What does the CQC's report say on use of restraint, seclusion and segregation

Last month CQC published their interim report on segregation in mental health wards for children and young people and in wards for people with a learning disability or autism.

This has been Phase 1 of CQC’s review. It focusses on 39 people who were in segregation (although they will have reviewed at least 62 people by the end of their review). 16 people have been in segregation for a year or more.

Page six of the report lists what they found on their visits.

CQC are concerned that the current system of care has failed people whose care pathway ended with them being segregated in a hospital. They state that “the system is not fit for purpose”.

The regulator notes that the difficult task of finding suitable accommodation and the accompanying bespoke package of care may have been made more difficult by the challenge of coordinating the input of various providers and commissioner organisations involved – and perhaps by disagreements about who should fund the care.

Phase 2 of the review will explore the same topics in mental health rehabilitation, low secure wards, social care homes, children’s residential services and secure children’s homes.

The final report is expected in Spring 2020.

In the meantime, the regulator makes five recommendations for immediate action.

In short, recommendations include:

• An independent review is undertaken of every person placed in segregation to confirm that they are receiving good care and that no opportunities are missed to end segregation or hasten discharge.
• Strengthening of safeguards that protect safety, welfare and human rights because they are concerned that some of the hospitals they visited had features of institutions that were at risk of developing a closed or punitive culture. CQC are particularly keen on strengthening the roles that advocates play.

You can read the full recommendations at pages 26-29.