Welcome Guide – Adult Inpatient Services

This Welcome Guide provides information about your ward, the staff, and the treatments and therapies that will be available to you. It contains a lot of information, so it may be helpful to read a bit at a time.

Your named nurse will discuss the Welcome Guide with you when you are first admitted and answer any questions about its contents throughout your stay. There is a service leaflet in the back of this guide which provides information about your ward.

At the back of this guide there is space provided for you to store your personal documents, including your Care Plan. Please keep this guide and all of your personal information in a safe place and do not share your information with other patients.

The Trust greatly values the very important work of family and friends caring for people who use our services. We believe that carers should be involved in decisions made about the person they care for, and we will give carers the opportunity to be involved in decisions about your care and treatment.

The Trusts’ admission and discharge policy is available from staff, if you would like a copy.

You can access the guide online at www.cntw.nhs.uk/resource-library/adult-inpatient-welcome-guide/

Coming into hospital can be a distressing experience for you and your loved ones.  Whether this is the first time that you have been admitted, or if you have been here before, we recognise that this is a difficult time. We will support you as much as possible during your stay.

Why have I come to hospital?

You have been admitted to the ward so that your mental health needs can be fully assessed. The ward provides a place of safety where specialist team members can offer the care that best meets your needs. The aim of admission is to aid your recovery, helping you to return to your everyday life by finding the treatment that is right for you. Wherever possible, staff will try to involve you in decisions about your care.

What will happen when I arrive?

On arrival you will be welcomed by a member of the team who will show you around the ward.

• Bedroom – you will be shown your room. We will try and keep your bedroom the same one throughout your stay, however there may be circumstances when we have to ask you to move rooms but only if there is a clinical need on the ward.
• Personal belongings – a member of staff will also show you where you can leave your belongings.
• Toilet, bathroom, TV and telephone – we will show you where these are.
• Lounge/sitting room – you will be shown the sitting room and when you feel well enough you will be introduced to other people on the ward.
• There is access to computers for you to use during your admission. A member of ward staff will support you to have a password and access to the room.
• Cigarettes, tobacco, lighters and lighter fuel should be given to staff on your admission. You can also ask a carer to take them home for you.

You will also be given a copy of this Welcome Guide and advised of who your name will be.

Bed linen and towels are supplied and will be replaced regularly during your stay.

The ward can also supply some emergency toiletries for people admitted without personal belongings and in the longer term you will need your own clothes and toiletries.

Where can I store my things?

Your bedroom is lockable by staff and inside your room there will be a small safe for you to store your belongings.

The Patients Finance Office will store any money or valuables for safekeeping and provide you with a receipt for your items.

What should I bring with me?

You may bring the following items to make your stay more comfortable:

• Nightwear, dressing gown and slippers
• Toiletries
• Watch
• Telephone numbers, address book, writing materials
• Sweets, snacks
• Books, magazines, reading glasses

Is there anything that I cannot bring onto the ward?

The following items must not be brought into hospital:

• Large amounts of cash, cheque books, credit cards
• Valuable jewellery
• Sharp objects
• Razor blades should be handed to staff
• Alcohol and any non-prescribed or illicit drugs. (If illegal drugs are found the Police will be contacted)
• Weapons of any kind
• Offensive literature
• Lighters, matches and smoking materials. On admission if you smoke you will be seen by a member of the Tobacco Dependency Treatment service who will talk to you and offer you support to be smokefree while you are in hospital.

This is not a full list and staff will inform you of any other items that are not allowed on your ward.

Soon after arriving on the ward a series of assessments will take place which look in detail at your needs.  Your carer, family and friends, with your permission, can also be involved in discussions. The assessments will be recorded in your care plan.

These include:

An assessment of your mental health – this involves staff talking with you and monitoring your activity. In some cases, a member of staff may need to be with you at all times.

An assessment of your social situation and needs – this looks at your housing, employment, leisure and family welfare issues.

A risk assessment – this helps maintain your safety.

A physical healthcare assessment  – this involves being examined by a doctor and various tests such as blood pressure, blood tests and urine sample testing. Some medications require these tests to be repeated regularly.

Within 72 hours the team will carry out a detailed assessment of your needs.  A care plan will be completed which sets out the care and treatment you require during your stay. You are entitled to be involved in decisions about your care plan and will receive a copy to keep in this folder.  If you agree we will also share this information with your carer.

Assessment

We will need to know some more about you to make sure you get the best possible help from us. To do this we talk to you, your family or carers (unless you really don’t want us to), and other professionals who work with you. We might also want to ask for specialist assessments to help us be very clear as to the best way forward. These may include:

1. Information about your mental and physical health
2. Assessment of your social situation and needs
3. What has helped or hindered in the past
4. The views of the people who are close to you like family, friends or carers
5. The views of the care team who have been looking after you previously

Planning your care

We will work with you to agree the goals of your stay and how best to work towards them. We will also discuss the treatments which are known to have the best effects in supporting your recovery. From this we will develop your personal care plan which will detail what needs to happen and who will do what.

One to one sessions

These are meetings you have with your named nurse/key worker or maybe another professional. You may discuss a range of things such as your progress, concerns, making plans for the future or developing a Wellness Recovery Action Plan (WRAP). Sometimes you will meet one to one with professionals like occupational therapist or psychologists for specific therapy sessions. All this will be agreed with you and written down in your care plan so everyone including yourself knows what the aims of these sessions are.

Making sure we are helping you make progress

We do this by holding regular reviews with you, your family, friends and carers and the care team working with you.

Ward reviews

Ward reviews are held regularly, this varies depending on ward and is an opportunity for the team to review aspects of your care. This may include observation levels, leave arrangements, medication, risk assessment and any of you and your carers requests.  This is to ensure that your care and treatment is reviewed regularly, and you and your family, friends or carers are kept up to date with your care and treatment plans.

