Searching of a Person (Patients & Visitors) and their Property Standard Operating Procedure (Forensic Service)

Transcription

1 Searching of a Person (Patients & Visitors) and their Property Standard Operating Procedure (Forensic Service) DOCUMENT CONTROL: Version: 1 Ratified by: Quality Assurance Sub Committee Date ratified: 30 October 2017 Name of originator/author: Senior Sister Amber Lodge ISU / Senior Sister Amber Lodge R&R Name of responsible Clinical Quality Group committee/individual: Date issued: 11 December 2017 Review date: October 2018 Target Audience RDaSH Forensic Service Staff

2 Section Contents Page No 1. Aim 3 2. Scope 4 3. Link to overarching policy and procedure 4 4. Responsibilities, accountabilities and duties The Modern Matron Senior Sisters/ Sisters Named Nurses Shift Co-Ordinators All Nursing Staff 5 5. Procedure/ Implementation (Types of Search) Room Search Rub-down Search Floor Restraint Searches Action if a search of the patient s back is felt necessary Documentation Action to be taken if visitor is suspected of possessing a dangerous item, drugs or alcohol 5.7 Disposal of dangerous or illicit items Alcohol removed from the patient Prescription/over-the-counter drugs removed from a patient 5.10 Suspected illegal drugs Weapons Training Implications Monitoring Arrangements Links to associated documents References Appendices 16 Appendix 1 Record of when a search of a person or 17 their property is undertaken. Appendix 2 Rub-down Search Flow Chart. 18 Appendix 3 Copy of Receipt Booklet Template 19 Appendix 4 Security Box Inventory List 20 Appendix 5 Patient/ Staff Debrief Template 21 Appendix 6 Copy of Contraband Page 2 of 23

3 1. Aim We search to deter, prevent and detect, unsafe activities, by removing unauthorised items from patients. We may disrupt undesirable activities that limit opportunities to escape, harm others or harm themselves. The standard operating procedure (SOP) aims to work in line with the Mental Health Act (MHA) Code of Practice requirement to provide an operational policy on searching patients detained under the Mental Health Act 1983, their belongings, surroundings, and their visitors (Code of Practice MHA 1983 Section 16.10) The aim of this SOP is to provide service specific guidance for staff that work within the Forensic Service and who are required to carry out both proactive and reactive searches. Ultimately, search techniques provide a systematic procedure for finding articles which may present a threat to the safety of people or property, or which adversely influence the control of a ward area, thus disrupting the hospitals therapeutic task (Elvin 1989). The searching of a person or their property is not routine and, as such, should only be carried out in exceptional circumstances, for example, where the dangerous or violent criminal propensities of patients create a self-evident and pressing need for additional security (Dept. of Health 2008). In such circumstances, nursing staff have a statutory duty to provide both a safe and therapeutic living and working environment for patients and staff and to protect the public. Therefore, searches are an essential and justifiable component for safe practice. This policy takes into account guidance issued within a number of documents, including the Short-Term Management of Disturbed/ Violent Behaviour in Psychiatric Inpatient Settings and Emergency Departments (NICE, 2005), and the Memorandum of Understanding between the Association of Chief Police Officers (ACPO) and the NHS Security Management Service (2006). It also follows the clear principles laid out within the Code of Practice Mental Health Act 1983 (Section 16.11), which are: - 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 person s privacy and dignity. - To undertake all searches with due regard to, and respect for, the patient s dignity. Page 3 of 23

