Overview: Enhanced Care Guiding Principles
This document, developed by the National Forum of Mental Health and Learning Disability Nurse Directors, outlines best practice principles for the use of enhanced care in inpatient mental health, learning disability, and autism services. It aims to replace the term “observation” with a more therapeutic and person-centred approach, recognising that enhanced care is a restrictive intervention that must be used judiciously and compassionately.
Key Themes and Objectives:
Terminology Shift: Recommends replacing “observation” with “enhanced care” to emphasise therapeutic engagement over passive monitoring.
Human Rights Focus: Emphasises the need to balance safety with the potential for trauma, ensuring all interventions are the least restrictive and rights-based.
Leadership and Culture: Stresses the importance of leadership at all levels to foster transparency, accountability, and continuous improvement.
Training and Competency: Introduces a four-level national training framework to ensure staff are competent and confident in delivering enhanced care.
Governance and Oversight: Calls for robust monitoring, reporting, and review mechanisms, including independent reviews for prolonged enhanced care.
Patient-Centred Planning: Advocates for co-produced care plans, dynamic reviews, and involvement of patients and their support networks.
Digital Integration: Encourages the use of digital tools for documentation, while cautioning against replacing human interaction.
Sixteen Core Principles:
These principles cover areas such as:
Defining and distinguishing enhanced care from routine care.
Ensuring consent and minimising restriction.
Embedding enhanced care within broader treatment plans.
Regular review and reduction of enhanced care.
Competency-based training and reflective practice.
Leadership responsibilities and governance structures.