The 10 key questions about Calderstones medium secure unit

CALDERSTONES bosses today pledged to do all they could to reassure people about security at the medium secure unit.

Chief executive Russ Pearce spoke as the NHS Trust and union officials issued joint replies to 10 Lancashire Evening Telegraph questions about the institution, which some staff have claimed is a danger to the public.

And he revealed he had already spoken to people considering buying homes on the new 300 house development next to Calderstones, which has come under fire for staffing shortages, to give them more information about the medium secure unit.

Today Ribble Valley MP Nigel Evans said he was not satisfied with the answers, which reveal residents of the secure unit escaped three times in the last year.

Nigel Robinson, chief officer of patient watchdog body the Community Health Council, said they were satisfied staffing levels were improving but they were still keeping a close eye on the unit.

A member of staff working in the secure unit, who did not wish to be named, said he was also worried by security levels on the site, which he said were still threatened by staff shortages.

Alfred McAlpine Construction, which is building more than 300 homes on the former Calderstones-owned land next to the secure unit, said it had told customers to contact Calderstones' management if they were worried about the unit.

Mr Pearce said: "We will do our best to keep people reassured and we want to be as open and up-front about what we do as possible.

"We have already spoken to a few people who are interested in buying the new houses and if anyone's got any queries, we will talk to them."

He added: "We are frequently inspected by the Mental Health Act commissioners, who demand standards of security. If there were issues that they had concerns about they would raise them with us and we would deal with them.

"The recruitment problem is better than it was during the summer."

He said security arrangements were adequate for the patients, who had been assessed as needing medium secure accommodation, not high levels of security.

The answers to the Lancashire Evening Telegraph's questions, issued by Unison leader Peter Hawkins, Mr Pearce and NHS Trust chairman Christine Kirk, did not give their own opinions on the siting of the new housing estate next to the medium secure unit.

It said they would review their security arrangements but said it was impossible to guarantee the new residents' safety. It added: "Our clients have not been assessed as being an immediate and grave danger to the public.

"There is no history of any major incident involving members of the public. We will continue to maintain this record and we will take all practical steps to ensure the safety of everyone."

In August, Mr Evans spoke out and insisted local people had a right to know when it was revealed that some patients had committed crimes including child abuse, arson and kidnapping.

Today he said: "The security arrangements have been shown to be deficient three times. They say they have reviewed security after each incident and I will be looking for the number of break-outs to be reduced to zero."

He said he believed village residents had not been aware that increasing numbers of the unit's residents had been sent there by the courts or prisons until it was highlighted in the Lancashire Evening Telegraph.

Mr Evans said: "Calderstones has always been a fair distance away from Whalley but now houses are being brought to it, it's especially important that they keep an open dialogue with local people."

The unnamed member of staff, who has previously raised security concerns with the Evening Telegraph said: "They may think security arrangements are adequate when three people have absconded, but I don't."

"They have said that each time someone has absconded, they have been returned within two hours, but a lot can happen in two hours. Some of these people are in for paedophilia, rape and all sorts of offences.

"I am frightened about what might happen on that housing estate. It's a tragedy waiting to happen." Lancashire County Coun Joyce Holgate, of Whalley, refused to say if she was satisfied with security at Calderstones but said she had a good relationship with Mr Pearce and Mrs Kirk and had often been reassured by them of the unit's safety.

She said: "We must not be complacent but continue to monitor the situation, always seeking reassurance for the safety of the residents of Whalley."

Two show homes opened on the site earlier this month, but no-one has yet moved in to the development.

Alfred McAlpine managing director John Cosgrave said he couldn't comment on security levels at the unit or its patients, around 80 of whom have been sent there by the courts.

He said: "We feel it is the responsibility of Calderstones Trust to consider all aspects of the management of its facility and we have every confidence in their ability to do that."

The questions and answers

1 Unions and staff have described morale at Calderstones as very low -- what is your assessment of the level of morale at the unit?

The results of a recent independent staff attitude survey showed that 80 per cent of respondents get satisfaction from doing their job and the majority of staff are proud of the services provided. Morale, as in any walk of life, is variable depending on the situation prevailing at the time. Quotations used in recent Press articles were 12 months old. Since then we have been working hard to improve our services and the working lives of our staff. The work that people do in services like ours is by its nature difficult. Our staff are extremely committed to their work and the vast majority find the work very rewarding and enjoyable.

