The language appearing to have been used by nursing staff to - and about - mental health patients is jarring. "She's a c***t."
"Fat b***h."
Then there is the image of a staff member, lying on a wall outside, appearing to have a nap in the sunshine while on duty.
Another clip appears to show a member of staff tickling a patient - a person the BBC says is a convicted murderer.
The footage was taken by an undercover reporter from Panorama as he discovered what the BBC described as a 'toxic' culture among some staff at the Edenfield Centre, on the grounds of the former Prestwich Hospital in Bury.
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The one-hour programme captured apparent humiliation, verbal abuse, mocking and assault of patients - plus alleged falsification of medical paperwork.
A patient called Joanna was filmed apparently being pinched twice by a member of staff, and, against the rules, three male patients are found in one room watching porn, it is claimed. One patient had been kept in a seclusion room with just two teddy bears for a year, it is claimed.
In one clip members of staff are seen discussing how to move an autistic patient called Harley back into a seclusion room without giving her the chance to discuss it. Eight members of staff then pick her up off the floor. She screams and cries out loud as they drag her back to seclusion.
Harley's tearful mum said she couldn't watch the footage. She told Panorama : "She's a young girl, she was calm. She asked for a chance to talk. It should not happen." The episode is described by one mental health expert as 'horrific'.
In another part of the programme, some staff attempt to give one patient a dose of antipsychotic clozapine. It emerges she has already had the medication. The mistake is realised and the bid to give her a second dose stopped. One member of staff admits that if she had had a second one 'she'd probably die'.
Greater Manchester Mental Health NHS Foundation Trust, which runs Edenfield, says it is taking the allegations 'very seriously' and has taken 'immediate action to protect patient safety'. The trust has suspended a number of staff at the unit.
Greater Manchester Police has begun a criminal investigation. The footage has been condemned by NHS England as 'shocking'. The Edenfield Centre has 11 wards for male and female patients and is a secure unit, with some patients from the criminal justice system. Around 600 staff care for 200 patients.
The programme also showed one patient being pulled up by a chair to be taken for an injection. They were dragged by the wrist down a corridor. She is mocked with foul language and some staff hold her down on a bed.
Another person, diagnosed with schizophrenia, is not allowed to go to the bathroom alone for her own safety. Panorama filmed a female support worker humiliating the patient by complaining to her about 'having to look at your a*******e, where biohazard f*****g waste comes out'.
An expert reviewing the footage said that in that instance, some staff acted 'like a gang, not a group of health care professionals'.
One member of staff is filmed refusing to check on a crying patient, who has a history of self-harm and has tried to kill herself. Staff then laugh and joke about her.
The programme also shows a clip involving a patient, Alice. During a 30-minute break from seclusion, she talks about her teddy bears - comforts she was allowed from a previous ward. In the scene, she is told: "You're lucky you've got a straw f*****g bed in there."
The member of staff adds: "If I was to run a place like this, they'd get straw bedding, eat it as much as you want, you're only gonna s**t it out and fertilise the garden."
In another clip, a member of staff suggests that the best place for patient Harley is prison, adding: "That will take her down a peg or two - she needs a good thrashing." Another patient, Olivia, tells the undercover reporter that she believes her condition has worsened since she was placed in the Edenfield Centre. She says: "It's like no one knows what they are doing."
Some female staff were filmed acting in a sexualised manner towards male patients, the programme appears to show. One got on top of a patient on a bed tickling him. The patient is a convicted murderer, the programme says.
A clip appeared to show a member of staff asking the undercover reporter to get involved in falsifying paperwork - recording that observations of patients had been done when they hadn't. The staff member asks: "Do you want to pretend you have been doing jobs?"
The state of the tiny seclusion rooms is also highlighted. The unit, during the period of filming from March to June, was said to be critically understaffed. During a five-week period there were 58 times when there were not enough nurses, the BBC programme alleges.
Commenting on the staffing situation one member of staff says: "This is a s**t show". Another says: "We can't care for them the way we should. None of the management come down."
What the trust says...
The trust is commissioning an independent clinical review of the Edenfield Centre led by Dr David Fearnely, chief medical officer for Lancashire and South Cumbria NHS Foundation Trust, which has already started.
A spokesperson for Greater Manchester Mental Health Foundation Trust said: "We are taking the allegations raised by Panorama very seriously since the BBC sent them to us earlier this month. We have put in place immediate actions to protect patient safety, which is our utmost priority.
"Since then, senior doctors at the Trust have undertaken clinical reviews of the patients affected, we have suspended a number of staff pending further investigations and we have also commissioned an independent clinical review of the services provided at the Edenfield Centre.
"We are working closely with local and national partners including NHS England, the Care Quality Commission and Greater Manchester Police to ensure the safety of these services. We will co-operate fully with all investigations. We owe it to our patients, their families and carers, the public and our staff that these allegations are fully investigated to ensure we provide the best care, every day, for all the communities we serve."
What GMP says...
Head of Greater Manchester Police's Public Protection Department Chief Superintendent Michaela Kerr said on Wednesday (September 28): "It goes without saying that these allegations are concerning. Since they were brought to our attention, we have been working with partner agencies to ensure the safeguarding of vulnerable individuals.
"We've also obtained the information required to open criminal investigations and enquiries are ongoing to ensure all offences are recorded and those involved identified.
"In consultation with the Crown Prosecution Service, we are reviewing footage from Panorama with a view to prosecuting anyone who’s captured committing a crime. Anyone who has concerns about care they or a loved one has received should contact us or Crimestoppers."
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