‘Broken’ care system letting patients down

The Care Quality Commission (CQC) has published a new report which highlights how patients with mental health problems, autism and learning disabilities are being let down by a ‘broken’ care system.

The hospital inspectorate is calling for an independent review of every person who is being held in segregation in mental health wards for children and young people and wards for people with a learning disability or autism, examining the quality of care, the safeguards to protect the person and the plans for discharge.

The CQC found that of 62 people were in segregation, including 42 adults and 20 children and young people – some as young as 11 years old. Of those people, 16 had been in segregation for a year or more - one person had spent almost a decade in segregation. The longest period spent in segregation by a child or young person was 2.4 years. Reasons for prolonged time in segregation included delayed discharge from hospital due to there being no suitable package of care available in a non-hospital setting, or, more commonly, to keep other patients safe under a belief the patient would be unable to cope around others.

Commissioned by the Secretary of State for Health and Social Care, the review also highlights the need for a better system of care for people with a learning disability or autism who are, or are at risk of, being hospitalised and segregated.

Paul Lelliott, Deputy Chief Inspector of Hospitals (lead for mental health), at the CQC, said: “We are calling for urgent action to strengthen the safeguards that protect the safety, welfare and human rights of people held in segregation. We think that independent advocates have an important role to play in this – if they are trained and supported to recognise what is good care and what is not.

“A better system of care would provide effective help early in life for people with complex problems and challenging behaviour. It must respond effectively when crises occur, so preventing the need to admit the person to hospital. If a spell in hospital is right for the person, this should be close to home and not prolonged because of lack of an alternative place for them to go. In short, the system must put the person at the centre and be engineered around their needs. This has implications for commissioning and for who controls the funding.

“We will also be reviewing and revising CQC’s approach to regulating and monitoring hospitals that use segregation to ensure we are gaining a true view of the quality of care for people subject to such restrictive practices.”