On the day briefing: Care Quality Commission interim report into restraint, seclusion and segregation
Care Quality Commission (CQC) have today published their interim report of its review into restraint, prolonged seclusion and segregation for people with a mental health problem, learning disability or autism. The report presents initial findings and conclusions concerning segregation in mental health wards for children and young people and in wards for people with a learning difficulty or autism. This briefing summarises key findings from today's report.
- CQC concludes that the 'current system of care', which incorporates national bodies, providers and commissioners, is not fit for purpose and has failed people whose care pathway has ended with them being segregated in a hospital
- the report draws on the return from an information request sent to 89 registered providers and visits to 35 wards where CQC assessed the care of 39 people
- CQC found opportunities are being missed to prevent people being admitted to hospital in a crisis and that more could be done to prevent segregation and facilitate discharge from hospital
- the report outlines a 'typical' pathway of care which may lead to segregation, which CQC will explore further during the remainder of the review. Not every element of the pathway was present for each of the 39 people CQC visited, and some of the people were receiving high quality care at the time of CQC’s visit
- CQC has made five recommendations:
- There should be an independent, in-depth review of the care provided to, and the discharge plan for, each person who is in segregation on a ward for children and young people or for people with a learning disability and/or autism.
- An expert group should be convened to consider what would be the key features of a better system of care for this specific group of people.
- Urgent consideration should be given to how the system of safeguards can be strengthened and what additional safeguards might be needed to better identify closed and punitive cultures of care, or hospitals in which such a culture might develop.
- All parties involved in providing, commissioning or assuring the quality of care of people in, or at risk of, segregation should explicitly consider the implications for the person’s human rights.
- Informed by these interim findings, and the future work of the review, CQC should review and revise its approach to regulating and monitoring hospitals that use segregation.