National Preventive Mechanism Third Annual Report 2011–12 During one inspection, RQIA found that voluntary patients with learning disabilities were deprived of their liberty because their ward was kept locked. In addition, staff were regularly restraining patients and doing so without training or adequate procedural guidance. The patients experienced infrequent family contact and there was minimal input from independent advocacy services. RQIA found there were few safeguards to promote the rights of patients: their rights to liberty, protection, autonomy and dignity were significantly compromised. In contrast, RQIA identified good practice in a regional intensive care unit for adults with learning disabilities. It found evidence of regular accredited training for staff, and a commitment to detailed recording and auditing of each incident involving the use of force and restraint. Police custody Police custody throughout the UK is monitored at two levels – by a professional inspectorate and by independent custody visitors. In 2011–12, HMIC and HMIP continued their joint inspection programme of police custody facilities in England and Wales. These inspections include an assessment of the use and governance of restraint. Generally, HMIC/HMIP observed good use of de-escalation techniques, which minimised the need to use restraint. Where restraint was used, it was done so proportionately, and staff continued to communicate with detainees to explain what was happening with the aim of de-escalating the situation as quickly as possible. 24 However, there were variations in practice. In Nottinghamshire, inspectors met police officers who said they would only use handcuffs when it was proportionate and necessary. This was borne out by an analysis of custody records, which showed few detainees arriving at custody suites in handcuffs. In contrast, in Northumbria, staff told inspectors that it was the police force’s policy that everyone arrested should be handcuffed. Many police officers said they would do this regardless of the alleged offence or the extent to which the arrested person was compliant. This approach resulted in children, pregnant women and compliant detainees being handcuffed. While individual uses of force were noted in detainees’ custody records, a repeated recommendation was that the police force should collate use of force data. Without data, the force was prevented from identifying trends in the use of force to help inform future policy, practice and training. This failure to collate data follows on from the removal of a Home Office requirement for police forces to submit monthly use of force returns. It is, therefore, difficult to make comparisons between police forces or to construct a national picture of how force is used in police custody. In light of this, the Ministerial Board on Deaths in Custody invited the Independent Custody Visiting Association (ICVA) to monitor the use of force in police custody by examining individual custody records. Custody visitors were due to carry out this work in 2012–13 and present their findings to the Ministerial Board in 2013. They will look at the type of force used, its duration and the point at which it was used during the detention process, the provision of medical treatment following the use of force, and the recording of the incident.