❓ A WA parliamentary question addresses an incident at the Bentley Adolescent Unit, probing staffing levels, policies, and bed availability across mental health facilities. The Minister provides detailed responses, tabling policies and outlining actions taken.
AnsweredQoN 4083Legislative Council
QuestionView source ↗
I refer to the incident at the Bentley Adolescent Unit on the 13 March 2016, and the associated article on page 3 of The Sunday Times on 27 March 2016, and I ask: (a) what is the timeline of significant events that occurred in the preceding 24 hours of the incident occurring; (b) how many patients were admitted in the 24 hours prior to the incident and how many were still there 24 hours after the incident; (c) will the Minister table a copy of the service's “restrain and seclusion” policies and advise how they were applied during the incident; (d) did any patients need medical treatment following the incident and, if yes, what are the details of the injuries; (e) who is undertaking the review launched by the Child and Adolescent Health Service; (f) as at the 12 March 2016, were any positions vacant at the unit and, if yes, which positions were vacant; (g) how many positions were vacant as at 5 April 2016; (h) have any positions at the unit been affected by the Barnett Government's recruitment freeze; (i) how many staff were on duty on the night of the incident; (j) up to 5 April 2016, on which dates and, for what reason, have code yellow alerts have been issued at the Bentley Adolescent Unit or Ward 4H at Princess Margaret Hospital in 2015-2016; (k) up to 5 April 2016, how many children and, on what dates, could not be admitted to either the Bentley Adolescent Unit or Ward 4H at Princess Margaret Hospital during 2015-2016; (l) what has been the minimum and median number of beds that have been open at the youth psychiatric unit at Fiona Stanley Hospital since its opening; (m) why were only eight of the youth psychiatric beds at Fiona Stanley Hospital open at the time of the incident; and (n) on the 5 April 2016, how many beds were open at the youth psychiatric unit at Fiona Stanley Hospital?
AnswerView source ↗
Answered
10 May 2016
Responded by
Minister for Planning representing the Minister for Mental Health
Response time
34 days
(a) In the 24 hours preceding the incident, the acuity within the Bentley Adolescent Unit (BAU) was high due to a complex patient cohort of older adolescents with a combination of antisocial behavior, marked by verbal and physical threats to staff and deliberate self-harm. This contributed to a highly-charged ward environment and was reflected in increased seclusion and restraint, and incidents of self-harm.
(b) I cannot answer the Member’s question as there are a small number of admissions to the BAU each day, therefore providing this information could potentially identify individual patients and compromise confidentiality.
(c) I table the Child and Adolescent Mental Health Service’s (CAMHS) policies (Attachments 1-4). Seclusions and restraints were applied during the incident in accordance with these and will be reviewed as per the policies. See tabled paper no.
(d) Yes, two (2) minor abrasions requiring first aid. One (1) patient required medical review but had no medical sequelae.
(e) CAMHS has initiated a Root Cause Analysis (RCA) into the events of 13 March 2016. The RCA will be chaired by the Director of Advanced Training in Child and Adolescent Psychiatry and include the following external staff on the panel:
(f) As at 12 March 2016, the BAU had a nursing staffing deficit of 5.15 substantive FTE. There was a further 9.6 FTE deficit due to secondments, workers compensation and higher duty allowances.
(g) No positions were vacant due to integration of the two (2) CAMHS inpatient wards.
(h) Yes, there are 5.15 FTE vacancies in the BAU and exemptions for these positions have been sought. The daily operational staffing levels are being managed to ensure appropriate staff levels.
(i) When the incident happened, the BAU had eight (8) nursing staff were present. This is two (2) more than the usual number of staff rostered, which was a decision made due to the acuity of the ward at the time.
(j) A code yellow was activated for the BAU on Monday 14 March 2016 following an incident on Sunday 13 March 2016, during which nursing staff were challenged by a group of adolescent patients. Staff were accosted (but not assaulted), verbally abused and threatened. The group of adolescents proceeded to cause structural damage to the BAU.
The attendance of Bentley Health Service security and police was required to contain the situation and ensure staff and other patient safety. The code yellow was activated to prevent further admissions until the ward environment was stabilised and nursing staff shortages could be addressed.
