Debbie Ivanova’s blog
Why lived experience is fundamental to understanding restrictive practices
Debbie Ivanova, Deputy Chief Inspector of Adult Social Care updates on our restraint, seclusion and segregation in hospitals and care services work.
We are now in phase two of the review which is looking at restrictive interventions in adult social care services, mental health rehabilitation and low secure hospitals, and some children’s residential services. The visits in phase two will go on until the end of October and the team will be visiting approximately 40 services.
My background is primarily in social care and in particular working with people with learning disabilities, and that’s why I will be leading the work in phase two, as most of the services we are visiting are in social care settings. Lived experience is central to how we understand and how we improve care. People who use services can tell us what they want from their care and help us to design and shape the services that they need. This must include how to best to support people when they are in crisis or things are not going well for them.
Visits are only one part of the thematic review, and a crucial part is gathering the views of families, carers and people who use services. So far, we’ve held two expert advisory meetings to gather challenge and feedback and two workshops to gather experiences. We’re holding more of these events in the autumn so please look out for details on our @CareQualityComm twitter page.
Lived experience is central to how we understand and how we improve care.
We know that we need to do more, especially to reach people that may not know about our work. People have told us that issues like restraint, segregation and seclusion are difficult to talk about and can be traumatic for those that have experienced these practices first hand. They can evoke strong emotions and can trigger the experience all over again.
That’s why we’re working with CHANGE people, a learning disability charity, and Advonet, a mental health organisation, to gather views from people that might be hard to reach — as we know that sometimes face to face events aren’t easy and accessible for everyone.
People must be given a choice of how they can contribute. At an event hosted by CHANGE and Advonet in Leeds a few weeks ago we asked people with lived experience to help us plan how best to involve people that aren’t already engaged. They suggested some people might prefer to speak on the phone or write down their experiences, some suggested having a family member there to support them might help too. Because of this, an accessible survey will be developed, and people will be given a choice of how to be involved, either online or in person.
People must be given a choice of how they can contribute.
As we’ve already mentioned, we know very little about how, and how extensively, staff in social care services use restrictive interventions. There’s a lack of centrally collected data in this area, and staff may have less access to advice and support than in hospital settings. However, that doesn’t mean we can’t do more to find how restraint, segregation and seclusion are being used in these services, and gathering the views of people with lived experience is an important way of us building a better picture.
That’s why I am personally committed to ensuring the voice of people who use services is at the forefront of our work, final report and recommendations. Only through working together can we bring about real change.