National Preventive Mechanism Eleventh Annual Report 2019–20 At this time, RQIA was also concerned about some deficits in the quality of the information recording mental health detention. This followed an audit of the forms that were submitted to detain patients in hospital for treatment for a period of up to six months, in accordance with the Mental Health (NI) Order 1986. RQIA is working with health and social care trusts, the Department of Health and the Royal College of Psychiatrists to improve the process, and will complete a further audit to ensure progress is being made. Children in detention While some developments in children’s secure care have been found by NPM members to be positive, national challenges remain. NPM members have identified significant issues across secure settings for children more broadly, particularly in YOIs. MWCS reported rising rates of detention among children and young people in Scotland, with its figures indicating that about 100 young people were admitted (not necessarily detained) in the wrong setting (in adult wards) last year.151 MWCs’ submission to the ongoing review of the Mental Health Act in Scotland also highlighted its concern that keeping the need for continued detention under review is not well realised in practice, and it will be doing more work in this area in the year ahead. As part of the move towards integrating care and justice settings which provide secure accommodation for children in Northern Ireland, the referral and admission process into Lakewood Regional Secure Care Centre has now been revised, with beds allocated through a regional multi-agency panel. The panel also monitors the care and services a young person is receiving, as well as discharge planning. Broader work on the integration, which will organise placement on a young person’s individual needs and risk management factors rather than the reason for detention, continues. It is hoped that this new approach will also feature an improved approach for reintegration into the community. Lakewood is the only Regional Secure Care Centre for children in Northern Ireland. RQIA was concerned about a rising number of incidents involving illicit drug use, self-harm, absconding and other concerning behaviours at Lakewood. It saw potential for young people’s safety and liberty to be impacted by poorly delivered care and has scrutinised the host health and social care trust which is now reviewing its arrangements for safeguarding children in residential care. The Beechcroft Child and Adolescent Mental Health unit, in Belfast, closed one ward for 15 weeks in 2019 due to risks arising from unsafe staffing levels (indicative of nursing recruitment challenges across Northern Ireland). Belfast Health and Social Care Trust, which manages the site, recruited a number of agency staff to fill essential gaps, but this was a temporary solution. RQIA found the psychiatric intensive care unit in Beechcroft needed improvement. RQIA called for a review of the use of blanket restrictions at the facility, which are aimed to prevent absconding but may also hinder young people in gaining confidence or 151 MWCS, March 2020, Young people monitoring report 2018/19 https://www.mwcscot.org.uk/sites/default/files/2020-05/ YoungPeopleMonitoringReport_2018-19.pdf [accessed 30/10/2020] 48