Paul de Savary

This week Secretary of State for Health & Care, Matt Hancock announced an ‘immediate’ review, to be carried out by the Care Quality Commission (CQC), into practices in Assessment and Treatment Units (ATUs), including the prolonged seclusion and long-term segregation used in the ‘care’ of individuals with complex learning disabilities and autism.

Utterly ridiculous for CQC to lead on this report when they are a contributor to ATU incarcerations. Registering the Right Support (RRS) is CQC’s bespoke model of care that mistakenly treats individuals with autism as a single cohort. The RRS model places unrealistic and wholly impractical limitations, blocking new services in the community for the most complex individuals locked up in ATUs.

In June 2017 CQC made RRS Policy having been challenged over its unlawful introduction as a Guidance. Since then, providers representing 3,385 specialist community-based beds have shelved plans to open 79 new beds (more across the whole sector) in the community for discharges from ATUs, a number that is compounding. Two years ago, CQC’s then CEO Sir David Behan and Chairman Peter Wyman were warned that RRS would crash the rollout of new services for the most complex individuals, a warning they ignored.

Any meaningful review must thoroughly investigate the effects of CQC’s RRS and their mission creep from Market Regulator to Market Shaper and now Market Wrecker. How can it therefore be appropriate for CQC to undertake it?

As quickly as individuals are discharged through the front door of this institutional hell, they are admitted through the backdoor. Shockingly, between 2016 and 2017 cases of restraint in ATUs, including the use of medication to sedate individuals, seclusion in padded cells, and physical face-down ‘prone restraint’, went up from 16,660 to 28,880. Individuals are also being fed through ‘hatches’ in their doors.

The Human Rights Convention states that all public authorities have a duty to respect and promote the rights of individuals in their care. They should be treated in accordance with key human rights principles such as dignity, equality, respect and autonomy.

David Isaac, the chairman of the Equality and Human Rights Commission (EHRC) said: “The current in-patient care system for people with learning disabilities has led to some horrific situations at a number of ATUs where people’s human rights are being disregarded.”

CQC knows all these facts having inspected the very services that the Secretary of State is now asking them to review. Where is the logic or genuine commitment to the review, when CQC’s RRS has compounded the problem? Secretary of State, using CQC’s own measure of performance, this is INADEQUATE. Actually, it’s a betrayal of the most vulnerable!  ~ Paul de Savary