Scotland) Act 2000

NHS Greater Glasgow & Clyde

Adults with Incapacity (Scotland) Act 2000

Report of the Supervisory Body to Board Clinical Governance Committee on Operation of Part 4

For the year 2010

Anne Hawkins Lead Director Glasgow City CHP William Street Clinic 120 William Street Glasgow G3 8UR

September 2011

Contents Page Page No

1. Introduction 3

AWIA Context and Overview of Act 3 Board’s role under Part 4 5 DWP Appointeeships 6

2. Role of Supervisory Body 6

3. Policy & Operational Procedure 7

4. Management of Funds 7

5. Training Activity 8

6. Inspection and Monitoring 9

7. Policy Development 10

2 1. Introduction

(a) Adults with Incapacity and Overview of the Act

1.1 The Adults with Incapacity (Scotland) Act 2000 provides a framework for decisions to be made on behalf of adults (those aged 16 years or over) who lack the ability (capacity) to make decisions about their own finances or welfare, including decisions about medical treatment. It provides a regulated structure which allows others to make decisions on individual’s behalf subject to safeguards and in specific well-defined situations.

1.2 The basis for “incapacity” as defined in the Act is either mental illness or inability to communicate (normally due to a physical condition). The main groups to benefit include people with dementia, people with a learning disability, people with an acquired brain injury or severe and chronic mental illness, and people with a severe sensory impairment.

1.3 The Act aims to ensure that solutions focus on the needs of the individual: for example, a person with dementia may be able to decide what sort of support he/she would prefer to help with day to day living, but be unable to manage his/her money. In such a case a financial intervention may be all that is needed. In other circumstances a combination of welfare and financial measures may be necessary.

1.4 The Act is divided into a number of distinct Parts each dealing with certain circumstances.

Part 1 sets out the general principles of the Act.

Part 2 covers both Welfare and Financial Power of Attorney and allows an individual who currently has the capacity to make decisions to plan for the future and specify how and who should act for them in the future should they become incapable to act for themselves. They do this by executing a formal legal document and registering it with the Public Guardian who supervises this Part of the Act.

Part 3 is about making arrangements to Access Funds of an Adult where they are no longer able to manage their affairs. This Section is also overseen by the Public Guardian and is limited to withdrawal of monies from established bank accounts etc to meet on-going day to day living expenses. An Access to Funds Order is sought by a relative, carer or approved organisation.

Part 4 allows a hospital or care home manager to manage the finances of residents who do not have capacity to do so themselves. This report is about the Health Board’s role in this respect. More detail is given below.

Part 5 allows treatment to be given to safeguard or promote the physical or mental health of an adult who is incapable of giving or refusing consent to the treatment in question.

Part 6 Covers Intervention and Guardianship Orders where a carer, relative or local authority can apply to the Sheriff Court for either:-

An Intervention Order – where a one off decision is required on behalf of the adult who lacks capacity to make it; or

A Guardianship Order which is more appropriate where there is an ongoing need to manage complex on–going issues.

Both these types of Orders can cover Financial and Welfare matters.

1.5 The Act is founded on a number of underlying principles. As such the Act aims to protect people who lack capacity to make particular decisions, but also to support their involvement in making decisions about their own lives as far as they are able to do so. Anyone authorised to make decisions made on behalf of someone with impaired capacity must apply the following principles:

Principle 1 – benefit

• Any action or decision taken must benefit the person and only be taken when that benefit cannot reasonably be achieved without it.

Principle 2 – least restrictive option

• Any action or decision taken should be the minimum necessary to achieve the purpose. It should be the option that restricts the person’s freedom as little as possible.

Principle 3 – take account of the wishes of the person

• In deciding if an action or decision is to be made, and what that should be, account must be taken of the present and past wishes and feelings of the person, as far as this may be ascertained. Some adults will be able to express their wishes and feelings clearly, even although they would not be capable of taking the action or decision which is being considering. For example, he/she may continue to have opinions about a particular item of household expenditure without being able to carry out the transaction personally.

Principle 4 – consultation with relevant others

• Take account of the views of others with an interest in the person’s welfare. The Act lists those who should be consulted whenever practicable and reasonable. It includes the person’s primary carer, nearest relative, named person, attorney or guardian (if there is one).

