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."

For readers just joining us - the findings of a public inquiry into the abuse of patients at Muckamore Abbey Hospital have been published.

The inquiry found that patients were abused, systematically bullied by some members of staff and that there was a culture of not reporting abuse.

It also found:

• Ineffective external inspection failed to uncover the abuse and the system failed to function as a meaningful safety net.
• A long-term policy beginning in 2001 to move all patients with Learning Disabilities and Autism from hospital settings into community based care was not matched by necessary investment.
• Prior to 2017, incidents of peer on peer and patient on staff assaults increased even as the patient population was diminishing, indicating a rise in intensity and potential danger.
• Safeguarding arrangements did not provide effective protection for vulnerable adults
• Systems and structures in place were wholly inadequate to manage the scale of abuse uncovered through CCTV review in 2017.
• Evidence from CCTV footage taken from inside the hospital captured patients clinging to wheelchairs, being spat at and so heavily medicated that they'd become "zombified"

Brown says for the families, being vindicated is not the same as getting justice.

His son Aaron was among those whose physical abuse was captured on CCTV.

He calls for support, treatment and counselling to be provided to survivors of the abuse and to families.

He also calls for financial redress that "reflects the gravity and duration of what was suffered".

Brown adds: "The families will not stop until there is real change and meaningful redress for those that were harmed.

"Anything less would be yet another insult to our loved ones."

He calls for the health minister to meet families urgently.

Families of patients at Muckamore Abbey Hospital says the inquiry's findings are the "the formal confirmation of a truth we have lived and fought to expose for years".

Reading a statement, Glynn Brown whose son was a patient, says families were not believed.

"For years these families were told they were exaggerating.

"Today the inquiry confirmed what we always knew, that their loved ones were abused on a staggering scale and that the failure was systemic, that the warning signs were there to be seen and that those in power to stop it did not.

"This report belongs to the families and the patients, including those who did not live to see it."

Kark says there must be a commitment to ensure that what happened at Muckamore Abbey Hospital can never be repeated.

The report has been formally submitted to Northern Ireland's health minister.

“The inquiry was established to examine what happened, why it happened, and how it was allowed to continue for so long.”

He says recommendations must be implemented immediately and monitored rigorously.

The lessons, he says, are stark.

"This cannot be allowed to happen again. There should be no delay, no dilution, and no side-stepping in the delivery of the recommendations.”

Tom Kark says politicians now need to get on with legislation to implement the inquiry's recommendations.

"We don't do that very well in Northern Ireland," he adds.

Image source, bbc

Kark says one of the things that went wrong at Muckamore was that people "lost sight of the fact that they were dealing with individuals who had personal needs and requirements.

"That led to dysregulated behaviour, and that led to far too much restraint, overmedication and eventually abuse."

Closed circuit television (CCTV) played a pivotal role in uncovering abuse.

In fact the report goes as far as to note that without it, the abuse of patients is unlikely to have been exposed, and the inquiry itself may never have been established.

But, CCTV and its use must be "carefully considered, regulated and monitored".

There was a significant lag between its installation in communal areas and the policy around its use being approved in about 2017.

The pivotal time came in August 2017 after a report that a patient had been struck by a staff member. When CCTV was reviewed "they discovered not only that the incident had been recorded, but that other unreported incidents were visible on the footage".

The panel notes that while it was essential in revealing the truth the Trust was "unprepared for the consequences of that revelation".

The panel concluded that CCTV can be a powerful safeguarding tool in high-risk settings, but only if accompanied by clear policy.