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Services failing on use of restraint, says regulator

More people with learning disabilities are being cared for in services that have failed regulatory standards on safeguarding than in services that have met them, with the use of restraint the biggest cause of concern.

The Care Quality Commission’s State of Care report, published today, draws conclusions from around 13,000 inspections of health and social care services.

It found use of physical restraint varied greatly and was often poorly recorded in services.

This meant it was difficult to work out why the patient had been restrained, how often and for how long and lessons were not learned from them, the CQC report said.

Just 51% of independent healthcare providers were meeting the safeguarding standard, compared to 59% of adult social care and 79% of NHS services. Overall 58% of people were being cared for in a service that was non-compliant.

The report also raised concerns about the use of seclusion as a form of restraint, as well as the use of blanket rules restricting when patients could have a drink, go for a cigarette or contact their family.

It said this could make people feel “controlled” and “unable to exercise their own choices”.

In about a third of care homes, staff had no training on Deprivation of Liberty Safeguards and inspectors also reported a lack of understanding of the Mental Health Act among staff.

This meant patients, who were not formally detained, being subject to the same restrictions on their liberty as those that were.

The report said a lack of staff or insufficiently skilled staff added to the risk of excessive use of various forms of restraint.

Readers' comments (6)

  • I have never received any formal (or informal) training in DOL or the mental health act yet I am expected to care for patients subjected to both.

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  • I have a learning disabled brother who is in a care facility. Whilst he is not restrained and does not need to be, his care is apalling. There are medication erroros abour every 2 months, his clothes are in an appaling state, the trousers they dressed him in were so big they fell down in public,even though we regularly replace them. We have made frequent complaints about these events. The attitude of the place is that they are in charge and we should shut up, to this end they will only let us know about medication errors or any other issues weekly so it could be several days after an event before we are notified. Despite all of this CQC have passed them on inspection, their report being based on information supplied to them, by the facility, when it registerd 2 years previously. So not only is the care poor the regulation is poor also, both are in this instance not fit for purpose. I agree with Lord Wiilis (NT 26 Nov) all care staff should be regulated they would then be accountable for their actions and ignorance would be no excuse.

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  • tinkerbell

    Anonymous | 24-Nov-2012 8:43 am

    Totally agree, any one in a position of power looking after vulnerable others should be responsible and accountable for the care provided. Sadly it is so easy to abuse the power invested in us.

    It is a mark of a civilised society to protect the vulnerable.

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  • LD and MH nurse specialist with positive practice behaviour qualification and Rampton trained restraint instructor with 30 years+ experience. Fired six months ago by NHS Trust LD forensic service following a two year campaign complaining and being ignored about various patient abuses and particularly abusive seclusions. First enquiry completely ignored seclusion concerns and previous complaint about reported seclusion complaint being ignored. Subsequent appeal to CEO resulted in "Seclusion Review" whitewash and cover up written by the folks responsible and who had previously ignored complaint. Thanked by CEO then promptly fired for accessing seclusion victims file. Reduced on appeal which inevitably decided that accessing OK but time spent too long. Referred to NMC via misleading statement who subsequently placed interim suspension order in the public interest that should only be applied where a patient is harmed, public risk continues and crucially is accompanied with additional serious allegation according to caselaw. None applies. No work now for one month just before Christmas. RCN pulled out when I insisted on addressing the NMC directly about concerns. NMC guided by own directives that say in the event of dispute weight should ere towards referer. So much for whistle blowing nurses support instruments and statements.

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  • tinkerbell

    Anonymous | 24-Nov-2012 8:03 pm

    More good people like you needed, sad you have had to suffer this injustice but at least you did the right thing. Bless you!

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  • tinkerbell

    Perhaps like Terry you could apply to work for the CQC, they could always do with a few more good men/women who know what they're talking about.

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