"Searches Policy - Policy on Searches Policy on Searches"
Policy on Searches Policy on Searches Control sheet The Specialist Health Services Management Team recommends that the Risk Management & Service Governance Committee accept the Policy on Searches and confirms that it is in accordance with legislation and best practice’. Status new or review: Review Policy owner: Arthur Green, Service Governance Lead Contact Details: 01865 228029 Arthur.Green@ridgeway.nhs.uk Sponsoring Director: John Turnbull, Director of Performance, Information & Nursing Contact Details: 01865 22817 John.Turnbull@ridgeway.nhs.uk Date last reviewed: August 2007 Approved By: Risk Management & Service Governance Committee Date Approved: July 28th 2009 Next Due for Revision: July 2012 Date Policy Becomes Live: 1 August 2009 Policy number: Equality Impact Assessment in place Yes Summary of key updates since the last Monitoring arrangements reviewed review in line with NHSLA guidance & names of various committees altered to reflect changes since 2007 Further comments to be considered at the The policy is a requirement in time of ratification for this policy (i.e. order to be compliant with NHS National policy, Legislation and Litigation Authority standards and consultation across SHA). Standards for Better Health Compliance with – • Mental Health Act • Equality and Diversity • Equality and Diversity • Human Rights Act • NHSLA • CNST • Standards for Better Health • NHSLA • CSCI • National Service Frameworks • Employment legislation • Standards for Better Health • Quality Accounts • Freedom of Information Act • Data Protection Act • Health and Safety Act Compliance with Monitor expectations: Yes Training needs analysis: Yes Consultation process followed: N/A Is public or service user consultation required – if so consult with Company Secretary for approach to be used: Version Information Version No. Updated By Updated On Description of Changes 2.1 Arthur Green July 2009 Updated to meet requirements of the Policy for Policies and the NHSLA and Care Quality Commission standards -- ii - RIDGEWAY PARTNERSHIP (Oxfordshire Learning Disability NHS Trust) Policy on Searches Table of contents Page 2 1 Introduction Page 2 1.4 Terminology Page 2 2 Fit with Trust’s vision or strategic objectives Page 3 3 General Policy statements and monitoring arrangements Page 3 3.2 responsibilities Page 4 3.4 Procedures on admission Page 5 3.7 Detained patients Page 5 3.8 Informal patients Page 5 3.9 Patient Consent Page 6 3.10 If consent is refused Page 6 3.11 Procedure for search Page 6 3.12 Frisking a male patient Page 6 3.13 Frisking a female patient Page 7 3.14 Destruction of illegal drugs and substances Page 8 3.15 Obligation to inform the police Page 9 3.16 Documentation Page 9 3.17 Monitoring Page 9 4 Fit with other key documents such as Quality Strategy Page 9 5 Links to national agenda/policy or legislation Page 10 6 Detail on any benchmarking Page 10 7 Background to development of the policy, detail on any collaboration or consultation Page 10 8 Communications and Training Plan Page 10 9 Supporting templates Page 10 References Page 11 APPENDICES Page 12 Annex 1 – Information for Patients Page 14 Annex 2 – Consent for destruction of substances Page 15 Annex 3 – Information for Evenlode Page 20 Annex 4 – Search procedure, for Evenlode Page 25 Annex 5 – EIA -- 1 - Policy on Searches (July 2009) 1. Introduction 1.1 The purpose of this policy and procedure is to help reduce the risk of harm to patients, staff, visitors and members of the public. Also, to meet two objectives. Firstly, the creation and maintenance of a therapeutic environment in which treatment shall take place and, secondly, the maintenance of the security of the establishment and safety of patients, staff and the public. 1.2 The Trust’s Policy will be implemented with regards to Human Rights Act 1998 1.3 This policy and procedure applies across all inpatient services in specialist health services. Additional safeguards relate to the Oxford Clinic (Evenlode) and this is reflected in the procedures attached. 1.4 Terminology Within this policy, the term patient applies to formal and informal admissions within specialist health services. For the purpose of the Mental Health Act, all inpatient units are classed as hospitals. 1.5 This policy must be read alongside the following related policies: • Therapeutic Management of Violence and Aggression • Policy for Supportive Observation • Consent to Treatment • Mental Capacity Act Policy • Accident, Incident and Near Miss reporting Policy 1.6 Annex 1 – Information for Patients Annex 2 – Consent for destruction of substances Annex 3 – Information for Evenlode Annex 4 – Search procedure, for Evenlode Annex 5 - EIA 2 Fit with Trust’s vision or strategic objectives 2.1 This policy will allow the Trust to measure its performance in relation to national standards and best practice. This will aid the Trusts aim to become the leading specialist in the South of England providing integrated, tailor-made specialist services for people with complex support needs and long term health conditions -- 2 - 3 General Policy statements 3.1 Responsibilities of the organisation It is the responsibility of the Ridgeway Partnership to provide the appropriate level of support, guidance or training for employees, patients and contractors in order to meet the needs of this policy and statutory legislative requirements. 3.2 Lines of Responsibility The Chief Executive is accountable to the Trust Board and responsible for ensuring that the Trust has an effective risk assessment and management processes which; • Defines staff responsibilities • Ensure that all appropriate and reasonable steps are taken to asses and reduce clinical/practice risk • Ensure the policy is communicated to all relevant staff. Responsibilities of Staff All employees (including Bank & Agency staff) and contractors are required to adhere to the policies, procedure and guidelines of the Trust. This means that staff must do everything that it is reasonable to ensure that they operate within the framework of this policy. It is the responsibility of all managers: • To ensure that all staff are made aware of their roles and responsibilities in relation to this policy. • To ensure that all staff have read the policy and are aware of what actions they need to take. • To identify any addition training and support needs required by their staff to enable them to perform their duties as defined in this policy • To monitor periodically staff awareness of their roles in relation to this policy 3.3 The person in Charge in consultation with Responsible clinician or Duty Consultant will be responsible for deciding that the search is necessary. Following a search, a report must be entered in the patient’s notes stating the following:- a) reason for the search and if the service user/patient agreed b) time and place of the search c) articles/items retrieved or found (or if nothing relevant was found) d) where the articles are being kept e) names and grade of staff undertaking the search f) has anyone been injured during the search, if so the accident/untoward -- 1 - g) Incident procedure should be followed h) if restraint was used, ensure Incident and Accident form is completed and ensure each incident of restraint is reported. i) inform the Line Manger/Senior Manager of the incident or the on-call manager out of hours. 