Last update 27th. August 2004

PPIFO

MONITORING VISIT REPORT - PPI FORUM Camden and Islington MH&SCT

Helen Boyle Ward Royal Free Hospital was visited on 17th August 2004 by Nick Green, Gillian Jordan (RFHTPPI) and Luke David (Ham & High). Imogen von Halle (UCHTPPI) assisted Nick Green with interviews of ex-patients.

DESCRIPTION OF SERVICE AND STAFFING

12 female patients with three nurses per shift. A manager and sundry support including psychologist and two consultants.

PREMISES

The ward has one to four beds in a room. Offices for managers, nurses, patient interviews and a common room for patients. The general impression was dingy and drab which suggested redecoration was overdue and cleaning was inadequately thorough.

EQUIPMENT

None inspected

STAFF VIEWS

Safety training was reviewed. No figures were available for violent incident frequency (for a patient requiring restraint). Doctors often attended the 9.30 shift change handover. Hours of patient/doctor exposure were not available. The Staff did not wear uniforms.

PATIENT/CARERS VIEWS

The visit was prompted by an article in a local newspaper (Ham&High p8 13th August) that stealing, drinking and assaults were routinely unchallenged in this and other wards in MH Trust controlled wards.

ANALYSIS

We would like CANDIMHT to describe their routine procedures for dealing with theft, assault and the use of intoxicants, alcohol and marijuana including at what point police are involved. There is also the question of misinterpreting patient anger with the incompetence (and untruths) of care staff leading to inappropriate sedation and continued sectioning of patients. How is this question routinely decided? We would like to know how many hours patients spend with doctors and nurses. There is an unfortunate impression that organisation is for the convenience of staff rather than supporting the therapeutic needs of patients.

To what extent are care plans being agreed with patients? Will the single sex policy be implemented? Many patients asked us to say they preferred staff in Uniforms. On arrival (a confusing and disorienting time for fragile and bewildered patients) knowing who was staff and who not adds to the sense of security so urgently needed to start the healing process.

THANKS TO STAFF

The staff and patients we met were friendly and helpful. As we left questions of validity of Luke David's written permission were raised. We hope the Forum will resolve this question as a matter of urgency. This report was based on one visit of about and hour and a half and several interviews with past patients of Helen Boyle ward. Thanks also to Gillian Jordan, Luke David, Imogen von Halle and several past patients for their help to the Forum.

RECOMMENDATIONS (To be agreed by the PPI Forum)

To consider appropriate action when the Trust has responded to the questions arising from the inspections and interviews with patients.


Questions to Camden and Islington MH&SCT from the Patient Forum


  1. How many thefts and assaults are reported last year and how many were investigated?
  2. How are assaults and thefts investigated?
  3. What measures are taken to secure patient's personal property?
  4. If property is stolen or injury sustained what procedure is adopted in compensating patients? How much compensation was paid last year?
  5. How is Trust policy on drinking alcohol, smoking tobacco and cannabis applied?
  6. Has the Trust any intention of requiring staff to wear uniforms?
  7. What standard of cleaning and decoration is required by Trust managers in Wards and how is this monitored?
  8. How many hours do doctors spend in actual patient contact?
  9. For how many hours are doctors present on the wards?
  10. How many hours do nurses spend in actual patient contact?
  11. How is the appropriate dose of medication reviewed and decided?
  12. How is patient frustration and anger dealt with?
  13. When staff make a mistake what kinds of mistake are most common and how are they dealt with?
  14. In what circumstances would it be necessary to withhold information from a patient about the nature of their condition?
  15. What proportion of patients have no agreed Care Plans? What obstacles are there?
  16. When will single sex ward policy be implemented?
  17. Are potentially violent patients always separated from non-violent patients?
  18. In MHT wards at RFH are patients routinely sedated at night?
  19. Is ECT used and for what conditions?
  20. Is psychosurgery used and for what conditions?
  21. What is the Trust policy on releasing patients to visit local shops and cafes? How many patients abscond while on these visits?

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