Rabab, Sana, Tomlin, Jack ORCID: https://orcid.org/0000-0002-7610-7918, Huband, Nick and Völlm, Birgit (2020) Care Quality Commission inspections of high-security hospitals. The Journal of Forensic Practice, 22 (2). pp. 83-96. ISSN 2050-8794 (doi:10.1108/jfp-09-2019-0044)

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Abstract

Purpose
Patients detained in high-security psychiatric hospitals are particularly vulnerable to excessive restrictions and exploitation. In the UK, the care quality commission (CQC) monitors and regulates forensic healthcare provision. The purpose of this study is to identify key concerns highlighted in CQC inspection reports of the three high-secure hospitals in England between 2010 and 2018.
Design/methodology/approach
In this qualitative study, 49 CQC inspection reports from three high-secure hospitals were subjected to thematic analysis.
Findings
Five central themes emerged: staffing and management; restrictive practice; physical environment and ward atmosphere; patients’ needs and involvement in their care; and legal and statutory matters. There was some variation in the overall quality of care between the hospitals. Positive staff–patient interactions and good practice in assessing and delivering care were consistently observed. However, enduring staff shortages within each hospital were experienced negatively and sometimes co-occurred with concerns over restrictive practices, poor care-plan procedure and inadequate legal documentation. Over time, Rampton and Broadmoor Hospitals appeared to worsen with regard to staffing levels, staff morale and management involvement. While services progressed over time in providing patients with access to advocacy and information concerning their rights, in some recent inspections it remained unclear whether patients were adequately involved in the care-plan process.
Practical implications
These findings provide preliminary indicators for areas requiring further attention from policymakers, clinicians and advocates.
Originality/value
This study appears to be the first systematic analysis of key concerns expressed in CQC reports of English high-security hospitals.

Item Type:	Article
Additional Information:	Publisher: Emerald Publishing Limited Copyright © 2020, Emerald Publishing Limited
Uncontrolled Keywords:	high-security hospitals; quality of care; care quality commission; forensic; mental health; inspection reports
Subjects:	K Law > K Law (General) R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine
Faculty / School / Research Centre / Research Group:	Faculty of Liberal Arts & Sciences Faculty of Liberal Arts & Sciences > School of Law & Criminology (LAC)
Last Modified:	01 Mar 2023 09:37
URI:	http://gala.gre.ac.uk/id/eprint/38127

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