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Our review of restraint, seclusion and segregation

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We're reviewing the use of restrictive interventions in places that provide care for people with mental health problems, a learning disability and/or autism.

Restrictive interventions are when someone receiving care is restrained or put in prolonged seclusion or segregation.

Why we are doing this review

At the end of 2018, Matt Hancock, the Secretary of State for Health and Social Care, asked us to look at the use of restrictive interventions.

The review will look at how places providing inpatient and residential care for people with mental health problems, a leaning disability, and/or autism use these interventions. We will also make recommendations about their use.

We started work on this review in December 2018. We will report on our interim findings in May 2019, with a full report by March 2020.

What we will look at

The review will look at whether and how specific health and social care settings use restrictive practices.

In stage 1 we will consider whether and how restraint, prolonged seclusion and segregation are being used in:

  • NHS and independent child and adolescent mental health wards
  • NHS and independent sector wards for people of all ages with learning disabilities and or autism

In stage 2, we will consider whether and how prolonged seclusion and segregation are being used in:

  • Mental health rehabilitation and low secure wards

In stage 2, we will also explore whether and how restrictive interventions are used in these settings:

  • Residential care homes for people with learning disabilities and/or autism
  • Children’s residential services (in partnership with Ofsted)
  • 14 secure children’s homes in England (in partnership with Ofsted)

How we will do this work

We will carry out this work in collaboration with people who use services, their families and relevant stakeholders.

For people with a mental health, learning disabilities or autism diagnosis, we will be asking the following overarching questions:

  • How can hospital and residential care providers, protect the welfare and rights of those who are subject to prolonged seclusion or segregation? How can they minimise the likelihood of this being the outcome of care?
  • How can the wider system protect the welfare and rights of those who are subject to prolonged seclusion or segregation?
  • What changes do providers need to make to create an environment that minimises the use of restraint?

To carry out his work, we are:

  • Collecting and reviewing existing literature and data
  • Asking providers for information about their use of restrictive practices
  • Visiting health and social care settings where people are subject to restraint, prolonged seclusion and segregation
  • Interviewing people who have been subject to segregation/prolonged seclusion and with families and carers

We follow a consistent process when we carry out reviews.

What we aim to achieve

There is understandable amount of concern about the use of restraint, prolonged seclusion and segregation for people with mental health problems, a learning disability or autism.

The review will:

  • examine the range of factors that lead to people being subject to restrictive interventions
  • assess the extent to which services follow best practice in minimising the need to use force
  • identify what needs to be done to reduce the use of these practices

We will make recommendations to the Department of Health and Social Care and the wider system in our March 2020 report.

It is vital that society protects the rights, welfare and safety of children and adults with a mental health problem a learning disability and or autism, and that they receive the safe, high quality care that they deserve.

Last updated:
30 September 2019

 


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