72 hour meeting

Staff will meet within 72 hours of your admission to discuss your care and treatment plans, where possible, you will be invited to contribute to this meeting. This will be after they have met with you and your family/carers and will feedback all hopes and expectations you have to form part of your recovery plan. After the meeting, a member of the team will feedback the outcomes and discuss them with you.

Care plan reviews

Usually yourself and named nurse/key worker meet to look at how things are going with your recovery and the plans to make that happen. You may focus on just one or two plans or all of the plans with the aim of being clear what actions everyone needs to take. These will be at least monthly and may be more often.

Care review

These happen every 3-6 months and usually involve you, your doctor, your key worker, family/carer and your named nurse/key worker. Sometimes if you are working with an occupational therapist or psychologist they will attend too. The point of the meeting is to look at the bigger picture, checking you are making progress and planning the bits of work which need to happen in the next couple of months including planning your discharge. You can also request a care review at any time.

Meet your consultant

You will meet with your consultant regularly through your stay.

Measures and questionnaires

We sometimes use questionnaires to monitor your improvement and also how satisfied you are with the service you are receiving.

Throughout your stay there will be opportunities for you to be involved in discussions about your care. Your wishes will be carefully listened to, and treatment decisions should have your agreement.

All leave is arranged individually for all patients on the ward, and you should understand how this affects you.

Informal and voluntary patients – have the right to leave the ward at any time. However, we may ask (depending on your personal care plan) that you stay on the ward for the first few days so you and staff can get to know each other.

If you would like to go on day leave or overnight leave, you can discuss this with your doctor or carer. Please be aware that staff have a duty of care towards you and are expected to know where you are at all times. Staff are required to assess you before you leave the ward. The outcome of this assessment will be discussed with you (and your carer where appropriate) and may result in you not being allowed to leave the ward.

Detained patients – are required to stay in hospital unless you have permission to leave from your responsible clinician (called ‘Section 17 leave’).

The Trust produces a booklet about your rights as an informal/voluntary patient, copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

However, there may be times when this is not possible. If you are ‘sectioned’ under the Mental Health Act staff may have the power to prevent you from leaving the ward or to insist that you take medication. Such decisions will only be made in your best interest, when staff believe you are at serious risk.

Staff are committed to putting you at the centre of your care, ensuring that you have options and control over the things that matter to you and make you who you are. This can range from things such as food choices to your treatment plan where possible. We will always try to involve you and your family/carers where possible and want to help you develop your strengths to live a fulfilling life.

Family, partners and friends play an essential role in supporting people accessing our services; they are known as carers. A carer is someone who looks after another person, usually a family member or friend, who could not manage without their support due to illness, disability, mental health problems or an addiction.

Caring for someone could include helping with:

• Cooking
• Phone Calls
• Personal care
• Attending appointments
• Emotional support
• Medication

We will work in partnership to involve carers, not just because we have a statutory duty to do so, but because we want to and appreciate knowledge and experience that a carer has.  This can benefit and improve the care we give. We understand that carers play a critical role and without their support, we would not be able to deliver the hope, treatment and care that we always aim to do.

We recognise that, on occasions, carers will also need support for themselves.

Carers will be:

• offered a Carer Card which will enable staff to recognise you in your role as a carer. A member of staff can provide further information.
• asked how you want to be involved in the care of the  person you care for and what practical measures can be put in place to support this.
• given the opportunity to discuss any difficulties you are experiencing in your caring role, with staff.

A useful range of carer resources are available at www.cntw.nhs.uk/carers

Visitors

You can have visits from anyone who matters to you, and you would like to see. There is no time limit on visits, and they can happen Monday – Sunday, either in the visitors room or off the ward depending on your leave. Family and friends can bring things in for you, but these belongings will need to be checked before you take them to your room so we can keep you safe. We ask that visitors ring the ward in advance so we can make sure your visit isn’t disturbed by any other meetings or appointments and to book out the visitors room for you.

Protected mealtimes

Arrangements are in place so you can enjoy your meal without any interruptions, i.e. no meetings.

Your family/carers play a very important role in your recovery. We will work with them to provide the information and support they need to support you.
At the first opportunity a member of staff will meet with your main family/carers to get to know them. Staff will provide them with a copy of the Carer Promise and information about their caring role, and what needs they may have to carry out this role.

We will inform family/carers of local services, so that family/carers can receive their own support and advice. We can also provide them with a range of useful carers leaflets.

There may be things that you do not want to share. You should discuss these first with your care team so that you can understand the impact this might have on your relationship with your family/carers. Usually, we would recommend that your family/carers are fully involved and informed in your care.

Advance decisions are about making choices about your healthcare while you are well. In mental health, this means that your wishes can be taken into account if you ever become mentally incapable of making informed choices during a crisis.

An advance decision can be spoken or written down and should be reviewed regularly.

The Trust produces an Advance Decisions and Statements booklet. Copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

If you are detained under the Mental Health Act, there may be circumstances where you are given treatment that you have previously stated you do not want. This decision will only be taken if your refusal would have a severe impact on your treatment.

If you would like information leaflets about your medicines ask your named nurse.   You can keep them at the back of this Welcome Guide.

Pharmacy Medicines Information Helpline

The Trust has a helpline for confidential advice about medication. You and your carer can call the helpline between 9am and 4pm, Mon-Fri.

The helpline number is 0191 245 6604.

The Trust produces a booklet about how patients can request a change of consultant or second opinion.  This leaflet is available from staff or the Patient Information Centre 0191 246 7288.

