Mental Health Services Group
Level 3, 44 Taharoto Road
Private Bag 93-503, Takapuna
Auckland 0622
Telephone: (09) 487-1300
Freephone: 0800 80 9342
Facsimile: (09) 487-1333
Visit: www.waitematadhb.govt.nz
3 November 2017
Health Sector Workers Network
[FYI request #6682 email]
Dear Sir/Madam
Re: Official Information Act Request – OPCAT Monitoring places of detention report 2015-2016
Thank you for your Official Information Act request to Waitemata District Health Board (DHB) received 11
October 2017 in which you sought the fol owing:
In the 2015-2016 Optional Protocol to the Convention Against Torture (OPCAT) Monitoring Places
of Detention report, there were a number of recommendations made to mental health inpatient
units in the Auckland region. The Office of the Ombudsman’s report within the OPCAT document
states:
10 recommendations were made to He Puna Waiora;
Six recommendations were made to Waiatarau
Could you please provide the details of those 16 recommendations?
Please be aware that the Waitemata DHB Specialist Mental Health and Addiction Service serves a
population of more than 615,000 within the Waitemata district and is the largest service in the country by
volume of service-users seen.
The Adult Mental Health Service also provides treatment in two adult acute mental health inpatient units.
He Puna Waiora is a 35-bed unit on the North Shore Hospital site and Waiatarau is a 32-bed unit on the
Waitakere Hospital site.
The Crimes of Torture Act (the Act) gives effect to New Zealand’s international obligations under the
United Nations Optional Protocol to the Convention Against Torture ('OPCAT').
The objective of OPCAT is to establish a system of regular visits by independent international and national
bodies to places of detention, in order to prevent torture and other cruel, inhuman or degrading
treatment or punishment.
The Act provides for the designation of 'National Preventive Mechanisms' (NPMs), whose role is to
examine, at regular intervals, the conditions of detention and treatment of detainees and make
recommendations for improvement. (
www.ombudsman.parliament.nz).
We believe our adult mental health inpatient units (He Puna Waiora and Waiatarau) provide a high
standard of care to our service users and acknowledge there are always opportunities for further
improvement. We are always open to independent external feedback that can assist us to continue to
improve our services for the benefit of our service-users, family and whanau within Waitemata DHB.
OIA response – Health Sector Workers Network
1
The following recommendations were identified by COTA during a visit to Waiatarau and He Puna Waiora
and we have taken the fol owing actions to address each finding:
Crimes of Torture Act (COTA) Report: Waiatarau
Summary of Findings
Recommendations
Actions taken in response
This finding related to the fact that Waiatarau’s
1. Informal clients are
The practice of arbitrarily
front doors are kept locked to ensure that very
being arbitrarily
detaining clients should cease
unwel patients who are being compulsorily
detained.
immediately.
treated are not able to leave the unit. Informal
patients have always been free to leave, simply by
asking a staff member to open the doors for them.
Notices are displayed at the reception area and on
doors leading to the main ward highlighting the
process for family/whanau around leaving the unit.
The seclusion register and
The service is currently developing one electronic
2. There were anomalies in restraint register should be ful y
reporting system for restraint and seclusion
both the seclusion
maintained and accurately
recording.
register and restraint
reported on. A quality assurance
register
framework should be applied to
Documentation is also reviewed at the weekly
the completion of al paperwork.
‘Restraint & Seclusion Panel’ meetings and the
monthly ‘Restraint & Seclusion Minimization’
meetings. At these meetings al documentation is
updated fully.
3. Not al family/whānau
As part of the sectioning process, Where the service-user is sectioned in the unit, the
are consulted as part of
the Unit records and reports on
family are contacted and this contact is recorded
the sectioning process
the family/whānau consultation
and documented on the HCC clinical notes.
process.
4. Contact details for the
Contact details for District
The District Inspectors’ phone numbers are
District Inspectors were
Inspectors should be available
available in the phone boxes for service-users and
not displayed in a place
next to the client telephone(s).
are replaced when they are removed.
easily accessible to
clients.
5. Some soft furnishings
Damaged furniture and worn
There was a replacement of chairs and furniture in
and carpet were
carpets should be replaced.
Waiatarau in May 2017. Replacement of carpets is
damaged and worn.
underway.
6. Not al clients have
All clients should have access to
The High Care Areas and open ward have enclosed
access to at least one-
at least one hour in the fresh air
courtyards that can be freely accessed by service-
hour fresh air daily.
daily. This should be recorded
users during the day.
accordingly.
