RRN responds to Muckamore Abbey Hospital inquiry findings

The findings of a long-running public inquiry into the historic abuse of patients at Muckamore Abbey Hospital, County Antrim, were published yesterday.

Drawing on the harrowing experiences of people with learning disabilities, autistic people, people experiencing mental health difficulties and their families, the inquiry found that patients were subject to preventable abuse and bullying, by certain staff trusted to care for them and keep them safe.

The RRN is shocked by the accounts within the report, describing repeated inappropriate misuse of restrictive practices including the frequent misuse of physical restraint, routine use of seclusion, and overuse of medication (chemical restraint).

The misuse of restrictive practices at Muckamore is an indicator of a toxic, closed culture, and a failure to meet the needs of people accessing support. Over time, the use of restrictive practices became normalised, and was rarely questioned, with no analysis of patterns that might indicate abuse was taking place, meaning warning signs were not acted on.

Restraint is, by its nature, traumatic. It can and does cause physical and psychological harm. While in some exceptional circumstances restraint can be lawful and lifesaving, we should seek to eliminate its use except to prevent serious and imminent harm.

There is clear evidence that proactive, rights respecting approaches such as the Merseycare HOPE(s) model can eliminate the misuse of restrictive practices and create environments where people feel safe, supported and cared for. Skills for Care states the need for staff to be skilled in trauma informed care, capable environments, active support and Practice Leadership. Investing in good Practice Leadership strengthens culture and creates the conditions where good support is more likely to happen, more consistently.

The RRN champions the Six Core Strategies of restraint reduction; leadership, data, workforce development, preventative strategies, involvement of people with lived experience and post incident debriefing, to eliminate the use of restraint and prevent toxic cultures. The report recommends that action is needed to ensure these principles are fully embedded within services, policies, and practices.

Ben Higgins, RRN CEO, said:

“RRN is deeply concerned by the report’s findings. Hospitals should be places of safety. It is simply unacceptable that vulnerable people’s rights were abused every day through normalised restrictive practices and abuse by those responsible for their care.

We welcome the inquiry’s recommendations, including the need for a whole-system commitment to reducing the use of restraint, prioritisation of post incident learning, regular audits on the use of medication and the assertion that the use of seclusion should be an ‘exceptional event’.

It is vital that immediate steps are taken to address and implement these recommendations to prevent yet another national scandal such as the abuse uncovered at Muckamore.”

Read the full report and Easy Read Executive Summary.

A recording of the summary of findings and recommendations is also available here.