Principle 5 – encourage the person to use existing skills and develop new skills

(b) Board’s Role under Part 4

1.6 As indicated above, Part 4 allows a hospital or care home manager to manage the finances of residents who do not have capacity to do so themselves subject to compliance with relevant procedures and compliance with the Act and A Code of Practice issued by the Scottish Government in July 20031. For Care Homes and NHS residential premises, the “Supervisory Body” is responsible for overseeing the operation of Part 4 of the Act2. The Supervisory Body in relation to Care Homes is the Care Commission3 and for NHS premises it is the relevant Health Board. Within NHS Greater Glasgow & Clyde the responsibilities of the Supervisory Body have been delegated to a Group Lead by the Director of the Mental Health Partnership4. Also in membership are the Mental Health Services Medical Director and the Mental Health Services Nurse Director together with the Head of Nursing for the RAD and Clinical Services Manager Emergency Care. The Group is supported by the MHP Legislation Team and the Mental Health Services Head of Administration.

1.7 Part 4 is seen as a default power to intervene where the other provisions within the Act have not been invoked. Within the NHS setting all residential establishments are issued with a Note of Authority to manage residents’ financial affairs. Such Notes are issued once the Supervisory Body is satisfied that the necessary procedures are in place. Notices last for a maximum of one year and then require to be renewed. Within NHS Greater Glasgow & Clyde three separate Registers of Authorised Establishments are maintained covering:-

• Adult RAD and Acute Physical In-patient Services

• Older People’s Services within RES and CH(C)Ps

• Adult Mental Health, Learning Disabilities and Addictions.

A copy of the Registers as at December 2010 is attached as Appendix A to this report.

1.8 As well as authorising the establishments, named individuals (and deputies) are appointed as authorised managers to manage patients' funds under the Act. Under the Act they require to be issued with a Note of Authority to act.

1.9 Authorised managers then need to be granted a Certificate of Authority to manage the affairs of each named resident who is covered by Part 4 of the Act.

1 Code of Practice for Supervisory Bodies under Part 4 of the Act ISBN 0 7559 1041 9 2 The State Hospital Board performs this role in relation to the State Hospital 3 From 1st April 2011, this responsibility passed to Social Care & Social Work Improvement Scotland. 4 Now the Director of Glasgow City CHP

1.10 Alongside the provisions relating to Part 4, staff of the Board are often appointed to administer State Pension Benefits received by residents. These arrangements are separate from the Part 4 provisions but as a general rule the same principles about accounting for monies entrusted to the Board’s Officers apply in these cases and the funding managed is monitored by the Supervisory Body.

2. Role of the Supervisory Body

2.1 The Supervisory Body is responsible for monitoring and reviewing the manner in which managers of authorised NHS establishments are conducting the management of residents’ funds under Part 4 of the Act. For this purpose the Supervisory Body:-

• approves and periodically revises Policy and Operational Procedures;

• reviews and approves the inclusion of Authorised Establishments on the Register, issues Notes of Authority to Managers and Deputies and approves issue of Certificates of Authority in relation to individual patients;

• monitors activity and local procedures to ensure compliance with NHS Greater Glasgow & Clyde Financial Operating Procedures;

• commissions regular inspection visits to Authorised Establishments and Managers;

• oversees a continual programme of training in the operation of the Act for staff; and

• has responsibility for investigating any complaints received or commissioning enquiries as it thinks fit.

2.2 Where it is appropriate, the Supervisory Body can approve that procedural requirements about intimation to patients of the intention to apply for authorisation to manage funds is not made. It also has a role where an Authorised Manager proposes to dispose of any moveable property of a resident in excess of £100 or where it is proposed to hold residents funds under Part 4 in excess of £10,000. Such requests are time limited to ensure that monies are spent for the benefit of residents and that other more appropriate means of managing their financial affairs are fully explored.

3. Policy & Operational Procedures

3.1 A single Policy and Operational Procedure for use of Part 4 has been adopted by NHS Greater Glasgow & Clyde and applies across the Board

6 area. The current Policy and Operational Procedures are due for review in May 2011.

3.2 Within the Policy and Operational Procedure the role of the Authorised Manager is clearly set out as is the Inspection and Monitoring arrangements which are undertaken by the MHP Legislation Team. Feedback from Inspection and Monitoring visits is provided to relevant Authorised Managers and responsible Directors. An important element of the Monitoring procedure is the sharing of good practice (See Section 6 below).

