Contents
1 Aim
To create a safe and structured way of increasing patients access to the internet which will promote communication and contact between patients and their families and friends, build on technical skills, independence and promote rehabilitation and recovery.
The policy is designed to ensure that the service can respond safely and effectively to patients needs and changing technologies and ensure that national standards for low-secure services are met.
The policy aims to prepare patients, who may have lived in a secure setting for a long time, for modern day community living. To achieve the above, the trust has funded individual iPads for each patient on Amber Lodge.
All guidance within the document considers specific Ministry of Justice (MoJ) restrictions that may be in place for individual patients detained under section 37/41 of the Mental Health Act.
2 Scope
This document applies specifically to the forensic service and provides procedural guidance for use of colleagues working in this service including agency, bank and students.
3 Link to overarching policy, and or procedure
- Forensic services manual
- Mobile devices, social media, the internet and digital content, appropriate and acceptable use
4 Procedure or implementation
4.1 Assessment for use of internet and technology
Each patient will be assessed by the multi-disciplinary team (MDT) to decide on the appropriate level of internet use based on risk. This will be completed on an individual basis and included as part of the patient’s care plan. Some patients will have restrictions (internal and external) which may limit or include supervision or no access to certain types of technology (social media). The MDT will provide a rationale for any restrictions and provide education and support in respect of the risk to them or others around the use of internet and technology.
4.2 The process for increased internet access or access to technology
- Patient request or professional recommendation for iPad, smartphone, or other technological device.
- Request is reviewed in MDT meeting.
- Patient to complete IT education booklets with social worker (including “social media”, “getting a phone and email” and “shopping” booklets). Social worker to agree timeframe with patient for completion of the booklets.
- Review work completed in MDT’s any other business to agree request.
4.3 Agreed and prohibited devices and applications
The MDT have formed a brief list of agreed and prohibited technological device and applications with the aim of promoting patients’ care and treatment whilst at Amber Lodge and managing risk to themselves and others. The list is not exhaustive; any other requests will be discussed on an individual basis with the MDT.
4.3.1 Devices
Agreed:
- phones (basic and smartphones)
- iPads (including apps)
Prohibited:
- Sky
- broadband
- any memory device (including USB memory sticks, dongles and SD cards)
- smart TVs
- patient’s own devices (excluding agreed smartphones)
- gaming consoles with internet connection
4.3.2 Applications
Agreed:
- banking
- YouTube
- transport (for example, Travel South Yorkshire, Trainline)
- Facebook (excluding Messenger)
- online shopping (for example, Amazon)
- food delivery (for example, Just Eat)
- HMRC
- Netflix
- quiz apps
- videoc (for example, Zoom, Microsoft Teams or Skype)
- emailing (for example, Outlook)
Prohibited:
- TikTok
- Snapchat
- Facebook Messenger
- anything which requires a TV licence (for example, BBC iPlayer)
- gambling apps
4.4 Emailing
Patients will be supported to create individual email accounts is approved by the MDT. The email address must be appropriate and be identifiable to the patient (for example include their name or initials) and be agreed in MDT on a person-centred basis prior to the account being made. The email address will be subject to random checks which will be included in the patient’s individual care plans. Patients should ensure that they log out of their email account after each use.
4.5 Website access
Some patients who present a high level of risk will have an approved list of websites that they can access.
Patients are not permitted to accessing the dark web or any other illegal websites. Should this occur, it will be reported to the police without delay.
Patients are not permitted to access any websites of a sexual nature or adult nature whilst using the trust devices.
All items ordered on the internet will be subject to security procedures on arrival at the unit and if contraband items are found, they will be stored securely until discharge.
Patients should never delete the browsing history, as this will be subject to checking by colleagues on a regular basis.
4.6 Social media
Patients should only access social media if agreed by the MDT. Patients must provide colleagues with their profile and, or username and passwords, and patients social media will be checked by colleagues on a regular basis.
Patients should only add or follow others who have been approved by the MDT. Patients are not permitted to make unsolicited contact or search other profiles who do not wish to receive contact.
Patients must ensure they have logged out of their social media accounts after each use.
4.7 Prohibited internet use
- Accessing, sending or posting content that may cause distress to another individual intentionally or otherwise.
- Accessing, creating, sending, sharing any post or material (including information, question or opinions) which is libellous, pornographic, sexually explicit, obscene, indecent, or extreme or which is discriminatory, harassing or includes hostile material relating to gender, sex, race, sexual orientation, religion, disability or may incite hatred violence terrorism or any illegal activity.
