RESTRICTED DRAFT

Mapping health-based Places of Safety

Survey of the availability and accessibility of health-based Places of Safety for peoplesubject to Section 135/136 of the Mental Health Act Questionnaire for providers

Name of person(s) completing questionnaire:

Job title:

  1. Basic information

a)How many health-based places of safety (PoS) are there in your trust area? [Numeric]

b)For each health-based PoS, please provide:

  • Address, telephone number[1st line of address and postcode + tel no.]
  • Web address of any information about the place of safety, if applicable
  • The local authority area(s) served by this PoS [drop down: LAs – including options for selecting multiple areas]
  • Which provider is responsible for the PoS? [drop down: This mental health trust, Another mental health trust (with further drop down of all mental health trusts), Acute trust with further drop down of all Acute trusts), Other (free text)
  • The type of PoS [drop-down: A&E, mental health ward in general hospital, mental health hospital, other (please describe)]
  • Is this a dedicated place of safety (not intended to be used for any other purpose? [Yes/No]
  • When is the PoS open? [tick boxes all that apply – 24 hours a day/365 days a year, Mon-Fri 09:00-17:00, Mon to Fri17:00 – 09:00, Sat 09:00 – 17:00, Sat 17:00 – 09:00 Sun 09:00-17:00,Sun 17:00 – 09:00 public holidays 09:00 – 17:00, public holidays 17:00 – 09:009-5/5-9, Other (please specify), Not stated in policy, Information not available (with free text box to explain)]
  • In2013, how many times has the PoS been used for people detained under s136/135?[by month] - drop-down numbers, plus option for information not available – if this is selected, must enter why plus estimate]
  • Which services are used to transfer people to the places of safety in your trust area?[Respondents should list in order of frequency – Police, NHS ambulance, independent ambulance, Other – please specify (each should have option for n/a)]

c)Are there any local authority areas served by your trust that either do not have a health-based place of safety available to them or the PoS only covers part of the local authority? [drop down: LAs; further drop down: partial coverage, no coverage; if partial coverage: free text – what area is excluded]

  1. Sufficient provision

a)Does your Trust believe that there is currently sufficient provision of health-based places of safety in the local authority area(s) covered by the Trust?[Yes/No]

b)Please could you explain the basis for your response to Q2a? [Free text]

c)If No, how is this issue being addressed? [Free text]

  1. Place of safety governance and multi-agency working

a)Are all health-based places of safety subject to the same policy for governance? [Yes/No (if No, free text - please explain)]

b)Is the operation of the health-based places of safety within your trust area subject to an agreed inter-agency policy? [Yes / No / Not at all of our place of safety locations]

c)If Yes:

  • Who are the signatories to it? [tick box all that apply: Local Authority, Acute NHS Trust, Clinical Commissioning Group, police service, ambulance service, Other (please specify)]
  • Does it include all the areas set out in the Code of Practice 10.17? [Yes/No – if no, please specify what is not covered]
  • When was it last reviewed? [mm/yyyy]
  • When was the last audit completed against the requirements of the policy?[mm/yyyy or Unknown/No audit yet completed]

d)Do you routinely collect data from each place of safety to monitor the service?[Yes/No]

e)If yes, does this include information on: a) the profile of people brought to the PoS including [tick box - age, sex, ethnicity, disability, other protected characteristics]; b) the number of times people are turned away from the PoS; c) the reason people are turned away from the PoS; d)the outcome of the assessment carried out in the PoS; e) the number of people who are transferred between places of safety; f) delays in initiating a MHA assessment for people brought to the PoS [Yes/No for each question]

f)Do you have a multi-agency group that includes active representatives from [tick box all that apply: Local Authority, Acute NHS Trust, Clinical Commissioning Group, police service, ambulance service, Other (please specify)]]

g)What is the job title of the chair of this group?

h)How often did the group meet in 2013?[at least monthly/every 3 months/every 6 months/yearly/as required/Never]

i)What are the key issues the group is currently looking at? [free text]

j)What is the reporting mechanism to ensure that the Trust Board is sighted on key issues? [free text]

k)In 2013, how many complaints and incidents relating to places of safety were reported to the Board?[For each: Box for numeric entry, information not available (with free text box to explain)]

l)What is the reporting mechanism to ensure the local CCG(s) is/are sighted on key issues?[free text]

  1. Police support

a)Doyour inter-agency local policies include details of the expectations of police support? [Yes/No/No local policy/Not standardised across our local policies]

b)If yes, what are the expectations? [Tick Box - Always stay, stay until MHA assessment completed, stay if the patient remains disturbed, not expected to stay once handover has occurred]

c)Does your local policy state whether police are expected to assist in physical restraint? [Yes/No/No local policy/Not standardised across our local policies]

d)If yes,in what circumstances are they expected to assist in physical restraint? [Yes at times, only if patient very disturbed, never]

e)In your trust area, do police tend to contact the hospital prior to the person’s arrival at the place of safety?[All of the time/Most of the time/ Some of the time/ Rarely or never]

