Searching of Inpatients

Transcription

1 Searching of Inpatients Who Should Read This Policy Target Audience Inpatient Staff Version 2.1 March 2017

2 Ref. Contents Page 1.0 Introduction Purpose Objectives Process Dangerous and Prohibited Items Legal Considerations and Consent Actions Prior to Conducting any Search Process for Undertaking a Property or Environmental Search Personal Searches Use of Hand Held Metal Detector Post Search Actions Cultural and Diversity Issues Visitors Procedures Connected to this Policy Links to Relevant Legislation Links to Relevant National Standards Links to other Key Policies References Roles and Responsibilities for this Policy Training Equality Impact Assessment Data Protection and Freedom of Information Monitoring this Policy is Working in Practice 17 Appendices 1.0 Environment and/or Property Search Process Personal Rub Down Search Process Sign for Display outside Inpatient Areas Regarding Prohibited Items Sign for Display outside Inpatient Areas Regarding Prohibited Items - Punjabi Translation Sign for Display outside Inpatient Areas Regarding Prohibited Items - Easy Read 22 Version 2.1 March

3 Explanation of terms used in this policy Hand Held Metal Detectors - A battery operated device that can detect metal objects and alerts the operator through an audible alarm Offensive Weapons - Offensive weapons are defined in Prevention of Crime Act 1953: Offensive weapon means any article made or adapted for use for causing injury to the person, or intended by the person having it with him for such use by him or by some other person. Deciding how to interpret the context may be difficult and may require some understanding of what is normal for the individual s social and cultural background. Suspicions that the object has the potential to be an offensive weapon may be raised by the manner in which the object is carried, kept, used or the reason for its possession as indicated by the patient Environment - Within this document the term patient environment refers to a patient s room, however this can extend to any patient area (lounge, dining room, and kitchen) Personal Search - The term "personal search" applies to searching of the body i.e. rub down. This definition, for the purposes of this document does not extend to intimate searches i.e. the exploration of bodily cavities Prohibited Items - For the purpose of this policy, the term prohibited items is taken to mean those items or substances, which, in the judgment of the accountable practitioner constitutes a risk to the successful treatment of patients or the safety or welfare of any person on the premises of the Trust. Further information on prohibited items can be found in Section 4.1. Public Place - Prevention of Crime Act 1953 defines a public place as any highway and any other premises or place to which at the material time the public have or are permitted to have access, whether on payment or otherwise. NHS Protect acknowledges that this definition will cover most NHS premises Procedural Documents - The collective term for policies, procedures or guidelines Policy - Sets out the aims and principles under which services, Groups, or units will operate. A policy outlines roles and responsibilities, defines the scope of the subject covered, and provides a high level description of the controls that must be in place to ensure compliance Version 2.1 March

4 1.0 Introduction The Black Country Partnership NHS Foundation Trust is committed to ensuring the safety and welfare of its employees, patients and others, as far as is reasonably practicable. At times it may be necessary in the interests of maintaining a safe and therapeutic environment to carry out searches of a patient, their property or the ward or unit they occupy. This overriding duty of care and the provision of safe environments is underpinned by Health and Safety at Work Act This policy provides a framework within which nurses may conduct personal searches of service users, or their property and bedroom in a manner which is safe, legal, and consistent with their planned care. This policy does not cover intimate searches of patients; i.e. exploration of body cavities. If the risk is assessed as requiring an intimate search and the wider multi-disciplinary team have been consulted then the police should be contacted for advice and/or assistance. The Department of Health Code of Practice (2015) requires that the Trust have a policy on the searching of patients, surroundings and their belongings. 2.0 Purpose This policy is intended to ensure that searching of an individual patient, their property or the ward/unit they occupy complies with guidance in Mental Health Act (MHA) Code of Practice. The policy is intended to be utilised specifically within the adult acute mental health services. However, depending on typology of patients it may be utilised within other areas. In addition, the level of security afforded to individual units may also dictate the implementation of this policy. The policy provides staff with guidance on decision making and a systematic procedure to follow to ensure any search is undertaken professionally and effectively. The underlying reason for any search is for the identification and safe retrieval of items that pose a risk to the individual and/or others safety. The power of authority to perform searches is rooted in the principle of our duty of care to patients and our colleagues who may be affected by our acts or omissions. Guidance from Mental Health Act Code of Practice gives guidance when acting to prevent harm to self or others and the need for possible searches. 3.0 Objectives The policy is based on the following clear principles: The intention is to create and maintain a therapeutic environment in which treatment may take place and to ensure the security of the premises and the safety of patients, staff and the public The authority to conduct a search of a person or their property is controlled by law, and it is important that hospital staff are aware of whether they have legal authority to carry out any such search Searching should be proportionate to the identified risk and should involve the minimum possible intrusion into the individual s privacy, and All searches will be undertaken with due regard to and respect for the person s dignity and privacy Version 2.1 March

