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What’s Going On?
The Health and Social Care Information Centre (HSCIC) this week published further analysis of the September 2013 Learning Disability Census data. The census is a count of people with learning disabilities and/or autistic spectrum disorders (including Asperger’s Syndrome) and/or behaviour that challenges, who were occupying CQC registered beds in a variety of provisions on 30th September 2013. 104 provider organisations submitted data on a range of topics and this information represented some 3,313 people.
A snapshot of aspects of care
This latest report provides information on care planning , the costs of the provision, use of mental health legislation such as The Mental Health Act 1983 and Mental Capacity Act 2007 and the experience of care, including restraint, seclusion and use of medication etc. The use of psychotropic medication was reported in two thirds of those studied, with the majority of these receiving drugs on a regular basis. This is despite many recent studies that suggest medication is not the most appropriate means of managing challenging behaviours in people with learning disabilities compared to positive behaviour support, for example.
Restrictive practice and restraint
Around 34% of users had experienced physical hands on restraint at least once in their stay, which indicates that these incidents remain a feature for people in this type of care setting. There has been little change in the level of use of restraint, seclusion and medication in the years since 2006 despite the Winterbourne View scandal and evidence that there are more humane ways to support people with this type of challenging behaviour and mental ill health.
Progress in discharge planning?
The study also highlights how few Service Users have a discharge plan in place, despite the advice that such plans should be part of the process of care from admission. Many were subject to delayed discharge and others deemed not suitable for discharge. This suggests that hospital admission is not being used for treatment but as a means of containment for many people with learning disabilities and additional challenging needs.
The Census was commissioned as a direct response to the findings of the report into abuse at Winterbourne View in 2011. It is depressing reading how short a distance we have travelled toward alternatives to restrictive environments and practices for these vulnerable Service Users.