Care watchdog sees 'deterioration' in mental health hospitals

Mental health and learning disability inpatient services in England have seen a ‘deterioration in ratings’, according to the Care Quality Commission.

In its annual State of Care report, the Care Quality Commission (CQC) revealed that its inspectors have found within mental health and learning disability long stay hospitals, there are staff shortages as well as care delivered by staff who aren’t trained or supported to look after people with complex needs.

Ian Trenholm, chief executive of the CQC, said that this has led to “an impact on quality – and on people”.

He added: “Increased demand combined with challenges around workforce and access risk creating a perfect storm – meaning people who need support from mental health, learning disability or autism services may receive poor care, have to wait until they are at crisis point to get the help they need, be detained in unsuitable services far from home, or be unable to access care at all.”

If people can’t access the right care they need, it can mean that people with a learning disability and or autism can end up detained in unsuitable hospitals, according to the CQC.

Its report revealed that as of 30 September 2019, 10 per cent of inpatient services for people with learning disabilities and/or autism were rated inadequate, compared to one per cent in 2018.

Similarly eight per cent of acute wards for adults of working age and psychiatric intensive care units were rated inadequate, compared to two per cent in 2018.

Since October 2018, 14 independent mental health hospitals that admit people with a learning disability and/or autism have been rated inadequate and put into special measures.

In response to the lack of appropriately skilled staff working in mental health and the learning disability inpatient sector, Ian Trenholm called for an acceleration of the “ambitious plans to expand the mental health workforce to meet an increase in demand”.

On the upside, the report showed CQC ratings across the health and social care sector have remained broadly stable with Peter Wyman, chair of the CQC saying this “should be celebrated”.

He added that there is an “urgent need” to find a solution for funding social care saying failure to find a consensus “continues to drive instability”.

In response to the report, Professor Martin Green, chief executive of Care England, said it “only accentuates the fact that the Government cannot side-line social care reform for any longer. The risks of further inaction are too grave”.

VODG (the Voluntary Organisations Disability Group), the national body representing leading not-for-profit organisations, welcomed this year’s focus on mental health and disability provision. VODG chief executive Dr Rhidian Hughes said: “Year on year the State of Care report highlights the precarious financial state of the social care sector and the growing demands placed on it. Today the consequences of that lack of funding are clear.

“A tipping point has been reached as some people do not receive the care they need, and this is simply unacceptable. We believe the time has come for CQC’s remit to be extended to include full independent performance assessments of local health and social care commissioning. This is crucial to understand how commissioning is focusing on addressing people’s needs and the extent to which statutory duties are being met.”

This year’s State of Care report draws on quantitative analysis of inspection ratings of almost 32,000 services and providers, as well as staff and public surveys, as well as ‘Share Your Experience’ comments and case studies of the experiences of people who use services.

The State of Care report can be found at https://www.cqc.org.uk/publications/major-report/state-care