Forensic Services Directorate

Updated 5 February 2016

At this inspection, we inspected three medium secure forensic wards at the John Howard Centre. The wards we inspected were: Bow, a ward for 15 female patients; Morrison, a 16-bed long-stay rehabilitation ward for male patients and Westferry, a psychiatric intensive care unit (PICU) for 11 male patients.

The multi-disciplinary staff on all three wards included a medical team, consultant psychiatrist, qualified nurses, healthcare assistants, psychologists and occupational therapists.

Updated 5 February 2016

We last inspected forensic wards provided by East London Mental Health Foundation Trust at the John Howard Centre in December 2012. We carried out that inspection under our previous inspection regime. Consequently, we did not rate the service. The service complied with all the regulations we checked at that time.

We will rate forensic wards at our next comprehensive inspection of East London Mental Health Foundation Trust.

We carried out this focused inspection on 11 November 2015 in response to information we had received about the safety of the service. Some patients had gone absent from the service without leave. Additionally, in July 2015, there was a serious disturbance on Westferry ward.

This inspection was focused on checking whether the service was meeting the required standards in relation to:

• How staff managed risks to ensure the service was safe.

• Patient involvement in planning their care and treatment.

• Patient access to activities.

This inspection found:

• The service robustly assessed and managed risks. The service obtained information about each patient prior to their admission. This included detailed information on risk. Ward staff developed plans to manage risks to the patient and others which were put into practice as soon as the patient was admitted. The multi-disciplinary team (MDT) on each ward regularly reviewed risks and amended management plans to ensure they were effective.

• The MDT kept patient leave arrangements under constant review. Patients were only granted leave when staff had followed trust procedures and made the appropriate safety checks.

• The trust had undertaken detailed investigations when patients had gone absent from the service and after the disturbance on Westferry. The trust had ensured the learning from these investigations had been shared with staff to improve the security of the service.

• Staff safely administered patients’ medicines.

• The MDT assessed each patient’s needs and developed a comprehensive care plan. Patients’ mental and physical health needs were effectively met.

• Staff had the appropriate skills and knowledge in relation to working with patients in a forensic service.

• Staff supported patients to plan and review their care.

• Staff treated patients with dignity and respect.

• Patients reported that they were able to participate in a range of activities.