22 May 2008

SW Newsletter #37

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May 22nd 2008

Grasmere Ward, Dorothy Pattison Hospital, Walsall

Welcome to the Star Wards’ newsletter and a warm welcome to the new members of the Star Wards’ community. After the marathon last e-newsletter, I’ve tried to be rather more succinct this fortnight in writing up yet another inspiring and impressive visit. I’m sorry about the hiatus between sending out my notes about visiting Windermere, at Dorothy Pattison Hospital, and this feature about its neighbour downstairs, the hospital’s rehabilitation ward, Grasmere. Given how good both these wards are, it’s not surprising that they are taking part in the RCPysch’s demanding and valuable AIMS accreditation scheme. But DPH is the first hospital I’ve heard about which has a member of staff with a dedicated role to managing the scheme. (3 days a week for DPH’s AlMS’ manager.)

Ward managers who invite me to visit seem to have all sorts of qualities in common, such as egalitarian and inclusive values, a very clear sense of team purpose and direction. And, particularly strikingly, a great sense of humour. Mandy, Grasmere’s ward manager is no exception and I had a very enjoyable as well as informative visit. Grasmere is a rehab ward, and I’ve only been to a few of these. Possibly because they’ve been largely replaced by community-based facilities. Walsall have both types of facilities, wisely in my unsolicited opinion.

The average length of stay is a few months to a year and the benefits of being hospital-based were evident. It’s situated close to the admission wards, and Grasmere staff take part in reviews and identify people who they feel would benefit from time on a ward which has a very different purpose, pace and culture. For some patients, it’s less daunting than moving to a whole new place, so is a valuable and appreciated interim or transitional move. They may have already been down to Grasmere for a social visit. Being able to spend some time on Grasmere prevents younger people going straight from an admission ward to a nursing home because haven’t had the time or opportunity to develop independence skills.

Historically, the staff approach is that the ward is the patients’ home while they’re here and do everything they can to make it as homely as possible. Mandy came from an acute ward and her philosophy is that: “You have to give some of yourself.” It was apparent from what Mandy, patients and staff described that Grasmere staff have a

different way of getting involved and engaging with patients, which is less ‘detached’ than in most acute wards. They believe in breaking down traditional nurse/patient relationships, and the pace of life on the ward is much more relaxed.

Patients still have homes and the aim is to enable them to return there or at least get one step closer, although but others will go to nursing homes. Emphasis is on a therapeutic day and very much about independent living skills eg budgeting, cooking, self-medicating. People may need IL skills because young, or crisis has meant loss of skills, or longer-term mentally ill and haven’t used IL skills for years. Grasmere also provides opportunities for patients from other wards, whether or not they may become a patient there.

Meals come into ward on a trolley but some people cook one meal a day for themselves and all make their own lunches when meals aren’t delivered. Patients have £3 a meal budget, and may club together and or get takeaways sometimes.

The ward includes an art room and exercise room, lovely patio area, for BBQs etc. They may be able to take on part of a local allotment used by the early intervention team. CAB comes in to run surgeries twice a week. I spoke to one of the patients (one of so many benefits of having a fag break, invariably with fellow smoker patients.) She had been in the local community rehab unit which had closed and enthused about how she much prefers it here. “The staff are so supportive. There’s always someone to talk to.”

OTs do assessments at home when the patient is in the process of returning home. Staff are careful to remember they are guests when they visit patients’ homes as part of the discharge process. Home visits aren’t seen as a chore but an enriching, broadening part of their work.

A few rehab ward members have asked to be put in touch with other rehab wards and I’m sure that Mandy will be happy to hear from colleagues with similar challenges and pleasures.[email protected]. Many thanks to Mandy, colleagues and patients for being so welcoming and informative.

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