Mental Health Act 1983

You may be kept in hospital even if you want to go home, this is sometimes called ‘sectioned’ or ‘detained’. You will always be given an explanation and written information should this happen, so you understand what your rights are. Sometimes this could mean we give you medication for mental disorder without your consent.  However, we will always include you in decision making about your care and treatment.

Factsheets on each section of the Mental Health Act are available on the wards – please ask a member of staff for a copy relevant to your circumstances.  Copies are also available on the Trust website www.cntw.nhs.uk

Mental Capacity Act 2005

Sometimes people are so unwell that they are unable to make some decisions for themselves; this is called ‘lacking capacity’. We will always assume you have the mental capacity to make decisions unless an assessment has been carried out to establish that you have not got capacity. Where people ‘lack capacity’ we will always act in their best interests.

Informal/voluntary patients  

An informal/voluntary patient is someone who has agreed to come into hospital. This means they have the right to leave the ward at any time although we do ask that patients stay on the ward for the first few days so that patients and staff can get to know each other. Please be aware that staff have a duty of care towards patients, and the staff are expected to know where they are at all times. Staff are also required to assess patients before they leave the ward. If staff have concerns about the patient leaving the ward, they must arrange a further assessment. The outcome of this assessment will be discussed with the patient (and carer where appropriate) and may result in patients not being allowed to leave the ward. The Trust produces a booklet about your rights as an informal/voluntary patient, copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

Locked doors

Please be aware that it is normal for most of the exit doors in our inpatient areas to be locked. This is for patient’s security and safety. Patients should always know how and if they can leave the ward and peoples individual circumstances can differ greatly. If patients are unsure about how and if they can leave the ward they should always ask staff to give them information about this.

The Trust works from more than 70 sites across Cumbria, Northumberland, Newcastle, North Tyneside, Gateshead, South Tyneside and Sunderland. We also run a number of regional and national specialist services. Along with partners, we deliver support to people in their own homes, and from community and hospital-based premises.

We have around 9,000 people working for us and a budget of over £537 million

The services we provide are divided into three care groups, these are known as Inpatient, Community and Specialist.

Can you tell me about my ward?

Staff will provide you with a patient information leaflet about your specific ward.

There are likely to be many practical things to consider while you are in hospital.  Your named nurse and other ward staff can help you.

For example, you may need to:

• Make arrangements for the care of your children or others
• Get somebody to take care of your pets
• Get a change of clothing
• Pay urgent or outstanding bills
• Cancel/rearrange appointments
• Contact employers
• Disconnect gas and electricity
• Notify the benefits office

Staff on the ward can help you with any financial concerns while you are in hospital. For example, they can complete an inpatient medical certificate to verify your inability to work, or write letters on your behalf to resolve financial issues. Staff will also help you to understand your benefit entitlements.

A few frequently asked questions are answered below:

Will being in hospital affect my benefits?

This depends upon what type of benefits you were receiving before your admission.  If you were claiming benefits prior to your admission your benefits may change slightly.  Some

benefits can be affected by a hospital admission so it is important that the Department for Work and Pensions (DWP) is informed, staff on the ward can help you to contact them. If you were transferred from prison, staff will assist you to claim for any new benefits that you might be entitled to.

Where can I get help to sort out my benefits?

Staff will refer you to Patients Finance if you need any advice or support on benefits.  You can also get advice from the Citizens Advice Bureau. Please go to www.citizensadvice.org.uk and enter your postcode to find your local bureau.

What happens when I leave hospital?

This depends on your individual circumstances. In most cases if your money was reduced while you were in hospital it should revert to the full amount when you are discharged. The DWP need to be informed of your discharge to make these calculations.

If you are granted overnight or hostel leave you are eligible to full entitlement for those dates.

The Trust produces a booklet about Patients Finance. This leaflet is available from staff or the Patient Information Centre 0191 246 7288.

The following information will tell you a little about life on the ward.

Meetings

Meetings take place on a regular basis. In these meetings you will be able to discuss your needs and progress with your Consultant and other team members. You can invite your family and friends to attend if you wish.

Mutual help meetings

Take place on a regular basis. They give you an opportunity to meet with staff and other patients to discuss and resolve issues on the ward.

Housekeeping

Keeps the ward clean and tidy, a housekeeping service is provided within all inpatient areas every day. There may also be a washing machine for you to do your own laundry.

Meals

Your meals will be provided on the ward. You will be offered a menu and you choose your meals in advance.  Drinks are available 24 hours a day. On some wards you will be encouraged to prepare your own meals.  If you have special dietary needs or cultural needs please discuss these with your named nurse.

Toilets and bathrooms

The ward has toilets, showers and baths for you to use as you need.

Garden

All wards have access to a garden, which you will be able to use throughout the day.

Chill out room

Most wards have a chill out room which is a place for relaxation.  It offers comfortable seating, soft lighting, music and other soothing experiences.  Finding out what is most soothing for you can be helpful whilst you are in hospital and also when you are at home.   You can use the chill out room for relaxation and enjoyment.  It is also a good option to try if you are feeling worried, restless, anxious, angry or agitated as the experience can help you feel calm, think more clearly and focus on what you need to do.

You can speak to any member of staff about using the chill out room and they will show you what is available and work with you on an individual room plan.

Telephones and WIFI

There is a payphone on each ward that can be used to make personal calls. You can also use your own mobile phone or ask a member of staff to support you in making a call. Your family, friends and carers can also use these numbers to make calls to you. Free WiFi is available throughout all Trust sites.

A multi-disciplinary team approach is taken to your care on the ward. This means that there are many different people available to help you. Staff wear uniforms, there is a uniform poster on the ward, this will tell you what colour uniforms are worn by particular staff.

