National Preventive Mechanism Eighth Annual Report 2016–17 However, Cedars was closed during the year, reportedly due to relatively low use and high maintenance costs, and NPM members noted concerns about achieving the same standards for families and children in other facilities.38 Health and social care detentions Detentions in England under the MHA were estimated to have risen by 2% from the previous year.39 Detentions under the MHA have risen continuously for a number of years, and in 2015–16 reached 63,622, a 47% increase from 2005–06 and the highest figure reported during that 10-year period.40 Inspections by CQC of England’s three high secure hospitals during the year highlighted concerns about a shortage of nurses at Broadmoor and Rampton Hospitals, which it considered potentially put patients at risk at Broadmoor. Staff at Broadmoor and Rampton Hospitals did not adhere to guidance in the MHA Code of Practice on monitoring and reviewing seclusion and long-term segregation. All three hospitals applied ‘night-time confinement’ (a decision to lock patients in their room overnight, unrelated to the patient’s behaviour or risk assessment). At Broadmoor and Rampton Hospitals, patients were subject to night-time confinement and, because of staff shortages, had restricted access to therapies and leisure activities during the day. CQC raised concerns with the Secretary of State that this was contrary to government guidance that night-time confinement should only be used where it ‘will maximise therapeutic benefit for patients […] for example, confining a group of patients at night may release staff to facilitate greater therapeutic input for patients during the day.’41 The trend of increased detentions under mental health powers was also evident in Scotland and Wales. In Wales, during the year 2015–16, there was a 4% increase in the number of formal admissions under the MHA and other legislation to 2,001.42 Two new mental health hospitals able to admit detained patients were registered during the year, the first such registrations in Wales in a number of years. There was a rise in the number of episodes of compulsory detention under Mental Health (Care and Treatment) (Scotland) Act 2003 in Scotland during 2016–17. The number of emergency detention certificates completed rose to 2,458, an increase of 12% from the previous 38. HM Inspectorate of Prisons, 2017, HM Chief Inspector of Prisons for England and Wales Annual Report 2016–17, https://www.justiceinspectorates.gov.uk/hmiprisons/wp-content/uploads/sites/4/2017/07/HMIP-AR_2016-17_ CONTENT_11-07-17-WEB.pdf [accessed 22/08/17]. 39. NHS Digital, 2017, Mental Health Act Statistics, Annual Figures: 2016–17, Experimental statistics, http://digital.nhs.uk/ catalogue/PUB30105 [accessed 10/09/2017]. Due to a change in the way these statistics are sourced and produced and to incomplete data, this is an estimate only and figures are not comparable to previous years. The statistics note that ‘45,864 new detentions were recorded in 2016/17 and 4,966 new Community Treatment Orders (CTOs), but the overall national totals will be higher as not all providers submitted data. For the subset of providers that submitted good quality detentions data in both 2015/16 and 2016/17, we estimate there was an increase in detentions of around 2 per cent from last year’. 40. NHS Digital, 2016, Inpatients formally detained in hospitals under the Mental Health Act 1983, and patients subject to supervised community treatment, http://www.content.digital.nhs.uk/catalogue/PUB22571/inp-det-m-h-a-1983-sup-comeng-15-16-rep.pdf [accessed 23/08/17]. 41. Care Quality Commission, 2017, West London Mental Health NHS Trust: Quality Report, http://www.cqc.org.uk/sites/ default/files/new_reports/AAAF9938.pdf [accessed 10/10/2017]; Mersey Care NHS Foundation Trust High Secure Services: Ashworth Hospital: Quality Report, http://www.cqc.org.uk/sites/default/files/new_reports/AAAG3922. pdf [accessed 10/10/2017]; Nottinghamshire Healthcare NHS Foundation Trust: Forensic inpatient/secure wards: Quality Report, http://www.cqc.org.uk/sites/default/files/new_reports/AAAG2258.pdf [accessed 10/10/2017]. 42. Statistics for Wales, 2016, Admission of patients to mental health facilities in Wales, 2015–16, http://gov.wales/docs/ statistics/2016/160831-admission-patients-mental-health-facilities-2015-16-en.pdf [accessed 23/08/17]. 20