3.4 Procedures on Admission – Informal and Detained Patients • On admission it is vital to seek to ensure that the patient is entering a safe environment. • Each unit/ward/home must decide which items are acceptable or unacceptable for the patient to have. • The decision must be based on the service provided, the individual’s current mental state, the individual’s known history, their safety and the safety of others in the environment. • A check needs to be made through discussion with the patient to ensure that the individual does not have any items deemed to be unsafe to have on the ward/home by a first level nurse. 3.5 The following list of items that should be considered if appropriate for a patient/service use to have on a ward/home/unit. Please note that this list is not exhaustive. • Razors, scissors, tweezers, and other sharp objects which could cause harm. • Medication of any kind (except those agreed by the support team) • Weapons or potential weapons which could inflict injury i.e. guns, knives, straps, rope etc. • Any form of drugs or alcohol • Hazardous or inflammable substances i.e. glue, paint, nail varnish remover etc. • Make-up kits with sharp instruments etc. • Combs (plastic) • Cigarettes, lighters, matches, belts and aerosol cans (at discretion of the Person in charge) • Any other objects deemed to be unsafe 3.6 The patient, through discussion, should understand the reason why we are seeking to clarify whether they are in possession of a potentially harmful object. At this stage the patient will be required to sign the annex 1 form which clearly indicates that they have understood and that they are aware that a search of their person, bedroom or belongings may need to be undertaken if the need arises. If having discussed potentially harmful objects with the patient and there is reasonable cause to search, before any search is undertaken, staff should consider the risk of harm to staff or the patient. Where there is any doubt, the police should be contacted for advice and assistance. -- 2 - In the case of a search, two staff should carry out the search, one of whom should be the most senior staff available. 3.7 Detained Patients – Sections of the Mental health act provided for detention, treatment and assessment. Personal searches may extend to routine and random searching of detained patients without cause, but only in exceptional circumstances, for example, where the dangerous or violent propensities of patients create a self-evident and pressing need for additional security. Personal searches of patients detained may be necessary for therapeutic reasons to avoid interference with treatment, where appropriate. Searching is undertaken therefore for the following reasons:- • To prevent self harm • To prevent harm to others or to property • Avoidance of crime • For therapeutic reasons to avoid interference with treatment 3.8 Informal Patients Searches of informal patient will only be undertaken where there is a self evident and pressing need for this. Evidence of such a need may come from the patient clinical condition, previous medical history or recent reports as a result of which it is thought that the patient may be in possession of a harmful object or substance which he/she might use to cause harm to himself, others or property. A personal search of an informal patient is only possible where there is lawful authority and will only arise under the common law where: - A patient is suspected on reasonable grounds of possession of a harmful object or illicit substance The search of a patient or his possessions would be lawful if such action was required to prevent the individual from harming themselves or others Staff may be able to act on the above for the following reasons: - • That information has been received • Any evidence that raises concern 3.9 Patient Consent In all cases, the consent of the patient should be sought before a search is attempted. If informed consent is duly given, the search should be carried out with due regard for the dignity of the individual and the need to ensure the patient privacy. All actions must be recorded in the patient notes. -- 3 - 3.10 If consent is refused (Informal and Detained Patients) If the patient refuses consent, then you will need to consider the need to search. If you feel there is a justifiable need to search and the patient will not consent to this, then the procedure is as follows: - • The responsible clinician for the patient should first be contacted so that any clinical objection to a search by force may be raised. If no such objection is raised, the search should proceed. • If the responsible clinician advises that subjecting the patient to search would have adverse consequences for the mental health of the patient, the matter must be referred to the Medical Director of the Trust who will decide, after taking into account the advice of the responsible clinician and the interests of security and safety at the hospital, whether the search should proceed. • Before proceeding with a search to which a patient has refused cooperation, a further attempt to obtain informed consent must be made and the patient must be told that in the absence of consent a search would be undertaken. If the search cannot proceed safely without harm to patient or staff, the search should be immediately discontinued and the situation re-assessed for risk and the need for Police involvement. Person in charge, responsible clinician or Duty Consultant are responsible for decisions taken. Any delay should be kept to a minimum. Whilst the matter is being resolved, the patient should be kept under observation and isolated from other patient. The patient should be told what is happening and why, in terms appropriate to his or her understanding. If the search is to proceed without consent, it should be carried out with due regard for the dignity of the individual and the need to ensure maximum privacy. A member of the same sex must carry out a search of a patient person unless necessity dictates otherwise. If items belonging to a patient are removed, they should be given a receipt for the items and informed where they are being kept. All action must be recorded and kept in patient notes. 