Patient and staff safety put at risk by 'unsuitable' mental health seclusion area, NHS trust report says
Patient and staff safety at a Shrewsbury medical facility is being put at risk by an “unsuitable” mental health seclusion area, an NHS trust report says.
Safety and risk management head Duncan Kett writes that the doors of the facility, at Shrewsbury’s Redwoods Centre, “can be kicked open” by agitated patients.
In his report for the Midlands Partnership NHS Foundation Trust board, Mr Kett says acute use of the rooms increased in 2020-21 compared to the previous year.
Causes include increased demand and case severity “linked to Covid-19”, and the problem is compounded by a “young, inexperienced” workforce, he adds.
Mr Kett says a business case is being developed to repurpose the centre’s existing Oak Ward to provide a new seclusion suite.
Mental Health Act guidelines say seclusion should only take place in designated facilities that are not used for any other purpose.
They should have a strong outward-opening door and allow the patients to be observed and spoken to from outside.
Mr Kett writes: “There is no dedicated seclusion suite for mental health patients at the Redwoods Centre; this creates a risk to staff safety.
“Current seclusion and non-seclusion rooms are not suitable. The doors can be kicked open and staff do not have the ability to withdraw and this intensifies the risk.
“This raises the potential for severe injury to patients and to staff.”
Demand
He writes that the trust’s Forensic Mental Health team use the suite for “high-risk individuals” and Acute Mental Health has used it nine times since April, an increase on 2019-20.
He writes this is linked to “increased mental health demand and acuity linked to Covid-19”, a “national PICU [psychiatric intensive care unit] shortage and delays in sourcing” which leads to patients staying longer on acute wards.
Mr Kett adds: “This is compounded by there being a relatively young and inexperienced staff group and a high level of vacancies leading to a high level of agency staffing.”
Report says this risk has a risk rating of 16 out of 25, placing it in the “red” category. Mr Kett’s report says acceptable levels of risk vary across different areas, but risks of this kind should not exceed the green 1-6 category. This risk was last reviewed on March 11, and the next bimonthly review is due in May.
A business case is being developed for a seclusion suite, Mr Kett writes.
“The work is scoping out the potential to repurpose a ward which will inform the business case options,” he writes.
“As part of this work, further scoping is required to ensure that the proposed repurposed ward will be sufficiently secure for seclusion requirement.”
The Midlands Partnership NHS Foundation Trust board will discuss Mr Kett’s report when it meets on Thursday, March 25.