Staff include:

Nursing

• Associated Nurse – will be allocated to you as well as your named nurse/key worker, they will support the Named Nurse/Key Worker in delivering your care. Associate nurses are usually support workers.
• Clinical Lead – this is a senior clinical nurse, providing clinical leadership on the ward.
• Named Nurse/Key worker – is responsible for co-ordinating your nursing care while you are on the ward. They will be introduced soon after your admission and will be your key point of contact during your stay. All named nurses/key workers are staff nurses.
• Nurse Consultant – Nurse Consultants are practicing clinicians. They will see you on a regular basis to review your care and treatment and attend meetings including Daily reviews/MDT’s/72 hour /discharge and any other relevant clinical meetings that you will be involved with.
• Nurse in Charge – this is the nurse who is in charge of a shift and is responsible for ensuring the smooth running of the ward.
• Staff Nurse – a qualified nurse who is a Registered Mental Health Nurse. They deliver the nursing care and also psychosocial interventions to help you recover.
• Support Worker, Nursing Assistant, Health Care Assistant – supports the nursing staff in caring for you.
• Ward Manager – the ward manager is a nurse, is responsible for your care and provides both managerial and clinical leadership to all staff on the ward.

Medical

• Consultant Psychiatrists – are the most senior doctors in the hospital, with overall responsibility for your care. They lead on important decisions about your treatment and discharge. You will be introduced to your Consultant within 72 hours of admission and continue to meet regularly.
• Higher trainees – are experienced psychiatrists who are working towards becoming consultants.
• Pharmacy staff – the pharmacy team ensures that you receive your medication in a safe and effective manner whilst you are on the ward. The team can offer advice on medicines and any side If you would like to speak to a member of the pharmacy team whilst on the ward, ask one of the nursing staff who will let the team know.
• Ward doctors – are training to become psychiatrists or GPs. They will be available to you on a regular basis with regard to your physical and mental health and your care plan.

The wider multi-disciplinary team

• Activities workers – support nurses and occupational therapists in supporting you to participate in the therapeutic activity helpful to your recovery. A programme of activities will be displayed on the ward.
• Dieticians – are experts in food and nutrition. They provide dietary advice on a wide variety of conditions using the most up to date information. They help promote healthy eating habits and well-balanced diets based on individual needs.
• Exercise Therapists – devise specific therapeutic exercise programmes depending on your aims and objectives.  The exercise therapy department provides a weekly programme of exercise groups which are both hospital and community based.  They can also help you to make positive lifestyle changes e.g. healthy eating, stopping smoking.
• Occupational Therapists (OTs) – use activity to help to develop skills needed in recovery which include shopping, cooking, looking for work etc. This may be on a group or individual basis.
• Peer support workers – these are people who like you, who have been through similar experiences with their mental health so understand how difficult things might be. They are able to share things that have helped them overcome within their recovery, such as skills, WRAP plans, and the importance of time, connection and communication. They are someone who truly ‘gets it’ as they’ve been there themselves and are happy to share their experiences with you. Peer Supporters help spark joy again, they hold the hope for you and help you find meaningful activities, goals and ambitions to work towards.

‘When I was first admitted, I felt scared, angry and confused and it felt hard to know who I could trust or talk to. Getting to know the staff in one-to-ones and groups helped me come out of my shell. Having a Peer Supporter on the ward was really helpful as they helped advocate for me and made me realise that I’m not the only one who struggles and that things can get better. They helped me realise I am more than my illness; they saw me for who I am and believed in me.”

• Psychology staff – include Clinical Psychologists, Psychological Therapists, Art Psychotherapists and Assistant Psychologists. Psychology helps people understand and cope better with lots of different issues, such as:
  – Difficulties managing emotions
  – Feeling depressed or low in mood
  – Feeling anxious or experiencing panic attacks
  – Hearing voices or having unusual experiences
  – Experiencing distressing or traumatic events
  – Self harm or suicidal thoughts
  – Managing Anger
  – Difficulties in relationships with other people.

We can help you think about problems you have and talk about things that might help.

• Physiotherapists – work with you to help restore movement.  They provide any necessary physiotherapy assessment and treatment.
• Speech and Language Therapists – assess and treat speech, language and communication problems in people of all ages to help them better communicate. They also work with people who have eating and swallowing problems.

Other staff

• House Keeper/Domestic staff – undertakes housekeeping duties, serves and orders meals, assists with laundry, keeps the ward tidy and clean.
• Service Assistant – will ensure that there is a high level of cleanliness maintained on the ward.
• Students – the Trust supports the teaching of students from various professions. From time to time you may be asked whether a student can be present or deliver part of your care. Your verbal consent will be sought and you have the right to refuse. All students are supervised by a qualified member of staff.
• Ward Clerk/Ward Administrator – provides administration support and assists in the smooth running of the ward.

You might hear the following words and phrases when you are in hospital.

Care Plan – this is a way of recording the help and support you need and explains how this will be done.

Engagement and Observation – this is an important tool nurses use which helps us to get to know you and to help us maintain your safety whilst you are in hospital. You will always be fully informed if you are being observed and given the reasons why.

Key Worker – is a named person who will support you to help identify your needs, who may help support you and your family (if appropriate) and with you, will connect the various interventions to help with your mental health experiences. The keyworker will usually be someone who is trusted by you, and you are able to connect with. They may also help connect other supporters including other Health, Social care and Voluntary sector services to ensure your care is based on your needs and is helpful to you going forward. The key worker will also be a point of contact for you.

Multidisciplinary Team Meeting (MDT) or Ward Reviews – this is when all of the professionals involved in your care meet to discuss your progress with you, and your carers if appropriate. This meeting takes place on the ward.

Patient Advice and Liaison Service (PALS) – Provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care. Ask a member of staff for your local PALS telephone number or find details online at www.cntw.nhs.uk/contact/patient-advice-service/

RiO – This is the system that the Trust uses to securely store electronic patient records.  For further information see the section on ‘Information the Trust keeps about you’.

