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					NAME OR POLICY:     Disclosure & Search (Incorporating the
                    searching of service users and their
                    belongings, and banned Items)


TYPE OF POLICY:     Mental Health


REFLECTS SPECIFIC
LEGISLATION
OR NHS GUIDANCE:    Code of Practice Mental Health Act 1983


STAFF GROUP
TO WHOM IT
APPLIES:            All Clinical Staff throughout the Trust


DISTRIBUTION:       The Whole of the Trust


HOW TO ACCESS:      Trust Website/Policy Manual

ISSUE DATE:         June 2004

NEXT REVIEW:        September 2005


APPROVED BY:        Approval at MHA committee


DEVELOPED BY:       Mental Health Policy Development Group


DIRECTOR LEAD:      Deputy Chief Executives


CONTACT FOR
ADVICE:             Immediate Line Manager/ General Manager
           South West Yorkshire Mental Health NHS Trust


                         DISCLOSURE AND SEARCH
 (Incorporating the searching of service users and their belongings and banned
                                      items)




CONTENTS



   1. Introduction                                                      Pg 4

   2. Guiding Principles                                                Pg 5

   3. Disclosure of banned items                                        Pg 5

   4. Process of disclosure                                             Pg 6

   5. Failure to disclose                                               Pg 6

   6. Search – general                                                  Pg 6

   7. Search Procedure                                                  Pg 7

   8. Search Procedure                                                  Pg 8

   9. Police Involvement                                                Pg 9




Appendices

Appendix 1 – Banned Items                                               Pg 10

Appendix 2 – Definitions                                                Pg 11

Appendix 3 – Detention under Common Law                                 Pg 12

Appendix 4 – Notes on conducting personal/property searches             Pg 13


                                                                                 2
          MENTAL HEALTH POLICY DEVELOPMENT GROUP


      Memorandum to Mental Health Policy – Disclosure (incorporating the
       searching of Service users and their belongings, and banned Items


                           DISCLOSURE POLICY


This policy should be read in conjunction with The Mental Health Act, 1983
– Code of Practice (1999) chapter 25, and Trust Policies – “Section 5(2)”,
“Section 5(4)”, and “Control of pornographic material”

“Managers of hospitals and mental nursing homes admitting patients
under the Act should ensure that there is an operational policy on the
searching of patients and their belongings.” MHA, 1983 Code of Practice.




 Please note that in the interests of brevity, the masculine pronoun has been used
 throughout, the feminine pronoun applies equally. Words/phrases in italics indicates
 their inclusion in the glossary of definitions (appendix 2)




1.0     Introduction

South West Yorkshire Mental Health Trust respects the rights of individuals and
their need for privacy and recognizes that most people coming into contact with
our services do not present significant risk. Nonetheless, the Trust has a clear
duty to safeguard service users, staff and the public from harm and must
maintain a level of vigilance to ensure this. This policy covers the circumstances
under which a service user or visitor is asked to disclose information regarding
substances, implements or other articles which may harm or offend. This policy
also outlines the circumstances under which a personal search of a service user
and/or his possessions can be conducted, and the operational procedure which
must be followed. Clear guidelines are available for both service users and their
visitors in respect of this policy.

The appendix (1) details those items that are banned or restricted within in-
service user areas.




                                                                                   3
2.0      Guiding Principles of the Policy

2.1

There are a number of principles that apply to this policy which include:

       Explanation about the processes involved is always given to the person
        concerned and where applicable his consent is obtained
       Privacy, dignity and confidentiality are central to the process, including
        due consideration of cultural/religious/gender issues.
       Staff engaged in the processes of disclosure/search must ensure they are
        in compliance with this policy and the guidelines contained in the
        appendices.


3.0      Disclosure of Banned Items

3.1      Service users

3.1.1

The process of attaining disclosure of information and/or handing over items
which are banned or subject to control occurs initially during the course of an
admission to a ward. This policy complements local procedures which are used
for the reception of service users and examination of their belongings.
Subsequently this must be linked to an on going risk assessment which will
determine whether the service user is required to make further disclosures and
under what circumstances. Additionally, the service user is required to make a
disclosure when he is transferred from one ward to another. The service user is
asked to declare whether he has in his possession any items as detailed in
Appendix 1.

