Healthcare Improvement Scotland (HIS) has published its findings after a Mental Health Services Safe Delivery of Care inspection at NHS Lanarkshire’s University Hospital Wishaw in December.
A report has highlighted concerns about the use of restraint and seclusion in a mental health unit at a Lanarkshire hospital.
Healthcare Improvement Scotland (HIS) has published its findings after a Mental Health Services Safe Delivery of Care inspection at NHS Lanarkshire’s University Hospital Wishaw in December.
HIS inspected four wards on the mental health unit at the hospital, spoke to staff and patients, and reviewed policies and procedures.
The inspection found that while patients were treated with care and compassion and nurses were complimentary about their learning experiences, some concerns had been raised.
HIS chief inspector Donna Maclean said concerns had been raised about the use of “prone restraint”, the lack of physical health monitoring during and post restraint, and the use of seclusion.
She said: “During our inspection we observed staff treating patients with care and compassion. Staff told inspectors they were well supported by their senior colleagues and leadership was visible on the wards.
“Senior managers spoke positively about the workplace while student nurses were complimentary about their learning experiences.
“The hospital environment, including communal areas, were clean and inspectors found that the majority of areas were well maintained.
“However, after reviewing incident reports, concerns were raised about the use of prone restraint, the lack of physical health monitoring during and post restraint, as well as the use of seclusion.
“Inspectors also observed that the use of mixed sex and mixed function wards is challenging for staff and patients with regards to privacy and dignity.”
The inspection resulted in four areas of good practice being highlighted, three recommendations and 12 requirements.
Other areas for improvement included on documentation and protected learning time for staff.
An improvement action plan has been developed by NHS Lanarkshire to meet the requirements.
Eddie Docherty, director of quality assurance and regulation at HIS said: “Our previous mental health inspection programme was focused on infection prevention and control.
“It was agreed with Scottish Government to widen the inspection focus from infection prevention and control to a broader assurance function, creating a new and revised `safe delivery of care’ assurance model in NHS adult mental health units.
“We believe it is important to provide public assurance that adult mental health units in Scotland are safe for patients and staff, provide quality person-centred care, with clear leadership and a focus on improvement.”
Mental wellbeing minister Maree Todd said: “The safety and dignity of people receiving mental health treatment is paramount.
“While the report identifies good practice, we take very seriously the concerns around the issue of mixed sex and mixed function wards, the use of prone restraint, and the lack of physical health monitoring during and post restraint.
“The Government is clear that the NHS must uphold the Supreme Court’s judgment and adhere to the EHRC’s new guidance on single-sex spaces. I expect Lanarkshire to address this as a priority.
“Restraint must always be properly recorded, monitored and audited – used safely and only as a last resort.
“I am grateful to Healthcare Improvement Scotland for their report and I will be meeting with NHS Lanarkshire to discuss how they will urgently progress the recommendations.”
Claire Rae, chief officer at University Health and Social Care North Lanarkshire, said: “We welcome Healthcare Improvement Scotland’s inspection report into mental health services at University Hospital Wishaw.
“We’re pleased to see the good work of staff recognised in the report. Our staff work hard to provide safe, compassionate and person-centred care, and it’s encouraging that their commitment and professionalism is acknowledged.
“It’s particularly positive that the inspectors noted our staff treat patients with care and compassion. It’s also very reassuring that staff say they’re well supported and that student nurses are complimentary about their learning experiences.
“Work has already started to address the report’s recommendations to ensure we continue to support patients and families with safe, high-quality care.”
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