Positive and Proactive Care – setting standards for care plans and auditing in a secure hospital setting

Abstract

Positive and Proactive Care(DH, 2014) sets out guidance on the reduction of the use of a range of restrictive interventions. The guidance document provides a framework within which adult mental health and social care services should develop a culture where restrictive interventions are only ever used as a last resort. It identifies key actions that will better meet people’s needs and enhance their quality of life in order to reduce the need for the use of such interventions. It also sets out mechanisms to ensure accountability for making these improvements, including effective governance, transparency and monitoring (DH, 2014). This report describes the development of a set of standards that are based upon the key recommendations contained in the guidance. The resultant standards were used to audit care plans within a forensic hospital setting for men who have a diagnosis of autistic spectrum disorder and/or learning disability. This audit was conducted across the hospital, leading to recommendations about how aspects of care and the documentation supporting that care could be improved. Suggestions are made about how the audit standards could be improved for future audits of ‘restrictive interventions’ and in different settings.