2 Staff are also worried about the recruitment problems at the unit -- what is the current status of recruitment and are you happy with the staff/patients ratio?

Recruitment in the NHS is a nationwide problem and we welcome the extra resources identified by the Government for nurses, doctors and other professionals. Staffing requirements are based on judgments by experienced clinicians and our current levels compare extremely well with similar services in other parts of the country.

3 How many staff vacancies are still remaining at Calderstones?

At our last Trust Board meeting, the Nurse Director reported a figure of approximately 12 per cent vacancies at Calderstones. Since then 30 staff have been recruited. Our service is not unique in having recruitment difficulties -- we are in a better position than many other NHS hospitals. We are not complacent however, and in the last year we appointed 44 new staff at Calderstones.

(Note: Calderstones' latest nurse director's report issued last week reported vacancy levels of 8.4 per cent, with between seven and ten per cent vacancies for medium secure unit staff. This is described in the report as satisfactory.)

4 How many court-processed clients are there currently in Calderstones and how many were there two years ago?

We currently care for 375 people (211 at Calderstones, and 164 in the community). 85 people have been admitted through the courts, two years ago the figure was 67. These days, admissions tend to involve the courts (whereas 10 years or more ago there would have been more direct admission from the community). During the last two years we have increased our staffing establishment by 75 posts at a cost of £1.29million in employing additional doctors, nurses and specialist support staff e.g. psychologists.

(Note: People admitted through the courts include people who have been convicted or who are on remand awaiting trial or sentencing. Sometimes, courts ask for reports by psychiatrists and other professionals so patients stay for a few weeks at the medium secure unit while they are examined and reports written.)

5 How many patients have absconded in the past 12 months? When was the last time someone absconded and what happened?

There have been three cases of unauthorised absence from the Medium Secure Unit (West Drive) in the last year. In each case, clients were returned to the unit within two hours. Full reviews of circumstances surrounding each case were undertaken.

6 What are your feelings about the proximity of the new housing estate to West Drive?

Calderstones has co-existed in close proximity to the village of Whalley for over 80 years without major conflict or incident. Our clients, staff and visitors have always used the various facilities provided by the village. There is no reason why this positive relationship should not continue to the mutual benefit of both communities.

(Note: The new 300 house estate is on land that used to belong to Calderstones. The corner of the building site is less than 30 yards from the medium secure unit.)

7 What extra security measures will you be taking, given that proximity, and do you think a housing estate should have been built so close to the unit?

Because of the closer proximity of the new properties, we will regularly review our practices and procedures including security arrangements. We have given a public commitment to protect the safety of the public; our staff and clients, and we will continue to take all reasonable and practical steps to do so. We are working closely with the commissioners of our service to make sure that all appropriate measures are in place and we are independently monitored in all aspects of our work. There has been a great deal of public debate about the location of the new housing estate and we presume that planning authorities took all factors into account in reaching their decision.

(Note: Flats in the medium secure units are accessed via four doors, and the inner door to each flat is kept locked.)

8 What is the height of the wall separating Calderstones from the estate and does it entirely cordon the grounds off from the estate?

The property developers are currently erecting a solid brick wall to a height of two metres along the entire length of the development, which will totally separate the Calderstones site from the new housing estate.

9 Are you confident that all of the security arrangements operating presently at Calderstones are adequate?

We are confident that the security arrangements in place are adequate. They are agreed with our commissioners and are appropriate for the clients in our care. If clinicians decide that any client requires greater security, they will not be admitted to Calderstones. Security is not just about walls, fences and alarm systems. It is also about relationships between staff and clients, supported by clinical procedures and practices which are continually monitored and reviewed on an individual basis. Our Trust Board takes this issue very seriously and is closely involved in all aspects.

10 Can you categorically assure the residents of Whalley and the new housing estate that the patients pose no threat to them?

We provide a service to people with a learning disability (formerly called mental handicap). Some but not all of our clients require treatment and care in conditions of medium security. They do not need High Security, because they have not been assessed (by the courts, clinicians or by the people responsible for commissioning their care) as being an immediate and grave danger to the public.

It is not possible for anyone to give a 100 per cent guarantee about anything, but we can say that there is no history of any major incident involving members of the public.

We will continue to maintain this record and we will take all practical steps to ensure the safety of everyone.