CQC needs ‘urgent reform’ to protect patients from abuse

The joint committee on human rights has warned the CQC and clinical commissioning groups are not protecting patients with learning disabilities and autism, after an inquiry found patients’ human rights are being breached in mental health facilities.

The inquiry was prompted last year by reports of a young girl with autism, called Bethany, who had been held in seclusion within a private mental health unit for two years.

It also follows a series of scandals, including Whorlton Hall, into abuse and poor care of patients with learning disabilities and autism within inpatient units.

The committee’s report, published today, said: “The CQC, as the regulator, should be a bulwark against human rights abuses of those detained in mental health hospitals…

“However, evidence… suggests that the CQC’s ability to carry out this function is impaired and its approach and processes are in need of urgent reform.”

The committee called for the following changes:

• The use of “covert surveillance” where appropriate, and methods used by undercover journalists;
• For the CQC to recognise patient and family concerns about treatment as “constituting evidence”;
• Legislative changes to enable the CQC to act more swiftly, if necessary;
• A review of the system which currently allows a service to be rated as “good” overall even when individual aspects may have a lower rating; and
• Unannounced inspections at weekends and late in the evening.

The committee also said it was not confident CCGs were doing enough to assure themselves patients are receiving safe care, adding NHS England should ensure quality assessment visits are made to both locally and centrally commissioned services.

It said CCGs and local authorities should have a “legal duty” to ensure the availability of “sufficient community-based services” and to pool their budgets for these patients.

Priorities within the long-term plan for reducing the number of people detained were also criticised as “unambitious”. NHSE’s recent announcement of a new taskforce for children and young people’s mental health inpatient services would not address “a lack of political focus and accountability” to drive change, it said.

The committee recommended a Cabinet Office led unit be set up to focus on the issues.

The CQC is awaiting the outcome of an independent review into its inspection of Whorlton Hall.

Ian Trenholm, CQC chief executive, said the use of covert surveillance is a complex issue with its own considerations about human rights, and said the regulator already conducts unannounced inspections during evenings and weekends.

He added: “While the issue of covert surveillance is under consideration, we are also focussing on new technologies to better enable us to use existing sources of data and intelligence to identify services — across all sectors — where particular risks are present.

Jane Harris, director of external affairs at the National Autistic Society, said: “One major problem is that there’s not enough basic social care and mental health support for autistic people when they’re at home.

“Without it, autistic people find themselves in a vicious cycle — forced to go into hospital because there’s no support and then unable to leave because there’s no support. And currently the law says that you can be held in hospital against your will, simply because you’re autistic — even if you don’t have a mental health problem.”