YOU HELP ME CUT MA PEATS ‘N’ I’LL HELP YOU DIP YER SHEEPS

MENTALLY DISORDERED OFFENDERS THE HIGHLAND EXPERIENCE

Affric Ward12 BedsMixed sexAll rooms en-suiteSecure gardenPleasant surroundingsActivities within Ward

Affric Ward - MDT2 Consultant Psychiatrists - Consultant

covering General Adult psychiatry and consultant covering Forensic patients

Nursing StaffForensic MHOPharmacist Occupational therapy Forensic Liaison nurse

Affric Ward - ForensicsCovers all of NHS Highland area except

Argyll and ButeOccasionally takes from NHS Grampian if

patient is seen in Elgin or is from Northern Isles

Occasionally take from Western IslesOccasionally take from other prisonsOver 90% are admitted from Inverness

Sheriff Court or Porterfield prison

1 x Head of Forensic Nursing, Highlands VACANT1 x Forensic CPN, Inverness, Nairn, Strathspey & Badenoch1 x Forensic Specialist Nurse, Ross & Cromarty 0.4 x Forensic Specialist Nurse, Caithness & Sutherland 0.4 x Forensic Specialist Nurse, Lochaber VACANT0.2 x Forensic Specialist Nurse, Skye and Lochalsh VACANT

Forensic Community Nursing

Medical

1 x Consultant with an interest in forensics

MHO’s

1 x Senior Practitioner Forensic MHO 1 x Forensic MHO with 0.2 CJS commitment 1 x 0.5 Forensic MHO

FT ASSESSMENT OTCPN’SSW’SPartner Agencies

e.g wellbeing group, green gym, Abriachan

FT and CMHT/ CJS/ NC

e.g LIST ACT Emotional Control Competent Witness

No access to Forensic PsychologySporadic consultation – not criminogenic or offence focussed

THEREFORE HIGHLAND GREW THEIR OWN!

With grateful thanks to the Forensic Network

L

Risk AssessmentAffric Ward (IPCU)Introduced 12 years ago - evolved over this

periodHighly visible – red border kept at front of case

recordInclusion of missing person section which

includes the same risk definitions as used by the Police

Multi-disciplinary approachLinks to STORM assessmentMHOs place before Sheriff court when seeking

Compulsion orders

Scottish Patient Safety ProgrammeAffric Ward – chosen as Mental Health pilot

siteChosen workstream – Risk assessmentProposed changes - More user involvement - Signed by user - Safety plan not Risk management plan - Use of Risk assessment from BEST index

Advanced Risk AssessmentAffric have several staff trained in

- HCR 20 - SVR 20 - RSVP - C-BIT - RA 1-4 - BEST

Forensic TeamAdditional trainingRM 2000S&A 07RA 1-4LSCMIASSETSAMCAADA-DASHRICKTER SCALEIMPULSIVITY CHECKLISTBEST

Multi-agency approachNEW TO FORENSIC PROGRAMME

Facilitated by – - Secure Care manager - Forensic MHOs - Forensic Specialist nurse Cohorts included – RMNs, MHOs, CJS Social

workers, CPNs, Police, Prison Officers, Chaplains, MAPPA Co-ordinator, GP

Multi- agency approach (cont)Through teaching the programme we are

able to access, influence and equip others to contribute to 24 hour cover and Risk assessment

24 Hour cover – Triage New Craigs Hospital

Mental Health assessments Mental Health Assessment Team 8am – 9pm 7

days a weekDuty Doctor 24/7Triage nurse based at New Craigs between 11pm

and 8am, 7 days a week taking calls from NHS 24Triage nurse will also attend police custody suite

accompanied by member of staff from Affric or Night nursing team leader to assess people out of hours. This allows access to MH assessment for PF perusal prior to court appearance

24 Hour cover – Triage (cont)

Section 297 protocol agreed with Northern Contabulary

Mental Health Liaison nurses based at Raigmore Hospital (Acute Care)

During office hours Forensic TeamProvision of service toSPS-HMP Porterfield –

Consultant Cl – Consultant Clinic, FSN FSN surgery, FMHO assessment/detention

SCS – FSN and FMHO provide assessment, reports, advice, support and guidance to Highland courts in jurisdiction.

NC – FSN and FMHO provide assessment advice, support and guidance to Police officers, especially officers in the custody suite