Section Four National Preventive Mechanism member profiles Impact of NPM membership Since being designated as a member of the UK’s NPM, RQIA has adopted a human rights-based approach to its work. As a result, international human rights law and jurisprudence are considered in the inspection of health and social care services in Northern Ireland and training on OPCAT has been delivered to its staff. RQIA has worked with leading international human rights experts to develop expectation statements and indicators for inspection which are focused on outcomes for detainees and other service users. The use of these indicators during inspections has already resulted in changes such as the introduction of locks on toilet doors for some patients, increased access to fresh air and improved legal rights. Summary of activities and key issues In 2009–10, RQIA visited 28 mental health facilities across Northern Ireland, including all such facilities providing services to children. These mental health facilities hold a mixture of detained and non-detained patients. Key requirements identified during these visits included: • more accessible information for patients on their rights • improved access to advocacy services • a greater involvement of patients in their care plans • a greater emphasis on patient privacy, for example, during showering or visits. RQIA also visited a number of institutions providing residential care to people with learning disabilities. The majority of people cared for in these institutions are not detained under any lawful order, yet RQIA noted during some visits that entrances and exits were locked. RQIA visited all 53 children’s homes in Northern Ireland, including one providing secure accommodation for young people aged 13 to 17. As a result of this visit, RQIA expressed concerns about the use of physical restraint and the failure to record routinely the duration of restraint or any resulting injuries. RQIA also noted that some records indicated a lack of clarity over what constitutes restraint, why such physical intervention was necessary and whether it had been effective. During 2009–10, RQIA carried out fieldwork for the inspection of Magilligan prison in association with CJINI and HMIP. It also contributed to CJINI’s first inspection of police custody in Northern Ireland. Looking forward In the coming year, RQIA will roll out an inspection programme for inpatient mental health and learning disability facilities. It will continue work begun in 2009–10 on examining the experiences of children in secure accommodation and will develop a strategy for monitoring health and social care in prisons. Like most other members of the NPM, RQIA will continue its work while facing a reduction in its funding. 59