Inpatient –
Title:Night Shift
Li presented as happy and relaxed at the start of the shift, he expressed his relief at being taken
off eye sight observations, saying he was glad to have some privacy. Li was aware that his level
of observations depends on the risks he presents and was able to explain the agreement he and
Oliver had developed. Li asked to go to bed early and went to bed at 22.00, and appeared to be
asleep when checked at 22.30, he was seen to be restless in his sleep and woke briefly at 01.00
and 04.06. He has been nursed safely on intermittent observations throughout the night.

– —————————- Confirmed By RChapman@, 16/05/2012
Inpatient –
Title:Late Shift
Li has been nursed on 1-1observations until 17.00 today when his obs were reduced to
intermittent. Li was very happy and personally spoke to as many people as he could to share the
good news.
Li has been bright in mood, interacting appropriately with his peers, spent time on the x box and
watched some TV. Li has eaten a good sized portion of supper this evening. – —————————- Confirmed By JGraham1@, 15/05/2012
Title: Group Name: Music Jam
OT Intervention: Creative Expression

Li attended this session but left approximately 15-20 minutes before its end. Whilst in the group Li
appeared to be of positive mood and engaged well in the group activity. Li interacted well with
staff and peers. – ————————— 16 May 2012 11:19, Chris Snipp

Event By: Chris Snipp
Title: Following todays ward round I started our session by feeding back to Li the decision to
move him from eyesight to intermittent obs. He later agreed to the conditions of the corresponding
care plan and intermittent obs started at 5pm today (see care plan folder or plan section on epjs).
Li is very happy about this.

We discusssed some of the work Li had been doing with Haymond Lee (Support Worker) and he
said he had found this helpful. I explained that it was really good that other people were helping
him think about self harm. We discussed what would make Li feel safe to talk about about his
more severe self harm. Li felt he would be more comfortable approaching this diffcult subject with
me, and we agreed that Haymond would continue to work around the concept of his self harm,
but not go into any of the detail, including the distressing events Li connects with this.

We also agreed that as he didn’t like surprises, although it might make him anxious, we should
agree when to think about the details of his self harm. Li agreed that he would try this in our next
session on Thurs 17th May 5pm. – ————————— 15 May 2012 20:25, Oliver Sindall

Event By: Oliver Sindall
Ward Round Title: Rang foster carers, no reply so left a message to ring the unit at their convenience.

In ward round nursing team to keep being supportive towards him and using sleep hygiene
(relaxation/breathing techniques at bed time). Dr to discuss reduction of observation level to
intermittent with clear framework of expectations to be discussed with him as well.
Dr G proposed that if this went well maybe he could have some leave after his CPA on the 21st
@ 2pm to go out with foster parents for a short time. – ————————— 15 May 2012 14:57, Rebecca Clack

Event By: Rebecca Clack
Dietitian Title: Healthy lifestyle group: Session on physical activity where benefits, recommendations and
types were discussed: Li attended group and participated well throughout. He was able to make
relavant observations regarding the task set in group. Whilst saying that he wanted to leave, he
continued to contribute to the group. – ————————— 15 May 2012 15:50, Namrata Dhopatkar

Event By: Namrata Dhopatkar
Inpatient –
Title:Early Shift
Li has been nursed on intermittent observations this shift, he has remained safe. he has eaten
well including two whole meals at lunchtime, he told staff he is always hungry.
Li has attended education, said he likes ‘ going in ‘ as it passes the time, has also atteded group
this morning. Li has spent any free time playing on the x-box, he sits with peers minimal
interactions. Li has been pleasant on approach with staff, told staff he was pleased to see his
foster parents at weekend and that they had brought him some ‘ stuff ‘, he shrugged his shoulders
and didn’t answer when staff asked if it was exciting ‘ stuff ‘.
Li thanked staff for the car magaziines brought in to share out with other young people.
– —————————- Confirmed By [email protected], 15/05/2012
Inpatient –
Title:Ward review Dr.Prasad
H Garrett, L Guard, R Banton, C Roberts, J Coles, H Wilde, E Marlow, S Calver, R Clack, O
Sindall, N Reid, M Rajendraprasad
– On ward no e/o affective of psychotic diorder
– Risk assessment

o Bedding is dry; on 9/5/12 noticed to have a patch in pajamas – not clear if it was old
o Not happy about being on section
o Does experience anxiety;
o Has spent time with another young patient on the ward: this was considered worrying. HG has
asked R Banton
o Discussed 1:1 obs: agreed on 15min obs given settled behaviour on ward
o Discussed report from school: ?ASD
– Plan
o Reduce obs to 15min obs; to be increased if any new concerns – O Sindall and Dr.Prasad to discuss conditions which would trigger increase of level of obs
o Continue with psychology assessment
– —————————- Confirmed By MRajendraprasad@, 16/05/2012
Title: Li attended nursing led group – he was bright in mood and very vocal throughout, expressing
his opinion at both appropriate and inappropriate moments. He maintained interest throughout
however and worked well with another young person to create a jubilee banner of a union jack. – ————————— 15 May 2012 15:39, Rebecca Stockwood

Event By: Rebecca Stockwood