Guide to Ash Ward for Families and Carers Ash Ward Broadway Health Park Barclay Street Bridgwater Somerset TA6 5LX Tel: 01278 454131 Fax: 01278 454222 Patients phone: 01278 454204
Contents Page About this guide 3 Ash Ward Location and facilities 3 Visiting 6 Staff team, care planning and therapeutic activities 7 Time away from the ward 9 Involving families and carers 10 Reviewing the hospital admission 11 Discharge 12 Advocacy 13 Smoking Policy 13 2
About this guide This guide is intended for families and carers of Ash Ward patients. We are aware that supporting a loved one whilst they are in a mental health unit is difficult. In this guide we aim to outline the key pieces of information we believe you would like to know about our service and how we operate. In addition to this guide, early in the hospital admission we offer all families and carers the opportunity to meet with our ward social worker and/or other members of staff to hear your experiences and find out how we can best support you. (The section in this guide on involving families and carers gives more information on this). If you have any questions or suggestions regarding additional information you would like to see in this guide, please do contact us on 01278 454131. Ash Ward Location and Facilities Ash Ward is a 12 bedded low secure inpatient rehabilitation unit for male adults with mental health difficulties. It is located at Broadway Health Park, Bridgwater and is within walking distance of the town centre, bus station and train station. We opened in 2010 and operate in modern, bright conditions. We have three courtyards within the facility which patients can access with supervision. Patients are offered the opportunity to grow flowers and vegetables in the courtyard pictured below. 3
Communal areas and facilities There are various communal living spaces such as a television lounge, games room with pool table and a bright spacious dining room, though the times these facilities are available is limited in order to facilitate other activities and therapies available. Ash Ward has an activities room where group and individual occupational therapy sessions take place. It offers a fully equipped kitchen and those who are assessed to be safe and appropriate are invited to make use of this. We also have a laundry room, the use of which is supervised. We expect patients to take care of their own laundry and they are given help with this if required. Exercise is encouraged and there is an onsite gym together with a gym instructor who is available on a part-time basis to assist patients. Before this facility is available, patients are assessed to ensure it is appropriate to do so. 4
Bedrooms Each patient on Ash Ward is allocated an individual bedroom with en-suite facilities. One of the bedrooms is equipped with disabled facilities. Occupants are expected to keep these areas to an acceptable standard of tidiness and cleanliness and there is an allocated day each week when the bedroom is cleaned and bed linen changed. Patients are encouraged to assist staff in this. We encourage patients to personalise their bedroom and make it a comfortable place to be. Some personal electrical equipment, such as televisions and audio equipment is permitted. Meals and drinks Ash ward offers a full catering service and the dining room is open for meals as follows: Breakfast: 07.30 09.00 Lunch: 12.00 13.00 Dinner:: 17.00 18.00 (main meal) Supper: 20.30 21.00 Ash Ward caters for individual dietary requirements and daily meal choices plus self-catering options are available. Patients wishing to prepare their own meals discuss this with their care team and, if assessed as appropriate, supervised cooking sessions within the activity room may be facilitated as part of the rehabilitation programme. Some patients choose to self-cater a certain number of days per week and others everyday. Those who self-cater are supported in shopping and provided with a budget to do this. The facilities in the dining room provide a range of hot and cold drinks which are available at all times and supervised by staff. 5
Visiting Visiting is encouraged though it must be pre-arranged at least 24 hours in advance. There are no fixed times, but after 10am is the norm with visitors leaving by 8pm and avoiding visiting during mealtimes. We have meeting rooms on and off the ward that can be used for family visits. Visitors under the age of 18 are not allowed to enter the ward and we have a separate family meeting room for such visits, complete with a range of toys if needed. All external doors on Ash Ward are locked. To gain entry to the building visitors will need to press the intercom button located by the main door and speak to a member of staff. If you are meeting on the ward, you will be escorted through a set of double locked doors by a member of staff. Security boxes are provided in the reception area for you to store mobile phones and other prohibited items if you are meeting in the ward. A list of these prohibited items is on display in the reception area. If the person you are visiting is permitted unescorted leave, you can go out with them. This is usually for a specific amount of time agreed in advance and there may be restrictions about where you can go. If it has been agreed that you are taking a service user out for an event or day trip, an earlier start and/or later return than usual visiting times is often possible. Parking Some car parking is available immediately outside the ward. After parking, please obtain a permit from reception to display in your windscreen. Alternatively, there is a large public car park on Barclay Street. 6
