People with learning disabilities and autism face lengthy periods of seclusion and “punitive care” on mental health units that are “not fit-for-purpose” hospital regulator the Care Quality Commission has found.
A CQC review of the use of seclusion, segregation and restraint found that one adult with a learning disability or autism has been kep in segregation – a form of solitary confinement – for almost 10 years, and a child for nearly two and a half.
Parents of patients who have faced seclusion have told Sky News the conditions their loved ones face in mental health units are “horrific”.
The CQC review, commissioned by health secretary Matt Hancock, found “shocking evidence of poor and restrictive practices”, and has recommended a review of every individual held in segregation in a children’s mental health unit or an adult ward for people with a learning disability or autism.
The longest time a child or young person spent in segregation was 2.4 years, the report found
IT comes 24 hours after the Children’s Commissioner criticised the care of under-18s with autism and learning disabilities in mental health units, describing them as “a nightmare”.
There are more than 2,000 adults with a learning disability or autism in secure units in England and around 250 children. The CQC found that of these 62 were in segregation, the youngest just 11 years old. Of these 16 had been segregated for more than a year.
The report describes one young man who spends his day in a locked padded cell, naked under a blanket and unable to use the toilet properly.
His only education was a book held to the window in the door of his room, and he had only left the room 16 times in a year prior to being visited by the CQC, and was physically restrained at all times when he did.
“This research has shown that too many children are admitted to hospital unnecessarily and spending months and years of their childhood in institutions when they do not need to be there,” the CQC report states.
The CQC criticised the Government’s lack of progress against its own targets to reduce the number of people on in-patient units under the Transforming Care program.
A target to cut the number of in-patients by up to 50% by March was missed and the target has now been pushed back five years.
“Despite report after report and successive government programmes to address this problem, the number of children in hospital remains unacceptably high.”
The review also criticised staffing levels and training which often left employees resorting to seclusion because they did not have the confidence to deal with challenging patients.
Dr Paul Lelliott, CQC’s Deputy Chief Inspector of Hospitals, said: “We are calling for urgent action to strengthen the safeguards that protect the safety, welfare and human rights of people held in segregation.
“A high proportion of staff were unqualified, with little or no training in the skills essential for working with people with a learning disability or autism and complex needs.”
The parents of a man with a learning disability and autism who has spent 19 years in a unit, including many years in isolation, said they are “tired and weary” waiting for him to be release.
Roy and Pam, who’s son Tony is 41, told Sky News: “The situation hasn’t moved, hasn’t changed. We are still where we were. We are still waiting.
“They are talking about the money being released for the provider but nothing is moving.”
In the best case scenario, Tony will be discharged in around three years.
“He’s done all his 20s and 30s there, and now he’s going into his 40s. He will never get that back,” said Roy.
Health secretary Matt Hancock said he had been “deeply moved” by stories of people with autism and learning disabilities, and announced the Department of Health would be convening an expert group and funding an awareness campaign.
He said: “I hope this is a turning point so everyone receives the care they need. I will not let these people down – they deserve better.”
Jeremy, the father of Bethany, an 18 year old with autism who until earlier this year had spent two and a half years in seclusion, told Sky News he does not trust Government pledges.
“I only have faith in them to deliver empty promises,” he said.
The CQC will report in its full findings and recommendations in a final report next spring.