4 2. Scope The content of this SOP applies specifically to the Forensic Service within Rotherham Doncaster & South Humber NHS Trust (RDaSH) and provides procedural guidance for use by staff in this specific setting 3. Link to overarching policy and/or procedure This SOP is overarched by the Policy and Procedure for the Searching of a Person (Patients and Visitors) or their Property. It should also be used in conjunction with the Prevention and Management of Violence and Aggression Policy, and The Management of a Disturbed Patient Policy. Reference to the Forensic Service SOP for the Management of Prohibited and Restricted Items is also a requirement. 4. Responsibilities, Accountabilities & Duties 4.1 The Modern Matron The Modern Matron has the overall responsibility for ensuring that the SOP is cascaded and implemented to managers, sisters and the nursing team, that the SOP includes all relevant information and is reviewed, where appropriate, and in a timely manner. 4.2 Senior Sisters/ Sisters - The Senior Sisters and Sisters of the ward have the hands-on responsibility for ensuring that; the principles and practicalities of the SOP are embedded within nursing practice training is attended by nursing staff where required, care plans around searching are audited and reviewed with patient involvement where appropriate search equipment is readily available for effective searches to be carried out to deter, prevent and detect unwanted risk on the ward. It is the responsibility of the Senior Sisters to bring any issues around searching to the Modern Matron. 4.3 Named Nurses It is the responsibility of the Named Nurse, where justifiable and appropriate, the search care plans are written with the patient, where possible, and include: - Level of compliance in searches both historic and current. - The highlighted areas of risk concern, with reference to appropriate risk assessments i.e. SVR20/ HCR20/ HONOS. - Any contraband/ concerned items found - both historically and more recently. - Multi-Disciplinary Team (MDT) involvement in the care plan. - The patients level of insight into the risks. - Any religious or cultural guidance for staff, if appropriate to the individual, in relation to searching. This should include consultation with relevant communities. - A Proactive/ Reactive Search Record (Appendix 1) that highlights the dates and times of previous searches will provide a quick guide for staff. Page 4 of 23

5 It is important, however, that planned proactive searches (planned randomly) are not added to the chart for patient access. It is important that the care plans are robustly reviewed, and that any concerns are highlighted in the review i.e. volumatic control is fed back to MDT for guidance. It is also important that Named Nurses are responsible for ensuring that patient inventories (clothing and belongings) are up to date and are reviewed regularly with the patient s Special Interest Workers. An up to date patient inventory will act as support during a room search if any unknown patient items are found in rooms. 4.4 Shift Co-ordinators Qualified Nurse Co-ordinators must have an understanding of the current care plans in place, have the knowledge and competence required around the carrying out of searches (both proactively and reactively) and the risk, and are to be able to take the lead in organising this in a timely manner. Therapeutically, it is the responsibility of the Shift Coordinator to bring any issues around searches to the notice of the Senior Sister, Sister and Responsible Clinician, where appropriate. 4.5 All Nursing Staff All nursing staff have a responsibility to conduct their practice in line with this SOP and in accordance with the MHA 1983 and its Code of Practice. Staff must attend any training which is provided to promote the implementation of this SOP and bring any issues regarding searches to the Shift Co-ordinator, Senior Sister and Sister. 5. Procedure/ Implementation 5.1 Room Search On occasion, either proactively or reactively, rooms within the building may require searching. The need to search bedrooms, alongside environments is, in principle, for the same reason of detecting, deterring and preventing risk. However, the searching of a patient s bedroom requires a personalised approach. The ability to understand the differing risks that each bedroom may present, and how searching can also provide a means of gathering intelligence/ information on a patient during a search. If when the patient is asked for permission, this is not given, then it is important that a conversation is held with the patient to attempt to seek out the reasons for refusal. If the patient continues to refuse, then the Responsible Clinician is to be contacted for further advice. In the meantime, unsupervised access to the patient s bedroom is to be prohibited and, where possible, access locked off. It is important that a room search is carried out with the correct prior planning. It is essential that staff are professional, approaching and acting in a manner that shows empathy and respect for the patient s feelings and property. Room Search (with or without patient consent) Page 5 of 23