Wellness Recovery Action Plan (WRAP) – is a structured system for monitoring and managing your mental health through planned responses that work for you.  It also informs services and carers on how to respond should you find it difficult to make decisions for yourself should you become unwell.

Your care in hospital will comprise of a number of different treatments.  The main treatments on offer are outlined here.

Medication

Your doctor may prescribe medication to help treat your illness. A ward doctor can usually answer any questions you have about your medication or how it works.

On all wards a pharmacist will be available to assist with concerns or queries.

There are also many leaflets available with detailed information about individual medications. Staff on the ward will be able to supply these, you can keep them at the back of this Welcome Guide.

Pharmacy Medicines Information Helpline

The Trust has a helpline for confidential advice about medication. You and your carer can call the helpline between 9am and 4pm.  The helpline number is 0191 245 6604.

Physical Health

Your physical health is very important. We will regularly assess your physical health needs and work with your GP to provide you with appropriate advice and treatments.

Occupational Therapy

The main aim of occupational therapy is to assist your recovery by encouraging you to take part in activities that have meaning and value for you.

During your stay in hospital, Occupational Therapists (OTs) will look at your strengths and needs. An individual treatment programme will be developed and reviewed with you, which may be a mixture of one-to-one sessions and group activities. These take place in the hospital setting, Occupational Therapy department or community venues.

The following list gives examples of some of the activities that are available:

• Daily living skills to develop or improve your skills in areas like cooking, shopping, budgeting and other day-to-day activities.
• Health promotion with advice on different areas such as healthy eating, exercise and stress management.
• Work, training and/or education to help you develop the skills and confidence to take part in paid or unpaid work, courses or training that you may be interested in.
• Leisure activities such as pursuing a hobby or sport that builds on your self-esteem, social networks and gives enjoyment.
• Relating to yourself and others to improve your confidence and self-esteem and help you to develop coping strategies.
• Activities that encourage you to be a part of your local community and help you build links with other people in the area.

Availability of these activities does vary slightly from area to area; the current programme for your ward will be displayed on the wall.

Arts Therapies

The arts therapies are made up of art therapy, music therapy, drama therapy and dance movement therapy. They offer a creative way of communicating to those who, for whatever reason, find that words alone are not enough.

The aim of the arts therapies is to enable service users to experience him/herself differently and develop new ways of relating to others. They can give meaning to a person’s experience, creating an opportunity for change and recovery.

Exercise Therapy

The main aim of exercise therapy is to provide exercise as a therapeutic activity to improve your mental and/or physical health which can contribute to your overall recovery.

You will receive an assessment with the exercise therapist and based on your goals an individual exercise plan will be developed.  You will have the opportunity to take part in a variety of exercise groups including gym, cycling, walking, circuit training, healthy eating and weight management. You will receive regular progress reviews to monitor your progress and help achieve your goals.  Where possible you will receive support to continue with your exercise plan after discharge from the ward.

Individual sessions

Assessment

Psychology staff may meet with you to conduct further assessments around your difficulties and to help determine what support may be helpful both in hospital and in the community.

Formulation

Formulation can be used to improve your understanding of your strengths and difficulties and to help break your problems down into different parts.

Understanding what influences your mental health and wellbeing (5Ps) booklet is available from staff or online at www.cntw.nhs.uk/resource-library/understanding-influences-mental-health-wellbeing/

Therapy or skills-based sessions
Depending on your needs, psychological services may offer therapy or skills-based session during your inpatient stay or may make suggestions about what could be helpful for you in the community.

Psycho-education groups
On some wards psychological services help to run groups.  Groups can help you to learn new skills or coping strategies to help manage your feelings.

You can ask nursing staff or activity workers about the groups running on the ward.

Family Meetings
Working with you and your family can be an important part of your recovery.  Psychological services can meet with your family and help you communicate with them.

Supporting staff
Psychological services work closely with the ward staff to help support you, this may include attending meetings about your care or supporting with developing care plans informed by psychological approaches.

If you have religious or cultural needs the staff will help to support you.  This could include needing a different diet or dressing differently. You can talk to a chaplain if you would like to.  Staff can support you to access a team of chaplains from different faith communities who are available to visit you throughout the week, including weekends.

The Trust produces a leaflet about ‘Chaplaincy – Spiritual, Pastoral and Religious Care’. Copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

If you need an interpreter for your visit, please let the ward team know so they can arrange this for you.

Our Trust is smokefree

All of our Trust sites are now completely smokefree which means that you and your visitors are not allowed to smoke anywhere on our sites. This means both indoors and on our Trust grounds.  This is part of our approach to support service users and staff to achieve a healthy lifestyle and reduce the harmful effects of smoking.

Smoking materials are prohibited items

Smoking materials are prohibited items on Trust sites. If you come into hospital with tobacco products, cigarettes, lighters or matches, they will need to be given to staff. Cigarettes and tobacco products will be returned to you on discharge from the ward on request, lighters and matches will be destroyed.

Alternatively, they can be given to a family member or carer to take home with them.

Tobacco products, cigarettes, lighters or matches will not be given back to you for any periods of leave from the ward.

Visitors are asked not to bring any cigarettes or tobacco products (including lighters) on to the ward.

Smoking on Trust sites

Smoking anywhere on Trust sites is not permitted and is a breach of the law (the Smoke Free Regulations) to smoke inside any building which may result in a fine of up to £200.

Helping us to maintain this policy protects other service users, staff and the care environment.

Support to stay smokefree during your admission

On admission if you smoke you will be seen by a member of the Tobacco Dependency Treatment service who will talk to you and offer you support to be smokefree while you are in hospital. You will be offered nicotine replacement products such as patches, inhalators and lozenges on admission to keep you comfortable and help with nicotine withdrawal and cravings to smoke. You may also be offered an E-cigarette (vape).

