Care for mental health patients has deteriorated in England, regulators say
Some 10% of inpatient services for people with learning disabilities and/or autism were rated as inadequate by inspectors.
Tuesday 15 October 2019 11:28, UK
The quality of care provided at inpatient units across England for those with mental health, learning disability and autism has deteriorated in the last year, regulators have said.
Concerns over safety on these wards, staffing levels and inappropriate care has been highlighted in the Care Quality Commission's (CQC) annual State of Care report, which looks at all health and social care across the country, including NHS and the independent sector.
Some 10% of inpatient services for people with learning disabilities and/or autism were rated as inadequate - the lowest rating - by inspectors, compared to 1% the year before.
Fourteen independent mental health hospitals that admit people with learning disability and autism have been placed into special measures since last October, with three closing permanently.
And 7% of child and adolescent mental health inpatient services were rated inadequate, up on 3% the year before.
The CQC's Chief Executive, Ian Trenholm, described some services as "not fit for purpose", adding: "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."
The CQC highlight concerns over staffing in these specialist units saying many people are "being looked after by staff who lack the skills, training, experience or support from clinical staff to care for people with complex needs."
There has been a national shortage of nurses in these specialisms, with 8% fewer learning disability nurses registered with the Nursing and Midwifery Council in 2019 than 2015.
Last October, Sky News revealed that 40 people with a learning disability or autism have died while admitted to secure treatment units since 2015 - and told the story of a man who has spent 19 years in one unit.
And earlier this year, Sky News revealed that poor care in privately-run child and adolescent mental health services (CAMHS) units is putting vulnerable young people at risk.
In other services, the CQC said they are also increasingly concerned about the pressure on hospitals as new figures show more than half of A&E departments are inadequate or require improvement.
Inspectors said A&E departments had not had their usual "breathing space" over the summer to prepare for the coming winter months, which can see high numbers of patients suffering flu and existing illnesses made worse.
Mr Trenholm added: "It is about increasing demand. We've heard some stories in some emergency departments seeing a 10% increase during the last year alone.
"This isn't something the emergency department or even the hospital can handle on their own. We are calling for the whole system to work together - GPs, hospitals, social care - to come together."
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An NHS England spokesperson, said: "Despite the busiest-ever summer in emergency departments - and more than half a million more visits than the same time last year - it's good to see CQC saying hospitals, family doctors and mental health services continue to deliver good quality care - a testimony to hardworking NHS staff.
"While the NHS Long Term Plan set out an extra £4.5bn to ramp up GP and community care, the CQC rightly highlights the need for a long-term solution to adult social care so that older and vulnerable people get the right care when they need it."
A Department of Health and Social Care spokesperson said: "Everyone should have access to the best quality, compassionate care, whether that's in hospital or in the community.
"We have underlined this commitment through our Long Term Plan, which is backed by the largest and longest cash settlement in the history of the NHS, and extensive planning for the winter months is already underway.
"We are supporting our most vulnerable by transforming mental health services with a record spend of £12.5bn this year and are working to reduce the number of people with learning disabilities and autism in mental health hospitals by improving specialist services and community crisis care, reducing avoidable admissions and enabling shorter lengths of stay.
"We will set out our plans to reform social care in due course."
A Department of Health and Social Care spokesperson said: "Everyone should have access to the best quality, compassionate care, whether that's in hospital or in the community. We have underlined this commitment through our Long Term Plan, which is backed by the largest and longest cash settlement in the history of the NHS, and extensive planning for the winter months is already underway.
"We are supporting our most vulnerable by transforming mental health services with a record spend of £12.5bn last year and are working to reduce the number of people with learning disabilities and autism in mental health hospitals by improving specialist services and community crisis care, reducing avoidable admissions and enabling shorter lengths of stay.
"We will set out our plans to reform social care in due course."