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Quality Network for Forensic Mental Health Services

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Quality Network for Forensic Mental Health Services

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    1. Quality Network for Forensic Mental Health Services Preliminary Findings: Fourth Annual Cycle Sarah Tucker, Programme Manager Maddy Reeve-Hoyland, Project Worker

    2. Peer-reviews Cycle 4 239 wards across 64 units About 200 MSU staff participated as peer-reviewers About 2000 MSU staff were interviewed as part of the review visits About 300 service users were interviewed during self- and peer-reviews

    3. Our performance against internal standards 80% reports within deadline 85% Review teams quorate 94% units had service user telephone conferences as part self-review 23% of review teams included service user experts 4/64 reviews postponed

    4. Feedback: Host Units

    5. Feedback: Review Teams

    6. Feedback: Comments ‘The preparation process was very valuable…we probably made changes at that point’ ‘We particularly valued feedback from the service user expert…’ ‘There is a lot to reflect on…and hopefully we can build on the lessons learnt. Overall a very positive experience.’ ’The day was very useful..some of the good practice will be taken back to my unit’ ‘An excellent process to promote a quality service for patients, carers and staff.’ ‘I would happily recommend to other staff that they participate as I found it to be of great benefit’

    7. Initiatives & Developments Initiatives 2009-2010 Supervision Workshop Outcome and actively measures workshop and working group DH commissioned Quality Network to consult Best Practice Guidance Developments 2010-2011 Service User and Carer Involvement Standards for Learning Disability in secure settings Prison In-reach

    8. Cycle 4 Preliminary Findings

    9. Total % of Met Criteria Across All Units

    10. Average % of Met Criteria Per Section

    11. Comparison Between Cycles 3 & 4 – Previous Members

    12. Physical Security Achievements 95% of units ensure that staff receive a security induction before they are issued with keys 61/64 units have alarm systems that are able to identify the location of an activated alarm All 64 units have effective systems in place for recording the circumstances and justification for using physical restraint Challenges Perimeter Security – only 66% of services fully met the criterion regarding the secure perimeter Only half of the 64 units were noted to have clear lines of sight throughout the building 40/64 units have systems for patients to raise an alarm in an emergency

    13. Relational Security Achievements 100% of services will have a care plan in place within 24 hours of admission 58 services have a fully implemented OT programme in place Out of the 64 only 2 services did not fully meet the ‘Blame Free Culture’ criterion Challenges Frontline staff in 21 of the services reported that the nursing numbers are not sufficient to safely meet the needs of the patients Only 56% of services were found to provide patients with 25 hours of structured activity Only 3 units with female patients met all the requirements for the child visiting room

    14. Clinical and Cost Effectiveness Achievements 95% of services conduct CPA reviews within 3 months of admission and develop care plans in collaboration with patients 62 units ensure that patients on remand or on sentence are regularly reviewed to assess their suitability to return to prison Challenges Only 18 services provide monthly clinical supervision 21 services do not facilitate forums for staff to reflect on their experience of the work 26 of the 36 services with female patients use male bank/agency staff on female wards

    15. Patient Focus Achievements 94% of services provide access to civil advocacy Service users at 56 units reported that their rights are explained to them Service users at all but one unit reported that they are able to personalise their bedroom spaces Challenges Only 59% of units have a multifaith room available to service users Access to a phone which is private was a challenge for 36% of services Patient involvement – service users in 24 units do not feel fully involved in their care and the service development

    16. Environment & Amenities Achievements All units were noted to have appropriate facilities for the patient group 92% of services were noted to have environments which were clean and of a high quality All but 3 of the services with female patients have the facility for female service users to lock their door Challenges Food – patients at only 27 units were satisfied with the food provided Only 66% of services conduct ligature audits every 6 months 25% of services with female patients did not fully meet the criterion regarding providing a secure outdoor area

    17. Public Health Achievements 88% of services provide access to a GP 92% of services ensure that patients’ physical healthcare needs are assessed upon admission and regularly updated Challenges Access to a female GP and practice nurse was found to be a challenge for 25% of the services with female patients Only 78% of services provide comprehensive screening programmes for patients

    18. In Summary

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