3.11 Procedure for an Actual Search (Person in charge responsible for advice and supervision) The reason for requesting a search is to ensure that the patient does not have an object or illicit substance, which could put them or others at risk. The search will consist of a frisk of the patient by a member of staff of the same sex. Strip searches and intimate body searches are not authorised. -- 4 - 3.12 FRISKING A MALE PATIENT • Face the patient • Ask to empty pockets and remove jewellery • Search pockets and jewellery • Remove and search headgear (if worn) • Search around collar & tie and top of shoulders • Ask to raise arms with fingers apart and palms down • Using flat hands search each arm • Check hands • Using flat hands, check front of body from neck to waist, sides from armpit to waist and front of waistband and seat of trousers • Check back from collar to waist, back of waistband and seat of trousers • Check back and sides of each leg from crutch to ankle • Check front of abdomen and sides of leg • Check area around him for dropped objects • Ask him to step aside and observe immediate area • Lastly search any items carried e.g., bags 3.13 FRISKING A FEMALE PATIENT • Face the patient • Ask to empty pockets and remove jewellery • Search pockets and jewellery • Remove and search head gear, if worn • Search around collar and top of shoulders • Ask to raise arms with fingers apart and palms downwards • Using flat hands, search arms • Check hands • Using flat hands check underneath from shoulder to top of bra • Check sides and front of abdomen from beneath breasts to and including • waistband • Check back from collar to waist, back of waistband and seat of trousers or skirt • Check back and sides of each leg from crutch to ankle • Check front of abdomen and sides of each leg • Check area for dropped objects • Ask to step aside and observe immediate area • Lastly, search any items carried e.g., bags 3.14 DESTRUCTION OF ILLEGAL DRUGS AND OR SUBSTANCES Any illegal controlled drugs taken from a patient with consent will be handed over to the Trust Pharmacist for the purpose of destruction. The Pharmacist will only destroy controlled drugs where it is clear that they were for the patient’s prescribed use only. The destruction of controlled drugs (amongst others) will be witnessed by an -- 5 - ‘authorised’ person. An ‘authorised’ person within the Trust is the Health & Safety & Officer, or their nominated deputy All other illegal drugs taken from the patient must be handed over to the police Other substances such as alcohol will only be destroyed with the patient’s consent. If the patient consents to the destroying of any substances i.e., (alcohol) the patient must sign Annex 2 The destruction of any substance (alcohol) must be done in the presence of two trained staff. Both staff must sign the consent form in the presence of the patient. All entries must be made in the case notes of what has been destroyed, dated, timed and signed by both staff. If the patient does not consent to the destruction of substances such as alcohol, the substance must be removed from the patient and stored in a safe place (lockable cupboard). This must then be discussed with the Line Manager and a decision made about what to do with any confiscated substances The Line Manager must seek advice from Senior Managers, if necessary, to enable them to make a decision about the destroying of any confiscated Substances The patient must be requested to sign that they refused consent for the destruction of the substances. All entries must be made in the notes as to what has been removed and here it is being kept. Line Manager/Managers On Call must be informed of any action taken at all times. All action taken must also be discussed with the Consultant at the earliest possible time. All action taken must always be clearly recorded in the case notes, dated, timed and signed by two members of staff (both qualified if possible). 3.15 OBLIGATION TO INFORM THE POLICE There is no obligation for the Trust to assist the police but equally the Trust must not obstruct any police investigations. -- 6 - A balance has to be achieved between the duty of confidentiality to the patient and the public interest in detecting/preventing crime. If a patient is suspected of dealing in drugs or supplying them, the public interest is likely to outweigh the clinician’s duty of confidentiality. Likewise, if the patient is in possession of a dangerous object then the safety of the patient, other patients and staff must be a priority In addition, if the patient refuses to hand over the illegal drugs or dangerous weapons, the Trust may have no option but to call in the police. If you have any queries about this policy and procedure please contact Head of Practice Development. 3.16 Documentation Incidents requiring searches must be reported via the Trust accident and incident recording policy. Details must also be recorded in the patients care plan. This should include • Reason for the search • If consent was given • Were the search took place • Who was present • What was found • Debriefing/support offer to patient • If any changes to risk assessment, leave status/observation level is required 3.17 Monitoring Monitoring of accident and incident data as part of monthly reviewed at risk management and service governance committee. The recording of searches will be checked as part of the specialist health services quality monitoring visits. These take place ever six months and are reported to the specialist health services management team and the risk management and service governance committee. Any deficiencies identified and action required will be incorporated into the risk management and service governance committees’ action plan. This plan is reviewed monthly by the committee and reported to executive and Trust board on a quarterly basis. 