CAS
Action Taken
CAS Behavioural Health has introduced a blanket policy restricting the use of plastic bags in all their hospitals, following a review of their Reducing Restrictive Practice policy after the incident. (AI summary)
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Dear Sir Inquest into the death of Natasha Ford
— Regulation 28 report I vJite ith reference to the Regulation 28 report to prevent future deaths that you made following the Inquest into the death of Ms Ford. The contents of this letter has been approved by the Chief Executive of CAS Behavioural Health. You ha e expressed concerns in section 5 of your report on the basis of the evidence you heard at the Inquest “that there was a previous incident on 27 July 2017 where [Miss Ford] had placed a plastic bag over her head. Plastic bags were then restricted for a short time and then blanket restrictions were removed. This was due to a change in a policy in procedure and in line with Reducing Restrictive Practice Policy and Procedure”. As stated by Ms in her evidence at the inquest on behalf of CAS Behavioural Health and as reflected in the report that she provided to you for the purposes of the Inquest, at the time of the incident in July 2017 risk items were then restricted and removed from Ms Ford’s possession but later reintroduced once the Clinical Team assessed the risk as having reduced. This was in accordance with the CAS Policy and Procedure on Reducing Restrictive Practice in place at the time. this Policy reflecting the relevant provisions of the Mental Health Act Code of Practice that provides at chapter 26.37 that restrictions:
• be usedfor no longer than necessary to prevent harm to the person or to others;
• be a proportionate response to that harm, and
• be the least restrictive option. After the incident on 19 September 201 and the subsequent sad death of Ms Ford. C.AS Beha\ ioural Health re ie ed the approach taken in its Polic and Procedure on Reducing Restricthe Practice. In doing so, it has taken into account guidance published b the Care Quahty Commission entitled “Brief Guide’ The E se of “Blanket Restrictions” in Mental Health Wards”. Whilst the CQC Guidance adopts the approach of the \lental Health Act Code of Practice. it does ackno ledge that all mental health inpatient sen ices hake some prohibited or “contraband” items and that certam prohibited items, including plastic bags, should not he challenged b the QC for breaking the approach to blanket restrictions in the Code of Practice. Raglan House, Raglan Road, Smethwick, B66 3ND C E 53 C C C C5C589
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Behav ural HealTh Follo ing the review of the re1e ant Policy. CAS Behavioural Health has introduced a blanket policy restricting the use of plastic bags in all their hospitals. This Policy was put in place in October 2017 and a copy is enclosed. As a result of this Policy, no patients in any CAS hospitals are permitted to hae access to plastic bags in hospital. This applies to all patients. notithstanding the risk assessments undertaken in respect of each patient. All patients in hospitals operated by CAS Behavioural Health have in place a reducing restrictive practice plan that is reviewed monthly for the individual patients. There is a similar plan for the hospital/unit location that is reiewed three monthly. These plans detail why the relevant restrictions imposed on patients are necessary and what actions are being undertaken to reduce the restrictions. Again, this reflects the approach of the Mental Health Act Code of Practice, but I must emphasise that. as stated abo’e. it does not apply to the use of plastic bags as these are nov restricted by ay of a blanket policy. CAS Beha ioural Health intend to maintain the blanket ban on plastic bags in all their hospitals. CAS Behavioural Health and i, on behalf of Raglan House. consider that this fully addresses the concerns that you expressed in your Regulation 28 report. Floeer, if you have any further questions, please do not hesitate to contact me.
— Regulation 28 report I vJite ith reference to the Regulation 28 report to prevent future deaths that you made following the Inquest into the death of Ms Ford. The contents of this letter has been approved by the Chief Executive of CAS Behavioural Health. You ha e expressed concerns in section 5 of your report on the basis of the evidence you heard at the Inquest “that there was a previous incident on 27 July 2017 where [Miss Ford] had placed a plastic bag over her head. Plastic bags were then restricted for a short time and then blanket restrictions were removed. This was due to a change in a policy in procedure and in line with Reducing Restrictive Practice Policy and Procedure”. As stated by Ms in her evidence at the inquest on behalf of CAS Behavioural Health and as reflected in the report that she provided to you for the purposes of the Inquest, at the time of the incident in July 2017 risk items were then restricted and removed from Ms Ford’s possession but later reintroduced once the Clinical Team assessed the risk as having reduced. This was in accordance with the CAS Policy and Procedure on Reducing Restrictive Practice in place at the time. this Policy reflecting the relevant provisions of the Mental Health Act Code of Practice that provides at chapter 26.37 that restrictions:
• be usedfor no longer than necessary to prevent harm to the person or to others;
• be a proportionate response to that harm, and
• be the least restrictive option. After the incident on 19 September 201 and the subsequent sad death of Ms Ford. C.AS Beha\ ioural Health re ie ed the approach taken in its Polic and Procedure on Reducing Restricthe Practice. In doing so, it has taken into account guidance published b the Care Quahty Commission entitled “Brief Guide’ The E se of “Blanket Restrictions” in Mental Health Wards”. Whilst the CQC Guidance adopts the approach of the \lental Health Act Code of Practice. it does ackno ledge that all mental health inpatient sen ices hake some prohibited or “contraband” items and that certam prohibited items, including plastic bags, should not he challenged b the QC for breaking the approach to blanket restrictions in the Code of Practice. Raglan House, Raglan Road, Smethwick, B66 3ND C E 53 C C C C5C589
— C r a’
—— r r
Behav ural HealTh Follo ing the review of the re1e ant Policy. CAS Behavioural Health has introduced a blanket policy restricting the use of plastic bags in all their hospitals. This Policy was put in place in October 2017 and a copy is enclosed. As a result of this Policy, no patients in any CAS hospitals are permitted to hae access to plastic bags in hospital. This applies to all patients. notithstanding the risk assessments undertaken in respect of each patient. All patients in hospitals operated by CAS Behavioural Health have in place a reducing restrictive practice plan that is reviewed monthly for the individual patients. There is a similar plan for the hospital/unit location that is reiewed three monthly. These plans detail why the relevant restrictions imposed on patients are necessary and what actions are being undertaken to reduce the restrictions. Again, this reflects the approach of the Mental Health Act Code of Practice, but I must emphasise that. as stated abo’e. it does not apply to the use of plastic bags as these are nov restricted by ay of a blanket policy. CAS Beha ioural Health intend to maintain the blanket ban on plastic bags in all their hospitals. CAS Behavioural Health and i, on behalf of Raglan House. consider that this fully addresses the concerns that you expressed in your Regulation 28 report. Floeer, if you have any further questions, please do not hesitate to contact me.