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CQC says care system for patients with mental ill health, autism and learning disabilities not fit for purpose

21 May 2019

An interim review by the Care Quality Commission (CQC) into the use of restraint, segregation and prolonged seclusion in the health and care sector concludes that the current system as “not fit for purpose”.

The CQC recommends that the care, safeguarding and discharge plan of every person with learning disabilities or autism held in segregation be examined, as well as that of children detained on mental health wards.

The review identified 62 people in segregation (42 adults and 20 children, some as young as 11). In addition:

  • many of the patients had been placed in hospitals miles away from home
  • some had spent years in hospital, separated from other patients and staff
  • patients risked becoming stuck in segregation

The most common reason given for segregating was to keep other patients safe or a belief the patient would be unable to cope around others.

The CQC found some of the wards were not suitable environments for people with autism and many staff lacked the necessary training and skills to work with patients with complex needs and challenging behaviour.

Some of the hospitals visited had "features of institutions that are at risk of developing a closed and even punitive culture".

In the case of 26 of the 39 people the CQC visited, staff had stopped attempting to reintegrate them back in to the main ward environment, usually because of concerns about violence and aggression.

Often, a suitable alternative place of care, such as a community placement, could not be found.

The Secretary of State for Health and Social Care Matt Hancock, who commissioned the CQC review, said he was appalled by the distressing stories and promised all cases would be reviewed.

He added the government would fund specialist, independent advocates to work with families, join up services and try to move people to the least restrictive care and then out into the community.

Director of Policy and Development at Disability Rights UK Sue Bott said:

“This is a serious matter and was highlighted in the recent civil society report (of which DR UK was a part) that went to the UN committee looking at the UK’s implementation of Convention Against Torture. 

Rather than reviews it is urgent action that is needed, and I hope the Government will now ensure the detention, segregation and dehumanising treatment of learning disabled people is finally stopped.”

The CQC will publish its full review, that will look at the use of restrictive practices in a wider group of settings, in March 2020.

The CQC’s interim review is available @ www.cqc.org.uk