Tower Hamlets Mental Health Centre Visit Report by BZKdNn

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									Tower Hamlets Involvement Network (THINk)
Enter and View Visit

Tower Hamlets Centre for Mental Health (Mile End)
East London Foundation Trust

Date and time: 23rd March 2009, 1:30.
Areas Visited: Rosebank, Lea and Bricklane Wards

Visiting team of authorised THINk members
Lead member – Peter Nichol
Host organisation – Dianne Barham

ELFT Tower Hamlets Centre for Mental Health staff
Mags Groves - Borough Lead Nurse for Mental Health

Project information reviewed: We reviewed the core standards report of the East
London Foundation Trust submitted to Healthcare Commission in 2007/08. This visit
will form a part of third party commentary regarding the ELFT Annual Health Check
2008/09.

Key visit objectives: To observe how well the core standards are met and also to
gather relevant information in order to write Third part Commentary for Annual health
Check 2008/09

Background to Tower Hamlets Centre for Mental Health

Tower Hamlets Centre for Mental Health opened in February 2007

There are four Acute Adult Wards and two Psychiatric Intensive Care /Low Secure
Wards that cover adults aged 18-65 but some adults will be over 65 as they will
remain with adult services if they do not fit the criteria for transfer to Mental Health
Care of Older People.

Each adult acute ward has a female lounge and a resource room as well as other
rooms for sessional use. There are activities on and off the wards and there is an
Occupational Therapy Unit that provides a range of therapeutic activities within and
outside of normal working hours.

All wards are staffed with a multi disciplinary team- one modern matron per two
wards, one practice Innovation Nurse per ward, two clinical team leaders per ward, a
range of qualified staff nurses on each ward, I-Lingual Support workers, social
therapists and rehab workers, one Occupational Therapist per ward, one
psychologist per two acute wards and the PICU /Low Secure has a psychologist on



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each ward and finally a range of medical staff that include the Consultant group and
their junior doctors.

Globe Ward, 19 bedded mixed sex – caters for the population of Bethnal Green
Lea Ward, 19 bedded mixed sex – caters for the population of Stepney, Wapping
and Tower Hamlets Early Intervention service
The Modern Matron for the above wards is Maureen Brown

Roman Ward, 19 bedded mixed sex –caters for the population of Isle of Dogs
Bricklane Ward, 19 bedded mixed sex – caters for the population of Bow & Poplar
and the Assertive Outreach Service
The Modern Matron for the above wards is Suzanne Paginton

Rosebank Ward- 10 Bedded female ward that caters for the 3 localities within East
London Foundation Trust

Millharbour Ward- 14 Bedded Male ward that caters for the 3 localities within East
London Foundation Trust
The modern matron for the above wards is Jacqui Ritchie

Discussions with staff:
Mags Groves
Borough Lead Nurse for Mental Health

There are issues with the food coming in chilled and then being re heated which can
lead to it tasting a bit rubbery. If users want halal food they are ending up getting the
same meal every day. Some users can struggle with the individual menus that need
to be filled in in advance all the time.

Would like to get teachers in for those users who are likely to be there for longer
periods. This would give users a sense of progression, achievement and recovery.

Very good Acute Care Forum.

Community meetings happen every day and users get a chance to have a say in
what is planned for the day and to raise any concerns, issues, or things they don’t
like.

The current trend is to see more
    younger males
    middle aged Bengali women
    50 + women who are addicted to crack cocaine

There is still some issues with staff attitude at the lower level: Bands three and four
are good. The feeling is that about 20% of staff are not fit for purpose as they lack
the necessary empathy and compassion.

Physical health care is very good with dentists on site and a specific prgramme to
address issues of people who have a fear of dentists.


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There are no agency staff working on the wards now with any staff shortages being
dealt with through the Trust’s Staff Bank.

The number of vacant beds can vary from week to week and changes with seasonal
illnesses. When there is a shortage of beds patients are referred to other hospitals
and other wards in extreme cases roll out beds are used.

Staff appear to receive good diversity training and there is good access to
interpreting services for most core minority groups. The language service is good
and there is a diverse range of staff from the main community groups.

Good occupational therapy department and outside hours activities e.g Tower
Hamlets Tigers (football team), gym and evening groups.


Bricklane Ward, 19 bedded mixed sex – caters for the population of Bow & Poplar
and the Assertive Outreach Service

Authorised representatives’ observations;
The ward was clean and the patients seemed to be generally calm and occupied
with a variety of activities.

Discussions with users;
We talked to a young male who said that he had received a welcome pack when he
arrived and knew his named nurse. He felt that one to ones did not happen as often
as they should and that the named nurse was suppose to spend 20 minutes a day
with you and this did not always happen because they were too busy.
Staff should do more to encourage people to attend the community meetings in the
morning otherwise the people who do attend are faced with making all the choices
and then the other people just complain.
Staff sometimes came into rooms without knocking but generally he felt that staff
were good, there were a lot of OT and other activities and he was treated with dignity
and respect.
He said the food sometimes tasted like rubber as it was reheated rather than cooked
on site.

Rosebank Ward 10 Bedded female ward that caters for the 3 localities within East
London Foundation Trust

Authorised representatives’ observations;
Again the ward was nice and clean and there was hand washing facilities.
There is very little space for patients to store any personal belongings limiting their
ability to have their own things around them which would make their stay more
comfortable.
There is no staff room in the unit and staff have to outside to take breaks.
Notice boards were prominent and their appeared to be additional information
available in the computer room.

Discussions with users;


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We spoke with a women who said that she knew about the complaints procedure,
where to get a complaints leaflet and who to complain to. She received a welcome
pack when she arrived. She knew about the activities available and felt they were
good and was also aware of the spiritual support she could access. She felt that she
was treated with dignity and respect and her cultural needs were taken into
consideration in relation to the food.
We visited one of the rooms which seemed clean and had many of the patients
personal photo’s and items.

Discussions with staff
Community meetings take place every morning to enable women to make decisions
about the day’s activities
many of the women are on a diet and are trying to increase their exercise as this can
have a marked effect on their mental health.
Staff were working on putting up display boards with information on recovery plans.

Lee Ward 19 bedded mixed sex – caters for the population of Stepney, Wapping
and Tower Hamlets Early Intervention service

Authorised representatives’ observations
There was a lot of activity on the ward as staff were just changing over shifts, the TV
was on and some of the patients were having a jam session on instruments.
The ward seemed clean, light and airy. Again there was not storage for patients.

Discussions with users:
The man that we spoke to was difficult to keep focused on the questions we were
asking but seemed happy with the information and the care that he received.

Follow up discussion with staff
There are ongoing drug problems on the wards and patients are tested every three
months. Patients always seem to find access to drugs around the hospital and there
was a problem with a nearby takeaway restaurant supplying patients.

One to ones are the first thing to slip when there is a staff shortage.

Transfer to Mile End from Accident and Emergency at the Royal London has
improved dramatically. However A&E is the only out of hours access point as Mental
Health services shut at 10pm. A&E don’t have a separate mental health suite.

It would seem to make sense to move the emergency team from the Royal London
down to Mile End and for it to be well staffed.

Patients seem to be slightly unclear as to whether they had a care plan.

Summary



Recommendations


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