4. Management of Funds

4.1 NHS Greater Glasgow and Clyde published financial accounts at 31 March 2010 showing funds held in patients’ private funds accounts amounted to £3,823,871. These funds were held on behalf of approximately 900 patients at 18 hospital sites. Only a small proportion of patients have their funds managed under Part 4 as illustrated in Table 1

Table 1 – Management of Funds – AWIA Part 4

Pending Part 4 at New in Revocations at Year Part 4 at Location 01.01.10 Year in Year End 31.12.2010 Adult Mental Health Learning Disability Addictions and Adolescent 76 7 10 0 73 Older People Mental Health within RES CHCP 56 15 18 0 53 Adult RAD and Acute Physical Inpatient Resident Services 1 7 1 0 7 Total 133 29 29 0 133

4.2 There continues to be a significantly higher number of DWP Appointeeships held as shown in Table 2.

Table 2 - Management of Funds - DWP Appointeeships

Pending DWP at New in Revocations at Year DWP at Location 01.01.10 Year in Year End 31.12.2010 Adult Mental Health Learning Disability Addictions and Adolescent 173 33 77 1 110 Older People Mental Health within RES CHCP 94 34 26 0 89 Adult RAD and Acute Physical Inpatient Resident Services 14 1 6 0 7 Total 281 80 87 1 206

7 4.3 Table 3 shows details of the relative position between Part 4 and DWP Appointees within the Mental Health Partnership at the start and end of the year by value of funds held.

Table 3 – Snapshot of Value of Individual Funds Managed

< £10,000 > £10,000 > £20,000 > £30,000 >75,000.00 01.01.2010 AWIA 63 40 27 12 DWP 77 25 17 2 31.12.2010 AWIA 41 39 31 14 1 DWP 100 40 32 15 1

5. Training Activity

5.1 Training has been delivered during 2010 in a variety of different forms:

• A stand alone module delivered on a once per month basis for all key staff with priority to Authorised Managers and Patient Affairs / Cashier staff. • A stand alone module delivered on-site to staff groups, predominantly Nursing and Patient Affairs staff, closely linked to training needs identified during Inspection and Monitoring visits. • On a one to one basis for key personnel. • As a shortened version incorporated into the AWIA introductory training. The training covers the provisions in the Act relating to the Management of Residents Finances; it is open to healthcare staff who would be involved in decisions about the management of patients’ finances. It is expected that this will be Patient Affairs / Cashiers, Medical staff, Ward Managers, Charge Nurses and Senior Staff Nurses.

5.2 The overall Aims and Objectives have been:-

• To provide a working knowledge of provisions within the Act relating to the Management of Residents Finances. • To improve the knowledge base of staff in relation to the Act

5.3 By the end of a session it is intended that staff will have, through discussion,

• Demonstrated an understanding of the roles of the Supervisory Body and Authorised Managers • Demonstrated an understanding of the application process • Demonstrated an understanding of their role in the ongoing management.

5.4 Appendix B provides a detailed breakdown of the categories of staff and areas where training has been delivered during the year.

6. Inspection & Monitoring

6.1 A summary of the number and findings from Inspection and Monitoring visits undertaken during the year is provided at Appendix C. Arising from these visits a number of good practices have been identified (See Appendix D) and shared with Authorised Managers. Examples include

• Lead Nurse retains copies of Certificates of Authority, MDRT/Part 4 Minutes in folder for all patients in her area of responsibility. • Note of Authority is copied, laminated and posted on each ward. • Full minutes retained in case notes and records. Good record keeping showing AWI principles are in operation • Supporting evidence freely available and well documented utilisation of patients’ funds to allow relatives to visit from Canada. • Encouraging skills of individuals in work placements • The team plan is to improve practice by developing a monthly check list template to capture issue of notification to Supervisory Body and seek a regular Bed Management Report to continue to ensure assessment of Capacity requirements on six-monthly basis. • Residents have attended Money Management Course at Reid Kerr College • Resident funds used to purchase PC’s for 2 individuals. • Pictorial care plans in place for each resident developed with Speech and Language Therapists which includes legislative position. • Evidence of very comprehensive spending plans in place.

6.2 During the latter half of 2009 the Lead Director commissioned the Internal Auditors, PriceWaterhouseCoopers to conduct a review of our procedures under Part 4 of the Act. The scope of the review was to independently review and confirm that appropriate arrangements had been implemented to meet the requirements of the Act. Feedback was generally positive. Recommendations made on reviewing the frequency of inspection monitoring and adjustment of the template used to make it more specific in terms of checking conformity for each resident with the Act’s provisions have both been given further consideration by the Supervisory Body. The inspection tool and template has been reviewed and improvements are now implemented. The Supervisory Body has decided that for the present that the frequency of inspection visits should be maintained, but a revised methodology based on sampling techniques may be utilised in the future.

