CQC’s Out of Sight progress update shows worrying lack of improvement on use of restraint, segregation and seclusion

The Care Quality Commission's (CQC) progress update on the October 2020 Out of Sight review into the use of restraint, segregation and seclusion, has revealed little progress in the reduction of these practices in mental health settings. 

The CQC’s update follows on from their report, which made 17 recommendations for reform which were intended to stop unacceptable use of restrictive practices in services for people with a learning disability, autistic people and people with mental health problems. This new update shows that despite the CQC’s intervention, only four of their recommendations have even been partially met, with 13 not being met at all. No recommendation has yet been fully achieved. Instead, the number of long term segregations has increased since the CQC’s original report was first commissioned in 2018.

Reacting to the update, Rheian Davies, Head of the Legal Unit at Mind, said:

 “We are incredibly disappointed, but unsurprised, that there has been little in the way of improvement when it comes to the use of dangerous and humiliating practices such as restraint, segregation, and isolation in mental health settings. The CQC’s findings present a sadly familiar picture of a system under huge pressure, one that is failing to give people the support and care they need. As pressures on NHS crisis care have risen, and early intervention has dropped, it was inevitable that mental health settings would be dealing with more people experiencing more complex and severe problems. Patients experiencing these type of problems need and expect care and compassion, not coercive measures such as restraint, segregation and isolation.

“Use of force in mental health settings can have devastating results, including life changing harm to patients, and even death. People subjected to use of force and restraint often experience trauma as a result, and are provided with little to support them taking action where they feel they have been unfairly treated. Black and Mixed Heritage people are more likely to face discriminatory higher levels of restraint, segregation, and isolation; and are also more likely to need trauma informed mental health care. This is why it is so essential that the Department for Health and Social Care take this update from the CQC as the wake up call it ought to be – before further harm occurs.

“The UK Government must immediately give mental health services and their workforces the funding they need to reduce restraint, segregation, and isolation through earlier support for at-risk patients and expansion of community mental health services. They must also progress reform of the Mental Health Act, which will give further opportunities to reduce restrictive, discriminatory practices.

“Thankfully, next week will see the coming into force of Seni’s Law, which aims to protect patients from the use of excessive force by clinical staff and police through staff training and increasing the data mental health units must record, among other measures. We hope that this change will bring a much needed reduction in the harm caused by restraint, segregation and seclusion, but the CQC’s update today highlights how much further we have to go.”