Philip Moisson, who is currently facilitating the Patients' Council meetings, updates us about recent meetings:
Gardening has begun as an activity for patients, and this month we heard about a trip to the garden centre to choose plants and tools. This is a welcome activity in the summer, and as we have mentioned before, one of the challenges for patients is to try and fill the day in a meaningful way.
There are a number of things that can be done, and one patient who we met was keen on both art and writing. This month we're also looking at making links for patients who are able to visit local groups to pursue their hobbies.
For quite some time we've been looking at ways to support the request for more things to do on the ward. The task of providing a meaningful day alongside safety and security is a difficult one, and this month's session brought us into contact with some patients who had taken to following yoga classes on Youtube - which is a solution we like.
Another positive piece of news is that although we had more requests for proper talking therapy on the ward, it has developed very recently that a member of staff who is trained in Dialectical Behaviour Therapy is now running a group once per week - exclusively for in-patients.
Finally, the ward will be managed by Powys Teaching Health Board from June 1st onwards.
We had a relatively quiet meeting this month with just a couple of patients - and as it happens there was a good level of content with ward food and other details of daily life on the ward. To explain the situation briefly, one of the patients was suffering from psychosis and had been given anti-psychotics. They described the feeling of these drugs as 'a deadening one', but still had a very good level of spark and vitality, and they interacted with us keenly.
The anti-ligature work in the garden has commenced, and this means that not only can a smoking area be placed outside now, but that the space freed inside can be used for gym equipment. Also, and importantly, gardening can become an activity for patients before too long.
Our regular meeting with patients at Felindre Ward this month involved patients who spoke about a small matter, but one that raised the issue of which rules on the ward are set in stone and which are subject to staff discretion. To explain, we were discussing being allowed to smoke after lunch, and this can be subject to staff availability and whether people have finished eating.
Another matter that was on the same theme was the issue of what people who struggle to sleep can do at night time. In one's own home, a person has the option of getting out of bed - but on the ward this is generally not the done thing. However, as our own former patients advised, there was usually a common sense approach taken by night staff provided nobody else was disturbed.
Finally, our patients this month spoke of having no money or possessions on admission, and the suggestion was raised that small loans are available at this stage. This is being discussed.
Some of the issues we talked about this month included the suggestion that a store of spare clothes should be kept on the ward for visitors who perhaps come in at short notice, or who are waiting for their own clothes to arrive. We also talked about the requirements for access to a 'normal' doctor on the ward, as sometimes there are concerns over the physical health of patients.
There will soon be a new system where possessions belonging to patients are recorded to avoid any loss or confusion. Two of our other concerns at the moment include the level of activity on the ward and the level of one to one time with staff. The current ward manager explained to us that on shift staff are allocated to particular patients so that people can have that one to one connection.
The patients we met this month talked to us openly about their time in hospital and the challenges of being sufficiently stimulated whilst there. One person mentioned that smoking and sleeping were two important aspects for them, as despite the best efforts of the two Occupational Therapists there is still lots of down-time to fill. There is a Community Walk in Brecon which some patients attend, and this seems popular - as does the regular pottery workshop.
The on ward internet access is now good and reliable. This month also saw a visit to the ward from various health board officials accompanying Eluned Morgan AM, and we also had the chance to talk about our work with these guests.
In recent times the patients who we've met have been relatively vocal and positive about their time on the ward. We had a slightly different meeting this month, with some quieter patients who were curious as to what we had to offer. Trying to nurture a person's voice at a low point in their lives is no easy task.
We spoke to the ward manager about how quiet the patients had been - and how unusual this was. When we talked further, we were reminded of how the hope was that the ward will be quiet over Christmas - with people able to be treated at home whenever possible. No predictions are being made however, and the ward is preparing a party for in-patients next week which we are pleased to be going along to.
This month's feedback was almost entirely positive and we had a meeting during which we were completely blown away by the strength of character of the current in-patients. If lived experience was worth money, they'd all be billionaires. Some of the good things we heard about on the ward was a feeling of absolute safety and a good level of camaraderie amongst patients.
In terms of activity level on the ward we heard of encouraging efforts from staff to facilitate activities and a strong patient led drive to organise board games, art sessions or ping-pong tournaments. The fact that there's a talented pianist staying at present means that sing-a-longs have become a regular feature of the music room and anyone who doesn't participate is generally there to listen along.The break from normality and a place of suffering can inspire people to make new plans for the future. We were also able to take part in a good level of informal work and participation on the ward today, and we heard first hand of how even wealthy people with large houses and fancy cars can suffer extreme levels of distress.