3.2      Visitors

3.2.1

All visitors must report to reception upon arrival on a unit. It is the responsibility
of the receptionist to make visitors aware of the list of banned items (appendix 1)
and to ask the visitor to declare that he does not have in his possession any item
which may pose a danger. If the receptionist has any doubts, he asks the visitor
to remain in reception and seeks advice from the nurse in charge of the ward.
When reception is not manned, this responsibility is placed upon the member of
staff collecting the visitor from the reception area. Similarly, where a unit does
not have a reception this function is carried out by a member of the nursing staff,
such units must ensure that there is clear signage in the entrance instructing



                                                                                    4
visitors to report to the Nurse in Charge. In the event of a visitor declaring a
banned item, please proceed to 4.2

4.0    Process of disclosure

4.1

An interview with a service user must take place in an area where privacy is
assured, and not in view of other service users or visitors.

4.2

Any item which is handed over as part of this process, is recorded in the service
user’s notes. If a visitor is found to have in his possession a banned item he is
advised that the cannot enter the unit unless the item is handed to staff for safe
keeping or otherwise removed from the premises. A record of this made in the
clinical records of the service user who is being visited. A receipt is issued for
any item removed for safe keeping.


5.0    Failure to disclose

5.1

If, following the interview there is still concern that the service user has a banned
item in his possession, the person conducting the interview must consider
instituting search procedures. For visitors please go to 6.2


6.0    Search – general

6.1

Random or routine searches must not form part of a general practice.
A service user and his possessions may be subject to a search if, in the opinion
of the nurse in charge there is good reason to believe that a service user has an
item which is dangerous/banned in his possession – refer to appendix 1.

6.2

Visitors must not be subjected to a search. If a visitor is suspected of being in
possession of a banned item which her refuses to hand in for safe keeping, he is
not allowed access to the ward. If there is sufficient concern, the police must be
contacted.




                                                                                   5
7.0        Search Procedure

7.1

If a service user is suspected to have on his person or amongst his possessions,
a banned item or something which is otherwise considered dangerous, this must
be brought to the attention of the nurse in charge of the appropriate ward
immediately.

7.2

The nurse in charge decides whether a search is required and records this
decision and the reason for it in the service user’s clinical records.

7.3

If a decision to search is made, the nurse in charge explains this to the service
user concerned and seeks his consent. A second member of staff must be
present during this interview.

7.4

If informed consent is obtained from the service user to being searched, this is
recorded in the service user’s clinical records – please proceed to Section 8.

7.5

If the service user refuses, or is unable to give informed consent to a search of
either/or, his person or possessions, he is made subject to the highest level of
observation (please refer to local observation policy) and isolated from the ward
community until further decisions are made.

7.6

If the service user is informal and states at this point that he wishes to be
discharged, the following should be considered:

      a)     Does the service user fulfill the statutory requirements of Section 5(4)
             MHA (Nurse’s Holding Power) or if a doctor is present, the statutory
             requirements of Section 5(2) MHA (Doctor’s Holding Power)? The
             person carrying out the assessment should then consider invoking the
             statutory holding powers given in the MHA 1983.




                                                                                   6
      b)     That the service user is allowed to discharge himself against medical
             advice.


      c)     The police are immediately contacted if it is believed that the service
             user presents an immediate danger to himself, other service users,
             visitors, staff or the general public. Advice is sought from the police at
             this point. Reasonable attempts are made to engage the service user
             until the police arrive. (See Appendix 3).


7.7

Where the decision to search is made, the service user’s Responsible Medical
Officer (RMO), or the duty consultant is contacted and the position explained so
that he has the opportunity to offer clinical opinion and input into the process.

If there are concerns or conflicts these should be resolved at a local level.
Where there is a conflict of opinion the matter is referred to the responsible
director or, out of hours, the on call doctor (via the on call manager) for a final
decision.

7.7.2

The full outcome of the decision/s taken is recorded in the service user clinical
records and explained to the service user.


8.0        Search Procedure

8.1

The service user is escorted to an area which offers optimal privacy.

8.2

A search is conducted by two members of staff (of the same sex as the service
user) one of whom must be a registered nurse. Where this is not possible
immediately, advice should be sought from the service manager or on call
manager.