6 It is important, prior to the search being carried out, to ask the patient if they have any contraband or prohibited items in their room. Once the room search is organised, the patient is to be advised of the search in an appropriate place i.e. visitors room to allow for patient privacy. The patient is not to re-enter the bedroom once this information has been handed over. However, where possible, neither should the search be delayed after the information has been passed to the patient. If they so wish, the patient may be in attendance whilst the room search is carried out. It is important, however, that the patient is sat outside of the bedroom, allowing them sight of the search whilst ensuring that the hand held metal detector, is carried out within the same sterile environment from the point that staff enter the room to begin the search. Staff should also have a clear exit out of the room. Staff are to ensure that the search box is readily available prior to the search being carried out. The inventory of the search box should be checked, in addition to checking that the equipment i.e. torch/ search wand, is in working condition. Standard Personal Protective Equipment (PPE) will be readily available in the box i.e. gloves and aprons. However, the searching staff are to ensure, where appropriate, that extra PPE equipment is available, if any risks are highlighted within the patient s individual search care plan or if any risk is highlighted either prior to, or during, the search. The search will be carried out by two members of staff, one of whom will be the same gender as the patient. The other will be a Registered Nurse. The registered nurse will be responsible for leading the room search. It is preferable that either the registered nurse, or the same gender staff member, has attended the divisional Forensic Enhanced Search Training. It is essential that, prior to searches being carried out either pro-actively or reactively, that individual care plans are read thoroughly and that both searchers have a good understanding of the individuals current and clinical risk, whilst also taking into consideration any cultural and/or religious beliefs. The room search is to be carried out in a systematic fashion, for example, starting from top to bottom, left to right, breaking the room down into agreed segments and ensuring that all areas are adequately searched. It is paramount, however, that the searchers do not check any areas with their fingers which they cannot visibly see - this is to protect them from potential harm. Searchers are to use the search mirror (available in the search box) for these areas. The staff member leading the search (lead searcher) will be agreed prior to the search commencing and will commence the room search, with a second staff member. Working in conjunction with the second staff member the lead searcher will identify areas within each segment/area to be searched. The items in each segment, including loose furniture, will be moved (where possible) to the middle of the room and searched prior to being replaced. Page 6 of 23

7 Reasonable effort is to be made to replace items as they were originally found. It is important that the room search is continuously carried out by two staff members, as this will be key if any allegations are made, assaults attempted, or if any damage is reported/ found/ accidentally caused during the search. Any issues around search fatigue, i.e. if a search is taking over 2 hours, are to be discussed with the lead searcher and, if required, staff are to be given the opportunity to swap with another staff member. It is important however that, wherever possible, one of the original searchers remains, to ensure consistency and continuity. If any items are required to be removed from a room during a search, the patient/ visitor is to be given a receipt for the items removed and explanation is to be given as to why. In circumstances where damage is caused during the room search, this must be reported, with any damages caused being replaced. If any portable devices i.e. Playstations, memory sticks, are unable to be checked at the time, then it is imperative that these are removed for checking. If the devices are unable to be checked in the area, the RDaSH IT Service are available to support in searching the memory of such items, and should be contacted as follows: - Log the required search as urgent. - The system will confirm and will allocate the search an assignment number. - The item to be searched will be forwarded to 2 nd line desktop at Chestnut View. - Chestnut View will contact the area with a date and time for the device to be delivered to Chestnut View. - Staff to attend Chestnut View on the date and time given and remain present during the search of the item. Any evidence i.e. printing of the memory contents etc. is to be carried out at this time and the item returned to the ward. - Any contraband/ concerns identified within the search are to be fed back to the Responsible Clinician. At the end of the search it is important, and of therapeutic value, that the patient s compliance during the search is acknowledged by the searchers. At this point, a post-incident review is to be offered to the patient, both consenting or not. The outcome of the room search will be conveyed to the Responsible Clinician, detailing the length of time of the search, the level of compliance from the patient, a general description of the bedroom searched i.e. clean and tidy, a list of items removed (if any) and the reasons why. This information is also to be documented within the patient electronic records and updated within the individuals care plan. Any further action required will then be decided by the Responsible Clinician of Manager-On-Call. Page 7 of 23

