Contents
1 Aim
The forensic service aims to provide a safe environment for patients, visitors and colleagues.
Patients will have access to their personal possessions where appropriate. However it will be necessary to exclude or restrict some items from patients while they are resident at Amber Lodge.
Prohibited items are excluded because their makeup or properties are hazardous. This may be because they could be used to harm others; because of their harmful properties (for example: drugs or alcohol) or their intrinsic illegality (for example, child pornography or illicit drugs).
Restricted items may also be potentially hazardous. This may be because they could be used to; cause distress, to self-harm or to harm others. These items may be restricted but not prohibited because they can be valuable tools in encouraging normalisation and avoiding institutionalisation, providing opportunities for rehabilitation, social inclusion, recreation and diversion.
Access to restricted items will depend on many factors, some may be fixed and others subject to change. For items that may be considered for restricted use, colleagues should complete a thorough risk assessment in collaboration with the MDT team, and patients family and carers where appropriate. The risk assessment should include:
- person risk (individuals’ historical risks and current mental health state
- interpersonal risk (direct risk to others/patients and colleagues)
- environmental risks (ward dynamics and general service safety)
- common sense consideration of the item in question. 2019 CQC brief guide on the use of blanket restrictions in mental health wards
To ensure a safe therapeutic environment is maintained, for all patients, colleagues and visitors at Amber lodge.
This procedure describes the processes by which we will ensure best practice for the care and treatment of those using the low secure service and compliance against national standards for low secure services, whilst adopting the ethos of least restrictive practice.
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
This procedure is overarched by the forensic services manual and should be read in conjunction with the forensic service security procedure (see forensic services manual on the trust website).
4 Procedure or implementation
In the interests of health, safety and security, there are certain items which could pose a risk to the patient or colleagues on Amber Lodge. Notices detailing prohibited and restricted items are displayed in the air lock of Amber lodge (appendices G and H).
We therefore ask that visitors do not bring the items listed in section 4.1 onto the unit. All visitors prior to entry to the ward will be asked to store any prohibited or restricted items within the visitors lockers available in the airlock.
4.1 Prohibited Items
- Alcohol.
- Blu-Tack.
- Cans.
- CD’s or blank DVD’s.
- Chewing gum.
- Drones.
- Fidget spinner.
- Fire hazard Items, lighters, matches etc.
- Illicit or illegal substances.
- Laser pens.
- Equipment that can record moving or still images.
- Radio scanner.
- Recordable devices.
- Rope.
- Plastic bags.
- SD cards.
- Weapons of any type.
- Wire hangers.
- Wire-bound books
This list is not exhaustive.
4.2 Restricted items
- Aerosols.
- Basic and smartphone mobile phones.
- Energy drinks.
- Glass items.
- Glue or solvents.
- Identification.
- Laptop or tablets or USB.
- Money including bank cards.
- Needles or syringes.
- Photography equipment.
- Razors wet or dry.
- Scissors or cutting equipment.
- Steel toe-capped boots.
- Vehicle or house keys.
- Fidget spinners.
- Items of stationary
- Cutlery
- Tinned materials
This list is not exhaustive and needs to be aligned with the RDaSH blanket restrictions policy.
4.1 Procedure
On admission, patient’s property will be searched by colleagues as per the trust searching of a person or their property policy and any prohibited or restricted items will be removed and returned on discharge (depending on the nature of the restricted items). If any items are removed the details will be recorded into a duplicated Removed Items book (in line with the forensic service searching of a person, (patients and visitors) and their property procedure). A duplicated copy will be given to the patient as a receipt, one will remain in the book and one will be filed into the nursing care file for that patient. Under no circumstances will any unknown or illicit substances be returned to the patient. To dispose of any illicit substances, staff should follow the procedure outlined in the drug misuse on trust premises policy.
To dispose of weapons colleagues should contact the police for guidance. All removed items will be securely labelled and stored until their use is approved, or the patient is discharged or transferred from the unit. An explanation is to be provided to the patient of the reasons for this removal.
All visitors are required to leave all personal items included on the restricted items list in the lockers provided. This is to maintain the security of the unit, and for the safety of colleagues, patients and other visitors. Notices detailing restricted items are displayed in the unit airlock area. Any food or drink brought in by visitors must be shop bought, sealed and within its sell by date unless by prior arrangement with nursing colleagues.
Sharp objects held within the unit must be recorded as per the security Amber Lodge procedure.
Restricted items that patients have been granted access to by the multi-disciplinary team (MDT) must be stored in a secure cupboard within the service with nursing colleagues’ oversight and management. Any access to restricted items agreed by MDT will be individually care planned.
Patients are assessed by the MDT to establish the amount of money (for example, cash) they are able to hold on their person and in their personal bedroom safe. This also includes access to bank cards.
If colleagues suspect that a patient is in possession of either a prohibited item, or a restricted item not previously agreed, the following steps should be taken:
- the nurse in charge will ask the patient to hand over the item(s) to them and any patient’s leave may be suspended if required until discussed at MDT review dependent upon the items retrieved
- carry out personal or room search as per searching of a person, (patients and visitors) and their property procedure)
- inform responsible clinician and modern matron immediately
5 Appendices
Please see forensic services manual webpage for appendices attached to this procedure.
- Appendix G Restricted items poster
- Appendix H Prohibited items poster
Document control
- Version: 3.
- Unique reference number: 534.
- Approved by: Clinical policies review and approval group.
- Date ratified: 2 July 2024.
- Name of originator or author: Deputy ward manager.
- Name of responsible individual: Chief nurse.
- Date issued: 9 July 2024.
- Review date: 30 July 2027.
- Target audience: For all colleagues working in the forensic service.
- Description of change:
- Section 4: To remove ‘both units’ and replace with Amber lodge.
- Section 4.1 and 4.2: Patients now have e-cigarettes (plastics vapes) to remove from prohibited list.
- Section 5: To remove the sentence that restricted items are to be given to patients when they go on leave.
- Section 5: To include that any access to restricted items agreed by MDT will be individually care planned.
- Section 5: The amount of money patients can hold on their person is agreed by MDT to also include access to bank cards.
- Section 5: If colleagues suspect a patient is in possession of either a prohibited or not a previously agreed restricted item. (currently only mentions restricted items).
Page last reviewed: October 29, 2024
Next review due: October 29, 2025
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