Learning disability services are faring worse than other services, the Care Quality Commission’s (CQC) State of Care report has found.

The CQC’s report found that only 76% of NHS mental health, learning disability and substance misuse services met the CQC’s standard for care and welfare issues (254 inspections)

When looking specifically at NHS, independent healthcare and adult social care services for people with a learning disability the main concerns in relation to this standard (across all care settings) related to care planning (38%), meaning that people with learning disabilities and their families were not involved in the design of the care and therefore not in control of their own needs – a lack of person-centred planning was a significant feature.

Elsewhere, 91% of NHS hospitals and 86% of NHS mental health, learning disability and substance misuse services were treating people with dignity and respect.

The CQC report also highlighted a range of concerns about the enduring use of restrictive practices in services for people with mental health and/or mental capacity problems, including physical restraint, seclusion or segregation and ‘blanket rules’ governing life in a ward, unit or care home.

Dr Andrew McCulloch, chief executive at the Mental Health Foundation, welcomed the CQC’s report, but added that serious concerns remain. “It is totally unacceptable that the poorest overall performance is found in mental health and learning disability services, especially at a time when the Government has committed itself to parity of esteem between mental and physical health.

“The report highlights particular problems in mental health and learning disability services around medication management, safeguarding and a lack of patient involvement in care planning. This is especially disappointing given all the attention being given to these issues currently, and it is essential that the Commissioning Board gives these urgent attention as it starts its work. It is clear that currently vulnerable patients are facing unnecessary and unacceptable risks. Unless action is taken further scandals will be inevitable.

“A key part of this is a staff selection and training issue and ensuring that staff are aware of issues surrounding both mental health and mental capacity. We are therefore pleased that one of CQC’s six proposed priorities for the future is to strengthen the delivery of its responsibilities on mental health and mental capacity.”

David Behan, chief executive of the CQC, said: “Our report highlights concerns we have that pressures on some services are leading to problems in the quality of care, keeping people safe, treating people with dignity and respect, and involving people in decisions about their own care. These pressures cannot be used as an excuse to deliver poor care.”