April 2, 2012

Some care homes and hospitals are still not meeting their obligations on liberty safeguards, according CQC's second annual report

The Care Quality Commision's second annual report on "the implementation and use of the Safeguards" has found that some care homes and hospitals are still not meeting their obligations on liberty safeguards. The CQC report identifies "a need to increase understanding to ensure people's rights areproperly protected". It highlights training and guidance as playing a key role in developing consistent practice.

What are the 'safeguards'?

The safeguards are intended to protect people’s human rights in circumstances where they cannot consent to their care or treatment. Care homes and hospitals must apply to their supervisory body (local authority or PCT) if they intend to deprice someone of their liberty. The CQC definition of 'deprivation of liberty' includes: 

  • "Keeping them locked in or restricted to bed rails.
  • Physically restraining them.
  • Placing them under high-levels of supervision.
  • Forcibly giving them medication.
  • Preventing them from seeing relatives and friends".

What were the key findings from the CQC report?

  • "8,982 applications to deprive a person of their liberty were processed, of which 50 per cent were authorised.
  • Many services have developed good practice on the use of the safeguards, especially in involving people and their families in the decision-making process, but some were confused as to when restraints or restrictions on a person amounted to a deprivation of liberty.
  • Between a third and a quarter of care homes had not provided their staff with training on the safeguards, and in some cases only the manager had received training.
  • Most hospitals had held some training, but the proportion of staff involved ranged between 20-100 per cent".

What are the CQC going to do in response to the findings of this report?

The CQC have stated that the findings of the report show that there "continue to be cases where people are deprived of their liberty without regard to their human rights. Due to this, there is a clear need for a system of checks and safeguards".

They have identified three ways in which the CQC plans to improve their approach to monitoring the safeguards:

  • "embed the safeguards as a routine and major part of our inspectors’ practice.
  • improve our information on managing authorities’ applications and authorisations for the safeguards.
  • develop our ability to monitor the overall safeguards system and managing authorities."