8 It is noted, and staff are to be mindful when carrying out room searches, that patients restricted mail i.e. tribunal letters and Ministry of Justice correspondence, can be searched but is prohibited from being read. 5.2 Rub-Down Search Rub-down searches can be carried out either pro-actively or reactively. Proactively needs to be justified against areas of risk that will be agreed with the MDT and an appropriate care plan compiled and implemented. Reactively in circumstances whereby risk highlights as essential the need to carry out the search to prevent harm to the person, others, or members of the public. As a minimum, two staff are to carry out this procedure, one being a registered nurse and the other is required to be of the same gender as the patient. It is essential that the person who will be physically searching the patient is of the same gender as the patient. If, in extreme circumstances, there is not a male member of staff on the ward, then male staff are to be temporarily redeployed to carry out the search. The role of the second member of staff is to observe the procedure as support for the staff member carrying out the rub-down search. Prior planning is important before commencing the search. The searching staff are to ensure that the search box is readily available and that all required equipment is in working order. Where appropriate, the searching staff are to have a good knowledge of the search care plan. The searching staff are to ensure that an appropriate room i.e. the visitors room, is readily available for the search. This is to promote privacy, whilst also allowing an appropriate amount of space to carry out the rub-down search. When appropriate, the patient should be asked to move to the appropriate area for the search to be carried out. Under no circumstances is the patient to be given prior warning of the search, as this could give them the opportunity to remove any items from their person. It is essential that, prior to the search being carried out, the patient is asked whether they give permission for the search to be carried out. Upon permission being given, the individual is to be asked whether they have any contraband items, or items of concern, upon their person. It is important that, from the commencement of the procedure, the staff empathise with the patient, have an understanding of the procedure being carried out upon the patient and, where possible, maintain a therapeutic level of engagement with the individual, to promote both therapeutic working and to minimise the level of risk, where possible. Once permission is granted and any contraband items discussed, then where relevant, the patient should be asked to remove any watches and outer wear, empty their pockets and remove shoes. Staff are to ensure that the patient is asked to remove any religious or medical headwear i.e. Sikh turbans or wigs, and that they are encouraged to remove these themselves. Staff should search these items and allow the patient to put them back on at the earliest opportunity, and prior to the rest of the search being carried out. Page 8 of 23

9 At this point, the patient can be searched in a systematic manner, using the hand held metal detector from top to toe and section by section (as detailed in Appendix 2). Once the search has been carried out using the search wand, it is then to be repeated (again, as detailed in the flow chart), with the searcher using their hands, as below, rubbing down on the clothed body. Staff are not to rub-down areas of bare skin i.e. if the patient is wearing a t- shirt, as these areas are visible to the eye. Once this has been carried out, a thorough search is to be made of any items removed i.e. shoes, watches etc. The searching staff are to pay particular attention to items such as watches, which can have additional built-in devices ie. lighters./cameras, recording devices Staff are to ensure that receipts are given to the patient if any contraband/ items of concern were removed from them. Outcomes of the search are to be documented within the patient s electronic record, as highlighted in 5.8. If in any situation a patient either refuses a rub-down, or a rub-down has been carried out but staff still have concerns regarding a secreted item which they have been unable to detect during the rub-down, then the Responsible Clinician should be contacted for further advice at the earliest opportunity. Currently, the Low-Secure Forensic Service staff are not trained to carry out any higher-level searches i.e. body searches. There are occasions, however, when staff will have to carry out a rub-down of a patient under restraint. All nursing staff are able to carry out this search after completing the mandatory Enhanced RRI (Reducing Restrictive Interventions) training. This may be deemed necessary, following discussion with the Responsible Clinician, if the patient does not given permission or during occasions of restraint if a patient requires secluding, as detailed in section At the end of the rub-down search where permission was given by the patient, the level of the patient s compliance should be acknowledged by the searchers. A post-incident review is also to be offered to the patient. 5.3 Floor Restraint Searches This method of searching should only be used in exceptional circumstances, such as prior to the seclusion of a patient, and will only be conducted after the patients Early Warning Scores (EWS) have been completed and the patient is in the SUPINE (face up) position. Once the patient is in SUPINE restraint, the lead person will ask the patient if they have any items on their person that are illegal, dangerous or restricted. The patient should then be informed that they will be searched. A staff member of the same gender as the patient will then begin the search, initially using the metal detector wand/ glove. - The search will be conducted in a systematic/ logical order i.e. starting at the head and working down one side, and all areas such as pockets, collars, cuffs, hair, waistbands, socks and shoes etc, are to be searched. Once the search has been completed on one side, the staff member Page 9 of 23

