New Care Models Workshop Nigel Groves. Involvement Lead for Forensic Services Nottinghamshire Healthcare NHS Foundation Trust Service user. New Care Models Workshop

Collection of Patients feedback from Rampton High Secure Hospital PD Pathways & Women's National High Secure Service. RSU Wathwood Hospital M.H patients ( link to Rampton and transitions )

The East Midlands New Models of Care Programme is about redesigning Forensic Mental Health Services. Organisations across the region will be working together over the next 3 years to look at how they can improve care. They will look at issues including admission into services, what happens when you are in our care and how to improve transitions between services, discharge from services and support in community settings. Throughout the programme would like to hear your experiences and views about our services and how they can work better for you. The questions below will help us to think about how we begin to work together with you.

Be honest Co-production Involve me Clear pathway Better managed Values Be honest Co-production Involve me Clear pathway Better managed Collaboratively Hope

1. What is important to you in your care and your care pathway? Good relationship with staff & patients is important. It’s important to take my medications, staff working on my care plans. Therapies and activities are important. My family visits are important.. Have a good relationship with staff. Being honest, how I feel Having right amount of medication OT sessions Family to visit me Taking meds – listen to team. Being out of Long term Seg is good. I’d probably say to use tools – craft & garden Family visits make me happy & use of phone is important

The most important thing is who and what to do The most important thing is who and what to do. What course to do and properly explained on how to do it and what is the best pathway to do and how long will it take before you get to MSU, LSU I would rather be closer to home). . A. Face to face care – (understanding paramount). B. Having a definitive way out. C. Having a reliable and safe backup/safe support plan. Family. Being listened too. MSU attend all CPA’s. Hope. Not being kept here any longer than absolutely necessary – LEAST Restrictive ENVIORMENT. To have clear understanding of what is expected of me. Knowledge of when I’m getting out as well as psycho evaluation and knowledge of any treatment and medication. . My children are important – is this & my mum. Make sure I take my med. Sec 17 team is important. Therapy & education.

That I am being listened too. Respecting my decisions. Understand where I came from and where I am going. Going to something better to move on my path. That I am being listened too. That I am included in my treatment and my care pathway. That I know exactly what goals we are working towards collaboratively.

2. How would you like staff to work with you? Like staff to listen & talk. Encourage me to do more stuff and try to move me on. Have more staff around so I could talk, or make phone calls Treat me as a person like it should be listen to me. (Promises care. In Community – staff let me down Rampton – happy with care.) Involve me in decisions & my care. I would like the staff to work with me in a humane way and not to judge me, help me to keep on the right pathway with one to ones and have respect for me. Consistently – adapt were necessary. Explain any changes, read care plans – don’t make wild assumptions. Creatively give me room but maintain safety.

Clear pathway identified Clear pathway identified. Clear understand of what MSU expects of me before they’ll accept me. Respectful. Communication. . Between Rampton & Wathwood there are big differences. We need better planning when moving on Psychiatry is important to me. Like staff to be positive and engage me. Medication is not everything Need a picture. Relationships. Staff need to have an all-round personality & understand of each patient personality – we are not all the same, no pre judging – empathy. To include you in your discussions regarding treatment. Have 1:1 sessions. Have a bit of “banter” on the ward to show that staff & patients can get on.

3. What are the important things to get right so you can live and work well with others in our services? Patient to be civil with each other. Trust each other. .Having right medication. Having right frame of mid. Budgeting well. Clean clothes. Having family visits weekly. Try to get home overall. Have a good relationship with family & patients. If noisy on ward it unsettles me. Listen to what is being said, instead talking all the time. If I abide by rules – it’s a nice environment. I don’t want to leave Rampton I am safe, my family like it. Scared to leave Rampton because of past. And care I received outside

The important things to get right is to keep on doing your course, understand the right situations and use the tools you have learned to work with others. Feel safe, be understood, have a routine, have a safe space to reduce stimulation. Not to rely on directorates label for right’s to access relevant care & equipment. Enough staff on ward. Enough staff to provide off ward activities. Most importantly of all enough staff to ensure treatment session run, i.e. DBT/VRB etc as every week these are cancelled is another week of my life lost!!!. The thing they get wrong at Rampton is they had all of us on the same wards. as treatment & aliment. With bad behaved people they went no-where. We were forced to live them. The ICU Adwick isn’t enough. People were there 5 minutes and people were there 5 years on same ward. Would like it quite on the wards and ignore any situation when the ward disturbed . Understanding others. To maintain therapeutic engagement with both staff & patients. To be trusting (but not too trusting). To be able to get along with others. To show understanding.

4. How would you like to be involved in your own care? . A say in my care plan is important. Named nurse session important. My CPA having a say in this. To live with my husband Being involved with name nurse and other staff, care plans, CPA Would like transition time to be quicker. Named nurse sessions – involve me in care plans & CPA. Ward round very helpful – frequency about right. Communication is about right. Be involved with all my care. Be listened too. I would like to be involved in my care, being told how I have engaged in therapy and how far II have come to getting ready for a RSU. Fully, but instead of me having to come you with all the answer/suggestions – 2 way street.

I think we should be held in High Secure for a short a time as possible; once we have self harm etc. Better managed we should be in least restrictive environment. What actually happens is we get stuck here for 5-7 years completing course we could do in MSU’s is it any wonder so many of us loose HOPE. I would like to have input on a week to week basis. To be involved in my own decisions about medication, at least to be informed. At Rampton I felt like a passenger in ward round by now I’m more empowered. Would like to know what reports are about me… good & bad – sometime I fear what people think about me. I would like to be kept up to date with all decisions that are made. I would like to be listened to. I would like people to take on board my points & opinions.

5. How would you like us to communicate with you about this programme 5. How would you like us to communicate with you about this programme? How would you like to be involved in working with us to redesign Forensic Mental Health Services as part of this programme? Focus Groups I don’t feel comfortable with male patients. To be involve in a “women’s only” focus group. In any way possible I would be involved by redesigning the Forensic Mental Health by getting information off the computer and being involved in all the meetings to get the feedback and have my say. Fully expert by experience. I would like to carry on being involved from here on. I would really like you to completely re-evaluate the purpose of high secure. I’ve been her 4 yrs and 90% of PD patients I’ve met could quite easily be managed in MSU’s. If you don’t feel it necessary to do above could you a very least make clear guidance as to reason people are kept her instead of MSU’s. Keep me informed. Meet involvement team again. Any input I give and is used make me feel better. Would like to continue one to one sessions. You say we have over 300 beds at Rampton I guess this is the most in this area. When are you going to run a co production event here… we can not come to you

7. Would you be willing to share/tell the story of your journey through services? If yes, please discuss how best to do this Yes by talking Yes I would but I would not like to talk about my offences. Yes – I’d be happy to attend & speak at a conference, if this was held within Rampton. Otherwise I’d be happy to be recorded. Yes happy to do – face to face interview. Yes, I will write my story

Thank you for listening Any Questions?