CQC publishes new Supporting Information on “closed cultures”

The CQC published new Supporting Information for CQC staff earlier this month, entitled “Identifying and responding to closed cultures”.

As part of a wider, ongoing review into the use of restrictive intervention, the CQC has identified concerns about the use of restraint, prolonged seclusion and segregation for people with mental health problems, a learning disability or autism. “Closed” cultures within the care environment are considered to give rise to an increased risk of abuse and human rights breaches, particularly for these categories of service users.

The new Supporting Information provides guidance to CQC inspectors and Mental Health Reviewers. It is intended to:

  • Help inspectors and reviewers identify where there may be a high inherent risk of a closed culture;
  • Help inspectors and reviewers identify warning signs of a closed culture, or a risk of such culture developing;
  • Help inspectors and reviewers monitor such services; and
  • Provide guidance on responding to inherent risks or warning signs through existing and “strengthened” regulatory policy, methods and processes.

From a provider’s perspective, this is likely to affect the way the CQC monitors and inspects services, and impact on how their enforcement decisions are made. This will be most relevant to those offering care services to service users with mental health problems, a learning disability or autism but the CQC will apply the same principles to a number of other care settings where people may are less able to self-advocate, need support with communication, live outside of their usual communities or are isolated.

Of particular note to service providers is that there will be a low threshold for deciding to carry out responsive inspections where there is a “high inherent risk” in a service of a closed or punitive culture developing.

The CQC proposes to review and update the Supporting Information and stakeholders can provide feedback to the CQC on the current version, which is valid until April 2020.

The CQC is expected to publish recommendations as part of its wider review in March 2020 and further Supporting Information may follow.

For further information, please contact Ridouts Professional Services Plc.

A summary of the supporting information is available here.

The full publication is available here.

More information about the wider review is available on the CQC website here.