Independent investigation: Eileen Cameron, Reading, Berks (1997)

that arrangements are made which ensure adherence to Health Service Guidelines concerning the care programme approach and discharge procedures.

that a senior manager within the trust is made responsible for ensuring that these Health Service Guidelines are put into practice.

that random audits of compliance with the guidelines are conducted regularly, and that these include verifying: • that a key worker (care co-ordinator) is identified for the patient following admission, and that s/he had a key worker when discharged; • … Read more that random audits of compliance with the guidelines are conducted regularly, and that these include verifying: • that a key worker (care co-ordinator) is identified for the patient following admission, and that s/he had a key worker when discharged; • that the patient had a care plan prior to discharge, with review dates, and that s/he and the carer have received a copy of it; • that a full assessment of risk, covering both risk to the patient and others, was conducted prior to discharge, and a plan devised to manage assessed risks; • that responsibility for checking that necessary pre-discharge arrangements were made before the patient left hospital was given to one member of staff caring for her/him; • that this member of staff had (and used) a checklist of what should have been done prior to that date; • that a manager scrutinised the after-care arrangements prior to discharge; • that carers were involved in the care planning process, and that their ability to cope, and access to emergency services and out-of-hours advice, was taken into account; • that they were informed about matters such as medication, symptoms to watch for, and where to get help; • that arrangements were made to provide necessary support at home; • that the needs of any children of the patient were actively assessed prior to discharge; and that the patient was not discharged to a home with children unless the risk to them had been thoroughly assessed. • that professionals and carers had a common understanding of information about past violence or assessed risk of violence. Show less

that where a patient discharges her/himself against medical advice, and a care plan cannot be completed prior to discharge, this is subject to exception reporting within the trust; and this information is shared with the Health Authority through routine monitoring. Read more that where a patient discharges her/himself against medical advice, and a care plan cannot be completed prior to discharge, this is subject to exception reporting within the trust; and this information is shared with the Health Authority through routine monitoring. Show less

that the trust, in consultation with the Health Authority, considers whether the departmental after-care form issued in 1995 should be used by hospital staff (see p.14).

that the trust should require staff to undergo further training on the care programme approach and discharge guidance, which deals specifically with the above requirements, and also involves local authority staff; and that records should be kept of those who … Read more that the trust should require staff to undergo further training on the care programme approach and discharge guidance, which deals specifically with the above requirements, and also involves local authority staff; and that records should be kept of those who have completed the training. Show less

that guardianship is considered during care programme approach reviews whenever a client has ceased to reside at specialist accommodation to which he has been discharged.

that, in line with the Cambridge model, a. the trust’s pharmacy department takes over control of Clozaril prescriptions, which are limited to 28 days at a time; b. a Clozaril clinic is set up, which is staffed by a dedicated … Read more that, in line with the Cambridge model, a. the trust’s pharmacy department takes over control of Clozaril prescriptions, which are limited to 28 days at a time; b. a Clozaril clinic is set up, which is staffed by a dedicated community psychiatric nurse (to assess the patient’s mental state) and a member of the pharmacy department (to co-ordinate the prescribing); and that funding is made available by the Health Authority for this. Show less

that consideration is given to linking this development with the development of a depot clinic and a lithium clinic.

that the trust and the social services authority devise simple procedures which ensure that, when a person in contact with either service commits homicide, the needs of the immediate family of both the deceased and the patient are ascertained, and … Read more that the trust and the social services authority devise simple procedures which ensure that, when a person in contact with either service commits homicide, the needs of the immediate family of both the deceased and the patient are ascertained, and they are supported; and that this includes offering support from a clinical psychologist. Show less

that clear standards are established, and then audited, which ensure that all clinical staff receive regular clinical supervision. Such standards should include frequency of supervision, those responsible for providing it, and methods for auditing its effectiveness. Read more that clear standards are established, and then audited, which ensure that all clinical staff receive regular clinical supervision. Such standards should include frequency of supervision, those responsible for providing it, and methods for auditing its effectiveness. Show less

that the Health Authority should enhance its monitoring of the trust’s compliance with Health Service Guidelines, in particular compliance with the care programme approach and discharge planning, using external consultants where necessary.

that the Health Authority should ensure that this report is readily available to individual practitioners and people in West Berkshire.