Independent investigation: Jankee Jaimungal, Batley (2007)

In line with current CPA guidance and the Trust’s own current CPA policy the Trust should undertake regular quality audits to ensure that: all those referred to its secondary mental health services have a comprehensive assessment of their needs; there is a clear formulation of the individual’s difficulties and needs; care plans are informed by appropriate assessment and formulation; all care plans have clear goals or outcomes; service users and, with their consent, their families and carers, are involved in the assessment of need, the planning of care, and any changes to either the care plan or the care co-ordinator; the agreement of families and carers is obtained before care plans are finalised which involve actions on their part; families and carers, with the agreement of service users, are provided with current care plans, including crisis management plans; where there is multidisciplinary or multi-agency involvement all those involved in delivering care and support are appropriately involved in the assessment and planning process with the knowledge and consent of the service user.

Having revised its risk assessment, mangement and training policy the Trust should institue a regular quality audit to ensures: that the formulation of the individual’s problems and needs informs the understanding of his/her risk; that robust and meaningful care plans are put in place; that the service user and other relevant individuals are involved in the assessment and planning process; that the risk management plan is appropriately disseminated.

The Trust should assure itself and its Local Authority partners that the Safeguarding policies and procedures which it has put in place and supported with training are being implemented. It should include audits of compliance with its Safeguarding policies in its regular audit cycle.