BOLETÍN OFICIAL DEL ESTADO
MÓDULO FORMATIVO 5
153 Table 19
Type 1 Standards for Young Peoples’ Rights and Safeguarding Children (n=25)
# Unit Standards Stakeholder Not
Met
Partially Met
Fully Met
Mode Qualitative reasoning 6.1.4 Staff explains to the young person who
their Nearest Relative/Named Person is and why this is relevant.
One 3 3 Generally, children admitted into the TLC
are aware of this given their admission with parents/carers and designated social services in support. Two 3 Three 3 Four 3 Five 3 Six 3 Seven 3
6.1.5 The young person’s Nearest
Relative/Named Person is recorded in the young person’s notes.
One 1 3 As standard practice, the details of the
children’s parents/carers are included in patient filing, which is usually collected during initial interviewing.
Two 2 Three 2 Four 3 Five 3 Six 3 Seven 3
6.1.6 Information is given to the Nearest Relative/Named Person about their rights.
One 3 3 According to the feedback provided,
information is provided to the Nearest Relative/Named Person routinely.
Two 2 Three 3 Four 3 Five 3 Six 3 Seven 3
154 6.2.1 Young people are able to see a clinician
on their own, although this may be refused in certain circumstances and the reasons why are explained.
One 3 3 According to clinical and nursing notes,
children have access to a senior registrar on a daily basis. Two 3 Three 3 Four 1 Five 3 Six 3 Seven 3
6.2.2 Young people are asked for their preference of staff member to act as a chaperone for physical examinations. This is provided if feasible and if not the reasons for this are documented.
One 1 2 Overall, this process is applied to a certain
degree. The admitted child’s interests are taken into consideration regarding preference and comfort of those present. It becomes difficult due to staff roster schedules where a preferred staff member may not be on duty.
Two 2 Three 3 Four 3 Five 3 Six 1 Seven 3
6.2.2* Staff members are able to access training or specific information about the mental health needs of young people from minority or hard-to-reach groups. This may include: • Black, Asian and minority ethnic groups; • Asylum seekers or refugees; • Lesbian, gay, bisexual or transgender people; • Travellers.
One 1 2 Overall, training within this area is available
for access but its unfortunately limited and not always accessible to all staff. Information tends to be accessed on an individual basis.
Two 2 Three 2 Four 2 Five Six 2 Seven 3
155 Table 19 Continued
Type 1 Standards for Young Peoples’ Rights and Safeguarding Children (n=25)
# Unit Standards Stakeholder Not
Met
Partially Met
Fully Met
Mode Qualitative reasoning 6.2.3 The unit has procedures to ensure that
young people’s access to media (e.g. TV, DVDs, audio and the internet) is age appropriate.
One 1 3 Overall, this is facilitated and supervised
according to the therapeutic programme established. Despite little to no access to the internet, all other materials are made available with strict supervision.
Two 2 Three 3 Four 3 Five 3 Six 3 Seven 3
6.3.1 Information provided on complaints assures young people and parents/carers that if they complain they will not be discriminated against and their care will not be compromised.
One 3 3 There is some contention with this standards
satisfaction. Some team members agree that a complaints and compliments policy and quality assurance policy is in place whilst others do not. Some are aware that parents/carers are informed of non- discrimination for complaints.
Two 3 Three 3 Four 3 Five 3 Six 3 Seven 3
6.4.1 The team effectively manages young people violence and aggression.
One 2 3 As standard practice, this management is
carried out by staff members, especially from the practical support provided by behavioural training offered by the TLC and Timian. However, in reality it is difficult especially with inexperienced staff who may use Time Out procedures more frequently and when not necessary. Two 2 Three 3 Four 2 Five 3 Six 3 Seven 3
156 6.4.1* Young people who are involved in
episodes of restrictive physical intervention, or compulsory treatment including tranquilisation, have their vital signs monitored by nursing staff in collaboration with medics and any deterioration is responded to.
One 2 3 There is some uncertainty with the
application of this procedure as some feedback suggests unawareness. According to nursing and clinical notes and vital sign charts, observations are conducted daily by staff members who engage with restrictive intervention. Two 2 Three 3 Four 3 Five 3 Six 1 Seven 3
6.4.1* Staffs know how to prevent and respond to sexual exploitation, coercion,
intimidation and abuse on the ward.
Guidance: Staff must consider whether sexual incidents that are said to be consensual have been the result of coercion, exploitation or where a person’s capacity to consent may have been affected by her mental health. Where there is any doubt, the incident must be investigated.
One 1 3 Overall, these incidents may be more
appropriate to adolescent units/wards, however, if such instances occur, it is subsequently attended to by the team where incident reports are completed thereafter. The parents of the child involved are made aware of this. Two Three 2 Four 1 Five 3 Six 3 Seven 3
6.4.3 After any episode of control and restraint, or compulsory treatment including rapid tranquillisation, the team makes sure that other young people on the ward/unit who are distressed by these events are offered support and time to discuss their
experiences.
One 2 3 Overall, as standard practice, the staff of the
TLC run ‘worry groups’ to provide a safe and secure space of support for the children to discuss what had incurred and how they managed what they were feeling. Again, this is dependent on the level of experience of the staff members. Two 2 Three 3 Four 3 Five 3 Six 1 Seven 3
157 Table 19 Continued
Type 1 Standards for Young Peoples’ Rights and Safeguarding Children (n=25)
# Unit Standards Stakeholder Not
Met
Partially Met
Fully Met
Mode Qualitative reasoning 6.4.4 Parents/carers are informed about all
episodes of restraint within 24 hours. If for any reason this does not occur, reasons are documented in the young person’s notes.
