National Preventive Mechanism Ninth Annual Report 2017–18 providers of services for people with a learning disability and/or autism.51 In June 2017, CQC wrote to the Secretary of State for Health and Social Care to advise him of concerns identified during inspections of high secure hospitals in England, which had taken place between November 2016 and March 2017. Throughout the year, CQC engaged closely with Broadmoor and Rampton high secure hospitals, NHS England, and the National Oversight Group for the hospitals to monitor the response to its concerns. This led to some improvements, including increasing staffing numbers and the hospitals working together to share good practice and training. CQC also raised concerns over the provision rehabilitation services in units that are often out-of-area and may be unduly restrictive.52 It recommended that the government and its agencies work with local health and care systems to reduce the number of patients placed in such units. Throughout the year, the office of the Children’s Commissioner for England (CCE) talked to children in custody about their experiences and well-being as part of a rolling programme of visits to establishments holding children. The aim of the work is to improve the outcomes and life chances of children who are detained. During the year, the Commissioner raised particular concerns to Ministers and policy makers about safety, periods of isolation in cells, restraint, mental health support, access to appropriate education and rehabilitation. The Commissioner continued to liaise with Children’s Commissioners in Scotland, Wales and Northern Ireland on common issues of concern. A joint reciprocal agreement of understanding is in place with the Children’s Commissioner for Wales to observe and monitor the well-being of children who are detained out of their home country. The CCE’s advice and representation service ‘Help at Hand’ received a number of enquiries during the year from children and young people in custody who were concerned that their rights were not being upheld. In a number of cases, the Commissioner wrote to the governor to seek resolution to the issue. Additionally, the Commissioner has made representations to responsible local authorities on behalf of children in the custodial estate. Many cases have centred on inadequate release planning, with children having no accommodation secured in the weeks and days leading up to their release. Other children felt their views and feelings were not being taken into account in release planning, or they were not able to communicate effectively with the local authority. The CCE has successfully secured positive outcomes for a number of children on whose behalf representations were made. Criminal Justice Inspection Northern Ireland (CJINI) secured permission to publish reports from June 2017 (in the absence of an executive in Northern Ireland). CJINI carried out three inspections during the year: Maghaberry Prison in April 2017 as an unannounced follow-up to the 2015 recommendations; Magilligan Prison in June 2017; and the Juvenile Justice Centre. Reports were published on the two prison 51 Registering the Right Support, available at https://www.cqc.org.uk/sites/default/files/20170612_registering_the_right_ support_final.pdf, accessed 21 November 2018. 52 Mental health rehabilitation inpatient services, available at https://www.cqc.org.uk/sites/default/files/20180301_mh_ rehabilitation_briefing.pdf, accessed 21 November 2018. 40