5 4.0 Process All searches must be carried out using the least restrictive and proportionate principles, have clear justification and be carried out in a coordinated, dignified and respectful manner. There may be specific rationale for the decision to search, for example: A patient with a known history of carrying and/or hiding offensive weapons A patient expressing the view that he/she intends to injure him/herself or another person with an implement Information passed from other patients or visitors that the patient has a weapon A patient who is acting in a threatening manner in conjunction with a risk assessment that highlights the person s unpredictability There is a reasonable belief that the patient is in possession of items that are dangerous to themselves or another person s health and safety e.g. drugs, weapon or alcohol A new admission to the ward environment which necessitates a property log. A property search should be included as part of this process A risk assessment that indicates a high risk of the patient being in possession of prohibited items A patient who has a recent history of being in possession of prohibited items and their return from unescorted leave If a patient has purchased a prohibited item whilst on escorted leave and the escorting staff could not dissuade the patient from purchasing, the escorting staff must notify the unit immediately on return Staff working within the Gerry Simon Clinic must familiarise themselves with local security procedural documents that details rationales for searching patients, in accordance with low secure standards. 4.1 Dangerous and Prohibited Items It is important to acknowledge that staff members should never attempt to physically disarm a patient who is brandishing a potentially harmful object in a threatening manner, although verbal requests to place a weapon or potential weapon down on a surface or in a neutral space and for the patient to move away from the item may be a reasonable course of action (NICE 2015). To bring a weapon or potential weapon or any item that is illegal, unsafe or hazardous to the patient or others into the In-Patient Units is strictly prohibited, wherever possible this should be explained to a patient prior to admission. Each service area should agree on items that are not allowed onto particular service premises. The patients right to privacy and autonomy must be balanced against the safety of other patients and staff. In a rehabilitative environment consideration must also be given to aspects of positive risk taking. Service areas must ensure that patients are aware of the prohibited items, and that the information is understood. This may constitute the relaying and reinforcing of the information periodically in a reinforcing manner, using translators and easy access language if needed. Staff must also make family members, carers and friends aware of the prohibited items and reinforce the need for a continued safe environment. It is not practicable to produce an exhaustive list of contraband items or substances, however, examples may include: Version 2.1 March

6 Sharps e.g. knives, razors, scissors, needles and other items that have been sharpened to a blade or point Alcohol, illicit drugs and solvents Glass or ceramic items Metal coat hangers Medication purchased over the counter or prescribed Toxic substances e.g. bleach Lighters, matches etc. for those service users where these items may present a risk Flammable liquids If a search of a patient s property or belongings locates an item that is suspected to be a firearm then police assistance must be immediately requested by making a 999 call if police officers are not already in attendance. No attempt should be made to remove or have any contact with the item and the area should be immediately vacated by staff, patients and visitors. 4.2 Legal Considerations and Consent Legal Considerations Mental Health Act Code of Practice (2015) and Misuse of Drugs Act (1971) give authority to staff to undertake searches where items that are deemed hazardous to the health and safety of the individual patient are suspected. Any searches must be proportionate to the anticipated level or risk and harm to the patient, and others. Possession of an offensive weapon in a public place without lawful authority or reasonable excuse is an offence under Prevention of Crime Act 1953, Section 1. Reasonable excuses could include a carpenter carrying a chisel, a community nurse carrying a syringe, or a Sikh wearing a kirpan. If a patient (detained or informal) is suspected on reasonable grounds of possessing an offensive weapon it would be lawful to search the patient s possessions or environment if it is deemed safe to do so. The possession of an offensive weapon in a public place is an offence under Criminal Justice Act (1988) Section 139. Human Rights Act 1998, Article 8; subsection 1 highlights the need for individuals to have the right to a private and family life. However, article 8; subsection 2 provides exclusions to temporarily suspend Article 8. Subsection 2 identifies that a public authority (NHS) can suspend this right in the interests of continuing safety, to prevent a crime and for the protection of health, morals, and other individuals human rights. Powers of search and the confiscation of property should be fully and clearly justified before being implemented as they may significantly interfere with a patient s privacy. Staff members should consider if the necessary objectives of protection of health can be met by less intrusive means Consent Where it appears that a patient does not have the capacity to consent, for example due to intoxication or acute mental health, then a multi-disciplinary decision needs to be based on the best interests of the patient and the minimisation of any predicted harm. The search process may proceed if the decision dictates that a search is necessary. Version 2.1 March