Staff team, care planning and therapeutic activities Ash Ward has a team of specialist mental health professionals, which includes doctors, nurses, psychologists a social worker, occupational therapist and support workers. The team has a wide range of skills and offers a service to people with many differing needs. Our aim is to support patients on their individual journey to recovery and independent living. We offer advice, treatment, therapy and education and strongly encourage the involvement of family members and carers. We work together as a multi-disciplinary team and closely with community care co-ordinators, advocacy service and other outside agencies. Therapeutic Activities All patients have a key worker who works closely with them to support their hospital stay, with a focus on hopes and goals for the future. We have a small team of clinical psychologists. The team includes a specialist psychologist who works with the complex issue of dual diagnosis, where people experience problems from both a mental health condition and substance misuse. Groups & Activities Meaningful activity is an important part of recovery and we provide various individual and group activities that patients can choose to be involved with such as daily living skills (budgeting, self-care, preparing meals), exercise, arts & crafts, gardening, leisure activities. These are discussed at daily Plan your day morning meetings as well as monthly Have your Say meetings. The picture below shows the blackboard, updates daily, showing activities on offer which is on display in the dining area. We aim to provide a wide range of activities and involved patients as much as possible in deciding what is offered. 7
We are also visited by some external agencies, such as the SUCH Project (Service User Complimentary Therapy). Qualified complementary therapists visit the ward each Tuesday to offer a range of therapies including head massage, back massage and hand massage. This is free of charge to patients. We strive to offer comprehensive, individualised one to one activities, for example helping people to attend community based college, voluntary work or referral to the supported employment service. We have our own transport that we can use for some outings, however we also expect patients to walk to local areas or use the public bus service where possible. Care Plans All patients have an individualised Recovery Care Plan. This is updated weekly and a copy given to each patient. Key workers work closely with patients and other members of staff to plan care programmes. Input from family members and carers is welcomed when the service user wishes this to happen. Reflection and Spirituality There is a small reflection room at Ash Ward, which is available for all patients who wish to use it with a selection of spiritual texts. We also have a Chaplaincy team, providing spiritual and religious support for patients, their carers and staff. This ranges from small religious services (Christian) on the ward through to ensuring that those requiring the support of someone from another faith tradition or spirituality is put in touch with the appropriate person. 8
Time away from the ward All Ash Ward patients are sectioned under the Mental Health Act. This means that patients may only leave the ward when they have been granted authorisation to do so by the ward consultant psychiatrist. This is known as section 17 leave. Section 17 leave will be individual to each patient and discussed with patients and the care team. Prior to any leave being granted, a multi-disciplinary care plan meeting will be held. Patients can make requests for, or changes to, Section 17 leave at the weekly multi-disciplinary team meeting. Leave granted may be escorted by a member of staff or unescorted. The period of leave allowed usually builds up over the course of the hospital admission. Where appropriate, we support overnight home leave particularly for celebrations such as Christmas. We actively involve families and carers in planning and arranging leave, where patients wish us to do so. 9