- Sending any communications other than from MDT approved individual personal email that much be identifiable to the patient.
- Downloading or distributing programmes, music or films which may infringe copyright.
If a prohibited use is identified, the session will be terminated, and access suspended until an investigation has been completed by the ward team. Repeated or serious breaches may result in the patient’s internet access being permanently suspended. Any breaches that are thought to be criminal in nature will be reported to the police at the earliest opportunity.
4.8 Risk assessments
The use of internet and technology in forensic services are restricted as per patient’s individualised care plans. Prior to any internet access, all patients will be individually risk assessed using guidance below:
| Risk | Example of risk | Guidance |
|---|---|---|
| High risk |
|
One to one close supervision of all internet use or no access to social media. |
| Medium risk |
|
|
| Low risk |
|
|
Across all levels of risk (high, medium and low), patient devices will be subject to weekly trust IT history review.
The level of risk identified for each patient is subject to review. All increased access to the internet will be discussed at MDT. Should there be concerns about inappropriate use of the internet, access to the internet will be suspended by colleagues.
All colleagues will have iPad training sessions with trust IT service to support them with basic knowledge of navigating such device, and to increase awareness of recognising inappropriate internet use which could compromise safety and security.
4.9 Safeguarding
All patients will receive an individual log in to access the trust’s Wi-Fi. This will enable monitoring of internet usage by weekly IT history checks and enable any illegal activity to be attributed directly to the individual.
All colleagues will be supported by visual easy read guides, to enable them to competently check devises (iPad and smartphones). Patients will be limited to purchase iPhone or Android devices only, to ensure that colleagues are able to navigate the searching of devices for the protection of the patients and others.
Devices cannot be shared between patients. The iPads will be individually allocated and identifiable to each patient; this will be achieved by marking each iPad with a UV pen.
Patients will only be allowed unsupervised access to iPads or smartphones (if agreed by MDT) in their own bedrooms to mitigate safeguarding concerns. This is due to these devices having audio and video functionality which may be disruptive to other patients and the content may be offensive and or upsetting to some. In addition, images and recordings may be taken overtly and covertly, edited and, or shared without consent.
Patients must not live stream, as this adds a specific risk in terms of safeguarding, as it allows very little scope for intervention by professionals before the content is seen by an audience.
Patients who are allowed unsupervised access to iPads and smartphones must agree to turn their hotspot off to ensure that no other patients can access internet from their devices.
Where there are concerns relating to the patient’s capacity to consent to any restrictions being considered a capacity assessment must be undertaken and evidenced on a Mental Capacity Act (MCA 1) form. Where the patient lacks capacity to consent and there is a risk posed, a best interest decision should be made and evidenced on a MCA 2 form. Colleagues should seek further guidance from the trust’s MCA Mental Capacity Act 2005 policy.
Where there are specific concerns about the patient’s capacity around use of social media and the internet, a separate assessment of capacity should be undertaken.
It is a breach of relational security for patients to attempt to contact colleagues on social media or by other means online and for colleagues to accept these from patients or members of their family. Any breach will result in suspension of the device until review by the patient’s responsible clinician in the next monthly MDT meeting.
Should any patient not have a mobile phone, there is access to a telephone during their stay. On Amber Lodge there is a private telephone room available to all patients. Calls are connected by the trust switchboard then charged to the individual by the finance department. Calls to solicitors, social workers, care coordinators etc. are free of charge.
Once a patient is discharged from the service, any devices belonging to the trust will be sent to the IT department to be re-set. Any intentional damage to trust devices will be discussed within the patient’s multi-disciplinary meeting and an outcome and, or action agreed.
4.9.1 Security
Colleagues and visitors are requested to leave mobile phones and other devices in the lockers provided when entering the forensic wards.
Colleagues will carry out weekly environmental checks around the ward to review any ability to detect “hot spots” from any areas surrounding Amber Lodge.
Patients will not be allowed any unsupervised access to trust devices due to the risk of accessing confidential information.
Document control
- Version: 3.
- Unique reference number: 529.
- Approved by: Clinical policies review and approval group.
- Date approved: 7 May 2024.
- Name of originator or author: Forensic ward manager and social worker.
- Name of responsible individual: Chief nurse.
- Date issued: 15 October 2024.
- Review date: 31 October 2027.
- Target audience: All colleagues working in the forensic service.
- Description of change: General review and thorough inclusion of internet access, mobiles, and online devices being used in forensic inpatient setting.
Page last reviewed: November 18, 2024
Next review due: November 18, 2025
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