7 If a patient who has capacity to consent but who refuses consent to the search, their responsible clinician (or, failing that, another senior clinician with knowledge of the patient s case) should be contacted without delay in the first instance, if practicable, so that any clinical objection to searching by force may be raised. If any concerns and clinical objections are raised then this must be escalated to the duty senior nurse or manager on call for guidance. In particular circumstances there may be cause to conduct a search urgently, prior to contacting the responsible clinician due to the risks that are posed. In such circumstances a risk assessment must be undertaken involving the nursing team. The reasons for the search must be clearly recorded in the patients ward based and clinical records and the responsible clinician and or his deputy or on call consultant informed immediately after the event. If it is felt that the patient to be searched will not give their consent then it will be prudent to plan how to notify the patient of the search to reduce any chance of discarding any concealed object(s). All aspects of searching can proceed regardless of the legal status of the patient, ensuring that there is clear risk management and legal rationale behind the search, and all other avenues of communicating with the patient and risk reduction strategies have been exhausted. If a personal search has been undertaken with informal patients who have declined to consent, then this should be discussed with the patient as part of a clinical review at the earliest opportunity. 4.3 Actions Prior to Conducting any Search The staff in charge ascertains whether a search is necessary. The patient should be kept under close observation while awaiting a search. This is to minimise any opportunity for the patient to secrete or pass on the item to other patients. Consideration must be given to the number of staff undertaking these observational duties and any proposed risk. The person in charge should explain to the patient why a search is required Consider issues surrounding consent as outlined above in If the patient consents then the senior nurse should be informed that a search is to take place If a patient is being directly admitted from the police station or from any location with police assistance (i.e. Section 136 suite) the clinicians accepting the patient for admission must ensure that a search of the patient and their belongings has been completed prior, or at the point of their arrival by the responsible police officers. Information regarding any items located as a result of this search must be communicated by the police officers concerned to the clinicians conducting the patient s admission. If police have not searched the patient, then nurses can request that this occurs before allowing entry of before the police leave Before any search of a patient takes place the staff member must take reasonable steps to give the person to be searched the following information: - The rights of the staff to search Version 2.1 March

8 - A clear explanation of the purpose of the search is given to the patient - If the person to be searched does not appear to understand what is being said due to language, medical condition or any other reason, the staff involved must take all possible reasonable steps to explain the process of the search 4.4 Process for Undertaking a Property or Environmental Search The request to participate in checking of patient s property should be routinely carried out as part of an assessment for admission, an admission procedure, or returning from absence without leave. Whilst undertaking any search, staff must remain aware of the possible high risk of injuries as a result of sharps. If stab/puncture resistant gloves are available then these may be used. Disposable gloves must be worn at all times, even under the stab/puncture resistant gloves. Staff must never blindly place fingers or hands into areas that they can t see the contents of and sharp safety must be adhered to at all times to minimise potential injury. The patient should be invited to observe the search process. If a patient observes the search then staff need to be mindful that a patient s behaviours may change when a possible item is close to being found. If valuables are located then staff must verify the value, i.e. how much money. In exceptional circumstances it may be necessary to undertake multiple environment searches. Rationales underpinning this may be where staff hold a belief of a situation which poses a health and safety risk to both staff and patients, for example, a chronic substance abuse problem where multiple patients are involved. These searches, although classed as random, must be carefully planned with the multi-disciplinary team and must be planned and proportionate to the possible risk to minimise disruption and increase effectiveness. Guidelines for searching of rooms and /or bags can be found in Appendix Personal Searches Process for Undertaking a Personal Search Two members of staff should carry out personal searches, at least one staff being of the same sex as the patient, but ideally both. Mental Health Act Code of Practice (2015) states a personal search should be carried out by a member of the same sex, unless necessity dictates otherwise. Obviously, staffing within single sex areas may not allow the same gender of staff to perform. The practice of differing genders between the patient and the staff performing the personal search should only be regarded as an exceptional occurrence and all staff should make all reasonable efforts to ensure that mixed gender practice is to be avoided where possible. Consideration must also be given to the cultural needs of the patient when identifying staff. Only those staff having received training for conducting searches are authorised to undertake a personal search. It is imperative that any personal search takes place in an environment that protects the patients dignity. Version 2.1 March

