Government-commissioned review to probe restrictive practices in hospitals and care homes

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The Care Quality Commission (CQC) has been asked by the Government to review the use of restrictive interventions on those with mental health problems and learning disabilities and/or autism in care homes and hospitals.

The review and recommendations will focus on the use of physical restraint, prolonged seclusion and segregation in settings that provide inpatient or residential care for people with mental health problems and a learning disability and/or autism.

The announcement follows concerns about the care and treatment of this group, including poor care, excessive use of restraint, institutional abuse and people being placed in inappropriate settings, often far from home.

It will first look at specialist NHS and independent hospital wards for adults and children, including assessment and treatment units, where problems are believed to be greatest. It will then consider mental health rehabilitation and low secure wards, then carry out exploratory work to identify whether and how restrictive interventions are used in specialist care homes and children’s homes, and secure children’s homes.

NHS England, NHS Improvement and Ofsted will work with the CQC on the review, which is scheduled to report back to the Government in March 2020, with interim findings expected in May 2019.

CQC Deputy Chief Inspector of Hospitals and Lead for Mental Health Dr Paul Lelliot said it was vital that services minimise the use of all forms of restrictive practice and that providers and commissioners work together to find alternative, less restrictive, care arrangements for people currently subject to seclusion or segregation. He said: “The experience and perspective of the people affected by these practices, either as a patient or as a carer, will be central to this work. It is vital that society protects the rights, welfare and safety of children and adults with a mental illness, learning disability or autism and that they receive the safe, high quality care that they deserve.”

Set up in the wake of the 2011 Winterbourne View scandal, the ongoing Transforming Care programme was designed to address these problems. However, an investigation by the BBC’s File on 4 programme found a substantial increase from 2016 to 2017 in the use of restrictive practices in inpatient settings for this group.

Last reviewed 14 December 2018

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