It is worth noting that the ward no longer conducts ward rounds with large numbers of staff discussing one patient in front of them. This is now conducted on a one-to-one basis, although support in completing a pro-forma prior to this is still available. Finally, we were once more impressed with the attitude of the new ward manager Lisa Hale and are content that we can all work well together.
Talking through similar issues with new people at each of our meetings helps us provide some structure with which to guide patients towards expressing what's on their mind - to help them raise their voice.The trigger at this month's meeting for a patient to request an advocate, and after we had explained the service, was a joke made by another patient. It seemed to bring a realisation of something, some new direction or purpose.
Amongst our group this month were some visitors from a busy ward in Pontypool, who seemed to like Felindre. We heard some good comments and some praise for staff listening skills, with further good comments too about the kitchen activity with the new Occupational Therapist. There is a new acting Ward Manager, who we met with, and we were once more reassured by the energy and enthusiasm of the person in that role and we look forward to working together over the coming months.
Phil is on holiday, so this month's report is by Carla Rosenthal:
We had a lively Patient's Council meeting in September which prompted a patient to remark on the need for physical activities to be available on the ward. Although there is a list of equipment that can be used to organise outside games, some patients on observation cannot go out due to staff constraints. This highlighted the benefit of having a safe and secure outdoor area that enables patients to be able to move freely outside without the requirement of having a member of staff present.
Plans are afoot to convert the space behind the ward (currently underused) to a patients' garden which can be designed, maintained and enjoyed by anyone staying on Felindre Ward. The garden area will have a smoking hut thereby freeing up the internal smoking room which will then be converted into a gym for patient use. Patients' Council are pushing forward these plans and hope to be able to report positive news soon.
Television viewing is a common issue that arises and at this meeting the possibility of having a booking system for patients to choose a particular programme to watch, was brought up. The possibility of having Film Nights was also talked about. There is a need to make it clear that there are laptops available to borrow and DVDs can be watched in the privacy of a patient's room if requested. A sign will go up on the notice board alerting patients to all the resources available.
The new Occupational Therapist is doing a grand job organising activities throughout the day and also for the evening after he has left the hospital. His enthusiasm and positivity in encouraging everyone to have a meaningful and enjoyable stay whilst in Bronllys has been praised by staff and patients. Hopefully, in the near future, music therapy activities will also be available. Details will be released as soon as there is confirmation.
Not everyone is aware that they can request the support of an Independent Mental Health Advocate who can assist and advise in a range of issues. Again, this service will be advertised in greater detail on the ward notice board.
If any patient who has been released from hospital would like to have a say in how mental health services are run in Powys, please contact PAVO's Mental Health Team to find out what participation opportunities are available.
We had a very positive session this month, where the voice and ideas of patients was celebrated. We also heard some positive feedback about nurses and the occupational therapists - and in fact there's a new OT who is very receptive to planning more evening activities.
One of the patients asked if we could start a compost heap, and we hope that between us all this will happen soon. It would be great to be able to respond quickly to patients, as some changes on the ward take time to achieve - for example the new gym and the garden we hope to create together one day.
We had some more private issues raised, and we were reminded once more of the need to explain things as much as needed to new visitors on the ward. Our colleague Carla Rosenthal suggested we create a 'Did you know?' wall in the recovery room with useful tips.
The ward is currently fairly quiet, but we held our meeting and had a few discussions with some patients. One of these patients is a young person who we have seen several times, and they're now preparing for a new start in a new location and can be seen as full of happiness and positive expectations for life once more.
Another person who we met is struggling with being sectioned and with life on the ward. We tried to empathise, and the volunteers spoke about similar feelings that they'd had when they were on the ward. Needless to say the specifics of the situation are being dealt with by an advocate for that patient, and there will be a tribunal in this instance.
One issue which is very important that was raised today is what to do when a person wants to practice their religion on the ward. We heard that a religious community had made contact with a specific patient with firm beliefs and practices, and that there was some scope for continuing the fellowship that they had been used to.
Finally, we were blown away with the enthusiasm and positivity which came from the new ward manager Lauren Edwards, herself a qualified Dialectical Behaviour Therapist. We really look forward to working together following the good progress under her predecessors Penny Price and Richard Rudge.
As an extra task this month our lead volunteer Rhydian Parry has compiled a list of CDs, DVDs and games equipment held by the ward - useful as a guide for patients who are looking for entertainment. We are very grateful to people who donated DVDs and CDs to the ward and now there is a list of what's on offer.
Our regular meeting was a very positive one and contained a lot of praise for the environment at Felindre, which we passed on to ward management. We heard about nightly scrabble games and table tennis, and the joys of pottery each week. What has also been praised is the camaraderie amongst patients who look out for one another during their stay. Although there have been several discharges this week we also heard an interesting perspective from someone who was really glad of the peace and quiet of the ward and the chance for a rest from their family, whilst they connected with other patients on the ward.
