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Searches Policy - Policy on Searches Policy on Searches

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					                                                         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 -