By Philip Whiteley

Only one of five secure units investigated by goverment inpectors had a comprehensive policy for social work agreed by health and social services.

The Social Services Inspectorate this week warned that the needs of mentally ill offenders in medium secure units are 'rarely mentioned'.

The SSI, in its first investigation into social work in the units, looked at five of the 30 centres in England and Wales. It reveals that numbers in medium secure units increased from 572 in 1990 to 792 in March 1995, and are set to soar to 1,200 by the end of this year,

'Many people were unsure about what they could expect of social workers,' the report concludes.

Medium secure units are provided by regional health authorities but social work for in-patients is the responsibility of local social services.

Patients are sent directly from the courts, moved from the three special hospitals, or are transferred from psychiatric hospital when it is felt they need a higher degree of security.

In two of the five teams examined, managers were based in the community. But inspectors also noted effective supervision of staff and commitment to training by departments.

Individually, staff achieved 'excellent' work with patients and their families. The social work teams had little knowledge of care assessment and management, and of linking these processes with the health-led care programme approach.

Social workers tended to be in multi-disciplinary groups, which 'contributed to the development of good working relationships....[but] limited the scope managers had to use their resources more flexibly', the report states.

In the units themselves, social workers should be represented on senior management teams, inspectors recommend.

· An Inspection of Social Work in the Medium Secure Units, from DoH, PO Box 410, Wetherby, LS23 7LN.