One 1 1 Overall, restraint as defined here is rarely
utilised by staff members as opposed to escorting the child to Time Out. Depending on the severity and consistency of the behaviour, parents/carers may be informed but usually not within 24 hours.
Two 1 Three 3 Four 1 Five 3 Six 1 Seven 3
6.4.4* Individualised support plans,
incorporating behaviour support plans, are implemented for all young people who are being managed through the repeated use of restrictive physical interventions. Guidance: The support
plans are developed using functional analyses/applied behaviour analyses to understand, manage and prevent incidents.
One 2 2 Overall, according to nursing and clinical
notes and staff weekly meeting schedules, detailed behavioural plans are developed occasionally but not routinely. It’s important to try and individualise plans and goals for each child admitted to the TLC
Two 2 Three 3 Four 2 Five 3 Six 1 Seven 3
6.4.4* Systems are in place to enable staff members to quickly and effectively report incidents. Managers encourage staff members to do this.
One 2 3 Overall, systems of effectively reporting
incidents from staff members are established at the TLC which is discussed thoroughly in team meetings such as operational
management meeting. More encouragement is needed for staff members to learn from these incidents and reports as supposed to means of practice Two 3 Three 3 Four 3 Five 3 Six 3 Seven 3
158 6.4.5 The team audits the use of restrictive
practice, including face-down restraint.
One 1 1 Overall, audits are conducted on Time Out
procedures and not restrictive practice as outlined in this unit standard.
Two 1 Three 2 Four 1 Five 3 Six 1 Seven 2
6.4.6 Staff members know how often young people are restrained and how this compares to benchmarks, e.g. by participating in multi-centre audits or by referring to their previous years’ data.
One 1 1 Overall, no audits or comparisons are
conducted with other units on restraint statistics. Staff members, however,
reportedly know how often children admitted are restrained. Two 1 Three 3 Four 1 Five 1 Six 1 Seven 2
6.4.7 The unit follows organisational policies for untoward occurrences and critical incident reporting. Guidance: This
includes the circumstances and justification of using restraint, and the recording of information after a restraint has occurred.
One 2 3 Overall, this policies and procedures are
followed through behaviour management policy and incident reporting. However, more reflective practice is recommended.
Two 3 Three 3 Four 2 Five 2 Six 3 Seven 3
159 Table 19 Continued
Type 1 Standards for Young Peoples’ Rights and Safeguarding Children (n=25)
# Unit Standards Stakeholder Not
Met
Partially Met
Fully Met
Mode Qualitative reasoning 6.5.1 It is recorded as to whether or not a
young person has a child protection plan in place.
One 2 3 Overall, there were little detailed responses
to this unit standard specifically. From the feedback there was an understanding that this plan is carried out through the social work department but there is uncertainty to what the local equivalent would be.
Two 3 Three 3 Four 2 Five 3 Six 3 Seven 3
6.5.2 The unit has a named child protection lead and staff knows who this is.
One 1 1 Overall, there were little detailed responses
to this unit standard specifically. One point refers to the social worker who takes up this role of child protection lead whilst the other point disagrees with a position being available in the first place.
Two 1 Three 3 Four 1 Five Six 3 Seven 3
6.5.3 The unit has policies and procedures which are compatible with LSCB (or local equivalent) guidelines, including the conduct of reviews and procedures for working together.
One 1 1 No responses were provided on this unit
standard. Two Three 2 Four 2 Five 1 Six 3 Seven
160 6.5.4 Staff knows what to do if there are
safeguarding concerns and who to contact, during and out of working hours.
One 1 3 The TLC staff are aware of these procedures
through the RCWMCH social work department standard operating procedures and Department of Social Development.
Two 3 Three 3 Four 3 Five Six 3 Seven 3
6.5.5 If a young person raises safeguarding concerns or someone else raises concerns about them, staff inform them of the process that will be followed by the unit and other agencies.
One 1 3 Overall, there were little detailed responses
to this unit standard specifically. According to feedback given, this process is reported to the social work department as standard practice. Two 2 Three 3 Four 2 Five 1 Six 3 Seven 3
6.6.1 The local authority will be made aware if a young person remains on the unit for a consecutive period of 3 months (in line with section 85 of the Children Act 1989).
One 1 2 Overall, the majority of responses have said
that this aspect is irrelevant to the TLC and is not carried out. Another response refers the reader to this process being carried out by the social work.
Two Three 3 Four 2 Five Six 2 Seven 3
161 Table 19 Continued
Type 1 Standards for Young Peoples’ Rights and Safeguarding Children (n=25)
# Unit Standards Stakeholder Not
Met
Partially Met
Fully Met
Mode Qualitative reasoning 6.6.2 The local authority is alerted if the
whereabouts of the person with parental responsibility is not known or if that person has not contacted the young person.
One 2 3 Under this conditions, which are apparently
rare, the TLC will ensure that the Department of Social Development are contacted. Two 3 Three 3 Four 3 Five 3 Six 3 Seven 3
Note. The unit standards that are marked with an * are duplicate standards from the updated and revised standards post the 2016
reviews. These revisions are either based on the type status or simply new unit standards that have been added to the overall checklist
with the same unit standard number.
162