4 Fit with other key documents such as Quality Strategy 4.1 This policy will enhance the ability of the Trust to achieve its objectives in relation to the quality strategy. It links into all the objectives. -- 7 - 5 Links to national agenda/policy or legislation 5.1 Racial equality; disability; gender; sexuality; age and diversity All policies will receive an equality impact assessment during their development in respect to equality issues and compliance with antidiscrimination legislation. The EIA form is attached at Annex . 6 Detail on any benchmarking 6.1 Nil at present 7 Background to development of the policy, detail on any collaboration or consultation 7.1 This policy has been developed to ensure that the Trust is managing its risks in relation to searches. It has been reviewed in the light of the latest guidance form the NHS Litigation Authority risk management standards for mental health and learning disability Trusts and the Care Quality Commission standards. 8 Communications and Training Plan 8.1 This policy will be shared with the organisation via the Managers Bulletin and cascaded via the line management route. 8.2 Line Managers will be responsible for cascading the policies to their staff and identifying any personal training needs and for ensuring local compliance. 8.3 No specific training has been identified in relation to this policy other than that highlighted above. 9 Supporting templates 9.1 Nil REFERENCES Mental Health Act Mental Health Act Code of Practice Related Policies and Procedures • The Concerns and complaints procedure • Risk Assessment and Management Pack • Grievance Policy • Disciplinary Policy • Risk Management Strategy -- 8 - • Risk Management Policy • Client risk assessments • Major clinical & Serious untoward incident policy • Whistle Blowing policy • Accidents, Incidents and Near Misses Guide book • Accidents, Incidents and Near Misses reporting policy • Claims Management Policy & Procedures • Complaints Policy -- 9 - APPENDICES Annex 1 – Information for Patients Annex 2 – Consent for destruction of substances Annex 3 – Information for Evenlode Annex 4 – Search procedure, for Evenlode Annex 5 - EIA -- 10 - Annex 1 Ridgway Partnership SEARCH POLICY ADMISSION FORM Part 1 In order to maintain a safe environment for patients, staff and visitors, it may be necessary to undertake random searches of personal belongings, environment and personal searches. Personal searches will not involve the removal of clothing. It will involve a ‘frisk’ of patient’s clothing, by a member of staff of the same gender. You will be asked on admission if you understand and agree to this procedure, you will then be asked to sign Part 2 of this form. The care staff will explain to you which of the following items are acceptable or unacceptable to have on the ward/home. Please note that this list is not exhaustive. Certain unacceptable items can be put in safe keeping by staff. Please note that illicit substances can not be put in safe keeping and must be handed over to the police. The following are a list of which you may not be allowed in keep on a ward/home/unit. • Razors, scissors, tweezers, and other sharp objects which could cause harm. • Medication of any kind, (prescribed medication will be administered by staff) • Weapons or potential weapons which could inflict injury i.e. guns, knives, straps, rope etc. • Any form of drugs or alcohol • Hazardous or inflammable substances i.e. glue, paint, nail varnish remover etc. • Make-up • Combs (plastic) • Cigarettes, lighters, matches, belts and aerosol cans (at discretion of the person in charge) • Any other items deem to be unsafe to have on the ward or home -- 11 - Part 2 (A) INFORMED CONSENT I have had explained to me the Search Policy and Procedure and I consent to a search if required. Signed……………………………...….……Print Name…......……………………… Name of Patient……………………………........………… (Completed by Nurse) Dated…………………………………… Witnessed by: Nurse Signature………………………......….…Print Name……..…………………. (B) CONSENT REFUSED I do not consent to a search Signed……………….........……… Name of Patient (Print)………………………… Dated…………………………… Witnessed by: Nurse Signature……..........…………. Name Of Staff (Print)……………………… Designation………………….......….. -- 12 - Annex 2 CONSENT FORM FOR DESTRUCTION OF SUBSTANCES (C) I …………………………………...have agreed that the following Substances …………………………………….................……………………can be destroyed by the nursing staff / pharmacist (please delete as appropriate). Name and Signature of Patient………………………………………........………… Name & Signature of Nurse/Pharmacist………………………………........……… Name & Signature of 2nd Nurse Witness/Senior Manager ……………………………………………………………………..............………… Date……………………….. CONSENT REFUSED FOR DESTRUCTION OF SUBSTANCES (D) I …………………….......……… refuse to give my consent for the following substances………………...........................................…………….. to be destroyed by nursing staff/pharmacist (delete as appropriate) Name (Print) and Signature of Patient …………………………………….............. Name of Nurse/Pharmacist (Print) …………………………....………….....……… Signature of Nurse/Pharmacist………………………...........………………………. Name (Print) and Signature of 2nd Nurse Witness/Senior Manager …………………………..............…………………………………………………… Date…………………………. -- 13 - Annex 3 Procedure for Evenlode 1.0 Introduction 1.1 Effective searching techniques within Secure Services will minimise the risks to patients, staff and visitors by ensuring that every reasonable step is taken to prevent drugs, weapons and instruments of self-harm from entering the patient areas. 1.2 Incomplete searching will increase the risks faced by patients, staff and visitors by allowing banned items to be in the possession of patients in our care, and by leading staff into believing that the environment is secure when possibly this is not the case. 1.3 All ward based staff should attend a Search Training Day run by OMHT Secure Services Staff. This is a course designed specifically for the needs of Secure Services and includes methods used in effective area searches and rub down search techniques. 1.4 Further refresher training takes place regularly on the wards and all staff able to attend these short sessions should do so. 2.0 The law 2.1 In all instance the patient’s permission should be sought before carrying out a search. 2.2 If a patient detained under a section of the 1983 Mental Health Act fails to give permission to a search the staff have lawful grounds carry out a search when the staff have reason to believe that the patient has items which present a danger. 