The use of physical restraint on children at Edinburgh’s in-patient mental health unit needs improvement, a report has said.
An unannounced inspection of the Melville Unit at the city’s Royal Hospital for Children and Young People was carried out in May.
The report said the use of nasogastric tube feeding under restraint “requires further inquiry and improvement by the service”.
The 12-bed unit cares for young people aged between 12 and 17 with a number of mental health conditions.
The inspection was carried out by the Mental Welfare Commission for Scotland together with Healthcare Improvement Scotland (HIS).
It comes after minister Maree Todd pledged to step up inspections of Scotland’s mental health units in response to cruelty allegations at Skye House in Glasgow.
The chief executives of the Mental Welfare Commission and HIS issued a joint statement on the Melville Unit.
It said: “Inpatient care provides intensive support for children and young people experiencing acute mental health crises and it is crucial such care meets both legal requirements and standards for the safe delivery of care.
“This report has identified areas for improvement as well as good practice.
“It is important (that) NHS Lothian addresses the recommendations and requirements with appropriate urgency.”
The report accepted that restraint is needed in some circumstances but noted physical health checks were not carried out afterwards, as well as poor record-keeping.
Nicola Killean, Children and Young People’s Commissioner for Scotland, said: “I’m deeply concerned about the findings from the Mental Welfare Commission into the care of children at Melville Unit, which highlight potential rights breaches including the safe and lawful use of restraint.
“This is further worrying evidence about the use of restraint on children living in some of the most vulnerable situations.
“Alongside partners I have been raising my concerns with the Scottish Government about the use of restraint on children in mental health provision for over two years.”
NHS Lothian said it had a robust action plan in place to address the issues in the report.
Deputy chief executive Jim Crombie said: “We want to reassure young people and families that we are committed to delivering safe, high-quality and effective care and we take the findings of the report extremely seriously.
“The safety and care of young people and staff is always our top priority. Restraint is only ever used in the unit as a last resort to prevent harm for young people or to staff or other patients.
“We introduced an initiative to reduce the use of restraint further, which was observed by HIS during the inspection, and has shown positive results.
“Systems are also in place to improve the recording, monitoring and auditing of restraints.”
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