10 conducting the search will move to the other side of the patient and the staff who are undertaking the restraint will be required to adjust their position to allow easy access to the patient for the search to be completed. Wherever possible, the staff member conducting the search is to avoid leaning over the patient to search their other side, as this can be intimidating for the patient. - Staff are NOT to put their hands into any pockets, and should use equipment such as tongs to pull anything out. - If the search is being undertaken prior to seclusion, then the patient s shoes, socks, belts etc. are to be removed, as per the Management of a Secluded or Segregated Patient Policy. - Once the metal detector search has been completed, a rub-down search should be conducted over the same areas previously searched, in order to pick up on anything that is not metal and so overlooked in the previous search. - Throughout the search, the lead nurse should be constantly reassuring the patient and keeping them informed as to what is happening and why. - Once the SUPINE search has been completed (this can take as long as it needs to take do not rush it, as both patient and staff should be safe and secure in this position), the clinical team can consider whether a search of the patient s back is required. 5.4 Action if a search of the patients back is felt necessary. - The patient should not be turned into a prone position to conduct a search of their back. The restraint team should turn the patients onto their side to conduct a search of their back (the restraint can still be maintained during this time). The patient can then be turned onto their opposite side, if required, to ensure that a thorough search is undertaken. - Once the patient is on their side, a full metal detector search can be completed of their back (this may require adjustments from the restraint team) followed by a pat-down search. - It is important that, during the search, staff are mindful of the physical monitoring (EWS) of the patient (as per policy) and, if necessary, the search can be halted in order to complete this. 5.5 Documentation A comprehensive record of every search, including the reasons for it and details of any consequent risk assessments, should be made. Code of Practice Mental Health Act 1983 In all cases the following action must be taken by the Nurse in Charge as soon as possible after the search has taken place, and before the end of their Page 10 of 23

11 period of duty. - Complete and submit an Electronic Incident Form (IR1). - Complete the record for when a search is carried out (see Appendix 1) and file in the patients clinical records. - Contact the registered nurse via the bleep and ask that the search be documented, if not pro-active. - Explain to the patient that any illicit or dangerous items will be disposed of and not returned to them upon discharge. - For any other items removed, the Patient s Money & Property Policy and Procedures must be followed. - The Nurse in Charge is to ensure that the patient/ staff debrief be carried out on the template attached, Appendix Where a patient s belongings are removed during a search, the patient should be given a receipt for them and told where the items will be stored. Code of Practice Mental Health Act The Nurse in Charge will make a decision regarding the level of observation the patient will require and record this in the clinical record once the search has been carried out, if appropriate. This is to be assessed on an individual basis. - The patient s risk assessment and care plan will be amended accordingly, if appropriate, and if changes are required to be made. - Inform the patient of the Policy & Procedure Relating to the Handling of Formal Complaints, should a patient wish to make a formal complaint in relation to the search. 5.6 Action to be taken if a visitor is suspected of possessing a dangerous item, drugs or alcohol. - The Nurse in Charge will discuss staff suspicions with the person concerned, explaining why the items are not allowed onto the ward and ask them to hand in anything they may have on them. - If they deny having anything on them, the Nurse in Charge will ask the person if they will consent to having their baggage and person searched. - If they agree, staff will continue as for person search, informing the person that any illicit or dangerous items will be removed, disposed of and not returned to them. Any other items will be removed, a receipt issued and retained until the visitor leaves. Page 11 of 23

