Section one Context Health Inspectorate Wales undertook 17 mental health hospital inspections, including one specifically for learning disabilities, during the year. Its findings of patients’ treatment were largely positive, and notably some services were working hard to reduce restrictive practices. However, care and treatment planning was poor, with improvements needed to manage risk in independent settings. One area of particular concern was the maintenance and refurbishment of wards which, in some cases, was having a detrimental effect on patient care, privacy and dignity and patient safety. Across mental health and learning disability facilities inspected in Northern Ireland, concerns were raised about the lack of safe and therapeutic environments. In the second half of the year there were concerns about the ill-treatment of patients detained under the Mental Health (Northern Ireland) Order 1986 at Muckamore Abbey Hospital, which provides inpatient mental health services for patients with a learning disability. A multidisciplinary inspection of the hospital undertaken by RQIA in February 2018 identified concerns in a number of areas of practice, including the use of restrictive practices and specifically seclusion practices. The events, reported in 2017, are now subject to a major police investigation. 35