Safety concerns remain at Edinburgh's teenage mental health ward

58 minutes ago

Lisa SummersScotland health and social care correspondent

Inspectors remain concerned about the safety of young people at Edinburgh's inpatient teenage mental health unit nearly a year after they identified problems with the use of physical restraint and force feeding.

A team from the Mental Welfare Commission (MWC) said some procedures at the Melville Unit had improved but processes for protecting both patients and staff from violence and aggression needed more work.

The MWC, which revisited the unit in March, said some children described feeling "scared and unsafe" at times.

NHS Lothian said safety of patients and staff was its top priority and that it took concerns and recommendations "extremely seriously".

The Melville Unit, based at the Royal Hospital for Children and Young People, cares for 12 to 17-year-olds who may have a range of mental health illnesses including eating disorders, depression and psychosis.

The most recent inspection found a number of young people had been experiencing high levels of stress and distress, which at times led to violence and aggression towards staff and, on occasion, other young people.

Some parents and carers also reported their child had been subject to physical aggression from other young people or had witnessed staff being assaulted.

The commission said managers at the unit should ensure all available options to manage risk are considered to maintain the safety of young people, staff and others.

Notable progress

The MWC said there had been notable progress since that visit, with improved care plans in place for children as well as multidisciplinary team working.

Young people spoke positively about members of staff, describing their approach to care as "compassionate", "empathetic" and "positive".

However, concerns remain about the use of restraint which was often used for nasogastric feeding - where a narrow feeding tube is placed through the nose down into the stomach.

The MWC said senior managers had reported an 84% reduction in the use of restraint.

But while the service had made overall progress, the inspectors said there should be improvements in reporting restraint accurately, as well as ensuring alternative options had been explored.

Jillian Torrens, services director for Royal Edinburgh Hospital and associated services in NHS Lothian, said: "Mental health is complex and can at times present very specific challenges.

"We work closely with young people to understand their needs, manage risk and recovery and always take prompt action to support anyone affected by challenging behaviour by providing additional care, separate safe spaces, increased staffing, one-to-one and enhanced nursing support and regular care reviews.

"We will continue to strengthen our safeguarding processes and keep patients and families informed as we work through our focused improvement plan."

NHS Greater Glasgow & Clyde said it had made significant improvements but admitted more needed to be done.