CQC Report – Monitoring the Mental Health Act

Care Quality Commission have published their annual report, Monitoring the Mental Health Act 2015/16, which reviews and understands the experience and effects of care provided for individual patients, setting out key findings from CQC’s work. It acts as both an account of their activity to Parliament and an outline of the important issues and concerns they heard from patients about their day-to-day experience when subject to the Mental Health Act [MHA].

The Mental Health Act 1983, a legal framework, provides authority for hospitals to detain and treat people who have a serious mental disorder and who are putting at risk their health or safety, or the safety of other people. The MHA also provides more limited community-based powers, called community treatment orders and guardianships. CQC’s role is to check that patients’ human rights are being protected, and look at how services in England are applying the MHA safeguards through visits to see how mental health services are supporting patients, make sure providers have effective systems and processes to meet the MHA, and check that staff are being supported to understand and meet the standards set out in the Code.

The report finds that in 2015/16 managers and staff were not receiving the support to understand and meet the requirements of the MHA and the recommendations of its Code of Practice. Throughout their monitoring visits and inspections, CQC found many examples of good practice, and met hundreds of dedicated staff who provide the best support and treatment for their patients. However, good practice is not consistent across the country. Published earlier this year, the State of Care Report found inpatient mental health services performed less well in general than community-based services. Some services are not meeting the expectations of the Code of Practice, leading to variation in the quality of care for people detained under the MHA.

In 2015/16, CQC found little or no improvement in some areas that directly affect patients, their families and carers and it was clear that some providers were not doing enough to implement the revised Code of Practice or inform patients of their rights. The report finds that there is an urgency for change, with more needing to be done by all stakeholders – providers, commissioners, national bodies and regulators – to ensure people receive high-quality and effective care and treatment under the MHA. The report suggests that providers need to do more to ensure that the MHA is properly applied, and that this supports better care of people detained under the Act, and services should focus on improving their oversight of the MHA safeguards for patients.

Kathy Roberts, Chief Executive of MHPF, commented:

“It is a challenging environment for mental health services and mental health funding is limited at the moment. We are pleased to see that there is good practice in many different types of mental health inpatient units but the high degree of variability in care being provided is of concern as is the lack of improvement in areas that directly affect patients. In challenging times, it is important for providers, commissioners, and national bodies to work closely with the voluntary sector to ensure people are receiving appropriate care and treatment under the MHA, services which are of a high-quality and are effective. The voluntary sector does not just have a vital role to play in the delivery of services but is a crucial planning partner, and it is important a partnership is developed and utilised between the voluntary organisations, NHS Trusts, providers and commissioners.”