Care for detained patients improves but more to be done

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There have been improvements in the quality of care for patients detained under the Mental Health Act but the quality and safety of mental health wards remains an issue, the CQC has said.

A new report, Monitoring the Mental Health Act in 2017/18, published by the regulator said progress had been made in the information provided to patients about their rights at start of their detention or community treatment order and involving patients in care planning.

However, despite a seeing a higher proportion of detailed care plans developed in collaboration with patients and carers, it said care planning remained one of its ‘greatest concerns’, with a substantial proportion still of ‘poor quality’.

The CQC, which carried out 1,165 visits to mental health wards in 2017/18 as part of its work to monitor the Act and its Code of Practice, also continues to be concerned about the quality and safety of care, particular on acute wards for adults of working age.

It said restrictive practices and segregation remained an issue on some wards, with long-term segregation – once thought of as extreme and usually limited to higher-security forensic hospitals – now ‘much more commonplace’.

The regulator is carrying out a thematic review of the use of restraint, prolonged seclusion and long-term segregation, with its interim report due in May this year.

CQC deputy chief inspector of Hospitals (lead for mental health) Dr Paul Lelliott said: ‘We are pleased to see an overall trend of improvement in the quality of care plans for people detained under the Mental Health Act. This is an achievement at a time of increased pressure on services and is in large part due to the dedication of frontline staff.

‘However, it is important that this does not mask the fact that many of the wards, in which people are detained under the Mental Health Act, are unsafe and provide poor quality care. We flagged this up in our State of Care report as our greatest concern and this continues to be the case.’