Falklands : Falklands: SECURITY SOLUTIONS SOUGHT FOR KEMH
Submitted by Falkland Islands News Network (Juanita Brock) 04.08.2012 (Article Archived on 18.08.2012)
Following the incident where a patient at the KEMH went missing, the Health and Medical Services Committee received a paper reviewing security measures at the hospital.
SECURITY SOLUTIONS SOUGHT FOR KEMH
By J. Brock (FINN)
Following the incident where a patient at the KEMH went missing, the Health and Medical Services Committee received a paper reviewing security measures at the hospital. It highlighted the significant difficulties that the health service faces in preventing patients from absconding from KEMH, the difficulties including balancing the following requirements: Patient safety, Numbers of staff as well as their skill base, Dilemma of removing the rights of a person to their independence, How to achieve removing the rights of a person to choice and independence in the least distressing manner, General building security, Fire safety, General access and especially access during emergencies and Confidence of patients and the public in the service offered.
A number of possible solutions to KEMH security were named, however a balance needs to be struck between patient safety, cost-effectiveness, practicality and community expectations.
The number of staff is based at a minimum number of staff to meet the needs of an average bed occupancy and dependency of patients. Increase in dependency of patients or increase in bed occupancy is met in general by the goodwill of the staff working extra hours. Nonetheless, by necessity the staff still needs time off so this can only be sustained for short periods.
To meet the needs of patients admitted under the Mental Health Act where the patient cannot leave the ward the KEMH has a ‘bank’ of casually employed Health Care Support Workers (HCSWs). These HCSWs normally do this in conjunction with other full time posts or to supplement part time work. Casual workers still are required to meet the HR requirements of fully employed staff. This means that it is not quick to employ someone on a casual basis. As the work is irregular it is not feasible to ask for full time funding. This means that finding HCSWs to provide cover over 24 hours and all week is not easy. The present HCSWs are a great asset to the department.
In general the department tries to avoid depriving people of their liberty and anticipates managing most people on a voluntary basis with one to one care by HCSWs closely monitoring the patient with the nursing staff to call upon when problems arise. This leaves the nursing staff to nurse the remaining patients. It will be understood that with three staff on out of hours there are many times when all staff are fully occupied providing the nursing needs of one or more patients. For the vast majority of the time this is the most cost effective way of managing. It is always most busy in the mornings with patients being assisted to get up and in the evenings with going to bed.
The cost of maintaining one to one care 24 hours a day is approximately £95,000 per annum (and if the patient is at increased risk of displaying challenging behaviour then £156,000) per annum. Clearly the use of one to one care can only be used minimally.
Locking of ward rooms is not currently done as this is deemed unacceptable to patients and is a fire risk. A further reason not to lock doors is that external audits have noted the friendliness and welcoming atmosphere of the department and this has to be balanced with the need for security.
Currently there are no relevant people available whose job it is solely to manage the access and egress of the department and security employees also serve as drivers so are not present 24 hours a day.
It is rare for patients to abscond from the KEMH and the system for searching for patients worked extremely well during the recent incident. However, learning from these rare occurrences is necessary to try and prevent it happening in the future. 24 hour support has been sought to address this issue in the short-term, but HMSC Members are invited to provide their views on potential longer-term solutions. These solutions may include: The provision of HCSWs for all patients that likely to abscond, Alarming of all access and exit points, Increased security staff and The locking of doors and windows.