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More action needed to ensure people with learning disabilities get the right care

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People with learning difficulties stay in hospital The report highlighted the challenges still faced by people with mental health needs in securing early interventions from health services

People with a learning disability, autism, or mental ill health often stay too long in hospitals and do not always experience therapeutic care, a report by the Care Quality Commission has said.

In 2018 the Department of Health and Social Care commissioned CQC to review the use of restrictive practices in services for people with a learning disability, autistic people, and people with mental ill health. Progress on meeting the recommendations made by CQC in its review has been limited with just four of the seventeen recommendations made in the 2020 report being partially met and thirteen not met.

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CQC’s progress report highlights that although there are still too many people with a learning disability in hospital, this has nearly halved since March 2015. However, the number of autistic people has increased considerably over the same period.

‘The Out of Sight report was intended to improve care for people and lever the change that must happen to improve the lives of people with a learning disability, autistic people and or those with mental ill health,’ said Debbie Ivanova, CQC deputy chief inspector for people with a learning disability and autistic people.

‘This has not happened and there are still too many people in mental health inpatient services. Just four of our recommendations to improve services have been partially met and thirteen not met. The pandemic has clearly had an impact on services and the people that use them in a way that could not have been foreseen. However, progress on the recommendations we made for change have not been happening quickly enough.’

The CQC’s report also notes that not enough progress has been made in reducing the use of restraint and challenges persist in the system which are preventing people from accessing early intervention and crisis support in the community. This can be particularly difficult for autistic people.

The report also highlights shortcomings in the commissioning of services. Currently people are fitted into services that are available, rather than providing support tailored to the individual’s needs. Commissioners are often not working in partnership with people, their families and between different organisations when delivering services.

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‘Almost 18 months have passed since we recommended what must change to improve the care and support received by people with a learning disability, autistic people, and people with mental ill health,’ said Jemima Burnage, CQC Deputy Chief Inspector of Hospitals and Lead for Mental Health.

‘Some investment has been made into projects supporting people to come out of long-term segregation, and funding has been allocated to increase community support. However, for real impact to be felt progress must now be accelerated.’

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