Improving how we assess closed environments

Care Quality Commission

Professor Ted Baker, Chief Inspector of Hospitals, and Kate Terroni, Chief Inspector of Adult Social Care, ask social care and hospital providers to consider how the system can better protect people who have a learning disability, autism and or mental health problem in their services.

On World Mental Health Day, we have written to social care and hospital providers to ask them to consider how the system can better protect people who have a learning disability, autism and or mental health problem in their services.

We have been concerned about the safety of mental health hospitals for some time, but the shocking discovery of abuse of patients at Whorlton Hall in May this year prompted us to look again at our approach across the sectors we regulate. Following the publicity triggered by this event many staff in other services have raised concerns with us so that we can take action to protect people in these services. We are grateful to them for doing so.

We are particularly concerned about hospitals where people stay for months or years, and are located away from their communities, and where staff may lack the right support and training. These types of services are more at risk of developing closed environments that can increase the chance of an abusive culture.

In social care services, it’s time to rethink how we can best protect people and ensure they get the right care and support. Our review of restraint, segregation and seclusion continues to highlight the variability of restrictive practices that are used in social care services and that can infringe people’s basic human rights.

We recognise that our assessment approach must be strengthened, but we urge all organisations in the health and care system to think about what more they can do. Providers, commissioners, clinicians working in these environments, government and regulators including colleagues here at the CQC, everyone has a duty to act where there is a risk of someone’s human rights being compromised or they are concerned someone is at risk of abusive practice.

Today we have asked providers that they ensure the services and staff they are responsible for are fully aware of what human rights are at risk of being breached when they are caring for people. These could relate to the right to life, right to liberty, right not to be tortured or treated in an inhuman or degrading way, right to respect for private and family life, home and correspondence, and right to be free from discrimination.

We know that action the health and care system has taken to date does not go far enough to protect people. We will be working closely with providers, with the public to increase the involvement of people who use services and their families and advocates in our work, so we can better understand the quality of care. We will be raising this further in our annual report to Parliament next week on the state of care in England.

This will be an ongoing piece of work. In terms of immediate action, we ask that everyone who works in the health and care system should consider whether they are doing everything they can to ensure that the human rights of the people receiving care are protected — and that staff are supported and motivated to deliver good, safe, compassionate care to these people at all times.

Care Quality Commission

Written by

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

Welcome to a place where words matter. On Medium, smart voices and original ideas take center stage - with no ads in sight. Watch
Follow all the topics you care about, and we’ll deliver the best stories for you to your homepage and inbox. Explore
Get unlimited access to the best stories on Medium — and support writers while you’re at it. Just $5/month. Upgrade