Inside CQC: An update on the ‘Out of Sight’ report and use of restrictive measures

Debbie Ivanova, Director for People with a learning disability and autistic people at the (CQC), updates on the progress relating to the ‘Out of Sight’ report and shares the regulator’s recommendations on reviewing the use of restrictive measures.

Over the past two years, we’ve seen the world change immensely as a result of the pandemic.

Marie Curie held its day of reflection on Wednesday 23rd March, for people to connect and reflect on our experiences, supporting millions of people grieving in such challenging times. I want to thank care workers, particularly those working in services for people with a learning disability and autistic people. My colleagues and I have seen how you’ve found creative ways to keep people connected to their loved ones and communities during the pandemic.

It is essential that people, their families and carers are at the centre of care planning, so they can be supported to live fulfilling lives in the way they choose.

Out of Sight

CQC has been concerned about restrictive interventions in mental health and social care settings for some time. Restrictive interventions include restraint, seclusion and segregation. In 2018, the Secretary of State commissioned CQC to review the use of restrictive measures. We looked at this across health and social care, Government, commissioning, local authorities and public services. In 2020, we published our first ‘Out of Sight’ report, with recommendations.

Last month, we published our latest ‘Out of Sight’ progress report, which found that not enough has been made since 2020. There are still too many people in hospital unnecessarily and too many people are subject to restrictive interventions. People continue to face challenges with getting the support they need in the community. Moreover, there are still too many people in mental health inpatient services who often stay too long and do not experience therapeutic care.

All this results in further trauma and ill health and further upset for their families and advocates. This must change.

CQC guidance

We’ve outlined the part CQC can play in making this change happen; recommendation six focuses on improvements to how CQC regulates services for people with a learning disability and autistic people. We’re doing this by ensuring inspectors focus on specific areas that are particularly relevant to people with a learning disability and autistic people on inspection. We’re developing new tools and approaches to assess, monitor and inspect providers from registration onwards. We’re using our guidance, ‘Right Support, Right Care, Right Culture’, as the fundamental basis for benchmarking that providers should use when setting up services for people with a learning disability and autistic people.

In addition, we are working to improve our regulation of community health services and mental health services. And we’re exploring the way we listen to advocates.

Finding the right home and support

People are coming together to make these changes but more urgency is needed. The Building the Right Support Delivery Board, led by Gillian Keegan, Minister of State for Care and Mental Health, is responsible for making the changes happen. Organisations like the British Association of Social Workers have helpful resources like Homes not Hospitals, which helps commissioners to develop more community services and, ultimately, aims to close some inpatient facilities.

Supported Living Coalition

Supporting people with a learning disability and autistic people to find the right home is essential because this extends to supporting them being a citizen in their community and having ownership of their lives. In my last column, I spoke about the Supported Living Coalition, which is a CQC action group that aims to be led by people with experience of supported living services. The actions from the group are taken forward by providers, local authorities, housing associations and other key partners. This Coalition continues to meet regularly to explore key themes and understand what can be done to, ultimately, improve services for people.

We would like more people with current or past experience of living in these services to join the Supported Living Improvement Coalition. If you would like to join the group or have consent from someone who is relevant and can advocate on their behalf, we want to hear from you. Contact CQC by email at

Related Content

Inside CQC: Supported Living and Integrated Care Systems

Into Perspective: Mental health and wellbeing plan

Inside CQC: Inspections, feedback and other upcoming priorities

Into perspective: Safeguarding for adults with learning disabilities

Inside CQC: Debbie Ivanova

Inside CQC: Debbie Ivanova

Notify of
Inline Feedbacks
View all comments

Caring for Care Workers. Donate to The Care Workers’ Charity and make a difference Donate