9 As part of the search process, patients are asked to remove top layers of clothing, for examples jumpers or coats. Situations may arise where difficult clothing may be worn by the patient, e.g. onesies, or loose baggy clothing with multiple layers and pockets. Patients should be asked to remove these provided that there is suitable alternative clothing available ensuring that privacy and dignity is respected at all times. Staff can search these items of removed clothing if it is still deemed necessary. If however, patients refuse to remove these items staff should precede with the personal search but keep the patient under close observation until the patient naturally removes the item of clothing. Staff should be mindful that any search should be a proportionate response and when all other least restrictive options have been explored. Staff should consult with the Practice Development Team if they reasonably suspect that this comparatively rare situation is a current issue within the inpatient area. Special consideration must be given for the searching of headwear worn for religious or medical reasons (e.g. wigs, Sikh turbans, Jewish yarmulkes, etc.). An individual may have this religious/medical headgear searched by a hand-held metal detector (where available). The headgear should only be removed if there is a detection that cannot be accounted for, or if there is further suspicions. If there is a need to search the patient s religious/medical headgear by hand, you must offer the individual privacy for this part of the search. The patient must be given the opportunity to remove the item themselves and, for a turban, unwind it themselves. They must also have access to a mirror which assists them in retying the turban. If the patient refuses to remove the head gear, then staff must do this. When removing a turban, staff must ensure that their hands are clean and that the turban is placed on an appropriate surface, i.e. a chair or table and not the floor. Further practical guidance on personal searches can be found in Appendix 2. *Part of section relating to searches of headgear for Sikhs has been prepared in consultation with Sikh Council UK Use of Restrictive Physical Interventions to Facilitate a Personal Search Both the Code of Practice and NICE 2015 state that if a service user refuses to be searched, a multidisciplinary review of the need to perform a search using physical restrictive interventions needs to take place and any potential consequences need to be considered in advance. The use of physical restrictive interventions should only be used as a last resort, and when all other least restrictive alternatives have been considered. Practically, the patient will remain standing, and therefore the need for a third staff may be needed. A fourth staff will undertake the actual searching techniques. Staff must constantly seek the patients cooperation during the search and if this is given then MAPA holds are to cease. Following any use of physical restrictive interventions to enable a personal search, a post incident review must take place, including a de brief for the patient. Version 2.1 March

10 4.6 Use of Hand Held Metal Detector The searching of individuals and their property can be intrusive and the use of Hand Held Metal Detectors (HHMD s) can reduce the intrusive nature of a search, improve the effectiveness (dependent on the item being searched for), and reduce the time taken to conduct a search. However, due to the possibility of non-metal items staff must be aware that the use of a HHMD should be used to augment staff actions and not replace. For personal searches scan with wand along outstretched arms back hips and down legs ensuring this is done in an environment which maximises safety, privacy and dignity. If the wand sounds staff should ask patient to identify item, if the item is a risk item, then this should be removed if safe to do so. 4.7 Post Search Actions Where items are recovered during a search the retention or disposal of such items needs to be considered. If items belonging to a patient are removed, and the items are such that they can be returned to the service user on discharge, then the patient should be given a receipt for the items and informed where they are being kept. Where a patient s belongings are removed during a search, the patient should be told why they have been removed, given a receipt for them, told where the items will be stored, and when they will be returned (MHA Code of Practice 2015, paragraph 8.45). If a dangerous weapon or drugs have been discovered please remove to a secure place and inform Local Security Management Specialist at the earliest opportunity. Drugs should be handled as controlled drugs. LSMS will liaise with the police concerning these items. All search activity should be clearly documented, detailing the type of search conducted, the staffs rationale for completing a search and under which legal justification. Whether any prohibited items are found or not, staff should therapeutically spend time with the patient and reiterate the reasons for the search, why the staff felt the need to undertake the search, any adjustments to their care plan, any changes to observational level and to discuss any changes to their risk assessment as a consequence. When no items are discovered, staff are to complete the search form which is located in the shaded information area immediately above the Datix form. There is no requirement to then continue to complete a Datix. If an item is discovered as part of the search then staff must complete a Datix. 4.8 Cultural and Diversity Issues Staff should be aware that some objects, which could be considered as weapons, may be carried by individuals for religious reasons. Awareness of diversity issues is important however; safety is the overriding consideration in all cases. Where items Version 2.1 March

