Why a professional should choose the service
Lyndhurst respects and involves people who use our services.
At Lyndhurst, all service users are involved in their care planning. Care plans are based on an understanding of the service user’s needs and condition. The care plans made are achievable, reflect on the progress the service user has made, and look at any obstacles that may stand in the way of the service user’s recovery.
Each service user has an initial care plan on admission based on the Recovery Star (used by many mental health Trusts as a tool for optimising individual recovery). Lyndhurst also follows the Care Programme Approach.
Care plans are reviewed a monthly basis with the care team and the service user.
All service users have an activity/therapy plan integrated into their care plan.
Interventions will primarily be determined by the service user, taking into account their needs and aspirations.
The Recovery Star is used as a framework and as a measure of progress. This is completed jointly but if the service user lacks capacity it can be scored by a member of staff.
Service user involvement
Lyndhurst holds service user meetings which are used to involve service users in issues which directly impact on the service. Service users are reminded in their service user meeting that they can have an up to date copy of their care plans and have involvement in their care plans.
All service users can access an advocacy service. This is provided by Rethink.
Lyndhurst has undertaken four inpatient experience surveys since January 2013. On average, the results of these surveys showed that 87% of service users acknowledged that they had a care plan, 76% understood what was in their care plan, and 95% were able to express their views at a meeting/review.
When last surveyed, 100% of service users found the service user reviews helpful with an average score over the last year of 91%.
When last surveyed, 75% said they would recommend the service to family and friends, with 50% of service users stating they would be extremely likely to recommend the service to family and friends.
When asked why they would recommend the service the following comments were made:
“Lyndhurst is a fantastic and caring service.”
All service users have their own rooms and are the unit complies with the NHS policy for mixed-sex wards.
Disabled access is from the left side of the building. There is an accessible bathroom.
Meeting people’s cultural and religious needs
Staff will find out how best to meet someone needs from gathering information both from the service user, the service user’s family and from finding out the information available on a given religion or culture.
Consent to care and treatment
Mental Health Act
As a service, Lyndhurst is able to admit service users detained under civil sections of the Mental Health Act 1983.
Consent to treatment
Capacity to consent to treatment is reviewed, as a minimum, every three weeks and/or if there are any changes in treatment. Service users detained under a treatment section of the Mental Health Act 1983 are subject to either T2/3.
T2 is implemented if service users are assessed as having the capacity to consent to treatment.
Second opinion appointed doctors (SOAD)
If a service user lacks the capacity to consent to medical treatment, a SOAD and the service user will complete a T3 form.
Service users have their rights read to them on admission and this is repeated at regular intervals and/or if there are changes.
Care and welfare of people who use services
All service users are assessed prior to admission to Lyndhurst. Service users who have been repatriated from out of area placements and/or secure placements have their care needs identified and their care plans written prior to visits commencing.
Assessments and care plans are reviewed by the whole multidisciplinary team at Lyndhurst prior to admission.
Service users at Lyndhurst are on a minimum of level 4 observations (hourly). This can be increased if there are concerns.
Crisis planning, risk assessment
The assessment includes a summary of their risk assessment (past and current) and a crisis plan
The team keeps up to date with best practice.
Positive risk taking
Positive risk-taking takes place with consideration to the person’s risk history and assessed mental health
Lyndhurst will implement the Safewards plan.
Meeting nutritional needs
At Lyndhurst, service users are expected to be as independent as possible in preparing shopping for meals. If during the assessment someone is identified as needing extra support, staff will provide this. Lyndhurst has a housekeeper who will provide some cooked meals based on the service user’s expressed preferences, likes, dislikes, and cultural needs.
Occupational therapy (OT)
All service users will be assessed by the occupational therapist. The OT team provide support and input in relation to dietary intake, meal preparation and advise on healthy lifestyles as required.
Co-operating with other suppliers
Multidisciplinary team (MDT) reviews
MDT reviews are carried out weekly and are attended by a consultant psychiatrist, clinical psychologist, OT, registered mental health nurse (RMN), service user and any other support network identified by the service user, recorded by an administrator.
Nursing reports are produced prior to the MDT meeting.
Care coordinators are invited and they are expected to attend a minimum of one in three ward reviews.
Care Programme Approach (CPA) meetings are held every six months to discuss the service user’s assessment and/or discharge plan. A detailed report is produced for each CPA meeting by the service user’s key worker.
Progress reports are prepared for the CCG panel.
Links with other services
The service has close links with the local acute unit, community teams, low secure services and independent sector.
