PRICE – review of “CQC – State of health care and adult social care in England 2025/26”

(Focus on restrictive practices – Care Quality Commission) by Jim Ridley.

October 2026 saw the release of the Care Quality Commission’s “State of Care Report 2025/26” which is a summary view of activities completed by the care regulator related to a number of activities and services that they have responsibility for reviewing and regulating.

As part of this report they offer feedback and commentary on restrictive practice(s) and offer summary comments related to their use. As to be expected they have identified that the focus on the use of restrictive practice(s) goes beyond the use of restraint, seclusion and segregation offering examples of approaches which would likely fall into the category of psychological or coercive practice. Examples being given including the use of wheelchair’s when people can mobilise or using “bibs” when someone is eating their meal. Restrictive practice(s) of any nature can have a significant and devastating physical, emotional and psychological impact on the individual exposing them either to traumatic experiences or retraumatising experiences. Of course this also has the increasing potential for those individuals to experience activities that may breach their human rights. Also making the point that everyone working in health and social care have a role to play in the active reduction of restrictive practices and their use.

CQC have identified that their expectations of how this should be achieved is by supporting relational support that promotes positive cultures that establish and support trust, safety and wellbeing alongside the processes used to enable individuals to recover. Enabling those around the individual to support experiences that help re-establish, or maintain a positive quality of life that is meaningful to them. However, this report does acknowledge that although there has been some reductions in those experiencing seclusion and long term segregation the overall use of restrictive practice(s) continues to be at a level that needs further support and scrutiny to support the commitments to rights based approaches and least restrictive practices.

At PRICE training we take our commitments to protecting people’s rights and the least restrictive practice to every level of what we do and our very name is based on the following principles of Protecting Rights In Care Environments. As such we recognise the diversity of health and social care services and ensure that when we are offering learning and development or direct consultancy that we do so with our principles at the forefront of everything we do. When reviewing the state of care report related to restrictive practice(s) it seemed important to consider how we at PRICE training respond to some of the key themes identified in the report and their findings related to restraint, seclusion and segregation.

Assessing people’s requirements – emphasis is made in the report about understanding people’s experiences and requirements. This is such an important factor to be considered as it can have a significant influence both on the individual and their responses to staff as well as to the environment. We acknowledge the importance of “Knowing” and ensuring that those we support and those who are offering support recognise that although this may sit in the context of primary interventions it’s also about “seeing the person”. It’s important to be able to respond to the individual in ways that are meaningful to them, periods of distress can be all consuming, confusing and scary. So, knowing what supports the individual can be the important anchor point that can support the individual to reduce their distress, or enable them to have a “Bad day” with a system of support that is safe for them as it is guided by them.

Staffing – as a provider of training and learning we certainly can recognise the importance of having supporters that have the skills and knowledge which enables them to meet the needs of those that they support. We know this is far beyond just being able to offer techniques that can be used, rather we maximise our focus on supporting the skills and knowledge of those responding so that they are empowered and offer the practical support that can enable the individual to maintain their safety and return to a place that is meaningful to them.

Environment – this is something that we tend to have less control over as we aren’t offering services, however that doesn’t mean that we don’t make clear reference to the impact environment can have on individuals and those who offer support. Environment should be seen holistically, focusing on both the external environment but also the individual’s internal environment. Both of these can offer supportive approaches that can reduce or even eliminate someone’s distress as they are able to meet their needs, as such we recognise the importance of the environment and our influences on it!

Discharge planning – although this is referenced in the report it is once again something that we have limited influence on, however if we are supporting those, we teach to recognise the importance of “me” and protecting my rights then moving forward is more likely to be successful. Our learning about how and when to support an individual can be such an important part of that individuals journey; so, we make sure that the “learning” we provide in our classrooms makes it clear that “learning” is not a onetime thing and that if we invest in our learning and share that investment with those we support then their journey will be strengthened.

PRICE training has reviewed the report and considered the themes related to restrictive practices and we completely support the focus and the commitment to reducing restrictive practices. As an organisation who is working within the health and social care sector then being able to reflect and learn from those we support and the expectations of them supports our commitments to our core principles and fundamentally the very nature of who we are and what we do – Protecting Rights In Care Environments.