After starting with a discussion of the possible benefits of e-cigarettes in an environment where many people smoke we had a thorough session this month which covered some old and new issues. There was excitement at the forthcoming kitchen activity which is new to the ward, and some praise for the atmosphere on the ward once more. It was mentioned that some of the patients had been playing a lot of card and board games, which is a good sign, and we heard about a game of boules outside when the weather was good.
There are one or two areas where it can be useful for patients to ask staff if they need something - for example going outside in the fresh air when the doors may be locked - or having an extra cup of tea in between tea-times. Talking through life on the ward helps us to clarify the good and less good aspects of life there, and in turn our experts by experience (who have spent time there themselves) can pass on some tips..
As our lead volunteer Rhydian Parry said on the way home "...today was a good day for Patients' Council." We met with some lovely patients who spoke cheerfully and honestly about their time on the ward, including both what they liked and what they didn't like so much. We heard about some key issues regarding access to Doctors on the ward and the availability of Community Psychiatric Nurses for ward rounds.
Our meeting with the Ward Manager was supported this month by Senior Nurse and former Ward Manager Penny Price, along with Carla Rosenthal (who is covering as PAVO's Participation Officer). There was a superb atmosphere in the room and we discussed the possibility of converting some outdoor space into a beautiful garden - perhaps with community involvement and certainly with patients involved. We're pleased that a new Occupational Therapist will soon commence on the ward and from our end we will also be working hard again before our next visit to refine two separate funding bids - watch this space for updates and hopefully some positive news later this year.
We met with some patients today and explored a few individual and a few general issues as best we could. Some of the stresses of being an in-patient were discussed again, and our sympathetic ears and open minds, together with the experience of being on the ward that our volunteers bring, seemed to be very helpful.
When ward rounds happen, there is a pro-forma - or a form on which patients can write things down regarding their wishes for treatment. We discussed how this works with people today, and had a further chat about a consultant who had that day offered only a very short appointment to a patient. We think, partly from our own experiences, that writing things down before seeing a doctor or psychiatrist is a useful tool to keep the things you know are important at the forefront of your mind and firmly on the agenda for discussion.
Some of what we talked about today was specific to one or two individuals so remains in confidence, but we were also glad that we were able to offer that supportive ear to people whilst gathering our usual few items of essential feedback for ward management. To give one example of feedback this month, we asked that staff continue to be encouraged to help patients in completing the ward round pro-forma.
There are quite a few patients on the ward at present, but we are happy to report that they are as content as can be expected. Our meeting this month was a fairly quiet one. We delivered the first installment of CDs and DVDs for the recovery room and after a brief meeting we had to also content ourselves that we had been available to other patients if they had also had something to say.
Admin time is useful, and we are looking ahead to a future meeting with almost the entire Psychology team from the health board next month to discuss our plan to bring more therapeutic work on to the ward. We can't say too much about that at present but we are optimistic that we will be permitted to seek charitable funding for work to commence on an extended trial period basis.
The other news we have for you is that we are looking to begin dialogues above ward management level to finally sort out the lack of internet issue on the ward. We know that this connection with the outside world is vital for some people to maintain contact with friends and loved ones, to educate themselves on their condition and the medications they are being given, to keep up to date with benefit, housing and employment information, to entertain themselves with music and video, and for many other reasons. We hope that a filtered wi-fi service can be brought to the ward without too much delay as the issue has been raised time and time again by our patients and we now have a duty to act purposefully on this.
At our New Year's meeting some of our patients talked about wanting to hear more music on the ward. Some of them had been present at the Christmas party last year where a small ensemble played beautifully for staff and patients. We also talked about what a difference internet access on the ward would make to in-patients, but this is sadly yet to be rolled out on the ward. Related to this, some patients reported that they would like more newspapers to be available for them to know what is going on around them as they contemplate the difficult process of recovery. With this in mind we phoned round all the businesses in Talgarth and thanks to the goodwill of Glanenig House Care Home their entire batch of Sunday papers will be donated to our ward each Monday.
We did hear about another very positive situation this month where staff had made a good work-around for the lack of specialist benefits advice on the ward and we would like to commend them for this.
Finally in our round up for January, we had a sensitive discussion with patients and the ward manager about the attitude of busy staff in their daily verbal interactions with patients. I am yet to meet a patient at Felindre Ward who I do not understand or who I have ever had to ask to repeat themselves, but the comment we fielded was that often staff ask people to repeat what they have said, and that this can seem demeaning. We have raised the issue and we have ensured that this indiscretion, although unintended, can act as a reminder to anyone who comes into contact with patients that they must interact with them as equal subjects.
