Supportive Observations in High Secure Service

1. Supportive Observations in High Secure Service Ashworth Hospital is one of three high secure hospitals in England Located in Liverpool 228 beds Adult mental with a diagnosis of mental illness and personality disorder + ‘grave and immediate danger’

2. Supportive Observations • Routinely used to :- • Manage risks – violence • Manage risks – self harm • Manage risks – LOA’s

3. Patient Experience • Restrictive • Creates dependency • Boredom • Feel safe • Feel punished for saying how I feel • ‘on obs’

4. Staff Experience • Restrictive • Creates psychological dependency • Boredom • ‘on obs’ • Engagement and promoting recovery • Positive risk taking • Managing therapeutic boundaries

5. Current Context • Staffing review • Use of CCTV • Financial climate • CQUIN 2014 – 2016 • Culture and innovation • Zonal observations