National health and care standards: consultation analysis

9. Views on proposed Standard 6: And where my liberty is restricted by law

Question 8: To what extent do you think this Standard describes what people should expect to experience from health, care and social work services?

9.1 373 (85%) respondents to the full consultation and 47 (80%) respondents to the easy-read consultation answered this question.

9.2 Table 8 in Annex 1 shows views by category of respondent to the full consultation. Table 9.1 below summarises these views.

Table 9.1: Views on the extent to which Standard 6 describes what people should expect to experience from health, care and social work services: full consultation

*Percentages may not total 100% exactly due to rounding.

9.3 77% of those who provided a view strongly agreed or agreed that Standard 6 describes what people should expect to experience from health, care and social work services. Individual respondents expressed stronger support than organisations with 36% of the former, compared with 28% of the latter, strongly agreeing with the statement. Relatively few (5%) respondents disagreed.

9.4 All of the Early Years and Childcare Services respondents who expressed a view strongly agreed or agreed that Standard 6 describes what people should expect to experience from health, are and social work services; the two statutory bodies who provided a view disagreed. Other categories of respondent were more mixed in views.

9.5 Views of those responding to the easy-read version of the consultation are summarised in Table 9.2 below.

Table 9.2: Views on the extent to which Standard 6 describes what people should expect to experience from health, care and social work services: easy-read consultation

9.6 All but one respondent who answered this question in the easy-read version of the consultation agreed a bit or agreed fully with Standard 5.

General views in favour of Standard 6

9.7 A few respondents expressed general views in support of Standard 6. What was perceived to be its strong focus on human rights was particularly welcomed as a basis for assisting in balancing issues of risks, whilst ensuring individual rights are respected.

9.8 Respondents considered that the Standard captured the role which restrictions play in ensuring security and wellbeing of the individual, underpinned by compassion, dignity and respect.

Broad concerns about Standard 6

9.9 The most common concern regarding Standard 6 was over the words "by law" in the Standard heading. A recurring view was that the Standard should apply to settings where liberty is restricted but not only on account of law, but due to other factors, such as safety and security of the individual. Respondents considered that the current wording is too narrow in focus, and should be amended to ensure wider applicability to settings such as mental health secure facilities. Alternative wording was suggested such as "And where my independence, choice or control is restricted", or simply, "And where my liberty is restricted".

9.10 Questions were raised over why this Standard does not include one of the key Principles, "Responsive care and support", with respondents suggesting that the reason for this should be made explicit.

9.11 There were some mixed views on whether the Standard should be separate, as a stand-alone, or mainstreamed into the other Standards. A key argument in favour of mainstreaming was that human rights should underpin all care provision rather than be associated only with settings where liberty is restricted by law. Others, however, welcomed the prominence given to human rights issues in a dedicated Standard.

9.12 A few respondents expressed concern that the Standard did not appear to reference wider, relevant legislative contexts such as mental health legislation, and requested reassurance of compatibility and alignment.

9.13 A recurring theme was that the Standard merited more discussion, consultation and detail to give it greater depth and relevance.

Summary of comments relating to each descriptive statement

9.14 More detailed comments were made relating to individual descriptive statements and are summarised in Annex 2, Table 6.

Views on omissions from the Standard

9.15 The main omissions suggested were:

• Explicit reference to recording and reviewing actions taken in the context of deploying restraint and sanctions.
• Right to independent advocacy.
• Right to access healthcare such as specialist dental care; optician.
• Rights of staff to be protected from harm.
• Requirements of staff to be fully aware of the law and understand the circumstances in which restraint is valid.
• Clarity on whether the Standard applies equally to children, young people, and older adults.
• How to deal with conflict in views and consent amongst family/individual/care providers.
• Providing for transitions between restricted liberty and liberty. Joined-up care.
• Maintaining and building relationships with family, friends and the wider community.
• In the specific context of restricted liberty, ensuring that communications' challenges are addressed and support is provided ( e.g. deaf prisoners; people whose first language is not English).