Your advisor will discuss with you a variety of options that they are able to support you with to be smokefree, they will listen to you and offer advice on the best option for you. They may be able to offer you alternative nicotine replacement therapy or medication and recommend the best treatment option for you.  This will also be discussed with your doctor as the dose of some of your medications may need to change (this may result in taking less medication).

Vaping/E-cigarettes

Provided you are 18 years old or over:

‘Vaping’ (use of an electronic cigarette/e-cig) is permitted by service users on Trust sites in outdoor areas, including ward gardens/courtyards (if available).

An e-cigarette can be supplied on admission if you wish to use one as an alternative to cigarettes.  Some of the cafes and shops on Trust sites sell replacement cartridges.

You may also use your own e-cigarette, however staff will need to do a brief check of your device and charger to make sure they are safe.

Some services may have restrictions on e-cigarettes for safety reasons.

Why does the Trust keep information about me?

The Trust needs to keep information about you, your health and treatment so that we can provide the best possible care for you.

We may also use your information for a number of different purposes including:

• Administration and management of healthcare services (such as maintaining records, receiving professional advice)
• Service improvement, evaluation and audit (in order to improve the healthcare services that the Trust and others provide, and to protect and improve the health of the public)
• Communicating with you and resolving any queries or complaints that you might have. Communicating with any other individual that you ask us to update about your care.
• Complying with our legal and regulatory requirements
• Clinical research and development
• Safeguarding purposes (for example, in order to ensure the health and safety of an individual)

Is the information kept confidential?

Everyone who works in the Trust and within the wider NHS must keep information about you confidential. All Trust staff, have agreed to a confidentiality statement within their contract of employment which enforces the need to protect and only access the information which is required for the purpose of their role.

We do share information within the team that is caring for you, and sometimes with other professionals in other organisations that are providing care for you, like Social Services.

From time to time, we may share your personal information with others. We will keep your personal information confidential and only share it for the purposes above.

If we do share information with other organisations, we would normally talk to you about it first and ask for your permission.  On very rare occasions we may also share information with other organisations because we feel that there would be a serious risk to you or to other people if we did not do so, or because there is a legal obligation, such as a court order, that means we have to disclose information.

What sort of information do you keep?

We keep information both on paper and electronically. The kinds of details that we keep include:

• Basic information about you, such as your name, date of birth, address, next of kin
• Records of your contacts with professionals, such as clinic visits
• Notes and reports on your health and any treatment or care that you need
• Records of any tests or assessments that we carry out
• Records of the treatment and care that we provide for you
• Relevant information from other health professionals, members of your family or friends who care for you and know you well

Can I see what information you have about me?

You have the right, under the Data Protection Act 1998, to obtain a copy of the information we hold about you. If you want to do this, you should write to:

Disclosure Team

Information Governance Department                                                                                                                                St Nicholas Hospital                                                                                                                                                          Jubilee Road                                                                                                                                                                    Gosforth                                                                                                                                                                            Newcastle upon Tyne                                                                                                                                                       NE3 3XT

[email protected]

How can I find more about the information the Trust keeps about me?

You can find further details about the information the Trust keeps about you and the processing purposes in the Trust’s Privacy Notice available via the Trust website www.cntw.nhs.uk/foi/data-protection/

If you have any concerns about the way the Trust is using or sharing your information, you can speak to your clinical team or the Data Protection Officer in the first instance.

The following safety systems are in place for your safety and security.  If you have any questions please speak to a member of the healthcare team who will be able to provide you with more information.

Body worn video

A body worn camera is a small video-camera device that can be attached to a member of staffs clothing. When the camera is turned on by staff, it will provide audio and video recordings.

If you have any concerns about your safety you can ask staff to turn on the camera. You can ask the nurse in charge for access to any recordings made, to be shared with you about your care.

Closed Circuit television (CCTV)

CCTV operates in all public spaces of hospital sites and in-patient wards. There are signs that inform everyone which areas are covered by CCTV. Recordings are stored for 30 days.

You can ask the nurse in charge for access to any recordings made, in relation to your care.

Metal Detectors

Metal detectors are used as part of search processes. This is to improve the quality and safety of care across in-patient services and prevent restricted items from entering the ward.

The clinical team will let you and your carers know what is and isn’t allowed to be brought onto the ward.

If you have any questions about safety systems, please email [email protected]

Fire safety

All Trust hospital premises are provided with automatic fire and smoke detectors which are installed for your safety.

If you hear the fire alarm, ward staff will direct you to a safe location away from the fire and away from danger.  Please follow staff instructions and please try to stay calm.

The staff will silence the fire alarm when it is safe to do so.

Infection control

Please speak to a member of staff or the infection control nurse if you have any concerns about the cleanliness of the hospital.

Narcotics search dogs

The Trust has narcotics search dogs and handlers who make both planned and unannounced visits to wards and departments.  The search dogs are trained to locate illegal substances such as cannabis, cocaine, amphetamine, ecstasy and heroin.

Oxevision

Oxevision (also sometimes known as Oxehealth) is an assistive tool for staff.

It provides three main functions:

1. Measuring vital signs (not constant monitoring)
2. Alerts to activity in room
3. Reports on risk factors

Oxevision is an assistive tool and does not replace human interaction or personal care.

It is important to note that Oxevision only measures a patient’s vital signs when a member of staff interacts with the system and prompts it to take vital signs. Oxevision will not provide an automatic alert if a patient’s heart or breathing stops.

The system will measure vital signs when staff take an observation, but will not constantly monitor them.

