Skills gaps drive deterioration in mental healthcare for adults with learning disabilities or autism –

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Skills gaps and capacity shortages have driven a deterioration in mental healthcare in hospitals for adults with learning disabilities or autism, the Care Quality Commission has found.

Too many staff in these services lack the skills, training, experience or clinical support to care for people with complex needs, the regulator said in its annual report on the state of health and social care, published today.

The problem has been exacerbated by falls in the number of mental health beds, apparently without compensatory increases in community support, limiting access to care, the CQC said.

Deterioration inpatient mental healthcare

The CQC said the quality of mental health inpatient care had deteriorated, with 6% of acute wards for adults rated inadequate in 2019, compared with 2% in 2018, and 4% of wards for adults with learning disabilities or autism carrying the lowest rating in 2019, up from 1% in 2018.

In relation to the latter group, the regulator raised particular concerns about independent providers, having rated 14 independent mental health hospitals that admitted people with autism or learning disabilities as inadequate since October 2018, putting them into special measures. Though two of these services have since improved, three are closed and one, though still registered, is closed to new admissions with on existing people resident.

The regulator said that staffing problems and skills shortages were significant factors. This included a lack of registered learning disability nurses leading to high reliance on healthcare assistants or other non-qualified staff, inadequate training, and high use of agency staff, which increased administrative duties for permanent workers, leaving them less time for patient care. Among mental health nurses, the numbers working in inpatient settings fell by 15% from 2014-19, though the numbers working in community mental health rose by a similar proportion.

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