It also has established links with residential placements, supported accommodation providers and local authority housing teams to ensure we can identify a suitable move on placement for our service users
Care Programme Approach
If there is more than one service responsible for a service user’s care, a member of the Lyndhurst team will attend the ward reviews/Care Programme approach meetings for the other services involved and also ensure the other services are invited to the Lyndhurst MDT review. The Lyndhurst team provide a ward review and a report for CPA meetings.
Crisis plans are shared and involve all in providing care to enable a responsive approach.
Safeguarding people who use services from abuse
Staff are trained in protecting vulnerable adults and will seek advice from the safeguarding adults lead. If there are safeguarding issues identified, this will be included in the service user’s risk assessments and be addressed in the service users care plan.
If the placement at Lyndhurst is of immediate concern this will be reviewed by the MDT and/or crisis team
It is recognised that the Mental Health Act 1983 provides a safeguard for service users having leave into the community.
Managing aggression and violence (MAV)
All staff at Lyndhurst are MAV trained
Lyndhurst has a specific visitors policy. This enables staff to make arrangements for things such as child visitors and the availability of the visitors’ lounge.
Cleanliness and infection control
All staff are assessed on their hand hygiene.
Housekeeping services are regularly audited.
All staff are aware of the need to contact the Trust’s infection prevention and control team if there is an outbreak.
Management of medications
Medication is kept in the clinic room.
All service users have their own supply of medication in their own storage drawer.
All services users have a prescription card directing the administration of medication.
Service users complete a risk assessment and are reviewed by the MDT prior to moving through the stages of self-medication.
Safety and suitability of premises
Lyndhurst is a 14 bed mixed-sex rehabilitation inpatient ward in the community.
It is situated on a busy road in a residential area between a park and a secondary school.
It is an adapted Victorian house. This gives a sense of homeliness.
Doors are locked for the security of residents.
Whilst some control is possible for service users without leave who do not have a key, security is reliant upon an individual service user’s compliance with their rehabilitation care plan.
The structure of the building means observation via line of sight is poor; therefore intermittent and short-term observations are possible in the context of meeting care needs.
There are 4 rooms (2 male, 2 female) where higher level observations are possible.
During the day, 4 members of staff are on duty, however, they will often be engaged in supporting service users in the community or offering direct treatment.
Lyndhurst is an open unit however it is accessed via a fob system.
CCTV and PinPoint are in place.
There is an annual ligature audit.
Safety and availability of equipment
All electrical equipment is PAT tested and is reviewed in terms of infection control standards.
There is a requirement for a minimum of 3 members of staff to be within the unit at all times. This ensures Mental Health Act (1983) and hospital registration compliance, adequate observation and minimum numbers for health, safety and security reasons.
This is the identified minimum staffing level however, more staff are required in order for therapeutic activities to be carried out, escorting service users and other day to day tasks as required. Therefore, on early and late shifts 4 members of staff are on duty with the addition of OT staff during the working week.
OT staff are supernumerary to the rostered staff to allow for scheduled or planned therapeutic activities in a range of settings.
On night shifts, 3 members staff are on duty.
All staff receive supervision every 4 to 6 weeks and an appraisal annually.
All staff have mandatory training and can be signposted for additional training.
Assessing and monitoring the quality of service provision
All service users have a risk assessment completed as part of the admission assessment and are subject to Sainsbury’s level 2 MDT risk assessment.
Complaints and compliments
Information is available on complaints and compliments. There are leaflets and posters on the unit with information for service users if they wish to make a complaint or compliment.
All staff are aware of how to support service users in making a complaint
Lyndhurst uses RiO (electronic records)
Each service users has a file for other documentation
Each service users has a medical file, which includes a copy of the Mental Health Act documentation.
- Individual goal setting to improve quality of life
- Risk assessment and risk management, positive risk-taking
- Management of physical health and health promotion
- Helping people to maintain or gain daily living skills
- Access to vocational opportunities
- Relapse prevention and symptom management
- Self-administration of medication
- Development of positive coping strategies
- Social inclusion and re-integration to the community
- Individualised structured routine and planning
- Collaborative care planning (involving people such as family, carers and staff in creating a care plan)
- Budget management
- Psychosocial interventions (teaching people psychological techniques that they can then use to aid recovery and help manage any future mental health issues)
- Motivational interviewing (a style of patient-centred counselling)
- Medication management and monitoring
- Psychoeducation (information offered to patients and their families to help them manage their condition)
- Pharmacy reviews
- Recovery and an increased ability to manage the symptoms of your condition
- Ability to self-care
- Discharged back into the community as soon as possible
- Improved engagement with community services
- Improved physical health
- Improved functional capacity
- Preventing relapse
- Self-management skills
- Ability to self-manage own medication
- To be socially included and involved