11 of religious significance, which may be considered as a weapon, are encountered, it is essential that safe working practise is maintained and where it is deemed unsafe for individuals to retain in their possession religiously significant items whilst an inpatient, those items must be taken into safekeeping. This should be undertaken in a respectful and sensitive manner preferably with the consent of the patient and with involvement of relatives/carers. Further advice and support to patients can be accessed from the Equality and Diversity department. The kirpan is a ceremonial sword or dagger carried by Sikh men or women. However, it would be disproportionate to remove the Kirpan from every inpatient, and therefore the decision to do so must be based on the clinical presentation of the patient at that time. If it has been decided by the multi-disciplinary team that the Kirpan can remain with the patient then staff need to consistently reinforce that the Kirpan must be worn close to the body and under fixed clothing, and not displayed. For example, the Kirpan is to be worn under whole garments and not under a cardigan type of garment. Failure to wear the Kirpan under the clothing will result in its removal, principally due to the risks that may be posed from other patients seizing the Kirpan. Visitors who are practising Sikhs may present themselves wearing a Kirpan, outside of their clothing. Staff should respectfully ask for them to remove this or wear it securely under their clothing, ideally under a fixed garment such as a jumper, as opposed to simply covering it with a coat. Staff should inform them that failure to do this may result in entry being refused. When a Kirpan is handed over to staff by visitors or patients, then staff must ensure that their hands are clean before handling the item, and place it in a clean sealable bag/envelope. This must be stored safely in a lockable cupboard or unit safe on the highest shelf possible. The cupboard or safe place must not contain any items such as tobacco or intoxicants at the same time, as this would be seen as disrespectful and offensive towards the Sikh Kirpan. The removal of the Kirpan from an inpatient may have a negative effect on the patient s mental health due to it being an essential symbol of their faith, and may hinder the patients recovery. Therefore, if a Kirpan has been retrieved from a patient then staff are to contact the Equality and Diversity Department for a possible replacement kirpan in the form of a small accessory, and to attend to offer spiritual guidance or to offer further guidance to staff. *Section prepared in consultation with Sikh Council UK. 4.9 Visitors Visitors of inpatients should be reminded periodically regarding the list of prohibited items. This should be supported by clear signage outside the ward outlining those items, the underlying principles of this policy, the need for the maintenance of a safe environment and the possibility of the use of HHMD (if available in area). All visitors should notify the ward of their arrival (normally done via reception, ringing the bell to gain access). Staff should take this opportunity to inform or remind visitors of this policy in a professional manner. Visitors should be encouraged to leave any prohibited items with reception or nursing staff for safe keeping. Staff should also routinely use the HHMD if available. The Trust reserves the right to refuse entry to any person who refuses to hand over items that could be used as a weapon or the staff have a firm suspicion of Version 2.1 March

12 the visitor bringing in harmful substances. This suspicion may be based on knowledge of the patient s history, any previous breach of Trust policy by an individual or group of individuals who visit, or a patient appearing intoxicated following a visit from an individual. The decision to refuse entry to visitors based on suspicion must be made by the multi-disciplinary team to ensure transparency in decision making. Staff are not permitted to undertake personal searches on visitors, only the police have the legal powers under Police and Criminal Evidence Act (1984) to undertake personal searches on member of the public. If an item found raises concern about the safety of the general public, then staff must ask the visitor to leave and inform the police immediately. If the visitor refuses to leave the area the senior nurse will ask them to leave explaining the reasons behind the request. If the visitor still refuses to leave then security can be contacted to provide assistance. Staff may also feel it necessary to contact the police to assist in the removable in concordance with Criminal Justice and Immigration Act 2008 (sections 119 and 120). See Appendix 3-5 for sign for display outside inpatient areas regarding prohibited items. 5.0 Procedures Connected to this Policy There are no procedures connected to this policy. 6.0 Links to Relevant Legislation Mental Health Act 2007 The Mental Health Act (2007) amended the Mental Health Act (MHA) of The main purpose of the legislation is to ensure that people with serious mental disorders, which threaten their health or safety or the safety of other people can be treated irrespective of their consent where it is necessary to prevent them from harming themselves or others. The amended act introduced: A new broad definition of mental disorder to encompass any disorder or disability of the mind An appropriate treatment test, preventing patients from being compulsorily detained unless appropriate medical treatment is available Community Treatment Orders to supervise the treatment of certain patients in the community New safeguards including a provision for Independent Mental Health Advisors to provide information and help people understand and exercise their rights New roles to replace the roles of approved social worker and responsible medical officer Provision for powers to reduce the time limits for the automatic referral of some patients to the Mental Health Review Tribunal Prevention of Crime Act 1953 An Act to prohibit the carrying of offensive weapons in public places without lawful authority or reasonable excuse. It must be borne in mind that whilst the definition public place will include many areas within Trust premises to which the public have Version 2.1 March

