2. YOU HELP ME CUT MA PEATS ‘N’ I’LL HELP YOU DIP YER SHEEPS MENTALLY DISORDERED OFFENDERS THE HIGHLAND EXPERIENCE

6. Affric Ward 12 Beds Mixed sex All rooms en-suite Secure garden Pleasant surroundings Activities within Ward

7. Affric Ward - MDT 2 Consultant Psychiatrists - Consultant covering General Adult psychiatry and consultant covering Forensic patients Nursing Staff Forensic MHO Pharmacist Occupational therapy Forensic Liaison nurse

8. Affric Ward - Forensics Covers all of NHS Highland area except Argyll and Bute Occasionally takes from NHS Grampian if patient is seen in Elgin or is from Northern Isles Occasionally take from Western Isles Occasionally take from other prisons Over 90% are admitted from Inverness Sheriff Court or Porterfield prison

9. 1 x Head of Forensic Nursing, Highlands VACANT 1 x Forensic CPN, Inverness, Nairn, Strathspey & Badenoch 1 x Forensic Specialist Nurse, Ross & Cromarty 0.4 x Forensic Specialist Nurse, Caithness & Sutherland 0.4 x Forensic Specialist Nurse, Lochaber VACANT 0.2 x Forensic Specialist Nurse, Skye and Lochalsh VACANT Forensic Community Nursing

10. Medical 1 x Consultant with an interest in forensics

11. MHO’s 1 x Senior Practitioner Forensic MHO 1 x Forensic MHO with 0.2 CJS commitment 1 x 0.5 Forensic MHO

12. FT ASSESSMENT OT CPN’S SW’S Partner Agencies e.g wellbeing group, green gym, Abriachan

13. FT and CMHT/ CJS/ NC e.g LIST ACT Emotional Control Competent Witness

14. No access to Forensic Psychology Sporadic consultation – not criminogenic or offence focussed THEREFORE HIGHLAND GREW THEIR OWN! With grateful thanks to the Forensic Network L

15. FT CWMIC-BIT Intro CBT WDPFS

16. ACTLISTPSSTFECOOCSFTSMRMIDPGPGSO

17. Risk Assessment Affric Ward (IPCU) Introduced 12 years ago - evolved over this period Highly visible – red border kept at front of case record Inclusion of missing person section which includes the same risk definitions as used by the Police Multi-disciplinary approach Links to STORM assessment MHOs place before Sheriff court when seeking Compulsion orders

18. Scottish Patient Safety Programme Affric Ward – chosen as Mental Health pilot site Chosen workstream – Risk assessment Proposed changes - More user involvement - Signed by user - Safety plan not Risk management plan - Use of Risk assessment from BEST index

19. Advanced Risk Assessment Affric have several staff trained in - HCR 20 - SVR 20 - RSVP - C-BIT - RA 1-4 - BEST

20. Forensic Team Additional training RM 2000 S&A 07 RA 1-4 LSCMI ASSET SAM CAADA-DASH RICKTER SCALE IMPULSIVITY CHECKLIST BEST

21. Multi-agency approach NEW TO FORENSIC PROGRAMME Facilitated by – - Secure Care manager - Forensic MHOs - Forensic Specialist nurse Cohorts included – RMNs, MHOs, CJS Social workers, CPNs, Police, Prison Officers, Chaplains, MAPPA Co- ordinator, GP

22. Multi- agency approach (cont) Through teaching the programme we are able to access, influence and equip others to contribute to 24 hour cover and Risk assessment

23. 24 Hour cover – Triage New Craigs Hospital Mental Health assessments Mental Health Assessment Team 8am – 9pm 7 days a week Duty Doctor 24/7 Triage nurse based at New Craigs between 11pm and 8am, 7 days a week taking calls from NHS 24 Triage nurse will also attend police custody suite accompanied by member of staff from Affric or Night nursing team leader to assess people out of hours. This allows access to MH assessment for PF perusal prior to court appearance

24. 24 Hour cover – Triage (cont) Section 297 protocol agreed with Northern Contabulary Mental Health Liaison nurses based at Raigmore Hospital (Acute Care)

25. During office hours Forensic Team Provision of service to SPS-HMP Porterfield – Consultant Cl – Consultant Clinic, FSN FSN surgery, FMHO assessment/detention SCS – FSN and FMHO provide assessment, reports, advice, support and guidance to Highland courts in jurisdiction. NC – FSN and FMHO provide assessment advice, support and guidance to Police officers, especially officers in the custody suite