The Care Quality Commission (CQC) has found "undignified and inhumane care" in some hospital settings providing complex care for people with a learning disability, autism and/or a mental health condition.
The CQC was commissioned by the Secretary of State for Health and Social Care to review the use of restraint, seclusion and segregation for these patients, with its findings and recommendations published in the final review report Out of sight – who cares?
Throughout the review, the Commission undertook 56 hospital visits, 27 social care services visits, two focus groups and five expert advisory group meetings.
Inspectors found that mental health hospitals are not always therapeutic environments and can be distressing, particularly for people with a learning disability/autism.
“We have seen too many examples of inappropriate restrictions that could have been avoided. We know in absolute emergencies this may be necessary, but we want to be clear – it should not be seen as a way to care for someone.”
The report calls for improvements in four key areas:
- People with a learning disability and/or autistic people who may also have a mental health condition should be supported to live in their communities. This means prompt diagnosis, local support services and effective crisis intervention.
- People who are being cared for in hospital, in the meantime, must receive high-quality, person-centred, specialised care in small units. This means the right staff who are trained to support their needs supporting them along a journey to leave hospital.
- There must be renewed attempts to reduce restrictive practice by all health and social care providers, commissioners and others.
- There must be increased oversight and accountability for people with a learning disability, and/or autistic people who may also have a mental health problem. There must be a single point of accountability to oversee progress in this policy area.
