Warning - this story contains details some people may find distressing.
Muckamore Abbey Hospital was intended to be a safe home for individuals with severe learning disabilities and mental health needs in Northern Ireland. However, some patients suffered abuse, and allegations of mistreatment were overlooked.
In 2017, the hospital became the focus of what the Police Service of Northern Ireland described as the UK's largest criminal adult safeguarding investigation. To date, police have referred 124 staff members from Muckamore to the Public Prosecution Service, which has directed prosecutions against 58 individuals.
The public inquiry's report confirmed that patients were subjected to abuse and systematic bullying by certain staff members. A critical element in the investigation was the extensive CCTV footage, amounting to hundreds of thousands of hours, which recorded events on the wards over a six-month span.
The inquiry's chair noted that without this footage, the inquiry itself might never have been initiated. The existence of the recordings came to light when Glynn Brown, a parent, questioned why he was denied access to footage of an incident involving his son.
Staff had believed the cameras were not operational, but they were, and the footage revealed 1,500 crimes on a single ward alone.
One individual tasked with reviewing the recordings told they witnessed vulnerable adults being "kicked, trailed by their legs down corridors and thrown into a seclusion room."
"They were goaded and abused in a place where they were meant to be safe."
'Snatched comfort blankets'
The source, who requested anonymity, described the footage as so distressing that they required psychological support after viewing it.
"I cried, I kicked a bin, I felt angry and in disbelief that health workers could be so cruel to people in their care.
"The CCTV footage revealed systemic abuse where some staff nurses showed no empathy and got joy out of intentionally hurting people physically and psychologically,"
they said.
The source agreed to speak publicly to highlight the extent of the cruelty and emphasized that the prolonged lack of leadership and managerial action was reprehensible.
Staff were observed snatching patients' comfort items such as blankets, dolls, or favourite books and magazines, which would trigger distress and lead to a "kick-off." This often resulted in a "struggle" between staff and patients, with patients being restrained and staff treating the outcome as a cause for celebration.
Our contact explained that while patients' reactions were involuntary, staff behaviour was deliberately menacing.
"At times it was just neglect and then cruel neglect, one man who had been in the seclusion room and was clearly agitated banging his head off walls for over 30 minutes was made to clean up his own vomit by staff who eventually opened the seclusion door,"
"Another was brought to the ground and was banging his head off tiles - he was restrained - it was the intervention of another patient who came to his aid and placed a pillow under his head, it wasn't the staff but another patient,"
they said.
'Hauled over a nurses' station'
Very few people have viewed the CCTV footage. One parent told the BBC that seeing a small portion was sufficient to motivate them to campaign for a public inquiry.
When the footage's existence is mentioned to other families, they often react with visible distress about what they have seen or heard regarding its impact on their children.
The source stated that the footage provides undeniable evidence and has enabled police to pursue ongoing criminal investigations.
They recounted several incidents, including one where a male patient was dragged over a nurses' station by his shoulders, causing airway obstruction and choking.
The patient was later seen being trailed down a corridor by his legs and lifted into a seclusion room where he cried and was left unattended for 40 minutes.
Other patients were left lying on floors while staff either kicked them or stood with their foot on their backs.
Although there is no evidence of sexual abuse, the source described "inappropriate gesturing" and "sexualising behaviour," including a staff member reversing inappropriately into a patient's lap and reclining, then quickly moving away when another staff member entered or noticed.
They added that while not all staff were directly involved, some witnessed the abuse and deliberately ignored it.
The Belfast Health Trust's disciplinary panel reviewed 192 staff members; 19 were dismissed or sacked. NI understands approximately 64 have been referred to the Nursing and Midwifery Council, 24 to the Northern Ireland Social Care Council, and 52 staff members are awaiting investigation.
On Thursday, the Belfast Trust issued a statement expressing deep regret.
Chief Executive Jennifer Welsh accepted full responsibility for the "wrongs committed."
"I am truly sorry for the distress, anger, and anxiety that this Trust has caused you, and continues to cause some of you.
"The mark of a civilised 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, by people who were there to care, who not only should have known better, but more importantly, should have behaved better."
Families have expressed frustration over the slow pace of staff investigations and the near absence of updates to them.
The individual who reviewed the CCTV footage attributed responsibility for the failures to the highest levels of the health trust, stating that over decades, the hospital was allowed to "drift out of sight."