13 access, this may not be the case for a restricted area such as a locked ward where the public do not have access. Section 1 of the Prevention of Crime Act 1953 provides that an offensive weapon is any article made or adapted for use for causing injury to the person, or intended by the person having it with him for such use by him or by some other person. Criminal Justice Act 1988 Section 139 of the Criminal Justice Act 1988 provides an offence when in a public place without lawful authority or good reason of having a blade or sharply pointed article. This includes a folding pocket knife where the blade exceeds 3 inches and a folding knife where the blade locks in position. It is a defence for a person charged with an offence under section 139 of the Criminal Justice Act 1988 to prove that he or she had good reason or lawful authority for having the article in a public place. There are also specific defences in respect of: Use at work Religious reasons or Carrying the item as part of a national costume 6.1 Links to Relevant National Standards NICE Clinical Guideline NG10 - Violence and Aggression (2015) This guideline has been developed to advise on the short-term management of violence and aggression in mental health, health and community settings in adults, children (aged 12 years or under) and young people (aged 13 to 17 years). This guideline updates and replaces NICE guideline CG25 (published February 2005). Within this document it outlines good practice in relation to maintaining a safe and therapeutic environment for patients, but also a safe environment for staff and visitors. This, at times, will include the practise of searching individuals, property and environments with the purpose of identifying and retrieving items that could jeopardise individual s health and safety. 6.2 Links to other Key Policies Restrictive Physical Intervention Policy The purpose of this policy will be to detail the Trust s strategy in managing physical and non-physical assaults against NHS staff and others by the use of restrictive physical interventions. The Trust recognises that person centred care is at the heart of all good practice and that all incidences of known or potential aggression must be dealt with on an individual basis in order to create a unique solution. The core aim is to promote a philosophy of proactive care and a reduction in the use of restrictive physical interventions. This policy is clearly linked when the situation, albeit rare, necessitates the use of restrictive physical interventions to facilitate a personal search. All staff who undertakes restrictive interventions must be familiar with this policy, especially regarding the need to use the least restrictive action, the need for de brief and Version 2.1 March

14 psychological support and clear record keeping and multi-disciplinary discussions and considerations. 6.3 References Health and Safety Executive (1974) Health and Safety at Work Act. London. HMSO Department of Health (2015) Mental Health Act; Code of Practice. London. HMSO Prevention of Crime Act (1953) as in NHS Security Management Services (2006) Offensive Weapons; NHS Security Management Service Guidance. Court of Appeal in Simpson (1983) as in NHS Security Management Services (2006) Offensive Weapons; NHS Security Management Service Guidance. Criminal Law Act (1967) as in NHS Security Management Services (2006) Offensive Weapons; NHS Security Management Service Guidance. Criminal Justice Act (1998) as in NHS Security Management Services (2006) Offensive Weapons; NHS Security Management Service Guidance. National Institute of Clinical Excellence (2015) NG 10 Violence: The short term management in mental health, health and community settings. London. Department of Health. Version 2.1 March

15 7.0 Roles and Responsibilities for this Policy Title Role Key Responsibilities Nursing Staff Adherence - Ensure they are familiar with the policy and be responsible for adhering to the procedures referred to within the policy - Provide support and information to patients and carers with regards to the application of guidelines implemented to address concerns regarding prohibited items and the search process - Undertake risk assessments on patients to where there is deemed a potential for prohibited items onto the unit - Review and update any risk assessments and care plans as necessary Nurses in Charge Operational - Ensure the guidelines and related procedures are adhered to on their shift - Facilitate any escalation if needed Ward Managers Implementation - Ensure they are familiar with the policy and be responsible for adhering to the procedures referred to within the policy - Implement the guidance across their areas of responsibility - Ensure risk assessments are current and reviewed in light of any dangerous items found - Monitor good practice standards and their adherence Local Security Management Specialist Advice and Support - Provide specialist advice and support to staff - Liaise with police concerning any dangerous weapons or drugs recovered during searching of inpatients Group Directors/ Service Managers Executive Director of Nursing, AHPs and Governance Chief Executive Responsible - Manage and organise resources to enable implementation of this policy - Monitor and review departmental performance in connection with this policy - Report mechanisms on departmental issues to and from the Chief Executive in connection with this policy - Provide support and guidance regarding resources and the consistent application of the policy - Identify and implement any future practice recommendations - Provide support to facilitate the continuation of a safe and therapeutic environment Executive Lead - Lead responsibility for the implementation of this policy - Allocate resources to support the implementation of this policy - Lead on strategies and innovations to improve current practice - Bring any serious concerns regarding the implementation of this policy to the attention of the Board of Directors - Ensure that all staff are aware of and operate within the requirements of the policy and that systems are in place for the effective monitoring of the standards contained within the policy Accountable - Ensure the provision of adequate resources to enable the effective implementation of this policy - Maintain effective reporting mechanisms into the Board in connection with this policy Version 2.1 March

