Out of Sight – Who Cares? CQC report reveals shocking use of restraint, seclusion and segregation

    Publication leads to calls for reform in care services

      • Sector News
    • 27.10.20

    The Care Quality Commission has published a report which reveals the use of restraint, seclusion and segregation in care services, against people with a mental health condition, learning disability or autism.

    Out of Sight – Who Cares? found that care services that have been paid to provide therapeutic care to patients, relied on restriction, seclusion and punishment, instead of understanding, meeting needs and supporting distress in trauma-informed ways.

    According to the report, poor leadership and cultures were a barrier to people receiving person-centred care, with staff often not feeling listened, or supported to look after the people in their care.

    Staff also reported that they often did not always have the necessary training and skills to understand people’s needs and they lacked training on communication skills such as Picture Symbols and Makaton. Where they were not able to help people communicate, this also caused people further distress and led to an increase in restrictive practices.

    The report also found that providers did not always recognise how distressing the use of restraint and other restrictive practices could be for people or the long-term impact it could have.

    Few staff were trained in trauma-informed care. As a result, people were not given opportunities to talk about the nature of their distress and were not supported to move forward.

    The CQC has called for tangible progress to be made in four key areas:

    1. People with a learning disability and or autistic people who may also have a mental health condition should be supported to live in their communities
    2. People who are being cared for in a hospital in the meantime must receive high-quality, person-centred, specialised care in small units. This means the right staff who are trained to support their needs supporting them along a journey to leave hospital
    3. There must be renewed attempts to reduce restrictive practice by all health and social care providers, commissioners and others
    4. There must be increased oversight and accountability for people with a learning disability, and or autistic people who may also have a mental health problem

    CMM: Out of sight – who cares
    Council for disabled children: The restraint review: a blog by Dame Christine Lenehan DBE
    CQC: Out of sight – who cares?: Restraint, segregation and seclusion review
    RRN: CQC publishes ‘Out of Sight – Who Cares?’, a review of restraint, segregation and seclusion
    LGA: LGA responds to CQC report on use of restraint, prolonged seclusion and segregation

    Maybo perspective

    Restrictive interventions continue to be used unnecessarily and excessively by some services, who could avoid these approaches through better understanding of the people they support.

    Maybo training starts with an understanding of human rights and recognising restrictive practices (it is surprising how many staff don’t have a full understanding). We then develop practical skills for building positive relationships, reducing and managing behaviours of concern, as well as developing skills around trauma-informed approaches to care.

    Training is important, but we need to remember that 'culture eats policy and training for breakfast', so clear leadership and active supervision is essential. Greater focus on supervisory skills and accountability is needed to deliver and maintain healthy cultures.

    Get in touch

    If you would like to discuss how we can help you please get in touch with one of our experts today

    Related ThoughtSpace items

    • Sector News

    02.11.20 | Staff training | Human rights |

    Calls for increased staff training within aged care services

    The Royal Commission into Aged Care has published a report that calls for greater staff training for people that work in aged care...

    • Expert Insights

    19.10.20 | Passenger Transport | Security, FM & Events, …

    What is trauma? What does being “trauma-informed” really mean and why is it important?

    Trauma can affect anyone, regardless of their age, gender, ethnicity or profession. It can come in many forms and can be the result of an...

    • Sector News

    18.10.20 | COVID-19 | Autism and special needs

    How are children with autism and special needs coping during the COVID-19 pandemic?

    National charity, Autism Spectrum, has published an insightful article that highlights the main coping strategies used by children with...

    Discuss your training with one of our experts