6.3 Arising from individual cases the Supervisory Body has this year produced Good Practice Guidelines which have been circulated to Authorised Managers to assist them in maximising the benefit to residents from the utilisation of funds in innovative ways. These were developed in association with the MHP Patient Focus and Public Involvement Forum.

7. Policy Development

7.1 During late 2008 the Scottish Government Health Analytical Services Division on behalf of the Primary and Community Care Directorate, Community Care Division commissioned research into Part 4. The aims of the study were to:

• assess the effectiveness of Part 4 of the Act including: the uptake; benefits to residents; and key stakeholders’ experiences of using the provisions in Part 4 of the Act; and

• make recommendations on any action needed.

The research found that there was a very low level of uptake of AWI Part 4 across all sectors.

7.2 Whilst the research was reported in December 2009 as yet there has been no response to its finding from the Scottish Government. Those recommendations which are within the control of the Supervisory Body e.g. encouraging expenditure on befriending services are being promoted within NHS Greater Glasgow & Clyde.

8. Conclusion

8.1 The responsibilities under Part 4 of the Act relate primarily, but not exclusively, to those who lack capacity due to mental illness. The Glasgow City CHP Director has lead accountability to the Board for ensuring that the Board’s obligations across the organisation for AWIA Part 4 are met. This is achieved through the Supervisory Body which is a formally constituted Committee of the Board.

8.2 During the year 2010 considerable effort has been expended in completion of the annual inspection and monitoring programme, reviewing the monitoring template and implementing improvements. The good practice guidelines entitled ‘Guide to the Purchase of Goods and Services through the use of Personal Funds’ has been widely distributed. Training has been delivered to an extensive group of staff at a variety of venues and sites and individual Authorised Managers and teams have been supported to progress applications

8.3 The Mental Health Services Legislation Team will continue to provide support to all sectors of the Board with responsibilities for adults with incapacity under Part 4 of the Act. Training will be developed to include a specific financial management module. During 2011 there will be:-

• a review of the Supervisory Body and Authorised Establishments Policy and Operational Procedures, • an update of the Registers within an electronic database, • a review of current systems and working practises of the patient affairs services which support Authorised Managers to reflect the changing structure of service delivery within the Board area

APPENDIX A

Registers of Authorised Establishments and Managers/Deputies as at December 2010. ADULTS WITH INCAPACITY (SCOTLAND) ACT 2000 MANAGEMENT OF RESIDENTS FUNDS REGISTER OF AUTHORISED ESTABLISHMENTS 1

Adult Mental Health, Learning Disability, Addictions Senior Officer Dr Linda Watt and Adolescent Deputising Officer Anne Hawkins

In-Patient Area Authorised Responsible for Authorised Establishment Manager/Deputy West Glasgow AMH David McCrae Gartnavel Royal Hospital All Adult MH in- David McCrae Head of Mental Health 1055 Great Western Rd patient services GRH Anne Marie McGill Glasgow G12 0XH site Tom MacKay North East Glasgow AMH Clive Travers Stobhill Hospital, a) Adult Wards - Clive Travers Head of Mental Health Mackinnon House MacKinnon House, a) Mary O’Donnell 133 Balornock Road Stobhill Glasgow G21 3UZ

The Orchards (formerly b) Adult Wards – Ruchhill Hospital) Orchards (formerly b) Tommy Fitzpatrick 153, Panmuir Street, Ruchill Hospital) Glasgow

Parkhead Hospital c) Adult Wards - c) Bob Gillies 81 Salamanca Street Parkhead Hospital Glasgow G31 5ES South West Glasgow AMH Calum MacLeod Leverndale Hospital All adult admission Calum MacLeod Head of Mental Health 510 Crookston Road long stay & rehab. June MacLeod Glasgow G53 7TU Wards, Leverndale,

Southern Gen. Hospital Wards 31+32 SGH. 1345 Govan Road Glasgow G42 9TY

Renfrew AMH Fiona McNeill Dykebar Hospital, a) all adult Katrina Phillips General Manager – Clyde MH Grahamston Road, admissions Caroline Burling Paisley, continuing care & Renfrewshire Rehabilitation wards- PA2 7DE Dykebar

Royal Alexandra Hospital, b) all adult MH Corsebar Road, admission wards – Paisley, Dykebar & RAH Katrina Phillips Renfrewshire Caroline Burling PA2 9PN