16 8.0 Training What aspect(s) of this policy will require staff training? An awareness of the policy and the actual search activity (personal, environmental and property search) Which staff groups require this training? Is this training covered in the Trust s Mandatory and Risk Management Training Needs Analysis document? If no, how will the training be delivered? Who will deliver the training? How often will staff require training Who will ensure and monitor that staff have this training? All acute mental health and Learning Disability forensic services. Other inpatient staff outside of these groups should be identified by service managers No, staff will receive specific training in relation to this policy where it is identified in their individual training needs analysis as part of their development for their particular role and responsibilities Through the delivery of specialised Face to Face training - bookings are to be made from ward level directly to trainers Practice Development Team A one off half a day session, and then subsequent updates on personal search techniques as part of the mandatory MAPA annual update Ward Managers 9.0 Equality Impact Assessment Black Country Partnership NHS Foundation Trust is committed to ensuring that the way we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group. The Equality Impact Assessment for this policy has been completed and is readily available on the Intranet. If you require this in a different format e.g. larger print, Braille, different languages or audio tape, please contact the Equality & Diversity Team on Ext or EqualityImpact.assessment@bcpft.nhs.uk 10.0 Data Protection and Freedom of Information This statement reflects legal requirements incorporated within the Data Protection Act and Freedom of Information Act that ap ply to staff who work within the public sector. All staff have a responsibility to ensure that they do not disclose information about the Trust s activities in respect of service users in its care to unauthorised individuals. This responsibility applies whether you are currently employed or after your e mployment ends and in certain aspects of your personal life e.g. use of social networking sites etc. The Trust seeks to ensure a high level of transparency in all its business activities but reserves the right not to disclose information where relevant legislation applies. Version 2.1 March

17 11.0 Monitoring this Policy is Working in Practice What key elements will be monitored? (measurable policy objectives) Where described in policy? How will they be monitored? (method + sample size) Who will undertake this monitoring? How Frequently? Group/Committee that will receive and review results Group/Committee to ensure actions are completed Evidence this has happened Completion and review off all inpatient search records 4.0 Process Review off all inpatient search records Group Directors Quarterly Reducing Restrictive Intervention Group Reducing Restrictive Intervention Group Minutes of meetings/ action plan signed off Completion of appropriate training by all inpatient based staff 8.0 Training Data collected and collated into general MAPA training report MAPA Trainers Quarterly Reducing Restrictive Intervention Group Reducing Restrictive Intervention Group Minutes of meetings/ action plan signed off Examination of incidences where a weapon has been discovered 4.7 Post Search Actions Report by the Risk Team Group Directors Monthly Reducing Restrictive Intervention Group Reducing Restrictive Intervention Group Minutes of meetings/ action plan signed off Version 2.1 March

18 Appendix 1 Environment and/or Property Search Process The staff conducting the search will wear disposable gloves. Two members of staff should carry out room searches The service user should be invited to observe the room search The room should be searched systematically, starting from the left-hand side of the door, working around the entire room in a clockwise direction The level of detail of the search will always be dependent on the items being searched for Remove all objects from the bed, including bedding one layer at a time; inspect each sheet, pillowcase, quilt, and covers Inspect the base of the bed, underside of the bed, the mattress and headboard. If the mattress cover is zipped, staff must also check inside the cover Inspect window frames and radiators Inspect all drawers and wardrobes. Remove all drawers if possible and inspect the underside of the drawers and recess Books, bags and other items should be searched individually and can be placed on the bed until their original location has been searched when they can be replaced When searching bags and cases, check the contents of external pockets first. Check there are no false bottoms where items can be hidden Check the lining of the bag for cuts and tears, possibly providing cavities in which items could be secreted Check any other freestanding furniture and their underside All clothing and other items removed from drawers and wardrobe should be done so in orderly fashion and with respect to the owner. They can be placed on the bed until the wardrobe/cupboard/drawer is empty whereupon, the items should be returned as found The room should be left as before with items replaced and the bed remade when the search is concluded Version 2.1 March

