|Welcome to the latest newsletter and a warm welcome to the new members of the network. Interestingly, we’re getting increasing numbers of enquiries from learning disability wards, and we’d welcome you encouraging your learning disability (and elderly) colleagues to join the network. The big development this fortnight is the survey. And… yet another plea for you to please fill it in and return it! The information we’ve got in from the few wards who have so far responded is fascinating and of real benefit to everyone, so we need YOURS!! Thanks!
The featured site this edition is Mill View Hospital in Sussex. But a quick mention of a lovely example of good practice – Hartlepool are having a carers’ conference, and we’re delighted that this will include a Star Wards’ stand.
News from trusts – Mill View Hospital, Sussex
The hospital has set up a really thorough, thoughtful new process for transforming patients’ experiences.
Joint Therapeutic working involves a systemic change in the ward structure to introduce a client centred approach based on recovery working, including integrated assessment, care planning and discharge process. It also includes the introduction of a full therapeutic programme on the ward orchestrated by MDT and service users at the daily morning meeting.
Staff felt that they weren’t able to make the most of their skills due to time pressure and were stressed by their work environment. They wanted to spend more time with clients, and the clients generally reported that there was little to do on the wards and they were bored. We visited Larch Ward in Worthing which is one of the participating sites in the Sainsbury project. They had tackled their issues by working with a Multi-disciplinary assessment tool on admission and daily planning meetings to foster a feeling of community. It was great to see a culture of change and positivity and it inspired us to visualise and plan for ourselves.
We wanted to start from the beginning with a RECOVERY focus. So we developed a holistic assessment tool which is based on the strengths model, it asks about expectations, clients own coping mechanisms and is designed to be contributed to by
all of the ward community. Clients are encouraged to fill in as much as they can and receive a copy to put in their recovery folder.
We looked at working in an acute environment and the tasks that we spend so much time on – first we asked ourselves are they necessary? Does it work? How can things be more accessible and open? For example Recovery plans took the place of nursing controlled care planning and a welcome pack was developed to ensure all clients get information on Recovery working, relapse prevention and crisis planning. We then looked at ways to create a better sense of community. There was a great will among the staff to be more engaged, to support group work and to increase their skill base. The OT dept and recreational workers worked intensively on Regency Ward to share their skills with the nursing staff and support their growth. It led to a well-attended morning meeting where the activities for the day are reviewed along with any issues and the evening activity is agreed upon by the participants.
Staff have been given time out of the numbers to work alongside and learn from other disciplines and it has promoted better communication and a greater understanding of each others roles. Staff have been able to develop their interests from CBT and psychological input, to activity, pampering, and relaxation groups. This has been a particular benefit for unqualified staff who may struggle to find a meaningful role in some circumstances.
The clients have a daily forum to express their views and shape their experience of the ward, from fully engaging in identifying their own needs and planning how to manage their care and deciding how to spend their time. There is more engagement as the focus is on activity, positivity and enjoyment, rather than containment and service led assessment (‘what do you have problems with?’ etc). It appears that the number of incidents has decreased although we are awaiting conclusive data but both clients and staff report increased wellbeing.
As we have begun to make changes for the better it has paved the way for other positive initiatives, such as an involvement by all the units’ wards in ‘Star Wards’, encouraged us to facilitate volunteers and helped us engage with Mind to bid for a project on better information for clients; to some extent it seems expectation of improvement self-perpetuates.
All the best