The Trust produces an ‘Oxevision – patient information leaflet’. Copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

Safety and restraint

The most effective care is provided in a safe environment. If a person acts in a way that compromises safety on the ward, staff will take action to reduce the risk to all concerned.

In most situations staff will try to resolve such issues through discussion. They will work with the individual to deal with any problems and may suggest moving to a quieter area.

There may be occasions when a more urgent response is needed, which can involve staff using physical restraint skills.  However, these techniques are only used when there is an immediate danger of violence towards yourself or others.

Physical restraint is only ever carried out by staff who have received training in how to use these skills safely. It is intended to allow for safe management of harmful situations and to make the environment safe as quickly as possible. Dignity should be maintained throughout any restraint procedure.

If you see anything that you think could pose a risk to yourself or others, you should report this to a member of staff immediately.  Staff can help to reduce the risk and discuss any concerns you might have.

If you want to make a comment, suggestion, compliment or complaint you can:

• talk to the people directly involved in your care
• ask a member of staff for a feedback form, or complete a form on the Trust website cntw.nhs.uk/contact/complaints/
• telephone the Complaints Department Tel: 0191 245 6672
• email [email protected] Please note that information sent to the Trust via email is sent at your own risk

We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention.

You can provide feedback in the following ways:

– the quickest way for you to do this is to complete our short online survey at www.cntw.nhs.uk/yourvoice

– complete a Your Voice survey, available on wards, reception areas or from staff

– other options for sharing your feedback and experience www.cntw.nhs.uk/yourfeedback

Patient Advice and Liaison Service (PALS)

PALS provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care.

We act independently when handling patient and family concerns, liaising with staff, managers and, where appropriate, relevant organisations, to negotiate prompt solutions. If necessary, we can also refer patients and families to specific local or national-based support agencies.

North of Tyne                                                                                                                                                          Tel: 0800 032 0202                                                                                                                                                          Email: [email protected]                                                                                                                                                  Post: FREEPOST PALS

South of Tyne                                                                                                                                                            Tel: 0800 328 4397                                                                                                                                                              Text: 07825 061 035                                                                                                                                                         Email: [email protected]

Post: Patient Advice and Liaison Service, Garden Lodge, Hopewood Park, Ryhope, Sunderland, SR2 0NB

9.00 am – 4.30 pm, Monday to Friday

An answerphone is available at all times for you to leave a message. A member of the PALS team will aim to return your call as soon as possible.

Patient Advice and Liaison Service (PALS)

Provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care. Ask a member of staff for your local PALS telephone number or find details online at www.cntw.nhs.uk/contact/patient-advice-service/

Independent advocacy

You are entitled to the support of an independent advocacy service to help you understand and speak up for your rights while you are in hospital.  Advocates provide an unbiased service and will work with you to understand your rights, your medication and treatment options and discharge plans.  They can also support you to take part in meetings, tribunals and appeals.

If you have been admitted to hospital under a section of the Mental Health Act, you can ask for an Independent Mental Health Advocate (IMHA) by contacting the service that covers the area where you live. This right extends to you if you are subject to a Community Treatment Order (CTO) or guardianship.

Even if you are in hospital as an informal or voluntary patient, you might still be entitled to advocate support. Feel free to approach hospital staff members to learn more about the advocacy services available in your area, including advocacy under the Care Act.

Hospital staff can also give you the contact information to connect to the right advocacy service or help you with a referral.  You can also find information online at www.cntw.nhs.uk/resource-library/do-you-need-an-independent-mental-health-advocate/

The Trust produces a booklet ‘Independent Mental Health Advocacy. Copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

Care Quality Commission (CQC)

The CQC is the independent regulator of all health and social care services in England.  It checks all hospitals in England to ensure they are meeting government standards of quality and safety. www.cqc.org.uk/public

Leaving hospital is an important life event; it’s a sign that you are making progress with your recovery.  It can be an exciting time and also for some people it may feel daunting. During this time, it is essential that you receive good quality support and care. Planning around your move on will start soon after your arrival on the ward and will be part of all care planning processes. Carers will be involved in the planning of any move on from the ward.

“I’m very grateful to everyone on the ward for the help they gave me. I’m pleased to be living back in my house and I am still being supported by staff to get out into the community and to do things I haven’t been able to do for a long time ”

Your move on will be a planned process involving you and the care team. Extra support will be available for you during this time to make your move on as successful as possible.

The following suggestions are things you will need to consider when planning your move on from the ward:

• Having the right accommodation to meet your needs.
• Having your finances in place.
• Having a GP (family doctor).
• Having a good understanding of your medication, where and how you will receive it.
• Having the skills you need to look after yourself.
• Understanding the future support and care you will receive.
• Having a Wellness Recovery Action Plan (WRAP) or Staying Well Plan in place.
• Informing your family, friends or carers so they know when you will be leaving hospital and where you are living.
• Knowing how you will spend your time i.e. interests, hobbies, activity and work
• Knowing how and where to get help when you need it.
• Any conditions attached to your discharge i.e. Community Treatment Order. A Community Treatment Order (CTO) – A CTO is a power given to your consultant under the Mental Health Act to place certain conditions on you which you must follow when you have left the hospital. It is meant to ensure that you receive the right treatment once you have left the hospital and it means you have to keep in touch regularly with your mental health team.

Staff on the ward will be able to help you with concerns you might have about these or any other issues and provide you with contact details of the crisis team.

My care team on discharge are:

Key worker 

Consultant 

Community Psychiatric Nurse (CPN) 

Support Worker 

Occupational Therapist 

Social Worker

Other

A care review is a way of planning and co-ordinating your care after you leave hospital.  It helps make sure that you are supported in a way that fits your individual health and care needs. A care review includes:

• Assessing your needs with you
• Developing a plan in response to the needs identified and agreed
• Sharing responsibility with you (and others as needed) to put the plan into action
• Reviewing the plan with you to check that it is meeting your needs and to agree any changes

What is meant by care review?