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Crimes of Torture Act (COTA) Report: He Puna Waiora
Summary of Findings
Recommendations
Actions taken in response
1. The Seclusion register
The Seclusion register should be
The service is currently developing one electronic
and some seclusion
fully maintained and a quality
reporting system for restrain and seclusion
records were
assurance framework applied to
recording.
incomplete
the completion of al seclusion
documentation (including
Documentation is also reviewed at the weekly
electronic records).
‘Restraint & Seclusion Panel’ meetings and the
monthly ‘Restraint & Seclusion Minimization’
meetings. At these meetings al documentation is
updated fully.
2. The Restraint register(s) The Restraint register should be
The service is currently developing one electronic
and some
ful y maintained and a quality
reporting system for restraint and seclusion
documentation were
assurance framework applied to
recording.
incomplete
the completion of al restraint
documentation (including
Documentation is also reviewed at the weekly
electronic records).
‘Restraint & Seclusion’ meetings and the monthly
‘Restraint & Seclusion Panel’ meetings. At these
meetings al documentation is updated fully.
3. Not al staff were up to
Al staff should be up to date with Staff training is routinely reviewed and where
date with mandatory
mandatory training requirements indicated staff are booked on training. Reminders
training requirements
regarding mandatory training, including e-learning,
are sent to staff to complete.
4. The Unit is a locked
Notices detailing the process for
Notices are displayed at reception area and on
facility and has the
entry and exit into the Unit for
doors leading to main wards highlighting process
potential to arbitrarily
informal (voluntary) service-users for family/whanau when needing to leave unit.
detain informal
(and visitors) should be displayed
(voluntary) service-
in prominent areas, including the
The process for leaving the locked unit is
users
Unit entrance.
accessible for visitors to He Puna Waiora to read.
5. The DHB’s complaints
Information on the DHB’s
The District Inspectors’ phone numbers are now
process, including
complaints process should be
available in the phone boxes for service-users and
contact details for
easily accessible to al service-
are reviewed regularly and replaced when needed.
District Inspectors, is
users. The contact details of
not well-advertised
District Inspectors should be
verified and updated on a regular
basis.
6. Service-users are not
Service-users should be invited to We accept the principle that service-users should,
invited to attend their
attend their MDT meeting and
as much as possible, be involved in the planning
MDT review meeting
routinely provided with a copy of and review of their care. Practical y, however, the
and do not routinely
the minutes of their review.
logistics of running such meetings with every
receive written
service-user participating directly would make the
feedback from the
running of the ward unmanageable. Input to
meetings
planning and review of treatment does happen in
other ways, including with family, in accord with
other standards and guidelines. MDT meeting
discussions are recorded in the clinical record,
which can be accessed by service-users at any time
should they wish to do so.
7. The DHB’s guidelines
The DHB should consider
Our usual position is that we encourage and
for requesting Police
adopting a zero-tolerance
support police involvement. However, a simplistic
assistance in adult
approach on violence (to service-
‘zero-tolerance’ approach is unrealistic and fails to
acute mental health
users, staff and visitors) by
recognise the clinical complexity of acute care.
units lacks detail
automatical y referring assaults
Clearly, if the person affected by a violent act
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and other serious incidents to the wants police involvement we wil support that and
Police. This could be
our usual approach is to encourage and support
incorporated into the current
police involvement for serious violence. However,
serious and sentinel events
we must be able to use our discretion on this,
policy.
taking a range of factors into consideration,
including views of victims and their caregivers.
8. In order to protect
In order to protect service-user’s
Staff discuss this issue with service-users as
service-users’ dignity,
dignity, staff need to be more
required and encourage them to dress
staff need to be more
vigilant with regard to ensuring
appropriately, while supporting individual choices.
vigilant with regard to
service users are appropriately
For those who are very disorganised, then staff wil
ensuring service-users
clothed.
ensure their dignity is maintained and support
are appropriately
them to dress appropriately.
clothed
9. Not al service-users
Service-users need to be offered
The High Care Areas and open ward have enclosed
have access to daily
at least one hour of fresh air
courtyards that can be freely accessed by service-
fresh air
daily.
users during the day.
10. There is no privacy for
Service-users should be offered
There are two phone boxes available on the main
service-users when
privacy when accessing the
wards and service-users in the High Care Areas are
accessing the telephone telephone(s).
able to take the phone into the interview room or
if using their own the bedroom. Service-users are
made aware of the availability of options should
they wish to take a phone call in a private space.
I trust this information will satisfy your request.
Yours sincerely
Pam Lightbown
General Manager
Specialist Mental Health & Addictions Services
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Document Outline