The code yellow remained in place due to ongoing staffing shortages causing inability to safely manage the unit. On 23 March, due to these ongoing shortages the decision was made to deactivate beds in Ward 4H and integrate the ward with the BAU to ensure adequate staffing. Therefore on 23 March, Ward 4H also became subject to this code yellow. The code yellow was subsequently lifted on 25 March.
(k) As at 5 April 2016, in 2015/2016 there were five (5) patients could not be admitted to a Ward 4H or BAU bed and were admitted elsewhere.
Details are provided below:
Date
Number of patients admitted to an adult bed
13/07/15
1
20/10/15
1
08/02/16
1
25/02/16
1
01/03/16
1
Total
5
(l) FSH opened six (6) Youth beds on 8 April 2015. The seventh bed was opened 9 November 2015 and eighth bed opened on 14 January 2016. The median number of beds is therefore seven (7) since 8 April 2015.
(m) The remaining six (6) of the 14 Youth beds have been placed on hold as the FSH Mental Health Service will reach its purchased activity for 2015/16 with only 24 of the 30 mental health beds on site being opened.
(n) Eight (8) beds were open at FSH for 16-24 year olds on 5 April 2016.
(b) I cannot answer the Member’s question as there are a small number of admissions to the BAU each day, therefore providing this information could potentially identify individual patients and compromise confidentiality.
(c) I table the Child and Adolescent Mental Health Service’s (CAMHS) policies (Attachments 1-4). Seclusions and restraints were applied during the incident in accordance with these and will be reviewed as per the policies. See tabled paper no.
(d) Yes, two (2) minor abrasions requiring first aid. One (1) patient required medical review but had no medical sequelae.
(e) CAMHS has initiated a Root Cause Analysis (RCA) into the events of 13 March 2016. The RCA will be chaired by the Director of Advanced Training in Child and Adolescent Psychiatry and include the following external staff on the panel:
(f) As at 12 March 2016, the BAU had a nursing staffing deficit of 5.15 substantive FTE. There was a further 9.6 FTE deficit due to secondments, workers compensation and higher duty allowances.
(g) No positions were vacant due to integration of the two (2) CAMHS inpatient wards.
(h) Yes, there are 5.15 FTE vacancies in the BAU and exemptions for these positions have been sought. The daily operational staffing levels are being managed to ensure appropriate staff levels.
(i) When the incident happened, the BAU had eight (8) nursing staff were present. This is two (2) more than the usual number of staff rostered, which was a decision made due to the acuity of the ward at the time.
(j) A code yellow was activated for the BAU on Monday 14 March 2016 following an incident on Sunday 13 March 2016, during which nursing staff were challenged by a group of adolescent patients. Staff were accosted (but not assaulted), verbally abused and threatened. The group of adolescents proceeded to cause structural damage to the BAU.
The attendance of Bentley Health Service security and police was required to contain the situation and ensure staff and other patient safety. The code yellow was activated to prevent further admissions until the ward environment was stabilised and nursing staff shortages could be addressed.
The code yellow remained in place due to ongoing staffing shortages causing inability to safely manage the unit. On 23 March, due to these ongoing shortages the decision was made to deactivate beds in Ward 4H and integrate the ward with the BAU to ensure adequate staffing. Therefore on 23 March, Ward 4H also became subject to this code yellow. The code yellow was subsequently lifted on 25 March.
(k) As at 5 April 2016, in 2015/2016 there were five (5) patients could not be admitted to a Ward 4H or BAU bed and were admitted elsewhere.
Details are provided below:
Date
Number of patients admitted to an adult bed
13/07/15
1
20/10/15
1
08/02/16
1
25/02/16
1
01/03/16
1
Total
5
(l) FSH opened six (6) Youth beds on 8 April 2015. The seventh bed was opened 9 November 2015 and eighth bed opened on 14 January 2016. The median number of beds is therefore seven (7) since 8 April 2015.
(m) The remaining six (6) of the 14 Youth beds have been placed on hold as the FSH Mental Health Service will reach its purchased activity for 2015/16 with only 24 of the 30 mental health beds on site being opened.
(n) Eight (8) beds were open at FSH for 16-24 year olds on 5 April 2016.
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