  1. Exclusion criteria

a)If you operate more than one health-based place of safety, does your local Trust policy (or agreed inter-agency policy) have a standardised exclusion criteria that can be applied to all locations? [Yes – in both local Trust policy and inter-agency policy / Yes – in Trust policy only / Yes – in inter-agency policy only/ No – differences in criteria for different locations / No – no exclusion criteria / NA – only operate one PoS]

b)What exclusion criteria (if any)are applied for accepting individuals to the place of safety? [tick box all that apply – No exclusion criteria, acute medical needs, disturbed behaviour, history of violence, criminal offence, risk of self-harming, intoxication, lack of capacity, resident out of area, people detained under s135, other (please specify)]

c)If your criteria for exclusion include intoxication, disturbed behaviour or a criminal offence, please explain your approach for assessing whether a person should be excluded? [Free text for each]

d)In 2013, has a patient been taken elsewhere for the reasons listed in a)? [By month for each criterion – drop down - No, Once, 2-4, 5-9, 10 times or more, Information not available]

e)Where an individual meets the exclusion criteria, what alternative resource is used? [tick box - different ward in same mental health hospital, different mental health hospital, A&E different ward/area in general hospital, police custody, other (please describe) – subsequent free text box to enter address, information not available]

  1. Patient groups

a)Which health-based place of safety can the following groups of people use? [to be laid out as a matrix as below, check box for each PoS/patient group]

Patient group / PoS 1 / PoS 2 / PoS 3
Under 16s
16-17 year olds
18-64 year olds
Over 65 year olds
People with a learning disability
People with a physical disability

b)If one or more groups of people is not accepted by any of the named health-based places of safety, where is this group generally taken to be assessed? [drop-down: different ward in same mental health hospital, different mental health hospital, A&E different ward/area in general hospital, police custody, other (please describe) – subsequent free text box to enter address, information not available]

c)Are there any other patient groups which are not accepted by this place of safety?[Yes/No; if Yes, please specify; if Yes, what alternative place of safety is used (as above)]

SPLIT FORM HERE – NEW QUESTIONNAIRE FOR EACH PoS

  1. Capacity

a)How many people can be assessed at any one time [Drop-down – 1,2,3,4,5 or more]

b)In 2013, how often has a person not been able to access the health based PoSdue to the assessment room(s) being used? [By month - drop down– 0, 1-4, 5-9, 10-19, 20 times or more, Information not available]

c)What arrangements are most often made when the PoS is already occupied[The person is transferred to another health-based PoS; The person is taken into police custody; another room on the ward is used (e.g. seclusion room); people wait in the transport in which they were brought to the PoS until it becomes free; Other - please specify]

d)In 2013, has the place of safety ever been used for another purpose (such as storage, seclusion, lounge, medication clinic, area for people detained under s2/3 to wait for beds)which has impacted on your ability to accept patients?[Yes-daily/most days, Yes-at least once a week, Yes-at least once a month, Less often than once a month or Never in 2013, Information not available]

e)In 2013, has the place of safety had to be closed because of the need to use it as an additional inpatient bed [Yes-daily/most days, Yes-at least once a week, Yes-at least once a month, Less often than once a month or Never in 2013, Information not available]

f)What is your local target time for MHA assessments to be initiated for people brought to the PoS?[free text]

g)In 2013, how many of the MHA assessments for people taken to the place of safety have taken longer than your target time to be initiated? [By month – numeric text boxes, plus information not available]

h) Where you have exceeded your target time, are the delays more likely to take place outside of working hours (i.e. Monday – Friday 9am-5pm)? [Yes/Makes no difference/Information not available]

i)What are the reasons for delays in initiating MHA assessments?[Order the following from most to least common, or not applicable: AMHP not available, s12 doctor not available, doctor who knows the person not available to attend, AMHP unwilling to initiate assessment until a bed is available, clinical grounds for delaying the assessment, Other (please specify)]

  1. Staffing

a)As a minimum, how many mental healthcare professionals are allocated to work on the place of safety? [Drop-down – None, 1, 2, 3, 4, 5 or more]

b)Is this number of staff always available at the opening times specified above?[Yes – always, Mostly, Occasionally, No – rarely/never]

c)Do these staff only work in the place of safety? [Yes/ No]

d)If no, which team do staff come from? [Tick box – CRHT, PICU, inpatient wards, other]

e)If no, when police arrive are there ever delays in providing staffing levels in accordance with your policy?[Yes – always, Most of the time, Occasionally, No – rarely/never]

f)If they are not always immediately available, in 2013 how long on average had people had to wait with the police before they are handed over to staff? [Less than 5 minutes/5-15 minutes/15-30 mins/30mins – 1h/1h-2h/2h or more, Information not available]

g)In 2013, has demand for the place of safety exceeded your staffing capacity (resulting in people being turned away)? [By month - drop down– 0, 1-4, 5-9, 10-19, 20 times or more, Information not available]

h)Do all nursing and medicalstaff working in the place of safety have training in:

  • Their roles and responsibilities under s136?[tick box: Yes – before they start work in the PoS; Yes – on the job; No]
  • Safe assessment and risk management practices?[tick box: Yes – before they start work in the PoS; Yes – on the job; No]
  • Management of disturbed behaviour, including de-escalation? [tick box: Yes – before they start work in the PoS; Yes – on the job; No]

Mental Capacity Act [tick box: Yes – before they start work in the PoS; Yes – on the job; No][Have check box for each bullet above for a) nursing staff; b) medical staff]

i)Are otherTrust staff (e.g. security staff) ever involved in responding to someone brought into the PoS? [Yes/No]

j)If yes, please indicate which staff group, how often and in what capacity they are involved. [Free text]

k)Do you also provide training to the other staff who may have contact with people requiring the facilities [Yes/No]

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