11 Inverclyde AMH Susanna McCorry Rice Ravenscraig Hospital, Corlic C & D –AMH John Mitchell Head of Mental Health Inverkip Road, continuing care & Gillian Robb Greenock Rehabilitation wards PA16 9HA & Gryffe unit

Inverclyde Royal Hospital IRH – Adult MH Larkfield Road, admission wards Greenock PA16 0XN West Dunbarton AMH John Russell Vale of Leven Hospital, All AMH - Christie Lynne Kennedy General Manager Main Street, Ward Paul McLeod Alexandria, Dunbartonshire. G83 0UA NHS GGC Forensic Martin Montgomery Leverndale Hospital a) All Forensic Wards Martin Montgomery General Manager 510 Crookston Road Leverndale, Wards Barbara Wilson Glasgow G53 7TU 5+6, Campsie, Whitehouse, Boulevard Rowanbank Clinic and Balloch Stobhill Hospital, 133 Balornock Road b) All Forensic Wards, Glasgow G21 3UZ Rowanbank Clinic

Dykebar Hospital, c) Bute Ward, Dykebar Grahamston Road, Paisley PA2 7DE NHS GGC Addictions Eric Steel Eriskay House, All in-patient Addictions Eric Steel Acting General Manager, Stobhill Hospital, beds Stobhill campus. Gail Reid Glasgow Addictions 133 Balornock Road Partnership Glasgow G21 3UZ Clyde Learning Disability Martin Montgomery Blythswood House, All LD in–patient beds - Martin Montgomery General Manager Fulbar Lane, Clyde Tom Kelly GGC Forensics R Renfrew GG Learning Disability Michael McClements 2 & 4 Waterloo Close All NHS in –patient Michael McClements Joint General Manager Kirkintilloch beds – LD Partnership Fiona Roberts Greater Glasgow Learning Glasgow G66 2Hl Disabilities Partnership Netherton 19 Blackwood Street Anniesland Glasgow G13 1AL

Overtoun Court 65 Rodger Drive Rutherglen Glasgow G73 3QZ

Pineview In-patient Unit Canniesburn Hospital Switchback Road, Bearsden G61 1QL NHS GGC Adolescent Alex Fleming Skye House All in-patient Alex Fleming Service Manager Stobhill Hospital adolescent beds – Lauren McLelland 133 Balornock Road Stobhill campus Glasgow G21 3UZ

ADULTS WITH INCAPACITY (SCOTLAND) ACT 2000 MANAGEMENT OF RESIDENTS FUNDS REGISTER OF AUTHORISED ESTABLISHMENTS 2

Older People Mental Health within RES/CHCP Senior Officer Mari Brannigan Deputising Officer Andrew Strachan

In-Patient Area Authorised Responsible for Authorised Establishment Manager/Deputy West Glasgow MH Ruth Davie, Gartnavel Royal Hospital All OPMH in- Ruth Davie RES Manager 1055 Great Western Rd patient services Glasgow G12 0XH Tate Timbury RES Manager Cuthbertson Wards

Helen McMahon North East Glasgow MH John Leckie Stobhill Hospital a) OPMH Wards John Leckie RES Manager 133, Balornock Road, 43/44 Stobhill Glasgow G21 3UZ a & b) Alison Paterson

Birdston N.H. b) OPMH Wards Birdston Road, Milton of Campsie G66 c) OPMH Wards c) Tommy Fitzpatrick The Orchards Orchards (formerly 153 Panmure Street, Ruchill Hospital) Glasgow G31 5ES d) OPMH Wards d) Bob Gillies Parkhead Hospital Parkhead Hospital 81 Salamanca Street Glasgow G31 5ES South West Glasgow MH Jillian Torrens Leverndale Hospital All OPMH Wards Jillian Torrens RES Manager 510 Crookston Road Leverdale – Banff RES Manager Glasgow G53 7TU Beith and Balmore

Darnley Court N.H. All OPMH Wards Christine Murphy 787, Nitshill Road, Glasgow G53

Rodgerpark N.H. All OPMH Wards 10, Rodger Drive, Glasgow G73 Renfrew MH Fiona McNeill Dykebar Hospital, a) all OPMH wards Fiona McNeill General Manager – Clyde MH Grahamston Road, - Dykebar Alistair Barclay Paisley, Renfrewshire PA2 7DE

Royal Alexandra Hospital, b) all OPMH wards Corsebar Road, - RAH Paisley, Renfrewshire PA2 9PN