19 Appendix 2 Personal Rub Down Search Process The search must be undertaken using open flat palms. The procedure is as follows: Stand opposite the patient Ask the patient if they have anything on him that they are not authorised to have Ask the patient to empty their pockets Ask the patient to remove shoes and belt. These are to be passed to second staff for checking Search the contents of pockets, jewellery and any other items, including bags they are carrying, then place to one side. Staff may have to turn out the contents Ask the patient to remove any headwear and pass for searching Ask the patient to ruffle their hair Lift the patients collar; feel behind and around it, and across the top of the shoulders (search any tie and ask him to remove it if necessary) Ask the patient to raise their arms level with shoulders Ask the patient to open and show their palms Search each arm by running your hand along the upper and lower sides Check between patients fingers and look at palms and back of hands Check the front of the patient s body, from neck to waist, the sides, from armpits to waist and front of the waistband Check the patients back from collar to waist, back of waistband and seat of the trousers Check the back and side of each leg from crutch or above knee to ankle Check the front of the abdomen (below waist level) and the front and side of each leg Look at the area around the patient for anything they may have dropped before and during the search Ask the patient to step to one side to ensure they are not standing on anything they have dropped before or during the search Version 2.1 March

20 Appendix 3 Sign for Display outside Inpatient Areas Regarding Prohibited Items Welcome to It is the staffs overarching duty to continue to provide a safe and therapeutic environment. One in which both patients and staff feel safe and secure to continue to work together to aid recovery, increase feelings of stability and the continued delivery of high quality care. With this in mind some items are prohibited to bring onto the ward. Please check the list that details these items. The staff may ask to check bags that you wish to bring onto the ward, and any attempt to bring any of these items onto the ward may result in staff refusing entry. This is purely for safety issues, for visitors, staff and more importantly, all patients. If you wish to speak to a staff regarding items being brought onto the ward please do not hesitate to speak to a member of staff. If you wear a kirpan, you can hand the kirpan to staff, before entry, for safekeeping. Please also be assured that this item will be handled with respect and sensitivity and be handed back to you once you have completed your visit to the ward. However, if you still wish to wear the kirpan please ensure that this MUST BE WORN UNDER SECURE CLOTHING and not be displayed. Failure to do this will result in entry being refused. Thank you for your cooperation Version 2.1 March

21 Appendix 4 Sign for Display outside Inpatient Areas Regarding Prohibited Items - Punjabi Translation Version 2.1 March

22 Appendix 5 Sign for Display outside Inpatient Areas Regarding Prohibited Items Easy Read The staff need to keep everybody safe To help them do this, some things are not allowed If you have any of these things, please give them to staff Please talk to the staff who will help you check other things you may have Version 2.1 March

23 Policy Details Title of Policy Unique Identifier for this policy State if policy is New or Revised Searching of Inpatients Policy BCPFT-CB-POL-05 Revised Previous Policy Title where applicable Policy Category Clinical, HR, H&S, Infection Control etc. Executive Director whose portfolio this policy comes under Policy Lead/Author Job titles only Committee/Group responsible for the approval of this policy n/a Challenging Behaviour Month/year consultation process completed * March 2016 Month/year policy approved April 2016 Month/year policy ratified and issued April 2016 Next review date April 2019 Executive Director of Nursing, AHPs and Governance Violence and Aggression Advisor Reducing Restrictive Intervention Group Implementation Plan completed * Equality Impact Assessment completed * Previous version(s) archived * Disclosure status Yes Yes Yes B can be disclosed to patients and the public * For more information on the consultation process, implementation plan, equality impact assessment, or archiving arrangements, please contact Corporate Governance Review and Amendment History Version Date Details of Change 2.1 Mar 2017 Minor amendments made to legislation as requested by LSMS 2.0 Feb 2016 Full policy review and new policy format 1.1 Jan 2013 Minor amendments; changes made to Personal Search 1.0 Oct 2012 New aligned Policy for BCPFT Version 2.1 March