12 - If the person refuses to have their baggage and person searched, staff will deny them access to the ward and ask them to leave, explaining their reasons. - The patient they had come to visit will be informed why the person was not allowed access to the ward. - An Electronic Incident Form (IR1) will be submitted. - The record for when a search is carried out is to be completed (see Appendix 1) and filed in the clinical records of the patient who was being visited. - The incident will be documented on the bleep report and the Responsible Clinician (RC)/ Matron/ Senior Nurse notified. - The Responsible Clinician of the patient whom the person had come to visit will be informed. A decision will then be taken as to whether the visitor may visit the patient. This will be a multi-professional decision lead by the Nurse in Charge of the ward or Matron, along with the Consultant. When making the decision, due regard must be given to the maintenance of a safe environment for all patients and staff. The decision will be fully documented within the clinical records and will also have a process for review included. Inform the visitor of the Policy & Procedure for the Handling of Formal Complaints. 5.7 Disposal of Dangerous & Illicit Items If the search uncovers evidence of serious criminal activity or where a need arises to preserve evidence then the items should be: - Handled as little as possible to preserve and avoid the contamination of any evidence. - Secured in a place of safety (away from the patients). The Police are to be contacted and the Local Security Management Specialist (LSMS) informed. Further advice on how to preserve evidence will be given by the Police and/ or the LSMS. 5.8 Alcohol removed from the patient. This will be disposed of by 2 staff members with the patient present, if they wish. The alcohol will be poured down the sink and the bottles/ cans safely disposed of. A record is to be made in the clinical records indicating what was disposed of and by whom. Page 12 of 23

13 5.9 Prescription/ over the counter drugs removed from patients. Any medicines brought into hospital by a patient remain their property and will not normally be destroyed or otherwise disposed of without their agreement. In the event that the patient is unable to consent to the disposal or not of these medicines, agreement can be sought from their carer. If the patient/ carer refuses to agree to the disposal of the medicines, they can either: - Be held in a sealed bag in a separate section of the medicines cupboard from all other stock until discussion can be held at the next MDT meeting. Or, - if the patient insists: - Be returned home. However, the patient and/or their carer must be advised that as the treatment regime will be reviewed whilst the patient is on the ward, it is likely that the supplied discharge medication will be different, and that this may pose a real risk that the wrong medication may be taken in the future. If there are safety concerns in relation to the medication being returned home, then the Nurse in Charge, in consultation with the Consultant Psychiatrist, may make a decision to refuse to return the medicines and have them destroyed. For the safe disposal of any medicines, staff should refer to the guidelines issued by their supplying pharmacy. All actions taken should be fully documented within the patient s clinical record Suspected Illegal Drugs The Trust does not condone the use of illicit substances and in accordance with its duties under the Misuse of Drugs Act (Home Office 1971) will not knowingly permit the use of, or dealing in, illicit substances on its premises. If any visitors are seen to be in possession of a suspected illicit substance, they will be asked to leave the premises. If any visitor is seen to, or suspected to, have passed illicit substances to a patient or other visitor, they will be asked to leave. The Nurse in Charge of the ward will then consult with the Matron about the need to report the matter to the police and consider the appropriateness of further visits by this person, in line with this policy. Page 13 of 23

