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Challenges ‘persist’ for people with learning disabilities or autism to access support, CQC says

by Mimi Launder and Beth Gault
28 March 2022

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There are still ‘too many’ people in hospital with a learning disability or autism, the CQC has found, with ‘a lack of community services’ which can provide early intervention and crisis support a contributing factor.

The findings come as part of the Restraint, segregation and seclusion review, which looked at the progress made on the recommendations from CQC’s 2020 Out of sight – who cares report which looked at the use of restraint, seclusion and segregation in care services.

The regulator said at the end of last week (25 March) that more people are now in long-term segregation than in 2018 when it was commissioned to carry out the review, while four of the 17 recommendations made in the resulting 2020 review were only partially met and 13 not met at all.

The number of people with a learning disability in hospital has nearly halved since March 2015 although ‘there are still too many’ but the number of autistic people has increased by 61%, it found.

A ‘lack of community services’ – which can provide early intervention and crisis support – ‘means people are more likely to end up in hospital,’ it added, although it acknowledged government investment in 2020 aimed to support people to come out of long-term segregation.

The report said: ‘Our recommendations called for the development of community resources to ensure that people could be supported in the community and therefore avoid hospital admission. Far from an improvement, we have seen that people have found accessing community mental health support more difficult.

‘This is partly due to the impact of Covid-19. The pandemic has led to a mental health crisis in a system that was already overloaded.’

It added: ‘New urgent referrals to crisis care teams fluctuate monthly but are increasing.’

This comes after the CQC also warned in 2019 that too many people with a learning disability or autism are in hospital in part because of a lack of local, intensive community services.

‘Time for action for people trapped in hospital’

Jemima Burnage, CQC lead for mental health, said investment must now be ‘accelerated’ after some increased community funding and to support people out of long-term segregation.

Integrated care systems (ICSs) will pay a ‘key role’ in ensuring the changes are delivered, she added, also welcoming the announcement that a named lead for learning disabilities and autism will be on each local integrated board.

Also responding to the report, Richard Kramer, chief executive of the disability charity Sense called for ‘urgent investment’ in community social care services so individuals ‘don’t reach crisis point in the first place’.

Mr Kramer continued: ‘People with learning disabilities and/or autism should be living in safe, suitable environments where they receive the right care and support. But as this latest review shows, many are still trapped in mental health hospitals unnecessarily, often far from their families.

‘Not only does this cause great anxiety and distress, but there have been too many instances of abuse and safeguarding violations, including restraint and isolation, in these settings – this cruel practice must end now,’ he added.

‘It’s a scandal to see yet another of these damning reports. Instead, it’s time for action and for people’s lives changing for the better.’

Dan Scorer, head of policy at learning disability charity Mencap, added that it was a ‘damning assessment on lack of action by the Government, NHS England and local authorities’ in addressing the recommendation by the CQC.

Last year, it was found that people with learning disabilities were missing out on annual health checks during Covid.

A version of this story was first published on our sister title Nursing in Practice.