In 2018 the Department of Health and Social Care (“DHSC”) commissioned the Care Quality Commission (“CQC”) to review the use of restrictive practices in services for people who have either a learning disability, autism, or people with mental health problems. On 25 March 2022, the CQC published a Progress Report to its 2020 ‘Out of Sight – who cares?’ restraint, segregation, and seclusion review (“Out of Sight Report”). The Out of Sight report was written after the Department of Health and Social Care requested that the CQC review the use of restrictive practices in services for those people with a learning disability, autism or mental ill health.
What did the report find?
The Out of Sight Report made a number of recommendations. The recent Progress Report finds that very little progress has been made towards meeting these recommendations with only four of the 17 recommendations being partially met and remaining 13 not met.
The Progress Report notes that the number of people with a learning disability in hospital has nearly halved since March 2015 but the CQC considers that the figure is still too high. These service users remain in hospital for too long, still experience restrictive interventions and the care provided is not always therapeutic.
The Progress Report highlights difficulties that autistic people can experience when trying to access early intervention and crisis support in the community, suggesting that better access may lead to a reduction in hospital admissions.
Connected to this, the commissioning of services, more generally, can often lead to commissioners placing people where there are spaces, rather than because the individual’s needs can be met.
More people are now in long-term segregation that when the CQC was asked by the Department of Health to carry out its review in 2018.
The CQC’s latest March 2022 progress report states that despite the number of people with a learning disability in hospital halving since March 2015, it is still too many. Over a similar time period, the number of autistic people in hospital has increased. This indicates that autistic people are not accessing the support they crucially need. The latest report in March 2022 reiterates that problems exist currently in the adult social care system that prevents people from accessing early intervention and crisis support.
The CQC acknowledged that the COVID-19 pandemic has impacted progress but has called upon all partners to ensure changes are made with a renewed vigor.