In-Patient Area Authorised Responsible for Authorised Establishment Manager/Deputy Inverclyde MH Susanna McCorry Rice Ravenscraig Hospital, Dunrod –All OPMH John Mitchell Head of Mental Health Inverkip Road, wards Ravenscraig Gillian Robb Greenock PA16 9HA

Larkfield Unit Ward 4 Larkfield Unit Ward 4 Larkfield Road, OPMH admission Greenock ward PA16 0XN West Dumbarton MH John Russell Vale of Leven Hospital, a) All OPMH in- Lynne Kennedy Head of Mental Health Main Street, patient services - a) Karen Masson Alexandria, VOL Dunbartonshire. G83 0UA

Dumbarton Joint Hospital, b) All OPMH in- b) Teresa McKernan Cardross Road, patient services - Dumbarton, DJH Dunbartonshire G82 5JA

ADULTS WITH INCAPACITY (SCOTLAND) ACT 2000 MANAGEMENT OF RESIDENTS FUNDS REGISTER OF AUTHORISED ESTABLISHMENTS 3

Adult RAD & Acute Physical In-patient Senior Officer Jacqueline Nicol resident services A&E Dept Western Lead Responsibility Older People’s Services Deputising Officer Elaine Burt Anne Harkness - Director, RAD Management Offices SGH Responsible for Area Authorised Responsible for Authorised Establishment Manager/Deputy West Glasgow a) Western Infirmary All wards Western Infirmary a) Liam Gallagher Dunbarton Road Acting Site Facilities Manager Glasgow G11 6NT a)Ian Thomson Deputy Site Facilities Manager b) Gartnavel General All wards Gartnavel General Hospital Hospital 1053 Great Western (b & c) Stuart Campbell Road Site Facilities Manager Glasgow G12 0NY

c) Glasgow Homeopathic All Wards Homeopathic Hospital Hospital 1053 Great Western Road

Glasgow G12 0NY

d) Drumchapel Hospital d) All Elderly & Rehabilitation d & e) Maria Pitticas 129 Drumchapel Road in-patient services (Bute, Facilities Manager Glasgow G15 6PX Cumbrae, Arran & Kintyre Wards)

e) Blawarthill Hospital e) All Elderly in-patient and 129 Holehouse Drive Continuing Care Wards (Islay GlasgowG13 3TG & Tiree)

f) St Margaret’s of f)Continuing Care partnership f) John McLintock Scotland Hospice Elderly beds Hospital Administrator East Barns Street Clydebank G81 1EG

North Glasgow a) Stobhill Hospital, All wards Stobhill but a) Eleanor Naismith 133 Balornock Road particularly wds 10A, 11A, Acting Site Facilities Manager Glasgow G21 3UZ 11B, 45, 46 & 47

b) Glasgow Royal All wards GRI b)Anne MacLeod Infirmary Acting Site Facilities Manager 84 Castle Street Glasgow G4 OSF

South Glasgow a) & b)Southern General a) All Wards Southern a)Ronnie Clinton Hospital General Hospital (excluding Site Facilities Manager 1345 Govan Road Adult MH, PDRU and ward a) Sharon Hutchison Glasgow G42 9TY 53)(RAD Wards –51, 54, 55, Hotel Services Coordinator 56, 57)

b) PDRU & ward 53 SGH b) Jean Alexander – Clinical Services Manager

c) Victoria Infirmary c) All Wards Victoria Infirmary c-g) Marjorie McCulloch Langside Road Deputy Site Facilities Manager Glasgow G42 9TY c-g) Ronnie Clinton Site Facilities Manager d) Mansionhouse Unit d) All Elderly & Rehabilitation 100 Mansionhouse Road in-patient services including Glasgow G41 3DX Stroke & CC – North 1, North 2, North 3, South 1, South 2, South 3, Cathkin View & Lomond View

e) Mearnskirk House e) Continuing Care Newton Mearns

Glasgow G77 5RZ

f) Darnley Court Nursing Home 787 Nitshill Road Glasgow G53 8LF f & g) Continuing Care Partnership Elderly Beds g) Rodgerpark Nursing Home Rodger Drive Rutherglen

East Glasgow

a) Lightburn Hospital a) All Elderly & Rehabilitation Eddie Watson 966 Carntyne Road in-patient services (Wards 1, Hospital Manager Glasgow G32 6ND 2 , 3 & 4) (Facilities)

b) Greenfield Park b) Continuing Care Nursing Home (East) Partnership Elderly Beds 291 Myreside Street GLASGOW G32 6BX

c) Four Hills Nursing c) Continuing Care Home Partnership Elderly Beds 8 Hazlitt St, Ruchill Glasgow G20 9NU