A care review describes the process of how mental health services assess your needs, plan ways to meet them and check that they are being met. You should always feel able to ask mental health workers to explain this process clearly to you.

Who will be my key worker?

Your key worker will usually be a nurse, social worker or occupational therapist. Ideally, they should be the person who knows you best and with whom you feel most comfortable to talk with. You should always be informed of the name and contact details of your key worker.

What does a care plan look like?

A care plan is usually a detailed form which states your needs, the range of services

required and who will provide these services. It might include things like your medication, your support at home and finance or other personal needs. The process of a care review is also about recognising what you are able to do and what you want to do (your strengths). A copy of the care plan will be given to you to keep.

What does a care review look like?

A care review is not all about complicated forms and meetings; it is about discussing and writing down your needs and checking they are being met. Reviews should recognise any progress that has been made and involve discussion of all elements of your care plan.

How do I call a review?

You (or your carer) and anyone providing services can call a review. If you feel that a review is needed, you should contact your key worker who will assist you with making the arrangements. A review should be flexible about where and when it happens and who attends – you might like to invite a family member or friend who supports you.

The Trust produces an information leaflet, copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

People can have setbacks.  On leaving hospital you will have a Wellness Recovery Action Plan (WRAP) in place that was developed with you.  This plan will identify any early signs that you are aware of that may mean you are becoming unwell and what you and your care team should do to prevent you becoming more unwell.  You will also have a plan in place should you become unwell.

If you, or someone you know, are in a mental health crisis, you can now call NHS 111 and select option 2 for urgent mental health support.  NHS 111 is available 24/7, every day.

If you are D/deaf or have hearing loss, you can contact NHS 111 using

https://signvideo.co.uk/nhs111/ or the 18001 111 Relay UK app.

If you or another person have been harmed or are at immediate risk you may require an emergency response, contact 999 and ask for the relevant service.

Recovery Colleges
A safe place where people can connect, gain knowledge and develop skills that support recovery from mental health problems. Courses are open to anyone who would find them helpful in their recovery from mental illness, substance misuse, trauma or distress. To find out more information visit www.cntw.nhs.uk/recovery

Mind Infoline
Tel: 0300 123 3393
Welfare benefits line Tel: 0300 222 5782

www.mind.org.uk
Email: [email protected]
2 Redman Place, London, E20 1JQ
Provides information on a range of topics including types of mental distress, where to get help, drug and alternative treatments and advocacy. Also provides details of help and support for people in their own area. Helpline available Mon-Fri, 9am-6pm.

Rethink
Helpline: 0808 801 0525
www.rethink.org
Rethink, PO BOX 18252, Solihull, B91 9BA
Provides information and a helpline for anyone affected by mental health problems. Helpline available Mon-Fri, 10am-2pm

Samaritans
Tel: 116 123
www.samaritans.org
Email: [email protected]
Freepost, SAMARITANS LETTERS
Provides confidential support for anyone in a crisis.

SANELine
Tel: 0300 304 7000
www.sane.org.uk
Email: [email protected]
SANE, St Marks Studios, 14 Chillingworth Road, Islington, N7 8QJ
Offers practical information, crisis care and emotional support. Helpline available 4pm10pm every day of the year.

Patient Information Centre – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust                                                                                                                                                                      Provides a range of health information covering conditions, treatments, medication, health promotion and self help guides.  www.cntw.nhs.uk or Tel: 0191 246 7288.

NHS Website www.nhs.uk  Information about conditions, treatments, local services and healthy lives.

Foundation Trust Membership

As a member of our NHS Foundation Trust, you can be as active a member as you would like, from just receiving regular information about the Trust to getting involved in issues that you care about.  The choice is yours!

To become a member, all you need to do is complete a membership application form or join online at www.cntw.nhs.uk/about/membership.  Membership is free and members can also benefit from discounts for many shops and services.

Patient and carer Involvement

The Trust values the involvement of service users, their carers and their families in making decisions about your care, and recognises this can lead to better outcomes and a better overall experience. Therefore, imagine the benefits and value that your contributions could make in the design, delivery and evaluation of our services.

The Patient and Carer Involvement Team co-ordinate and facilitate service user and carer involvement, in specific short-term activities and projects, to ensure their needs are represented and reflected at the heart of everything we do.  We have set up an Involvement Bank to help us do this work.

There are three levels to involvement which are:

Individual level – Ensuring you and the people who support you are at the centre of every aspect of care from assessment, through treatment to leaving a service. Increasing your control for recovery and wellbeing with a voice that is heard.

Ongoing development of services – Opportunities to be involved in forums, saying what’s working well and why, i.e. being part of ward and community meetings, sharing an understanding and awareness of what your personal experience has been and how this can help improve services.

In service change and service improvement – This is a more strategic level looking at service change such as transformation projects, commissioning of services, and service redesign.

Getting involved is easy, and how much you get involved is up to you.  If you are interested in influencing how we work, the Guide to Involvement and the Involvement Bank registration form are available in hardcopy or online at: www.cntw.nhs.uk/services/patient-and-carer-involvement.

If you would like more information or support with registering, the Patient and Carer Involvement Team would love to hear from you:

Tel: 01670 501 816

Email: [email protected]

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Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this guide, please get in touch.

This information can be made available in a range of formats on request (e.g. Braille, audio, larger print, BSL, easy read or other languages). Please contact the Patient Information Centre Tel: 0191 246 7288

Published by the Patient Information Centre

2024 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Ref, PIC/694/0724 July 2024 V7

www.cntw.nhs.uk    Tel: 0191 246 7288

Review date 2027