Involving families and carers Shortly after admission, we attempt to identify an appropriate family member or carer to offer a meeting with our ward social worker and/or other member of staff. This meeting is offered to all in-patients on Somerset Partnership wards and forms part of our Triangle of Care Policy. The meeting is informal and can take place on the ward or at your home by arrangement. If you are unable to visit the ward in person, we have facilities for you to Skype or teleconference. We aim to understand the experiences of caring and how they affect you. We can also explain more about life and routines on the ward and hear your expectations and hopes. We will also offer you a Carers Assessment in line with the provisions of the Care Act 2014. Where patients wish this to be the case, we are keen to continue to involve families and carers during the hospital admission. This may take the form of attending periodic meetings, telephone discussions with members of the team and home visits. If you would like support from the Somerset Partnership dedicated carers support team, we can make a referral on your behalf. Carers Assessment Workers (CAW) Based in Community Mental Health Teams, Carers Assessment Workers specialise in assessing the needs of Carers of someone with a mental health difficulty. They can provide advice on: Help with day to day caring How to access benefits and information about financial and legal matters Local carers support groups Carers help lines Carers education programmes Getting a break or holiday either on your own or with the person you care for How to access help in a crisis Adults CAWs: Mendip: 01749 836597 07738 898774 Taunton: 01823368396 07738187822 South Somerset: 01935 428420 07738 898775 Somerset Coast: 01278 720238 07909 906811 www.somersetcarers.org 10
Reviewing the hospital admission Weekly Multi-disciplinary meeting (ward round) A weekly meeting is held, generally on a Wednesday morning. Each patient is reviewed on a fortnightly basis and invited to attend. During this meeting, the mental health of each service user is reviewed and plans for onward care made. Decisions regarding leave from the hospital are also usually made during this meeting. Recovery Care Plan Approach (RCPA) Review Meetings Each patient has an in-depth review of their care within 3 months of arriving at the ward and then every 5 months thereafter. This offers an opportunity for the multi-disciplinary team to review how things are going and to plan for future care. We aim to work in partnership with patients to make sure the goals are being achieved and to make changes if they are needed. We also encourage patients to get involved in planning these meetings and inputting to decisions about how the meeting is conducted. All patients are offered the opportunity to invite appropriate family members/carers. Tribunals and Managers Hearings The appropriateness of patients remaining under section of the Mental Health Act is reviewed regularly via Mental Health Tribunals and Managers Hearings. 11
Discharge The average length of stay on Ash Ward is between 9 18 months. We aim to begin planning for discharge early in the admission. The most common options upon discharge are: - Supported living - Independent accommodation in the community - Living with family member or carer Where patients wish it to be the case, we involve family members and carers in the decisions and planning regarding next moves. It is usual for there to be a gradual phased discharge plan, beginning with day leave at the proposed accommodation and gradually building up the number and frequency of these towards overnight leaves. The progress of this is regularly reviewed. The type of discharge and length of time it takes to progress the discharge depends on which section of the Mental Health Act the service user is detained under. For example, those on a section 37/41 will need permission form the Ministry of Justice before being discharged and there will be conditions to their discharge. 12
Advocacy Service Advocacy services can help people with understanding their rights, communicating with mental health staff and other professionals, making sure people have enough information about their care and treatment, getting legal help and advice and supporting them at Tribunals. They can also help people with planning their care package, putting them in touch with other specialist services and making a complaint. All Ash ward patients qualify to be represented by an Independent Mental Health Advocacy (IMHA) who visits the ward on a weekly basis. More information about this is available on the ward. Advocacy is also available for carers. Smoking Policy Ash ward is committed to offering a healthy environment for patients, carers and staff. A smoking cessation practitioner is available to offer support to quit smoking and all patients are encouraged to discuss their smoking status early in their admission. Some patients choose to take the opportunity of time on the ward to quit, or cut down their smoking. Short appointments are also available, by appointment, to carers who would like to look at quitting. These would include discussion of options available. These can be followed by a GP referral for nicotine replacement therapy, if requested. The Trust is working towards becoming smoke free, in line with NICE guidelines. At present, smoking for patients is restricted to a supervised courtyard area, which is opened regularly during the day, and leave taken off the premises. We do not have a designated smoking area on the site for visitors. 13
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