National Preventive Mechanism Tenth Annual Report 2018–19 international law. Its recommendation has now been recognised and progress on what practical alternative arrangements can be made are underway. • CQC also raised, with government officials, the legal problems relating to the discharge of patients from detention in hospital under the Mental Health Act into environments, such as adult social care homes, where they continue to be deprived of liberty under the Act. The Supreme Court’s ruling on this matter in the MM case this year (Secretary of State for Justice v MM [2018] UKSC 60) suggests that some changes to the statute may be helpful to ensure that legal hurdles do not prevent patients from being cared for in the least restrictive environment available. The UK Supreme Court heard the case of the Secretary of State for Justice v MM in July 2018, and gave judgement on 28 November 2018. The case concerned a patient, MM, who was detained in a hospital under section 37 of the Mental Health Act, together with a restriction order under section 41. MM applied to the First-tier Tribunal (FfT) for a conditional discharge from hospital. A conditional discharge can only be authorised by an FfT or the Secretary of State for Justice. MM’s discharge would require him to live in a setting where he would not be free to leave, and would not be allowed out without an escort. Although a suitable placement had not been found, MM consented to being placed in such a setting. Despite this, the FfT ruled that it did not have the power to discharge MM with a care plan that would amount to a deprivation of his liberty or impose such conditions on him. The Supreme Court, in a majority of 4–1, found that the Mental Health Act 1983 does not give powers to the FfT or Secretary of State to impose conditions that amount to a deprivation of liberty, even if the patient consents. 50

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