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The National Hospital for Neurology and Neurosurgery Good

All reports

Inspection report

Date of Inspection: 12 November 2012
Date of Publication: 20 December 2012
Inspection Report published 20 December 2012 PDF

People should be protected from abuse and staff should respect their human rights (outcome 7)

Meeting this standard

We checked that people who use this service

  • Are protected from abuse, or the risk of abuse, and their human rights are respected and upheld.

How this check was done

We reviewed all the information we have gathered about The National Hospital for Neurology and Neurosurgery, looked at the personal care or treatment records of people who use the service, carried out a visit on 12 November 2012 and observed how people were being cared for. We checked how people were cared for at each stage of their treatment and care, talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The arrangements in place to protect patients from the risks associated with restraint need further development.

Reasons for our judgement

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. When we spoke to staff they were able to describe what their responsibilities were in reporting concerns. We also saw that safeguarding adults’ flowcharts were displayed to assist staff in taking the correct steps if there were concerns about patients potentially being abused. Posters raising awareness of safeguarding were also being displayed.

Following the inspection the trust provided us with data on the percentage of staff that had completed Safeguarding training. This showed that 88.7% had completed level 1, 72.7% level 2 and 54.5% level 3. Different roles require staff to be trained to different levels of knowledge. The provider might like to note this meant that more than a third of relevant staff had not completed level 3 training.

People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements. At the time of our visit the trust was in the process of developing a new restraint policy. The trust told us that restraint was only used as a last option. If required there were staff that had specific training who were available.

When we visited the Neurosurgical Intensive Care Unit we noted patients were having the use of their hands restricted through the use of protective hand coverings. This was for patients who were presenting a risk to their own safety through being in a state of agitation, confusion or restlessness. When we spoke to staff they told us that the hand coverings were used as part of the patient’s best interest interventions to maintain safety and they always verbally explained this to the patient’s family. The rationale for using the mittens was not always being documented in patient’s notes and no risk assessment for their use was in place. The provider might like to note this meant patient’s were being restricted without the reasons for this being fully documented.