• An evaluation of night confinement in a high secure hospital

      Braham, Louise G.; Heasley, Jonathan F.; Akiens, Sam (2013)
      Purpose: Night confinement (NC) has been proposed as an appropriate and safe way to make cost improvements in a high secure NHS hospital. Given potential controversy, evaluating the impact of this change is vital. This paper aims to focus on the issue. Design/methodology/approach: The study used a mixed methods design to assess the impact of a three month night confinement pilot on four high secure admission wards. In total, 158 staff and 42 patients were approached to complete questionnaires and interview prior to and following the pilot. Questionnaires were analysed using T tests, ANOVA and Mann Whitney-U to asses perceived changes in ward climate, working environment and quality of life. Thematic and saliency analysis was used to explore themes arising from semi structured interviews. Hospital data were collected to identify behavioural changes. Findings: The study found that NC had no adverse effects and incidents of self harm, other incidents and seclusion hours dropped by a third during this period. This was contrary to staff expectations. Research limitations/implications: Limitations include: a large number of researchers involved; average response rate and a disproportionate number of patients on Tilt restrictions on the pilot wards. Further evaluation is necessary if NC is to be adopted more widely. Practical implications: This evaluation suggests that NC can contribute to providing an efficient and effective secure mental health service. Originality/value: This study provides a unique opportunity to assess the impact of NC on patients and is of value to other secure units seeking effective cost improvements. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Evaluating neuropsychologically informed rehabilitation training for staff within a high secure intellectual disability service

      Annesley, Phyllis; Hamilton, Zoe; Akiens, Sam; Hicks, Rachel; Clarke, Martin (2020)
      Purpose: Neuropsychologically informed rehabilitation (NIR) is one approach to supporting people with intellectual disabilities, cognitive impairment and challenging behaviour. This study aims to evaluate a five-day training course in NIR for staff working with adult male offenders with intellectual disabilities in a high secure hospital. The impacts on both the staff who undertook the training and the patients with challenging behaviour were explored. Design/methodology/approach: Participants were psychology, nursing and day services staff and male patients. The staff completed a post-training questionnaire and three measures at pre-NIR training, post-NIR training and one-year follow-up. Patients completed four questionnaire measures within the same periods. Findings: NIR training was positively evaluated by staff. Staff members’ perceived efficacy in working with challenging behaviour significantly increased post-training which was maintained at follow-up. Thematic analysis showed that the training staff members built their confidence, knowledge and skills. Because of these being high to start with, the study could not evidence statistically significant changes in these. Thematic analysis yielded two main themes, namely, benefits and quality of training, each with their own subthemes. The impacts of the training on patients were difficult to assess related to various factors. Research limitations/implications: The knowledge and confidence measures used were limited in scope with an experienced staff group and required development. Practical implications: NIR training could assist staff in other secure and community settings in working with people with intellectual disabilities and challenging behaviours. Originality/value: This study positively contributes to an area that requires more research. © 2020, Emerald Publishing Limited.