The report found that 66 people the CQC met had been 'let down by the health and care system'. Its key findings include:
- Nearly all of the services it visited used some form of restrictive practice (restraint, seclusion or segregation)
- The majority of hospitals where learning disabled and / or autistic people were treated were not therapeutic environments
- The noisy and chaotic nature of the wards could add to people's distress, particularly for autistic people.
- Creating a package of care to meet their individual needs was often seen as 'too difficult to get right'.
- A lack of support in the community often led to people becoming increasingly distressed.
We have argued in legal cases on behalf of learning disabled and / or autistic people that the disproportionate and unnecessary use of restraint and seclusion is a breach of their human rights. Allowing these 'practices' to continue whilst under State funded care is, in our view, akin to torture.
This CQC report needs to be the last of its kind. Whilst its findings are helpful, the recommendations bear striking similarity to those repeatedly made in a string of previous inquiries:
- Learning disabled and autistic people need to be supported to live in their communities.
- The use of restrictive practices (restraint, seclusion, segregation) must be reduced.
- There needs to be increased oversight and accountability for people with a learning disability and / or autistic people who may also have a mental health problem.
These recommendations echo the campaigns fought by families following the Winterbourne View scandal, and the proposals made in the government's Transforming Care report in 2014. Since then, repeated exposés of abuse at institutions like Whorlton Hall and Yewtrees hospital have shown that change isn't happening quickly enough. The continuing commissioning of institutional models of 'care', rather than supporting individuals to live full, ordinary lives, is at the heart of this problem.
When care and hospital staff fall back on the use of restraint, segregation and seclusion, without searching for a more compassionate response to behaviour, the State acts in an inhumane and unlawful manner towards its citizens.
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