14 In the event that it is a patient who is suspected to have illicit substances upon their person or within their room/ belongings, the Nurse in Charge of the ward will discuss their suspicions with them and ask that they voluntarily hand over the substance for destruction. This discussion must be held in the company of another staff member who will act as witness to the handing over and disposal of the suspected illegal drug. The illicit substance will be: - Placed in an envelope. - An entry will be made in the controlled drug register under the heading of unidentified substance. - The envelope will be labelled with a reference number linking it to the entry in the controlled drugs register. - The envelope will be sealed. Both the Nurse in Charge and the witnessing staff member will sign and date across the sealed flap of the envelope. - The envelope will then be locked in the ward s controlled drug cupboard. - In order to maintain patient confidentiality, their name will not be documented in the controlled drug register. - The Chief Pharmacist, Accountable Officer for Controlled Drugs, should be notified of the unknown/ illicit substance as soon as it is practicable and arrangements will be made for the removal and safe disposal of the substance by the Trust Pharmacy Department. - If staff involved in the removal of illicit substances from a patient have reason to suspect that the quantity involved is greater than for personal use, advice should be sought from the Modern Matron with regard to the need for the matter to be reported to the police. NB Under no circumstances will any suspected illicit substances be returned to the patient. If the patient refuses to hand over the illicit substance for destruction, they are to be placed on 1:1 nursing observations and the need for further action, including searching, will be discussed with the Modern Matron and the patient s Consultant Psychiatrist. - All actions taken will be recorded in the patient s clinical record, or in the case of a visitor, on the ward report. - An Electronic Incident Form (IR1) will be completed and submitted for all incidents Weapons Small sharps can be disposed of in the ward sharps bins, but with regard to any guns, hunting knives or other items that staff are unsure about, the police should be notified, and will collect and dispose of the item. An entry will be made in the patient s clinical record indicating what was disposed of, when, and by whom. Page 14 of 23

15 NB UNDER NO CIRCUMSTANCES WILL ILLICIT OR DANGEROUS ITEMS BE STORED AND RETURNED. NOR WILL ANYONE BE COMPENSATED FOR THE LOSS OF SUCH ITEMS. 6. Training Implications The Mental Health Act Code of Practice 2008 requires that staff involved in undertaking searches should receive appropriate instruction and refresher training which, within the Trust, will be provided at induction and as part of the on-going Managing Work Related Violence training. Advanced forensicspecific training is currently being rolled out within the Forensic Service and nursing staff will have the opportunity to attend. 7. Monitoring Arrangements The exercise of powers of search should be audited regularly and the outcomes reported to the hospital managers. Code of Practice Mental Health Act 1983 Area for monitoring How Who by Reported to Analysis of search Outcomes Senior Modern incidents reported and of search. Sisters. Matron/ actions taken/ learning Patient/ Service from incident reports. staff Manager. Review of any complaints received which relate to the implementation of this policy/ procedure. debriefs. Complaints report. Modern Matron/ Senior Sister. Service Manager. Frequency Quarterly. Quarterly. 8. Links to any associated documents. Policy for Patients who are Missing or Absent Without Leave (AWOL), Clinical Policies/Clinical General/Care Treatment and Assessment Trust Website. Policy for the Prevention & Management of Work Related Violence and Aggression, Corporate/Learning and Development Trust Website Policy for the Provision of, Access to, and Use of Interpreters for Patients/ Service Users & Carers, Clinical Policies, Clinical General/Admission Trust Website. Policy for the Care of Inpatients who are identified as Posing a Significant Risk to Themselves or Others, Clinical Policies, Clinical General/Care Treatment and Assessment Trust Website. Clinical Risk Assessment & Management Policy, Clinical Policies, Clinical Page 15 of 23

16 General/Care Treatment and Assessment Trust Website. Drug Misuse on Trust Premises Guidance to Trust Staff, Policy, Clinical Policies, Clinical Genera/Care Treatment and Assessment Trust Website. Policy & Procedure relating to the Handling of Formal Complaints (including unreasonably persistent complaints), Corporate/Patient Experience Trust Website Patients Money & Property Procedures, Financial Policies Trust Website 9. References Department of Health (2008) Code of Practice Mental Health Act Memorandum of Understanding between the Association of Chief Police Officers (ACPO) and the NHS Security Management Service (2006) NICE (2005) The Short-Term Management of Disturbed/ Violent Behaviour in Psychiatric Inpatient Settings & Emergency Departments Home Office (1971) Misuse of Drugs Act, The Stationary Office Appendices Appendix 1 Record of when a search of a person or their property is undertaken. Appendix 2 Rub-down Search Flow Chart. Appendix 3 Copy of Receipt Booklet Template Appendix 4 Security Box Inventory List Appendix 5 Patient/ Staff Debrief Template Appendix 6 Copy of Contraband Page 16 of 23

