Enhanced care A&E leaflet

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What is Enhanced Care?

Enhanced Care is also known as Enhanced Observation. This means that a nurse or doctor has decided that we will try to have a member of staff with you at all times to keep you safe. 

The member of staff who will be giving you Enhanced Care should also focus on engaging with you. They can help you to look at your difficulties in a constructive (helpful) way. This can be through:

• sitting and chatting, talking about any concerns 
• encouraging and supporting you to take part in activities. 

Enhanced Care is a therapeutic intervention that aims to:

• keep you and other people safe
• help with your recovery. 

Why do I need Enhanced Care?

You will have been seen by a nurse or doctor who has assessed you. They are concerned that you, or other people, may come to harm because of your health issue. They have identified that you are at risk. 

You could be at risk of any or more than one of the following:

• harming yourself, or your personal safety being at risk  
• self-neglect (not looking after yourself) 
• falling or walking off 
• leaving or absconding 
• physical illness 
• harming other people
• vulnerability to harm from other people because you are struggling to look after yourself.

These risks may be because of:

• obvious changes in how you behave because of your illness
• hallucinations suggesting harm to yourself or other people 
• paranoid ideas when you believe that others pose a threat to you 
• reaction to medication
• not keeping to treatment programmes or taking your medicine.

We may also need to support you with agreed objectives in your care plan. For example, supporting you with identified triggers (things that we know make you ill); helping you with your diet.

What will the Enhanced Care be like?

There are two different levels of Enhanced Care.

After your risk assessment, a plan will be made for you. This will decide what level of Enhanced Care you will receive.

1. Within Eyesight observation. This means that a member of staff will be caring for you at all times. They may not always be close to you but will always be able to see you (within eyesight). 
2. Within Arm’s Length observation. This will mean that a staff member will always be close to you and be within arm’s length of you. 

There will be times when the staff member will need to accompany you to the bathroom.

The staff member allocated to you will have access to some resources to share with you (for example, books and sensory aids), that you can use by yourself, or with the staff member.

Who will be providing the Enhanced care?

This staff member will be either an Enhanced Care Support Worker, a Registered Mental Health Nurse, or a Health Care Assistant.

You will be allocated a member of staff to you for as long as needed.

They will introduce themselves. Please bear in mind that the staff may rotate between yourself and other people in need of Enhanced Care, so you may see different members of staff.

Who will review my need for Enhanced Care?

Your Enhanced Care will have been recommended by a member of the Emergency Department team or the Mental Health Liaison Team. Either of these teams will review you regularly.

They will make recommendations if you need more care. They will update you with any changes.

If I am concerned about something, who can I speak to?

Please speak to your allocated member of staff. Or, you can ask to speak to the nurse in charge of the area you are in. They will be able to raise your concern with the Head of Nursing for Mental Health too.

The Trust has a Patient Advocacy and Liaison Service (PALS) and you can be given the contact details if required.