Inpatient –
Title:TW Shift
Li appeared low having spoke with Dr G this afternoon. He was upset that he about being on 1:1
as he complains it makes him feel anxious. Li spoke on the phone to his mum for a short while
and said it was nice to speak to her. Despite wanting to leave and Li’s dislike of being on 1:1, he
has appeared quite bright in mood generally, smiling, laughing and chatting to staff and peers.
—————————–Confirmed By LLock@, 08/05/2012
Title: Group Name: Music Jam
OT Intervention: creative epression
Li joined this group approximately 15 minutes before its end after seeing a dog that had been
brought to visit the ward. Whilst in the group Li appeared to be of positive mood and interacted
well with both staff and peers. Lee did not take part in musical activity, choosing instead to
observe and talk with peers.
—————————-09 May 2012 13:43, Chris Snipp
Event By: Chris Snipp
Title: Pets as Therapy Group
OT Intervention: Animal Assisted Therapy
Li reported being scared of dog. However, with staff support he was able to stand near the door to
the patio and observe the PAT dog. He was able to tolerate this for 10 minutes, but declined to
come any closer to the PAT dog.
OT to support Li in getting closer to PAT dog next session.
—————————-09 May 2012 13:13, Joanna Loomes
Event By: Joanna Loomes
Inpatient –
Title:Li informed of MHA assessment
Li seen with Grant RhodaI explained that I was unable to get hold of his social worker, so sought advice within the Trust. I
also informed him that a MHA assessment has been arranged for Thursday at 1pm. Li asked for
more information, so I explained the process. He seemed accepting of this and thanked me as he
left the room.
—————————–Confirmed By HGarrett@, 08/05/2012
Inpatient –
Title:Mental Health Act assessment Thursday at 1pm
Phone call to Senior AMHP, Bob KirbyThey do not have any free slots for tomorrow, so agreed for MHA assessment to go ahead on
Thursday at 1pm.
If staff concerned in the meantime, they can consider using section 5 (2).
—————————–Confirmed By HGarrett@, 08/05/2012
Inpatient –
Title:Discussion with Sarah Cannell
After leaving three messages for his social worker, I phoned Senior AMHP within the Trust.
Sarah outlined that we have to weigh up the pro’s and con’s of him bieng an inpatient. Holding
him under the agreement of the local authority (as he is on a Full Care Order), stops being
acceptable, once he needs treatment for his mental disorder,(not to be sectioned, so he can have
a physical examination). Having ascertained that I had attempted to negotiate with him, Sarah
advised that I need to request a Mental Health Act assessment.
—————————–Confirmed By HGarrett@ 08/05/2012
Inpatient –
Title:Li adamant he wants to leave
Li seen- tense, closed body posture, mostly avoiding eye contact. Told me he has had enough of
being on one to one- that either this ends, or he wants to take his own discharge. He reported that
it is making him feel more stressed, ‘paranoid’ and distressed than he has ever felt before. I
explained that it is difficult for him, that he cannot self-harm when being observed, yet we have
not given him strategies to replace that. I discussed with him ideas such as flicking a rubber band
on his wrist, writing in red pen or holding ice cubes till they melt. Rebecca confirmed that she will
ensure that some are available. Li told me that he doesn’t feel he can wait till Thursday (to see
As there was no shift in his postion, I said I would try to speak to his social worker and get back to
—————————–Confirmed By HGarrett@, 08/05/2012
Title: Spoke to Li to ask how he was getting on. He said he was finding it diffcult being under oneto-one observations all the time. When I asked him if he could explain why, he said that it made
him feel paranoid and anxious. He said it was bringing back bad memories. I suggested that he
might benefit from meeting me on a regular basis to think about some of these feelings and the
memories attached to them. I explained that sometimes young people come in that we don’t know
much about and there are concerns about risks they pose to themselves and others, and that is
why they are put on 1-to-1. I explained that sessions with psychology would be a way of getting to
know him better and MIGHT allow us to review his obs. We agreed to meet on Thursdays at 5pm
(starting 10/05) and Tuesdays at 3pm (starting 15/05).
—————————-08 May 2012 17:02, Oliver Sindall
Event By: Oliver Sindall
Ward Round Title: Li’s social worker contacted, message left for her to ring the ward to gain feedback and plan
from ward round.
—————————-08 May 2012 14:51, Lynda King
Event By: Lynda King
Title: Group Name: Circus Skills
OT Intervention: Creative expression
Li attended this group for its duration and appeared to be of positive mood throughout. Li
interacted well with both staff and peers and engaged well with activities.
—————————-08 May 2012 16:08, Chris Snipp
Event By: Chris Snipp
Inpatient –
Title:Ward review Dr. Prasad
Ward review:
H Garrett, A Sheffield, L King, S Calver, O Sindall, L Marlow, N Dhapotkar, L Guard, M
Rajendraprasad, J Coles, T Dhomatob
– Risk assessment
o Evidence of mixture of blood and mucus in bathroom and bed following admission
o After 1:1 obs there has been no reports of bleeding
o Profile in the context of history suggests risk to others especially to other young people
– Diagnostic clarity
o Frustrated he cant self harm
o Has expressed that he may hit things if he feels frustrated
o Described memories/thoughts of the past which are vivid
o On average sleeps well, eating well, needs prompting with self care
o Not happy with being on 1:1; wants his computer back
– Education
o Long history of outbursts in school which included threat to other, destruction of property,
hacking into school computer
– Plan
o To complete: MFQ, SCARED – Primary Nurse
o Psychology assessment
o To persevere with trying for MSU; weekly MEWS
o To discuss with Li *Redacted By author – Private* test – Dr. Prasad
o To continue on 1:1 obs – eyesight
o CPA: 24/05/12 at 14:30

title:Early Shift
Li has expressed his frustration at being on eyesight observations, and wanting access to his lap
top. He agreed to wait for ward round feedback. He was difficult to engage in activities trying to
sleep instead, declining offers of other activities.
—————————–Confirmed By [email protected], 08/05/2012