2.3 Informal patients may refuse consent to search. Failure to give consent to a search may result in the hospital refusing admission or having the right to discharge the patient. Discussion may resolve this with the patient. In instances where damage to staff, patients or property may be anticipated an individual should not be admitted until the search has taken place. 2.4 Seek advice from responsible clinician in cases where patients permission to search has been withheld 3.0 Search Procedure -- 14 - 3.1 Searches should be carried out in an area where there is room to carry out the search effectively. 3.2 All searches of a patients person must be carried out by a staff member of the same sex in the presence of a witness from staff of the same sex. 3.3 Where a staff member of the same gender is not available the search will be carried out using a handheld metal detector with one staff member carrying out the search and another acting as a witness. 3.4 The procedure for carrying out a search using a hand held metal detector (OCSEC 13) is available in the procedures file in the ward office. Hand held metal detectors are held at reception and Kennet Ward office. 3.5 Colleagues should be informed of what you are doing and where you are. 3.6 Searches should be carried out away from public sight, away from other patients if possible and with due regard for the dignity of the patient. 3.7 It is important to approach the person to be searched in a friendly and courteous way as some people are quite uncomfortable with the invasiveness of a rub down search and may need to be put at their ease. A very officious approach can cause confrontation. 3.8 When searching be aware that you are physically very close to the person being searched and therefore vulnerable to attack. Try to minimise the area of your body presenting a target by maintaining a side on stance when possible. Keep your head up and your arms in a position where they are ready to be raised in defence. Maintaining a defensive stance does not need to be obvious, the act of searching will require your arms to be a raised and by positioning your body tactically throughout a search you can reduce the risk of injury to yourself in the event of an attack. 3.9 DO NOT PLACE YOUR HAND INSIDE POCKETS OR BAGS AS YOU SEARCH IN CASE OF NEEDLES OR OTHER SHARPS. Always ask the subject to remove items for inspection. 3.10 If any items belonging to the patient are removed they must be recorded and the patient must be informed where they are being kept 3.11 When the patient is discharged all confiscated property should be returned to the patient unless the police have been involved in removing the item as with illicit substances. Where illicit substances or weapons are involved the police should be involved in deciding any further action. 4.0 Rub down body search ( Male ) 4.1 Stand facing the subject. 4.2 Ask him if he is in possession of any banned items. 4.3 Ask him to empty all pockets. 4.4 If he is wearing a coat or jacket, ask him to remove it after emptying any pockets. 4.5 If he is in possession of any bags ask him to place these to one side for searching after the rub down search 4.6 Search through items removed from pockets. -- 15 - 4.7 Placing the coat or jacket on a flat surface, run hands over the entire surface of the garment feeling for any lumps which may indicate the presence of contraband. Check under the collar, sleeves and the lining of the jacket as well as the pockets. 4.8 If you discover a lump which could indicate a concealed item ask the subject to remove the item and place it with his other belongings so that you may identify it. DO NOT PUT YOUR HANDS INTO ANY POCKETS OR AREAS IF YOU CANNOT SEE WHAT IS IN THERE, DOING SO COULD RESULT IN A NEEDLE STICK INJURY OR SIMILAR. 4.9 Ask the subject to remove any headgear and pass to you for searching. 4.10 If his hair is long or thick ask him to run his fingers through his hair. Again, this is to prevent the risk of needlestick injury to yourself, needles are sometimes hidden in the hair. 4.11 If the subject is wearing a tie ask him to remove it and search it using the same method as a jacket. 4.12 Lift his collar and carry out a visual check before feeling around it. 4.13 Rub your hands over the top of the subjects shoulders. 4.14 Ask him to raise his arms level with his shoulders keeping his arms straight, his fingers open and apart and his palms facing down. Step slightly to one side, and search that arm by running your hands along the upper and lower sides of the arm from shoulder to wrist. Check between the fingers and look at the palm and back of the hand. 4.15 Repeat for the other arm. 4.16 Rub down the front of the body from neck to waist including the front of the waistband. Check both sides of the body from armpit to waist including waistband. 4.17 Ask the subject to turn around so that his back is to you keeping his arms in the raised position. 4.18 Search his back from neck to waist including the waistband and the seat of his trousers. 4.19 Before searching the lower portion of the body assume a kneeling position presenting yourself side on to the subject with the forward knee on the floor and the furthest leg from the subject flexed and propping back thereby keeping a stable base. The process of searching will keep your arms in a raised position which could be used as a defensive posture should the need arise. 4.20 Check one leg from crotch to ankle including the inside of the leg, the back of the leg and the outside of the leg. When searching the outside of the leg the search is from the waist to the ankle. 4.21 Repeat for the other leg. 4.22 Stand up. 4.23 Ask the subject to turn and face you keeping the raised arm, palms down posture. 4.24 Check the abdominal area of the subject. 4.25 Use the same kneeling position and technique as before to search the front and sides of one leg. 4.26 Repeat for the other leg. 4.27 In the event that you feel or see anything to indicate a hidden item during the search ask the subject to remove the item for inspection. -- 16 - 4.28 If necessary ask him to remove footwear and search shoes. DO NOT PUSH YOUR HAND INTO THE SHOE. First tap the heel of the shoe against the floor as this may cause any contraband to drop out. Carry out a check of the shoe by feeling for lumps from the outside and looking inside the shoe. If you suspect that something is hidden inside footwear ask the subject to remove it for inspection. Carry out a visual check of the sole and heel of the shoe as these can be adapted to carry contraband. 