Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what systems and controls are in place for recording, monitoring and oversight of the use of force and restraint against children receiving psychiatric in-patient care.

The Department does not currently collect data on restraint.

The Department is planning on categorising physical restraint as a patient safety incident. All incidents of restraint against children receiving psychiatric in-patient care will need to be reported to the National Reporting and Learning System.

Mental Health Commissioners visit patients detained under the Mental Health Act, including children and review all aspects of their care including restraint.

Plans for the monitoring and oversight of restraint in psychiatric in-patient services will form part of the Care Quality Commission's (CQC's) new inspection approach for all hospitals. The CQC is currently consulting on its handbooks for all sectors and has set out its planned approach to assessing services against five questions: Are they safe? Are they effective? Are they caring? Are they responsive? Are they well-led? Restraint will be reviewed in services against the question of whether the service is safe and the CQC is developing guidance for both providers and inspection teams that will draw upon good practice guidance and tools. For children's psychiatric services specifically, this would require specific key lines of enquiry to be used.

The CQC is planning to work with NHS Confederation to look at how the CQC expects providers to implement the guidance as set out in Positive and Safe and how this will be used in our monitoring and oversight approaches. Positive and Safe is a two year programme with the principal aim to radically reduce all restrictive interventions, including ending the deliberate use of face down restraint and – outside the Mental Health Act – seclusion. The work group will be preparing guidance on restraint in the light of Positive and Safe and using this to inform CQC tools and inspection methodology. The CQC always considers providers' approaches to restraint when carrying out comprehensive inspections. Mental Health Act monitoring visits to inpatient units will also look at individual concerns relating to restraint practices. The methodology for all reviews and inspections which the CQC carries out is informed by the available guidance and the Mental Health Act Code of Practice.