| SPOTLIGHT |
The Care Quality Commission has vowed to use its regulatory powers to secure improved mental health services for patients subject to the Mental Health Act, after its research found “too much poor and unacceptable practice” and even potential breaches of human rights.
In its first annual report on use of the Act, the CQC said it had concerns about how some care providers – in both the NHS and private sector – were adhering to the principles of the Act and its Code of Practice.
The watchdog outlined three priority areas for improvement. These were:
CQC chief executive Cynthia Bower acknowledged that staff and managers who work in mental health services do not always get the recognition they deserve. “Many of the men, women and children who come under their care may owe their very survival to their dedication and compassion, both on the hospital ward and out in the community,” she said.
However, Bower added that the CQC had found “too much poor and unacceptable practice and this must be tackled. Our top priority is to protect the interests of patients, and we will use our powers to ensure that care providers address these issues and make real improvements.”
She said the CQC’s predecessor, the former Mental Health Act Commission, had driven significant improvements in mental health services but did not have the regulatory powers available to its successor.
The CQC has so far placed conditions on four trusts providing mental health services. In three cases, this was because patients were not being cared for in accordance with their rights. Bower said the trusts has all made improvements but warned that the watchdog would continue to monitor their performance.
Bower said that involving people in the decisions that are made about their care was a key factor in helping their recovery.
In relation to the assessment and recording of patients’ capacity to consent to their treatment, she said: “When our Mental Health Act Commissioners visit patients on the wards, they often find that what patients tell them doesn’t match up to what the records say. It may be recorded that they have given their consent, but either they apparently lack the capacity to do so or they say they have refused to do so, and this is a concern.”
The CQC chief executive also urged hospitals to minimise the restrictions they place on patients.
She said: “We recognise the importance of ensuring people’s safety, but more hospitals are keeping psychiatric wards locked at all times, even though they often accommodate voluntary as well as detained patients.
"In some places there are blanket bans on mobile phones and internet access. These sorts of measures could compromise patients’ privacy or dignity, hold back their progress and even breach their human rights.”
In its report the CQC also revealed that more than 4,000 people had been made the subject of a community treatment order in 2009/10, more than ten times the number the Department of Health had predicted.
These orders, introduced in November 2008, are designed to ensure there is effective care outside hospital for patients who, on being discharged, may refuse to take their medication or co-operate with community mental health services. One in five patients was recalled to hospital.
