What happened
This nurse’s case ran across two inpatient employers, and the two halves are different failures.
At St Andrew’s Healthcare, on Pritchard Ward, a patient’s seclusion began on 18 September 2017. He completed the seclusion pack afterwards, without documenting that it had been done retrospectively. He recorded an incorrect incident number and an incorrect date. He also entered the seclusion area alone, while designated on a period when he was not to manage aggression, and left the patient unobserved during the seclusion. He then recorded inaccurately when the seclusion ended.
At Mill Lodge, on Amrik Ward in 2019, he used an inappropriate restraint technique on a patient, pushing the patient’s feet and ankles to the ground, and continued after a colleague told him the restraint was incorrect. He also instructed colleagues to lock doors to seclude the patient.
The outcome
The charges were proved at a substantive hearing, and the findings were carried forward through successive reviews. At the review hearing of 2 September 2026 the panel again found his fitness to practise impaired, on public protection and public interest grounds, citing deep-seated attitudinal issues.
No criminal proceedings are recorded.
What went wrong
Seclusion is the most restrictive thing a mental health service does short of restraint: one person, alone, in a locked room. It is lawful only while clinically justified, reviewed and observed. A pack filled in afterwards breaks all three, because the record authorising the seclusion is written by the person who has already decided to do it.
Entering the room alone removed the second pair of eyes. Leaving the patient unobserved removed the safeguard the seclusion depends on. Recording a false end time removed the evidence that anyone could have used to check any of it.
The Mill Lodge half is worse in a different way. A colleague said the technique was incorrect and he carried on. Pushing a patient’s feet to the ground is a pain-based hold at the far end of the body from the airway, where nobody is looking.
Then he told colleagues to lock doors. A nurse directing others to seclude outside any process is how unauthorised practice becomes a ward norm.
What it teaches
Seclusion paperwork is not admin. The pack is the legal instrument, and completing it after the event, with the wrong date and no note that it was retrospective, means the seclusion was never really authorised at all.
The second lesson is the colleague who spoke up. The objection was made and overridden. A service that trains staff to challenge, then leaves them to be overridden by a senior nurse, has trained them to no purpose.
The third is that none of these acts needed a violent patient. They are decisions about records, observation and doors, taken on ordinary shifts.
Questions for the room
- Who completes your seclusion records, and at what point in the seclusion?
- If a nurse entered a seclusion room alone, how would you find out?
- A colleague tells you your hold is wrong. What happens next in your service?
Evidence and limits
Confidence: confirmed. The Nursing and Midwifery Council’s review determination of 2 September 2026 was read, and it recites the charges proved at the substantive hearing.
This page follows the record’s own summary of those proved charges. It does not quote the substantive decision, which was not opened, so the exact wording of each particular is as the review recounts it.
The nurse is not named. He was not convicted of any offence, and the standing rule for this casebook is that staff are named only where a criminal conviction exists. Patients are not named.
Sources
Our restraint reduction training treats seclusion and restraint as one system, because the failures in this case ran straight from the paperwork into the hold.
Reviewed 20 October 2026.