4.29 Study the area around the subject for any item the subject may have dropped before or during the search. 4.30 Ask the subject to step to one side to check that he is not standing on anything he has dropped before or during the search. 4.31 In cases where it is strongly believed that a patient may be hiding something harmful to there person or to others but a rub down search has proven fruitless due to the restricted nature of the search the responsible clinician must be informed and may instigate a more thorough search under medical supervision. 5.0 Rub down body search (Female ) 5.1 Stand facing the subject. 5.2 Ask her if she is in possession of any banned items. 5.3 Ask her to empty all pockets. 5.4 If she is wearing a coat or jacket, ask her to remove it after emptying any pockets. 5.5 If she is in possession of any bags ask her to place these to one side for searching after the rub down search 5.6 Search through items removed from pockets. 5.7 Placing the coat or jacket on a flat surface, run hands over the entire surface of the garment feeling for any lumps which may indicate the presence of contraband. Check under the collar, sleeves and the lining of the jacket as well as the pockets. 5.8 If you discover a lump which could indicate a concealed item ask the subject to remove the item and place it with her other belongings so that you may identify it. DO NOT PUT YOUR HANDS INTO ANY POCKETS OR AREAS IF YOU CANNOT SEE WHAT IS IN THERE, DOING SO COULD RESULT IN A NEEDLE STICK INJURY OR SIMILAR. 5.9 Ask the subject to remove any headgear and pass to you for searching. 5.10 If her hair is long or thick ask her to run her fingers through his hair. Again, this is to prevent the risk of needlestick injury to yourself, needles are sometimes hidden in the hair. 5.11 If the subject is wearing a tie or scarf ask her to remove it and search it using the same method as a jacket. 5.12 Lift her collar and carry out a visual check before feeling around it. 5.13 Rub your hands over the top of the subjects shoulders. 5.14 Ask her to raise her arms level with her shoulders keeping her arms straight, her fingers open and apart and her palms facing down. Step slightly to one side, and search that arm by running your hands along the upper and lower sides of the arm from shoulder to wrist. Check between the fingers and look at the palm and back of the hand. 5.15 Repeat for the other arm. -- 17 - 5.16 Using the back of the hand search from the neck to the top of the bra. AT NO TIME TOUCH THE BREASTS. 5.17 Using the back of the hand search directly beneath the bra. 5.18 Using the flat of the hand search from beneath the bra down the front and sides of the body to and including the waistband 5.19 Ask the subject to turn around so that her back is to you keeping her arms in the raised position. 5.20 Search her back from neck to waist including the waistband and the seat of her trousers or skirt. 5.21 Before searching the lower portion of the body assume a kneeling position presenting yourself side on to the subject with the forward knee on the floor and the furthest leg from the subject flexed and propping back thereby keeping a stable base. The process of searching will keep your arms in a raised position which could be used as a defensive posture should the need arise. 5.22 Check one leg from crotch to ankle including the inside of the leg, the back of the leg and the outside of the leg. When searching the outside of the leg the search is from the waist to the ankle. If the subject is wearing a skirt the search must be carried out by running the hands down both sides of the leg from the outside of the skirt.( This makes it very difficult to search the tops of the legs and it may be necessary to use the hand held metal detector). 5.23 Repeat for the other leg. 5.24 Stand up. 5.25 Ask the subject to turn and face you keeping the raised arm, palms down posture. 5.26 Check the abdominal area of the subject. 5.27 Use the same kneeling position and technique as before to search the front and sides of one leg. 5.28 Repeat for the other leg. 5.29 In the event that you feel or see anything to indicate a hidden item during the search ask the subject to remove the item for inspection. 5.30 If necessary ask her to remove footwear and search shoes. DO NOT PUSH YOUR HAND INTO THE SHOE. First tap the heel of the shoe against the floor as this may cause any contraband to drop out. Carry out a check of the shoe by feeling for lumps from the outside and looking inside the shoe. If you suspect that something is hidden inside footwear ask the subject to remove it for inspection. Carry out a visual check of the sole and heel of the shoe as these can be adapted to carry contraband. 5.31 Study the area around the subject for any item the subject may have dropped before or during the search. 5.32 Ask the subject to step to one side to check that he is not standing on anything he has dropped before or during the search. 5.33 In cases where it is strongly believed that a patient may be hiding something harmful to there person or to others but a rub down search has proven fruitless due to the restricted nature of the search the responsible clinician must be informed and may instigate a more thorough search under medical supervision. -- 18 - Annex 4 Search procedure, for Evenlode 1. INTRODUCTION 1.1 At times it will be necessary to search or examine a patient’s person or property or areas of the MSU to which patients and visitors have access. 1.2 Any search will be conducted in a manner that affords the maximum amount of privacy and dignity. 1.3 Consent for searches will always be sought but searches may have to be carried out without consent. 1.4 The search procedure is divided into three areas:- 1) Individual/personal search 2) General/room search 3) Guidelines for random searches 2. INDIVIDUAL/PERSONAL SEARCH 2.1 The term personal search refers to a body search. This should only be undertaken with the consent of the patient. This procedure refers separately to routine ‘pat down’ searches and more rigorous ‘personal searches’. 2.2 Consent Any examination without consent will only be undertaken in exceptional circumstances where it is assessed there is an urgent necessity in order to protect the patients’ or staffs’ health and safety. If consent is refused and staff wish to proceed with a search, the responsible clinician or duty consultant should first be contacted and the need for a search by force discussed. The Mental health act Code of Practice states that, ‘If a search is to proceed without consent, it should be carried out with due regard for the dignity of the individual and the need to ensure maximum privacy. The minimum force necessary should be used.’ (Section 25.8) Such a search must be well planned, with the appropriate medical staff informed (and present if necessary). 2.3 ‘Pat down searches’ 2.3.1. Pat down searches of patients can be conducted as a matter of routine security. -- 19 - 2.3.2. This is not a full body search but patients are asked to turn out their pockets and may be ‘patted down’. This should be recorded in the appropriate section of a ward search book. 2.3.3. Pat down searches can be carried out by one member of staff in the ward air-lock or a suitable side room on the ward such as the clinical room. The member of staff should inform other staff of their intention and location. If in any doubt of their safety or integrity, they should ask for a second member of staff to assist and observe. 2.3.4. If a patient refuses a pat down search then their leave status will be reviewed by the person in charge. This will be handed over at the next CTM. 2.3.5. Pat down searches will be conducted of patients returning from ground leave on a random basis. Staff may decide that all patients returning from unescorted leave must have a pat down search, depending on circumstances. 2.3.6 A hand held metal detector is available should staff feel it would be useful. 2.4 Personal searches A more extensive personal search may be required if staff assess that an individual may be carrying a banned or illegal item that is not discovered by a pat down search. 2.4.1. Personal searches will be carried out by nursing staff of the same sex as the patient. 2.4.2. Personal searches will only be carried out after the nursing team has discussed the need for a search with the person in charge. The person in charge will organise the search (though may hand immediate direction of the search over to another member of staff for reasons such as gender). 2.4.3. At least two staff must conduct the search. Medical or OT staff may be asked to assist. 2.4.4. The reason and procedure for the search will be clearly explained to the patient and their co-operation sought. 2.4.5. The search must always be carried out in complete privacy and confidentiality. 2.4.6. All staff must be aware that a search is taking place and where it is being conducted. 2.4.7. If the search involves intimate bodily examination of the patient, it must be carried out under medical supervision. Such a search is highly unlikely. 2.4.8. Patients may be asked to change into a set of clothing provided by staff and hand over the clothes they are wearing for searching. This must be done in such a -- 20 - way as to preserve the dignity of the patient whilst minimising the potential for deceit. Alternatively they may be asked to remove items such as jackets and shoes for closer examination and to lift up clothing. 2.4.9. The care of the patient after a search must be planned, with consideration for levels of observation required, and the need to reassure and counsel patients. 2.4.10 the reason for and outcome of the search must be documented on the patient’s case notes, together with the procedure followed. 2.4.11. The search will also be recorded in the appropriate section of a ward search book. 2.4.12 The responsible clinician must be informed of the search as soon as possible. 2.4.13. The reason for, outcome of, circumstances surrounding and procedure of a personal search will be reviewed at the clinical team meeting. 2.4.14. If personal searches are care planned as part of a patient’s treatment package, this will be agreed at the clinical team meeting and reviewed each week. 2.4.15. The nurse-in-charge should ensure there is a ‘debriefing’ session after a personal search in which the staff involved can discuss their opinions of the search procedure. 3. GENERAL/ROOM SEARCH A general search of parts of the MSU may be necessary to seek out a missing object, stolen goods or objects that may jeopardise individual safety or the integrity of the ward. 3.1. When a search is necessary, it is the responsibility of the nurse-in-charge to discuss the reasons for and procedure of the search with the nursing team. 3.2. All staff must be aware of when, where and why the search is taking place and any role they are expected to play. 3.3. Patient movement should be restricted during a search. If patients must leave the Unit, then steps should be taken to ensure that the items sought are not being taken out. 3.4. All rooms on the Unit should be locked to prevent movement of the item and to allow a systematic search to be made. 3.5. As part of their induction, staff must be made aware of potential and unlikely hiding places so these are not overlooked. Ward manager and CSM to ensure that -- 21 - staff receive appropriate training and instruction to search effectively and that appropriate equipment is provided. 3.6. Patients rooms should be searched last. 3.7. After each separate locked area has been searched, it should remain locked and inaccessible until completion of the search. 3.8. When searching patients’ bedrooms and belongings, two staff must be present and at least one should be of the same sex as the patient. The patients will be informed of the reason for and procedure of the search before it begins. Their consent and presence will be requested, but searches can continue without either. After being informed of the imminent search, they will not be allowed into their rooms without a member of staff present. 3.9. In the case of a patient’s room and belongings being searched, this should be recorded in the patient’s nursing notes. The outcome of the search should be recorded, even if nothing is found, as well as the patient’s response and consent/lack of consent. 3.10. The search will also be recorded in the appropriate section of the search book. 3.11. The care of each patient after a search must be planned, with consideration for levels of observation required and the need to reassure and counsel patients. 3.12. Following the procedure, a staff/patient meeting should be held to discuss matters arising to allay unnecessary anxieties and resentment created by such procedures, and to discuss the reasons for and outcome of the search. 4. RANDOM SEARCHES 4.1. Random searches of patients’ rooms and communal areas will be conducted. They will include areas such as the dining hall and lounges. 