Care Quality Commission
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One year on from Out of Sight – what’s changed?

In our Out of sight – who cares? report, published in October last year we made recommendations to support changes in care for people with a learning disability, autistic people, and people with mental ill health.

We yesterday published a progress report to highlight what has been achieved so far and which areas need more focus since the recommendations made in the 2020 Out of sight – who cares? Restraint, segregation and seclusion review.

Key findings:

  • The health and care system has taken action to understand the needs of people with a learning disability and autistic people in inpatient units
  • It has also made a commitment to increase the range of community support available to help prevent hospital admissions


  • The commitment around increasing community support needs to be converted into real change
  • Commissioning the right support and services for people with a learning disability and autistic people is not happening quickly enough
  • People are still being placed in services which are not able to give them the right care

Overall, we found that more progress must be made in reducing restraint, segregation and seclusion and the fundamental change in approach needed to tackle this has not yet been translated into care settings. We also found that COVID-19 has had an undoubtable effect on delaying progress in this area.

CQC Deputy Chief Inspector for people with a learning disability and autistic people, Debbie Ivanova yesterday said:

“It is vitally important that all people are treated with dignity at all times and while some welcome progress has been made, more still must be done.

“A year on from our report’s findings, we still find that too many people are being subjected to overly restrictive practices and inappropriate use of long-term segregation. Not enough people are getting the support and care they are entitled to, delivered in a way that demonstrates respect.

“This year the Mental Health Act white paper made several recommendations to improve the way people with learning disabilities and autism are treated, so we will work closely with the sector on the best ways this can be delivered.

“We will continue to encourage improvements through our reports like Out of Sight, so that people with learning disabilities, autism or mental ill health are not forgotten and real change is achieved.”

CQC Deputy Chief Inspector of Hospitals and lead for mental health, Jemima Burnage yesterday said:

“There has been a great deal of work to improve people’s experience of care despite challenging circumstances, but this report shows that, sadly people are still being placed in services which are not able to give them the right care.

“We are continuing to take enforcement action where this is necessary but a fundamental change is needed to address inappropriate restrictive practices.

“We welcome the ambition of the sector to deliver change but this must be met with a better range of higher quality services now. Without coordinated action and a whole systems approach, that utilises the breadth of expertise available across the sector, we risk missing an opportunity to deliver real change for people with learning disabilities, autism and a mental ill health.”

CQC has agreed to publish a fuller report, looking at each of the recommendations, in Spring 2022.


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