The Care Quality Commission’s Annual Report ‘The State of Care’ has been published today, offering us the CQC’s latest assessment of health care and social care in England.
Access details of the report, view the Press Release launching it , and download the Summary and Full Report from this page on the CQC website.
A key finding of the report is that “a better system of care is needed for people with a learning disability or autism who are, or are at risk of, being hospitalised, segregated and placed in overly restrictive environments”.
The CQC calls the current situation unacceptable.
Its report describes that situation as follows:
Some people are struggling to get access to the mental health services they need, when they need them.
This can mean that people reach a level of ‘crisis’ that requires immediate and costly intervention before getting the care they need, or that they end up in inappropriate parts of the system.
Some people are detained in mental health services when this might have been avoided if they had been helped sooner, and then find themselves spending too long in services that are not suitable for them.
Too many people with a learning disability or autism are in hospital because of a lack of local, intensive community services.
We have concerns about the quality of inpatient wards that should be providing longer-term and highly specialised care for people.
We have shone a spotlight this year on the prolonged use of segregation for people with severe and complex problems – who should instead be receiving specialist care from staff with highly specialised skills, and in a setting that is fully tailored to their needs.
Since October 2018, we have rated as inadequate 14 independent mental health hospitals that admit people with a learning disability and/or autism, and put them into special measures.
This is an unacceptable situation. A better system of care is needed for people with a learning disability or autism who are, or are at risk of, being hospitalised, segregated and placed in overly restrictive environments. We must all work together to make this happen.
We also know that people with the most severe and enduring mental ill-health do not always have access to local, comprehensive rehabilitation services and are often in inappropriate placements far from home. This weakens support networks and the ability of family and commissioners to stay in close contact, sometimes with devastating consequences.
We are seeing issues with the availability of care. There has been a 14% fall in the number of mental health beds between 2014/15 and 2018/19. While this is in line with the national policy commitment to support people in the community, it is vital that people in crisis can access support when needed.
All of this is underpinned by significant issues around staffing and workforce.
Our inspectors are seeing too many mental health and learning disability services with people who lack the skills, training, experience or clinical support to care for patients with complex needs. In the majority of mental health inpatient services rated as inadequate or requires improvement since October 2018, the inspection reports identified a lack of appropriately skilled staff as an issue.