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CQC- Interim report on the use of restraint, prolonged seclusion and segregation

Closely following the Children’s Commissioner report on Monday 20th May, the Care Quality Commission (CQC) has published (Tuesday 21st May) its interim report on the use of restraint, prolonged seclusion and segregation of people with learning disabilities and/or autism who are in inpatient units. 

 

The report confirms that despite Transforming Care (2012), and the recently expired 3-year plan “Building the Right Support” (2015-2019) care has not been transformed and the systemic change promised after the scandal exposed by Panorama in 2011 at Winterbourne View private hospital has not been delivered.

 

The individuals in segregation in the report should have been known to and protected by the system – protected by the legal system, known to commissioners, their care reviewed by the Transforming Care CTR process, and their services monitored and inspected by CQC. This report concludes that this system is failing them.

 

Children, young people and adults with learning disabilities and/ or autism and/or mental health problems are still not receiving the right support in the right place at the right time. The CQC report describes the current “pathway of care” as unsuitable for people with complex needs - it does not support early intervention and adopts a crisis management approach, leading individuals into services where they have little hope of thriving and getting their needs met.

 

We welcome the investigation into seclusion and restrictive practices, which uncovers the extent of these practices and exposes current poor treatment of people with learning disabilities and or autism in inpatient units, but it needs to lead to urgent action.  We are concerned that the review has not given sufficient attention to restrictive practices other than seclusion and segregation, and all types of restrictive practice, including restraint, should be investigated fully in the second half of the review.

 

The report makes a number of recommendations, and although this is an interim report we need more detail about how they will be actioned as it leaves a number of unanswered questions. We note that the recommendations acknowledge that CQC must review and revise its approach to regulating and monitoring hospitals that use segregation, but this must include external input. There is no explanation as to how the recommendations from the report fit into existing initiatives, link to recommendations made in recently published reports including the Children’s Commissioner Report or how progress and outcomes will be measured.  The recommendations from this report need to be embedded into a learning disability strategy and coordinated with actions from other reports for a sustainable, coherent, strategic approach to drive change. 

 

Tonight (Wednesday 23rd May) there will be another BBC Panorama programme that will expose abuse of people with learning disabilities and autism in a hospital. Strong cross Government leadership focussing on early intervention and good support in the community, accountability and action to drive change is long overdue to ensure children and adults with learning disabilities and/or autism receive the high quality care and support they have a right to.

 

Read the full CQC report here: https://www.cqc.org.uk/sites/default/files/20190521_rssinterimreport_full.pdf

 

BBC Breakfast (1.12.15): https://www.bbc.co.uk/programmes/m00059p0

 

BBC Panorama programme listing: https://www.bbc.co.uk/programmes/m00059qb

 

Children’s Commissioner report: https://www.challengingbehaviour.org.uk/cbf-articles/latest-news/far-less-than-they-deserve.html

 

For confidential support with any of these issues, our Family Support Service is available on 0300 666 0126 or support@thecbf.org.uk

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