8.3

When a search of a service user’s room takes place, the service user is asked to
remain in the area.




                                                                                     7
8.4

Staff conducting the search do so with the utmost regard for the dignity of the
service user, taking into account cultural/religious considerations and ensuring it
is carried out under conditions of maximum privacy.

8.5

Before commencing the search, staff familiarize themselves with “Notes on
conducting personal/property searches” (see appendix 4)

8.6

If an item is removed from the service user, it is put in a safe place and a receipt
is issued.
An explanation is given to the service user which details where the item is being
kept, and under what circumstances it will be returned to him. Where there is
concern that the item should not be returned to the service user under any
circumstances, the item is kept in a safe place, and the matter referred to the
service manager as soon as practicable. The Trust accepts responsibility for any
steps taken by staff who are concerned about returning an item to a service user.

8.7

At the conclusion of the search, the outcome is recorded in the service user
clinical records.
A risk incident recording form is completed and a decision made as to whether
the matter constitutes a Major Incident as outlined in the policy.


9.0   Police Involvement

9.1

Where an item is found in a service user’s possession that is of concern and may
constitute a criminal act e.g. illicit drugs, the nurse informs the police
immediately. If a practitioner has any doubts about pursuing this course of
action, he may seek advice from the service manager, his deputy or the on call
manager.




                                                                                  8
                                                                     Appendix 1



Banned Items

This list should not be considered as exhaustive; clearly it is not possible to list
every single item that may under certain circumstances, pose a danger to the
service user or others.

Service users and their visitors may not have in their possession the following:

    Weapons and replica weapons
    Corrosives e.g. bleach
    Substances containing solvents e.g. certain glues
    Patent (over the counter) medicines e.g. paracetamol,
    Alcoholic drinks (please see footnote)
    Items which could be used to cause harm for which the service user/visitor
     can have no use whilst in hospital e.g. screwdriver
    Petroleum spirit and similar fluids other than that contained in individual
     cigarette lighters
    Obscene pornographic material


Additionally, some items may be kept by staff and managed by the risk
assessment and management process:

      Razors and razor blades
      Other items with a cutting edge
      Flammable liquids and sprays e.g. hair spray
      Inhalators or medicines not prescribed by the Trust’s medical staff
      Electrical equipment and flexes
      Glass bottles and containers
      Matches and cigarettes lighters
      Vitamin compounds, herbal remedies etc


Alcoholic beverages

In some care areas alcoholic may be considered as controlled rather than
banned e.g. Older People’s Services, where use of alcohol is considered a



                                                                                   9
feature of an individual’s normal functioning. Where this is the case, it should be
clearly documented in the service user’s clinical notes.




                                                                    Appendix 2



DEFINITIONS


For the purposes of this policy, the term “Personal Search” means:

A detailed examination of a service user’s clothing and body including major skin
crevices and hair, but specifically excludes internal body cavities ie, the rectum
and vagina. However, a visual examination of the mouth is permitted provided
that the service user consents to this.


“Routine or random” means:

Conducting a search where there is no clear and specific reason for doing so.
So for instance, a search of a service user and/or his possessions may not be
carried out say, every Sunday afternoon, or for no particular reason. It is
permissible to carry out a routine search if this is indicated through a risk
assessment.


“A search of a service user’s possessions” means:

A detailed examination of all property belonging to a service user which is stored
on the premises of the hospital/unit. Additionally, drawers, cabinets etc to which
the service user has access are also included in this definition.


“A safe place” means:


                                                                                10
A locked cupboard, drawer or safe on Trust premises, to which only the Nurse in
Charge or other senior officer has access.


“Unit” means:

Any inservice user service area including community rehabilitation units,
community units for the elderly and learning disability villas. The policy
specifically excludes Forensic Services and community learning disability homes.
Where the word “ward” is used, it refers to individual care areas within a larger
unit but also applies to individual villas, community units etc.


                                                                  Appendix 3



                  DETENTION UNDER COMMON LAW



Detaining a service user under common law must only be considered if it is
believed that the service user presents an immediate danger to himself, other
service users, visitors, staff or the general public. Moreover, he must not meet
the requirements of detention under Section 5(2) or (4) of Mental Health Act,
1983 i.e., he must not be exhibiting any manifestations of his mental disorder.




