RQIA Independent Review of Child and Adolescent Mental Health ...

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RQIA Independent Review of Child and Adolescent Mental Health ...

Criterion 2.4.4 - Trusts should develop protocols to ensure the best interest of the young person on the adult ward:

including access to separate bedroom accommodation, with supervision according to assessed risk, completed risk

assessment and identification of how risks will be managed: This should also include care and treatment planning,

including educational and leisure activities.

All trusts had developed protocols. Southern and Western Trusts provided the most comprehensive protocols in relation to this

and provided evidence of good practice. All trust protocols reflected the guidance issued and this was validated through visits to

three adult wards. The Northern and Southern Trusts reported that the older adolescent admitted to adult wards may not be

placed on observation throughout their stay in hospital. However, a risk assessment is completed, in accordance with DHSSPS

guidance letters, to ensure a joint risk assessment informs this decision.

Criterion 2.4.5 - Proactive consideration of specialist adolescent inpatient units elsewhere to facilitate young people who

may require inpatient care for prolonged periods.

All trusts indicated that young people in an adult unit would be considered for specialised care in an area which provides the

service required. The Northern Trust were able to provide an example of when this happened in a recent admission of a young

person who required secure care.

Criterion 2.4.6 - Evidence of facilitated early discharge from inpatient facilities with provision of appropriate care package

in the community.

Trusts identified that discharge was considered at the earliest possible point in admission. This would be discussed at an initial

meeting in the Northern and Western Trust areas.

Criterion 2.4.7 - Discharge planning should be initiated as soon as possible after the service user is admitted to an

inpatient psychiatric facility.

All trusts suggest they are compliant with this and protocols often indicate that discharge planning starts from admission.

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