Inverclyde

a) Inverclyde Royal a) All Wards Inverclyde a-c) Catriona Glenn, Hospital Royal Hospital (excluding Clinical Services Manager – Larkfield Road, Adult & OPMH) IRH RAD Greenock PA16 0XN

b) Larkfield Unit, b) All Elderly & Rehabilitation a-c) Roseanne McDonald Inverclyde Royal Hospital in-patient services (except Clinical Services Manager - Larkfield Road, PDRU Larkfield Unit) RAH RAD Greenock PA16 0XN

c) Ravenscraig Hospital, Inverkip Road, c) Corlic - All Elderly & Greenock Rehabilitation in-patient PA16 9HA services

d) PDRU Larkfield Unit

d) PRDU Larkfield Unit d) Jean Alexander – Clinical Services Manager

Renfrew a) Royal Alexandra a) All Wards Royal Roseanne McDonald, Hospital, Alexandra Hospital (excluding Clinical Services Manager - Corsebar Road, Adult & OPMH) RAH RAD Paisley, Renfrewshire Catriona Glenn – Clinical PA2 9PN b) All Elderly & Rehabilitation Services Manager – in-patient services IRH RAD b) Johnstone Hospital, (Deputy) Bridge of Weir Road, Johnstone, Renfrewshire PA5 8YX

West Dunbarton Vale of Leven Hospital, All Wards Vale of Leven Margaret Connelly, Clinical Main Street, Hospital (excluding Adult & Services Manager - Lomond Alexandria, OPMH) RAD Dunbartonshire. G83 0UA Catriona Glenn, Clinical Services Manager – IRH RAD (Deputy)

APPENDIX B

Adults with Incapacity Part 4 Management of Residents Finances Training Report 2010 Part 4 Module

Staff Trained by Discipline Nursing Medical Other PT Affairs Authorised Staff Manager Trained 155 0 7 15 21 198

Staff Trained by CHCP / CHP North West East South East South West East Ren. West Dun East Dun Renfrewshi Inverclyde Glasgow Glasgow Glasgow Glasgow Glasgow CHP CHP CHP re CHP CHP CHCP CHCP CHCP CHCP CHCP 20 20 10 0 31 0 33 0 5 10

Staff Trained by Partnership / Acute Divisions Addictions Learning Forensic CAMH Acute Other Disabilities Division 2 10 12 1 43 10

Training Sessions by Month January February March April May June July August Sept October Nov Dec 1 4 2 1 1 3 0 7 3 1 3 0

AWI basic introduction Nursing Medical Social AHP Advocacy Vol. OrgsOther PT Authorised Staff Care Affairs Manager Trained Basic Introduction to 69 5 5 11 0 0 6 0 0 96 Adults with Incapacity

APPENDIX C

Summary of Inspection Visits

Authorised Register Date of No of No of No. Establishment Codes Inspection Res. Res Recs 1 Adults Subject Appship Examin. Findings of Visit 2 Older to 3 RAD Part 4 Netherton 1 28/01/10 6 6 3 Fully Compliant Overtoun 1 03/02/10 5 7 2 Fully Compliant Erisky House 18/02/10 0 0 2 Compliant. Ensure routine assessemtnof capacity is recorded routinely. Only 2 patients currently resient over 6 months, both in process of AWI 1 assessments

Gartnavel 24/03/10 7 12 3 Fully compliant. Supporting evidence available from case notes and mins. Royal Awareness of and implementation of AWI policies. 2

Western 30/03/10 0 0 0 Although there was no AWI supporting evidence in place, there was Infirmary evidence of previous training and an awareness of the need for 3 assessment procedures to be in place.