                                                                              11
                                                                   Appendix 4



 NOTES ON CONDUCTING PERSONAL/PROPERTY SEARCHES


Staff must read these notes before commencing a search of a service user

Personal searches, irrespective of whether they are carried out with or without
the service user’s consent can be hugely damaging to therapeutic relationships.
It is therefore important, when this is a requirement that every effort is made to
preserve the dignity of the service user and to carry out the procedure with the
utmost respect for the individual concerned. The process is not without its
hazards to the persons conducting the search, staff may be exposed to sharps or
other harmful objects, and the service user may react violently through fear,
anger, embarrassment or because of his/her mental state.

The following guidelines assume that the need to undertake a search has been
fully explained to the service user concerned, and strict adherence to the
personal search policy.

When the need to search a service user and/or his/her belongings has been
identified, the service user must be made subject to close supervision (please
refer to local observation policy).

The search should be the least invasive possible, so if there is suspicion that a
service user has on his/her person a relatively large item, e.g., a knife,
consideration should be given to limiting the search to a “rub down search”. Staff
conducting the search need to be mindful that a “rub down search” will not detect




                                                                               12
many items including illicit drugs and implements used to carry out acts of self
harm e.g. a razor blade.

The search must be carried out in a systematic manner with safety being a prime
consideration.

Re-iterate to the service user, the need for the search and give a clear
explanation about what is happening and what is required from the service user
in terms of how to stand etc.

Do not comment about the service user’s clothing, body, smells, tattoos etc.
Particular respect must be shown with regard to cultural issues e.g., the search
of a service user with a turban.

Start by asking the service user to empty his pockets. Do not, under any
circumstances, put your hands into the service user’s pockets. A suitable table
or similar flat surfaced furnishing should be provided on to which items can be
placed and examined. If the service user will not co-operate, clothing must be
searched when removed from the service user. In these circumstances examine
the inside of pockets, purses etc visually, before putting your hands/fingers
inside.

Conduct as much of the search as you can, standing behind the service user. As
a general rule, always start at the service user’s head and work down.

Check the service user’s hair and behind his/her ears.        If required, ask the
service user to remove any hair accessories.

Make a visible check of collar/s.

Pat down clothing. Starting at the shoulders, ask the service user to outstretch
his/her arms with palms facing down and work in a systematic manner along
each arm. Check the axilla (arm pit), watch if worn, and between the fingers.

Continue the pat down search, checking the service user’s back, sides and front
torso and include the service user’s waist band, and bra’ strap where
appropriate.

Check the service user’s groin area, clearly some sensitivity is required here, and
continue down each leg.

Ask the service user to remove shoes and socks and check these separately.

Depending upon the circumstances, consideration should be given to conducting
a removed clothing search. This should only be carried out where there is




                                                                                13
substantial evidence to suggest that a rub down search will not be sufficiently
thorough.

Removed Clothing Search

As the term suggests, a removed clothing search is the most comprehensive
type of personal search and involves the service user removing some or all of his
clothing. This facilitates a detailed search of the individual’s person and clothing.
Although this may be done without the consent of the service user it must be with
his cooperation. If the service user refuses to undress and/or is actively
resistant, so that this action could only be carried out under restraint, DO NOT
PROCEED but contact the service manager or on-call manager for advice.

The service user is escorted to his bedroom or private area where there will be a
minimum of two staff present. The staff carrying out the search must be of the
same gender as the service user, and a registered nurse must carry out the
search.

The procedure must be explained to the service user. A blanket or similar is
placed on the floor for the service user to stand on. The service user is asked to
remove his clothing and provided with clothing that has been previously checked.
The service user should replace his top clothing before removing lower clothing.
Staff make a visual check of the service user’s body during the procedure, e.g. in
the armpits and the soles of the feet, hands, ears, nose and mouth.

The removed clothing must be search thoroughly, along the seams and other
stitching, checking for alterations or tampering. Any damage to clothing must be
noted before and during the search.

Following the procedure the details of the search are to be documented in the
clinical notes.

DO NOT: -

Put your hands where you cannot see

Sniff, lick or taste any substance

ALWAYS: -

Assume that pockets, handbags etc may contain sharp objects

Wear gloves when handling suspected drugs or items contaminated with body
fluids.




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