"More action needed to improve care" for people with a learning disability, mental ill health and autism, says CQC
In a progress report published on the 25th March, CQC finds that there are still too many people in hospital.
Once in hospital they often stay too long, do not always experience therapeutic care and are still subject to restrictive interventions.
In 2018 the Department of Health and Social Care commissioned CQC to review the use of restrictive practices in services for people with a learning disability, autistic people, and people with mental ill health. Progress on meeting the recommendations made by CQC in its review has been limited with just four of the seventeen recommendations made in the 2020 report being partially met and thirteen not met.
CQC’s progress report highlights that although there are still too many people with a learning disability in hospital, this has nearly halved since March 2015. However, the number of autistic people has increased considerably over the same period.
Not enough progress has been made in reducing the use of restraint and challenges persist in the system which are preventing people from accessing early intervention and crisis support in the community. This can be particularly difficult for autistic people.
The report also highlights persistent challenges with the commissioning of services. Currently people are fitted into services that are available, rather than providing support tailored to the individual’s needs. Commissioners are often not working in partnership with people, their families and between different organisations when delivering services.
The Out of Sight report was intended to improve care for people and lever the change that must happen to improve the lives of people with a learning disability, autistic people and or those with mental ill health.
This has not happened and there are still too many people in mental health inpatient services. Just four of our recommendations to improve services have been partially met and thirteen not met. The pandemic has clearly had an impact on services and the people that use them in a way that could not have been foreseen. However, progress on the recommendations we made for change have not been happening quickly enough.
CQC's progress report also found:
- Although Independent Care (Education) and Treatment Reviews took place, they have not resulted in real changes to people’s lives as they are still unable to leave segregation and be discharged from hospital.
- There are more people known to be in long-term segregation now than when the CQC review was commissioned in 2018.
- All people with a learning disability and autistic people who are admitted or who are at risk of admission to a mental health inpatient service should have a Care Education and Treatment Review. However, recommendations made in Care (Education) and Treatment Reviews are often not being progressed by providers and commissioners.
Almost 18 months have passed since we recommended what must change to improve the care and support received by people with a learning disability, autistic people, and people with mental ill health.Some investment has been made into projects supporting people to come out of long-term segregation, and funding has been allocated to increase community support. However, for real impact to be felt progress must now be accelerated.
