Li has been nursed on general observations throughout this week, is spending significant periods of time off the ward. Li has now been stopped from spending time in reception without staff supervision. This is due to him ‘boasting’ that he is able to hack into the computer in reception, and team members reporting they have seen him sitting at the computer. Li has also taken things from the desk in reception such as post it notes and cellotape, the latter being used to tie others up and a peer used it to wrap around her neck. Bedding: Some staining possibly blood smear seen when his bedding was changed on the 28th no visible wounds, Li continues to have episodes of nocturnal enuresis. Li denied having self harmed and said they were stains. Other: There are no wounds visible on his arms.
23/7/12 Li repeatedly demanded to ‘discharge himself’ he was unable to listen to staff. He hit/kicked doors repeatedly and later in the evening tried to use chairs to break windows. He was let off the unit on two occasions as he was demanding to leave and not detainable. Li returned of his own accord on both occasions.
Li still need reminding to attend to his personal hygiene; he can look unkempt at times. He has refused to change soiled clothing or to do his laundry. When asked to rate his mood Li subjectively reported feeling ‘fed up’ and just wanting to get on with his life, he refused to try to rate on a scale of 0-10. Li has presented as low in mood at times and often irritable/argumentative. At other times he has spoken positively about activities in his new placement Li has been reluctant to get up on several occasions this week and expressed ‘feeling tired and just fed up wanting to sleep until he is discharged’. Li has complained of feeling nauseas and reluctant to eat on a couple of occasions this week and his appetite is reduced but he has taken adequate meals/fluid.
OTHER- Li is aware of the plans for his care and appears to have a good understanding of these, he refused to attend his hospital appointment for the 23/7/12, claiming to be too tired to get up for it.