4.2. As the term suggests, there is no set schedule for random searches or an anticipated regular time scale between searches. They should be conducted at the staff-in-charge’s discretion. 4.3. The purpose of a random search is to seek out banned items and help to ensure the safety of staff and patients. 4.4. All staff must be aware when and where a random search is taking place and any role they are expected to play. 4.5. Patient movement past the room being searched should be restricted to protect the dignity of the patient involved. -- 22 - 4.6. Two staff must be present; at least one should be of the same sex as the patient. Patients will be informed of the reason for and procedure of the search before it begins. Their consent and presence will be requested, but searches can proceed without either. After being informed of the imminent search, patients will not be allowed in to their room unless accompanied by a member of staff. 4.7. The search will be documented in the patient’s notes, including its outcome and the patient’s response. 4.8. Random searches will also be recorded in the search book. 4.9. The care of the patient after a search will be reviewed, with consideration for levels of observation, reassurance, counselling and any needed changes to planned care. 4.10. The occurrence of a random search of a patient’s room will be handed over at their next Clinical Team Meeting. It must be assured that their key and co-workers are aware that the search took place and its outcome, even if nothing is found. 4.11. In the case of a random search of a communal area, patients will be kept out of this area for the duration of the search. They should not be informed of the search until it is about to commence. 4.12. Two or more members of staff should conduct the search whilst the remainder continue to care for patients. 4.13. Following the procedure, a staff/patient meeting should be held to discuss matters arising, to allay unnecessary anxieties and resentment, and to discuss the reasons for and outcome of the search. 5. POLICE INVOLVEMENT 5.1 Police cannot search patients or their rooms without first obtaining a warrant. 5.2 The police may agree to assist in searches of communal areas and involve dogs if there is a evidence of drug use or illegal activity. 5.3 The police provide training on room and ground search techniques which will be utilised and fed back to other staff whenever possible. -- 23 - Annex 5 Ridgeway Partnership Equality Impact Assessment Policy/Function Name: __________ Policy _on Searches Names of persons completing Assessment: Arthur Green (Please print names Lead Director for Policy/Function: ____Director of Performance, Information and Nursing_ Date of Policy/ Function: ____July 2009__ Date Policy/Function assessed: ____July .09__ Policy/Function review date ___July 2012_____ When completed this Assessment should be attached to the policy/function and distributed accordingly. The main aims and impacts of the Brief description/explanation policy/function 1. What is the purpose of the policy/function? To describe the circumstances and procedure for carrying out search of persons and property -- 24 - The main aims and impacts of the Brief description/explanation policy/function 2. Who is intended to benefit Staff by having clear guidance. Patients by have assurance that the Trust procedures comply with from the policy/function? the law and best practice. (Who are the target group? Who will benefit directly or indirectly?) 3. Is there any adverse impact (s) from the policy/function on individuals from the following groups - service users, staff, carers, members of the public in relation to need, equal treatment, inclusion/exclusion based on: a) Age No b) Gender (male/female) No c) Learning Disability No d) Mental Health need No e) Sensory Impairment No f) Physical Disability No -- 25 - The main aims and impacts of the Brief description/explanation policy/function g) Race, Ethnicity, No Religion, Spiritual belief (including other belief),Language or Culture h) Sexual Orientation No i) Any Long Term No condition Yes 4. Is responsibility shared with another department to Individual management implementation across all Directorates deliver the policy/function? How is this managed? 5. Has anyone been involved in the development of the Yes policy/function? If so, who, e.g. service Specialist Health Services Management Team and the Risk Management & Service Governance users, staff, professional Committee includes representation from all directorates and different professions groups, H&S Executive, stakeholders, partners? Discussing, offering feedback and suggestions to policy – sending for endorsement How were they involved? Should anyone else have -- 26 - The main aims and impacts of the Brief description/explanation policy/function been involved – if so how will they now be consulted? 6. What information has helped towards the Impact Mental health Act Assessment? E.g. Audit Mental Health Act Code of Practice reports, feedback from groups/committees, surveys etc. 7.Which groups of service Staff & Managers, Specialist Health Services Management Team and the Risk Management & users, staff, carers, Service Governance Committee includes representation from all directorates and different members of the public, professions stakeholders, partners, have been consulted with during this assessment? What information have they Issues regarding implementation, examples of different situations provided? -- 27 - The main aims and impacts of the Brief description/explanation policy/function 8. Is there any evidence that No evidence some people may have different expectations of the policy? E.g. different racial groups/people with a disability, people with different religious beliefs, or on the grounds of age, gender, or sexuality. 9. Is more information No required? If so, what information and how will you get it? 10. Action Plan Who is responsible for When will the action be When will the What Action is required as implementing this action? implemented by? policy/function be re- result of this assessment? assessed for any adverse impact? -- 28 - Monitoring and evaluating in Arthur Green July 2012 July 2012 time for policy renewal Please send this form to Deborah Lawrenson, Company Secretary, for signing off and publishing on the Trust website. This Assessment is completed and any adverse impacts have been identified and action agreed. Signed _______________ -- 29 -