The CQC has recently published its third annual report on Monitoring the Mental Health Act entitled Monitoring the Mental Health Act in 2012, based on the findings of visits to wards by its Mental Health Act Commissioners.
In summary, the CQC found some overall improvements and for the first time the report names providers where good practices have been identified. However, many of the concerns highlighted in previous reports remain and these include concerns in relation to:
- Care planning – concerns include that in over half of the care plans reviewed by the CQC there was no evidence that the patient had received a copy of their individual plan, and in over a third of cases there was no evidence of discharge planning, which is considered a serious failure by the CQC
- Consent to treatment – in CQC’s examination of 2500 records, 45 per cent showed no evidence of consent to treatment discussions taking place before the first administration of medication
Two key trends identified by the report are:
- The number of people subject to detention under the Mental Health Act is increasing. In total there were 48,631 detentions under the Act for assessment and/or treatment in hospital in 2011/12, an increase of five per cent on the preceding 12 months. There was also an increase of ten per cent in the number of patients made subject to community treatment orders. The report, however, notes a number of signs that services are under pressure.
- There has been an increase in the use of section 2 and a consequent decrease in the use of section 3. The report suggests that this may in part be due to the influence of the advice in the Mental Health Act manual that patients whose mental health means that they require detention should be assessed, however well known they may be to the mental health service.
In drawing its conclusions, the CQC indicates its intention to focus future visits on the areas of required improvement highlighted in the report. Providers can therefore expect greater scrutiny of care plans and issues around capacity and consent.