National Preventive Mechanism Tenth Annual Report 2018–19 being inspected. RQIA also began work to embed human rights more firmly in routine inspections and to reflect this approach more clearly in inspection reports. This work was supported through a series of training sessions delivered by a human rights expert. A joint thematic review on the safety of prisoners in Northern Ireland undertaken collaboratively by RQIA and CJINI was completed in September 2018. During this review, RQIA identified a number of concerns relating to the physical environment in the Care and Supervision Unit (CSU) at Hydebank Wood Secure College. Care Inspectorate Wales (CIW) implemented a new organisational structure due to changes made in the Social Services and Well-being (Wales) Act 2014 which came into force in 2016, and those brought about by the implementation of the Regulation and Inspection of Social Care (Wales) Act (RISCA) in 2018. CIW’s structure has changed from a regionalised regulation and inspection model to one that works across Wales. The new CIW social care structure continues to prioritise responsibilities relating to the prevention of ill-treatment in children’s homes and the examination of Deprivation of Liberty notifications that come from adult care homes. To follow-up recommendations made about the provision of social care for adults and children in the secure estate, CIW continued to conduct routine performance reviews with local authorities throughout Wales. During 2018–19 CIW also undertook an informal survey with local authorities on arrangements for the delivery of care across the Welsh adult secure estate. 42 In December 2018, the Secretary of State for Health and Social Care asked the Care Quality Commission (CQC) to undertake a thematic review of restraint, seclusion and segregation, following reports of inappropriate use of seclusion and restraint and excessive lengths of stay for patients. The first phase of this work focused on people who are cared for in segregation on a learning disability ward or a mental health ward for children and young people. In March 2018 CQC highlighted to NHS England and NHS Improvement concerns about the high number of people placed in mental health rehabilitation hospitals a long way from home. As a result, NHS England and NHS Improvement set up a team to work with local health and care communities to develop services capable of meeting these people’s complex needs. During the year CQC also provided training on OPCAT and the NPM role to a range of groups within its organisation, including the overarching mental health group concerned with the registration and inspection of hospitals and social care homes. The new Chief Executive of CQC, Ian Trenholm, was appointed in May 2018. The Children’s Commissioner for England (CCE) continued to organise the NPM Children and Young Persons sub-group, which allows member organisations who inspect and monitor places that hold children to share knowledge and work jointly on emerging issues and concerns. The CCE’s team was expanded in 2018–19, which meant that it could increase the number of visits it undertook to places of detention or areas in which children were deprived of their liberty. The CCE team has since visited