Do we have capacity to admit this young person? Using the Universal Needs Based Resource Assessment (UNBRA) tool to measure capacity in inpatient wards

Background: Existing ward capacity models in mental health settings focus on bed availability and safe staffing, but neglect other crucial factors related to the delivery of care. Increasing complexity of needs in children and young people in tier 4 inpatient services have highlighted the importance of establishing an alternate resource-based ward capacity model. The study aimed to develop an objective tool to understand resource-based ward capacity. Method: Focus groups were used to adapt the Universal Needs Based Resource Assessment (UNBRA) tool—which evaluates the support needed for people living with intellectual disability—to assess the needs of children and young people experiencing mental health issues. Results: The UNBRA tool is useful for objectively determining resource requirements and capacity for children and young people in inpatient services. It enables intra- and interpersonal comparison as well as comparison between different wards. Conclusions: The UNBRA tool helps to establish resource-based ward capacity and can aid decisions on safe admissions, resource allocation and system-wide bed management. Implications for practice: Introducing the UNBRA tool for children and young people in tier 4 inpatient settings can result in needs-led resource allocation, and enable planning on a clinical, managerial and strategic level. This can have a significant positive impact on patient safety, quality of care and patient outcomes.