Secure units

Question 1

Physical / environmental security

Answer 1

Fence, locks, soft cutlery, removing glasses, sharps and hanging points,

Question 2

Relational security

Answer 2

Training, good communication, meaningful activities, knowing patients well and developing good relationships with them

Lack of relational security can decrease the actual safety net provided by physical security measures

Question 3

Procedural security

Answer 3

Searches, investigating and learning from incidents, staff pre-employment checks, other clinical governance arrangements, risk management

Question 4

High secure units

Answer 4

Mentally disordered offenders (MDOs) who are of grave and immediate risk

Question 5

Medium secure units

Answer 5

High risk MDOs

Question 6

Low secure units

Answer 6

MDOs with limited violence / absconding risk

Question 7

Young Offenders Institutes (YOIs)

Answer 7

Young offenders: 12-16
Juvenile offenders: 15-17

Detention schools higher security than YOIs, secure children’s homes lower levels

Adolescent secure hospitals = medium secure placement options

Question 8

Observations

Answer 8

General observations: location known at all times, but not within eyesight

Intermittent observations: at risk of violence / attempting suicide

Within eyesight observation: high & imminent risk of violence / suicide

Within arms length observation: high risk of acting very quickly

Question 9

Community forensic teams

Answer 9

Step down in physical and procedural security, whilst stepping up on therapeutic care

Parallel care model, integrated care model, hybrid care model