Background information. A routine monitoring visit from the Mental Welfare Commission had been expected and prepared for. A 15-bed psychiatric ICU, with all beds occupied. Staff complement is reduced because of annual leave and sickness, which is becoming a problem, and the ward often has to rely on bank nurses. The ward has been busy recently with a number of aggressive incidents and one serious suicide attempt by a patient. Management Scenario. During the monitoring visit to a detained patient in the ward by the Mental Welfare Commission, she had complained to the inspectors that a member of staff had assaulted her. She showed bruising to her upper arm that looked like it had been caused by being gripped firmly. The MWC representative had reported this to the ward manager. When asked by the ward manager who had done this she reported a nursing auxiliary on night shift and that she had been drinking. This patient is known to have reported such things in the past and is thought of as a ‘difficult woman’ who is often aggressive and arrogant to the staff. The member of staff concerned denied the assault but is known to have an alcohol problem. She is very upset and angry at being questioned about the incident. She calls in sick next night.