Review finds 'inhumane' use of restraint, seclusion and segregration

People with learning disabilities, autism and mental health needs have been let down by the system, the review shows.
Art work from cover of Care Quality Commission

People with learning disabilities, autism or mental health needs have been subject to ‘undignified and inhumane’ restraint, seclusion or segregation, according to a national review.

The Care Quality Commission review – commissioned by the health secretary and carried out before the pandemic – included visits to 56 hospital wards, 27 care homes for adults, and 32 children’s homes or services to hear stories directly from patients and service users.

“During our review we saw people receiving poor care in unsuitable noisy and chaotic ward environments, undoubtedly causing them distress,” said Dr Kevin Cleary, the CQC’s deputy chief inspector of hospitals and lead for mental health. “We saw too many examples where people were subject to unnecessary restrictions and examples of people’s human rights at risk of being breached.” This included lack of access to fresh air and toilets.

People had spent between three days and 13 years in long-term segregation. Of those people the CQC met, 66 in segregation had been let down by the health and care system because creating a package of individual needs was often seen as ‘too difficult and they had fallen through the gaps’.

Community care was generally better than that in hospital, the CQC added.

The review recommends that a range of public services pool their budgets and work together to provide care as soon as it is needed, overseen by a named specialist commissioner for complex care to ensure people’s care did not breach human rights.

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