17 APPENDIX.1 Patient Identification Label: Proactive/ Reactive Search Record Date & time that search Commenced & ended Reason for search? Proactive / Reactive Items Removed Entry made in duplicate book Date patient debrief carried out Names of staff conducting search Page 17 of 23

18 APPENDIX. 2 PERMISSION? POCKETS EMPTY? ANYTHING UNAUTHORISED? HEAD HEADGEAR COLLAR SHOULDERS (JEWELLERY) ARM INCLUDING WATCHES/CUFFS OTHER ARM AS ABOVE FRONT SIDES WAISTBAND BELT (PROTECT PRIVACY & DIGNITY) BACK WAISTBAND BELT ONE LEG AT A TIME BUTTOCK POCKET INSIDE LEG OUTSIDE LEG HEM CHECK FLOOR AREA Page 18 of 23

19 APPENDIX 3 N.B. The Receipt Booklet can be ordered via NHS Supply Chain order details as follows: Duplicate Book 125mm x 200mm Product Order Code: WEL208 Cost per item: 83p Page 19 of 23

20 APPENDIX 4 Search Box Inventory 1 Rubber Sonca Torch 9. Pictorial Rub down guide 2 Duracell Torch 3 Duplicate receipt book 4 Hand-held Security Detector 5 Straight Pole Search Mirror 6 One Box of Gloves 7 Disposable aprons 8 Clear sealed disposable bag Page 20 of 23

21 Patient - Incident De-Brief APPENDIX 5 Aim: To ensure patients are supported through debrief session, following any incident of violence or aggression on the unit. Format below to be used as a prompt for individual and group sessions. Date of Incident Ward/Unit Patient Date of debrief Format/Group or Individual. Staff member carrying out de-brief Discuss Incident with the patient: allow the patient to discuss from their perspective, What do they think triggered the incident were they already feeling upset about something? Encourage patient to reflect on incident. (How did you feel? What did you feel at the time? How do you feel about the incident now?) If patient not able to explain how they felt can they describe physical changes in their body or any changes to senses? Analysis - what went well? Analysis is there anything we could have done differently? Actions what needs to happen next, and who will lead? As a result of De-brief please add analysis and patients perspective to Care plans/risk management plans, make sure all staff aware of any changes to care? Name of Lead for Debrief Post Held Page 21 of 23

22 Staff Incident De-Brief Aim: To ensure staff are supported through group or individual debrief, following an incident. Format below to be used as a prompt. Date of Incident Ward/Unit Staff Involved Date of debrief Format/Group or Individual. Staff present at debrief Discuss Incident, timeline and events that occurred. (Involve and encourage participation from everyone present). Encourage staff to reflect on incident. (How did you feel? What did you feel at the time? How do you think the service user feels? Analysis - what went well? Analysis is there anything we could have done differently? Actions what needs to happen next, and who will lead? are Care plans/risk management plans updated and in place, are all staff aware of any changes to care? Name of Lead for Debrief Post Held Page 22 of 23

23 APPENDIX 6 RESTRICTED ITEMS The items shown below are not permitted at Amber Lodge. Lockers are provided for you to lock your items safely away whilst on the unit. This list is not exhaustive. Alcohol Needles/syringes Medication Mobile Phones Vehicle/House keys Cigarettes Lighters Aerosols Items made of glass Photographic equipment of any description Knives, scissors or sharps of any kind Page 23 of 23