Independent investigation: John Stringer, Canning Town (2005)

It is recommended that Newham locality is included in the Personality Disorder services provided by the Trust.

It is recommended that the |Trust receive evidence of the actual practice of CPA within clinical settings through regular audit. These audits should specifically include risk assessment, the use of risk management plans and evidence of the support given to carers.

In accordance with best practice and to ensure that staff have the opportunity to check that the evidence they have given to internal reviews is accurate and reflects the issues that they wish to raise it is recommended that all interviews undertaken for internal reviews are recorded and transcribed. These transcripts should not be included in the internal review reports, however they should be kept securely and made available to any subsequent independent investigation.

It is recommended that clinical staff should have access to training in the management of personality disorders. This training should include the diagnosis and management strategies for working with patients with personality disorders within their services

It is recommended that the Trust follow through their ambition to provide Alcohol services in-house.

It is recommended that a summary sheet is developed to be sited at the front of patients’ records and updated on a regular basis. This should include:
o Current and Diagnostic History
o Risk History with a detailed list of violent incidents and any link to abnormal mental state
o Risk Management Plan
o Changing diagnosis if relevant
o What medication worked well and problems with medication including allergic reactions
o Admission history
o Markers for relapse
o Signs of relapse
o Contingency plans to manage relapse
o Current care team and contact details