Rowanbank 30/03/10 1 7 To Compliant at ward level but no patient affairs manager present at the follow meeting therefore a follow up visit is required. All registers, inc DWP 1 up inplace. Positive recording of assessments of capacity and review part 4 mng. Gartnavel 07/04/10 8 8 3 Fully Compliant. Royal 1 Supporting evidence of good practice visible in all sections

Blytheswood 08/04/10 3 4 3 Fully Compliant 1 House Leverndale 08/04/10 7 16 5 Compliant. In one ward the cash book was not signed and initialled at Forensic 1 each transaction by 2 members of staff on behalf of AWI part 4 patients. Services Mins too sparse they require more detail. Gartnavel 28/04/10 0 0 0 Note of authority not available on the day. Although there was no AWI General 3 supporting evidence in place, there was evidence of previous training and an awareness of the need fro assessment procedures to be in place. Inverclyde RH 28/04/10 0 0 0 Compliant. Training to be organised t ensure continued awareness raising 3 and compliance with Part 4 and Financial Operating Procedures Dykebar 20/05/10 9 12 3 Fully compliant. Best Practice. 100% completion of lead nurse monthly review sheets. Financial plans in place for all AWI residents. Partial 2 availability of financial plans and mins at ward level. Incapacity discharge checklist fully completed on behalf of discharges resident. Royal 21/05/10 0 0 0 Compliant. New note of authority required as authorises mng no longer has Alexandria 3 responsibility for beds in Johnstone Hospital. Training required to ensure Hospital continued awareness among all staff Ravenscraig 27/05/10 9 0 3 Compliant. Partial availability of MDRT/Part 4 mins and spelling plans at Adult ward level. Excellent record keeping by authorised manager and PAM 1

Ravenscraig 27/05/10 3 0 2 Compliant. Partial availability of MDRT/Part 4 mins and spelling plans at Older People 2 ward level. Excellent record keeping by authorised manager and PAM

Mackinnon 29/10/10 8 49 3 Compliant. Patient status not recorded on ward cash book. Care plans 1 House lack detail. 1 patient has funds in excess on £60K Stobhill 29/10/10 0 0 0 Not compliant. No evidence off residency criteria being carried out i.e. authorised mng has no access to bed mng reports. No evidence of 3 assessment of capacity. No evidence of Senior Nurse wad audits being carried out. Glasgow 05/11/10 0 0 0 Not compliant. No evidence off residency criteria being carried out i.e. Royal authorised mng has no access to bed mng reports. No evidence of 3 Infirmary assessment of capacity. No evidence of Senior Nurse wad audits being carried out. Blawarthill 3 12/11/10 0 2 1 Compliant. No spending plans at ward level

Stobhill/ The 19/11/10 26 26 4 Compliant. Lack of attendance at MDRT by consultant / RMO Orchards/ 2 Birdston

APPENDIX D

Evidence of Good Practice ( Extracted from Inspection Reports)

• Excellent minutes retained in case notes and records of good record keeping showing AWI principles are in practice.

• Supporting evidence freely available and well documented utilisation of patients funds to allow relative to visit Canada

• Supporting evidence freely available of patients being involved in decision making e.g. outing, trips to theatre, gifts for relatives, and well documented.

• Encouraging skills of individuals in work placements.

• Good record keeping showing AWI principles are in practice.

• Excellent use of patient funds in provision of alternative therapies for continuing clients with mental health problems.

• Through research, into physical, physiological and psychological effects putting into place qualified massage therapist cleared through disclosure Scotland with adequate professional indemnity insurance cover.

• Care Plan documentation has been devised to ensure an accurate record of all treatment plans and outcomes

• Each ward has its own folder retaining AWI info with a master folder retained centrally for the authorised manager of the Forensic Directorate.

• Responded well to previous examples of good practice circulated via Supervisory Body.

• Evidence of a patient-centred approach involving family carers and Multi Disciplinary Team.

• Purchase of materials for art classes tailored to individual interest and talent.

• Positive recording of capacity. Lead nurse monthly checks conducted 100% returns.

• Deputy authorised managers highlights the outcome at monthly communications meeting

• Residents have attended Money Managment Course at Reid Kerr College.

• Residents funds used to purchase PCs for 2 individuals.

• Pictorial care plans in place for each resident with learning disabilities.

• Evidence of very comprehensive spending plans.

• Evident of holidays / activities and work experience for individuals..

• Review of procedures in liaison with bed manager with review of all residents’ capacity to manage finances after 2 weeks

• Guidance folder produced and distributed to all wards as a resource tool.

• Staff at ward level received training in financial operating procedures by Patient Affairs Officers.

• 100 % completion of lead nurse monthly review sheets.

• Incapacity discharge checklist fully completed on behalf of discharged resident. Identified individuals patients interests i.e. fishing, attending concerts etc and encouraging patient to participate by facilitating the purchase of own fishing season ticket and tribute night to "The Beatles" and organising holiday to Oban.

• Forward planning in evidence in regard to the discharge redesign. Some residents to local authority care others to new NHS accommodation.

• Well organised at ward level.

• Good record keeping at Patient Affairs Officers.