Felindre Ward at present is very quiet, with only a handful of in-patients. Our usual session wasn't really required, but we did get to have another conversation with the new Ward Manager, Richard Rudge, who's been promoted from the Home Treatment team.
As much of our work is ongoing, we met with Jane Cooke (PAVO Mental Health Team Manager) to develop our plan to increase the level of activities offered on the ward. This has been a recurring theme in our meetings for some time now and we hear of the problem from other Patients Councils too. Our plan is to bring in activity leaders from the voluntary sector, possibly from beyond, and to achieve this we are reaching out to partner organisations to discuss our capacity to hopefully run several small projects that help bring increased meaning and enjoyment to the days of in-patients.
Our funding fate is uncertain but we believe that we can put together a very strong case to bring a large number of tangible benefits from a little bit of money. We look forward to speaking to some of you about this in the near future- and please, get in touch with the Mental Health Team at PAVO if you already think you'd have something to offer. If you're curious but aren't quite sure why you'd want to - then all I'd say to you is that if my role has highlighted one central thing to me so far it would be this: it's a huge privilege to spend time with people on that ward.
This month we had a good turnout for our meeting with patients. The mood in the room was overtly positive, which made for a pleasant discussion in general.
We talked about a number of on ward and more general issues - the on ward issues being to do with how to peacefully ensure people can all watch things they want on television and another one to do with use of the games room for meetings by staff.
We also had a really in depth chat about the attitude of some psychiatrists - and whether they realise that they can seem a bit high and mighty in relation to their patients. In any case we gathered feedback on many issues again this month and we're also pleased that we made sure that staff who are involved in sectioning people are reminded of what it's like to be on the other end of this process too.
To give you a taste of this month's meeting - it could be described as difficult and emotional but ultimately purposeful. Guided by our lead volunteer our listening skills were fully employed and in our capacity as representatives we empathised with a small selection of patients - chipping in with helpful comments wherever we felt we could.
At a practical level the issues varied slightly this month, talking about relationships with staff (including special or favourite nurses) and we also aired a topic which may not seem obviously important to everyone. It is to do with cleaners being aware that moving things in a person's own room - even just to clean the space underneath- can seem intrusive if you are currently feeling vulnerable. Of course, we also listened at length to the underlying feelings present there- of what it's like to be kept away from your home, your friends and loved ones, and the frustrations of just wanting to be allowed to leave.
In terms of our other achievements this month, we delivered two large boxes of used books to the Recovery Room which were generously donated by Builth Wells Community Support. We also brought in new posters advertising our regular presence for staff and patients. Finally, despite learning of a funding 'brick wall' with regards to getting benefits advice back onto the ward we have made provisions to raise awareness of the vital role Powys Citizens Advice can play in assisting with benefit claims for people from all walks of life.
At this month's Patients' Council we had some new perspectives on some familiar themes. It has to be said that one of the patients who joined us this month is one of the most eloquent and well spoken people I've ever met. Food and activity levels were the main topics of conversation, and although it was said that the food is better than on most other wards, people long for variety during their stay.
As far as activities go, Rhydian Parry, John Lilley and myself who host Patients' Council are keen to make progress on the difficulties faced by patients and staff with limited time in getting enough activity on the ward. We discussed having a second television set for peak hours, the possibilIty of more art and craft tutoring (so that people could spend their free time progressing with these skills) and also, from outside the ward, we're now actively pursuing a donation of used books to further fill the shelves of the Patients' Council Recovery Room.
We hope to have some good news for you next month, in the meantime I would like to take the chance to thank Rhydian and John for welcoming me to their team over these past few months and wish to commend them for their ongoing and tireless work as volunteers - as in truth it makes my role far easier...
Our last two Patients' Council meetings have involved a variety of themes and some very interesting discussions. One thing that has stood out is how positive in general the feedback on the experience at Felindre Ward has been in comparison to other wards in other areas. We again discussed issues such as food and activity levels and asked people what they thought of plans to install a gym in the current smoking area - which most people like the sound of. Some people have been more content in general than others, and we have liased with staff over the situation for those with specific dietary needs. As it turns out, the catering will be provided from elsewhere soon. We are also chasing up the availability of benefits advice for patients - particularly for those who stay longer term, and hope to make progress on this soon.
Some matters that were discussed in June included the procedure for patients to comment on ward meals. Also, there were some discussions around the proposal to turn the current smoking room into a gym therefore allowing the chance for more physical activity - which itself has increased with the work of occupational therapists. We were told that advocates are now on the ward less often, which is disappointing. Also, some of the practicalities of having full but filtered internet access on the ward were talked about.
Grants available to Third Sector organisations in Child & Adolescent Mental Health Services. Closing date 30 June 2017.