many of us were in disbelief at being believed."

McGuckin says Kevin "cried all the time" and wanted to go home from Muckamore and did not want to talk about it.

McGuckin questions: "Why were they not guarded and protected?

Tom Kark says they recognise that there are still allegations of abuse at other facilities in Northern Ireland.

He says relatives will continue "in your struggle to get the best for the people you love".

"This report should be a powerful tool to assist you," he says.

He says the report does not address in detail the issue of redress for victims.

"Importantly, however we do recommend that the Department of Health should set up a working party to consult patients, service user groups and families of those who have suffered abuse at Muckamore.

"That will ensure that the issue of redress to meet the needs of the victims can be considered and looked at in a proper, focused manner."