Adult Inpatient Specialist

The team embrace the CHIME model of recovery.

The CHIME model is a research-based model of recovery. It was created to help people live a good and fulfilling life, with or without mental health symptoms. There are five factors that are important for recovery:

• Connectedness
• Hope
• Identity
• Meaning
• Empowerment

Everyone's recovery journey is different and you may find different areas of CHIME important. You can talk to your team about the CHIME model, what you feel your strengths are, and what you feel might be important to work on. This will help you to think about your recovery and how the team can best support you in this. Together you might want to come up with some CHIME goals.

CONNECTEDNESS

• Developing meaningful, healthy and supportive relationships
• Being part of a community
• Feeling connected to the self
• Feeling spiritually connected (if relevant)

HOPE

• Having belief in recovery and the motivation to change
• Having a positive outlook on life and the future
• Having goals, dreams and aspirations

IDENTITY

• Having a positive self-identity and a positive social identity
• Having a sense of individuality
• Knowing and understanding who we are, what we like and want
• Rebuilding identity after adverse experiences

MEANING

• Having a meaningful or purposeful life
• Having a good quality of life
• Understanding what is meaningful or motivational to us
• Finding meaning in our mental health or life experiences

EMPOWERMENT

• Having a sense of control over our lives
• Identifying our strengths and utilising them
• Taking personal responsibility for our actions

This information was co-produced by the Mental Health Recovery Pathway and service users.

What happens when you come to the hospital?

• Meadowbank will be sent a referral on your behalf
• Staff will come to assess you and together you will talk about visiting our unit and work out if this is a suitable ward to meet your needs
• An information pack about Meadowbank and our treatment programme will be given to you
• If after discussion, you are accepted, we will plan your stay in hospital 
• Within 24 to 48 hours of arriving at the hospital you will get: 

1.  A personalised welcome pack
2.  A physical health assessment
3.  Your first contact with an occupational therapist
4.  Your carer will be contacted, if you have given us to permission to do this

Information about your treatment plan

• At your first ward round we will talk about your possible length of stay and plan a temporary date for you to go back home.
• There will be three weekly ward rounds
• Your plan will include group and individual tasks
• Your first Care Programme Approach (CPA) meeting will be within 4 to 6 weeks
• You will build new skills 
• We will identify strengths together 
• You will have a comprehensive assessment
• There will be an opportunity to look at vocational qualifications

What happens moving forward?

• Your care planning will be co-produced
• You will have developed skills to help you manage and feel confident to be independent  
• You will have built skills that will help you transition back in to community life 
• We will ensure that somewhere to stay has been identified, this may mean returning home or to a supported accommodation
• Your leave will be graded before you leave the hospital. This means there will be a phased and structured process of transition back in to the community. You will be supported back to independent living or a less restrictive setting. 

Informal patients

If you are an informal patient, it means you have said yes to staying in hospital for an agreed period of time. You will be given a leaflet about your informal rights.

Formal patients

If you are a formal patient, it means you have said yes to staying in hospital for an agreed period of time, but you are still subject to detention on a section of the Mental Health Act (1983). A member of staff will explain your rights and a leaflet will be made available to explain more about this.  Other leaflets are available for your information regarding an independent mental health advocate, second opinion regarding your care and the process for appealing against your section.

Your rehabilitation team will include:

A consultant

Your consultant is main doctor in charge of your care during your stay in hospital. Working with the multidisciplinary team, they will prescribe your medicine. The consultant will decide when you can go out on leave and work with other professionals to help you get better and ready to go home. 

Your consultant usually has a weekly ward round when you, and your family or carers, can ask questions. Please ask a member of staff about your ward round times. If you want someone to be with you, you can ask for a family member or advocate, please speak to staff about this.

If you wish to see a doctor on a day that is not your ward round day, please make a member of staff aware of this and they will try and help. 

Specialist doctors                          

Specialist doctors supports the consultant, completing assessments and working with other professionals to help get you better and ready to go home.  

Ward Manager

Your ward manager supports the overall running of the ward and can be the first point of contact if you have any questions or needs.

Primary/ named nurse

Your primary or named nurse is a qualified nurse who will be in charge of making sure that all your care needs are being met. This includes care planning, assessments, as well as spending time with you to help work towards feeling better and feeling ready to go home.

Associate nurse

This is a member of staff on the ward who will help support your named nurse to complete care plans and assessments. They will spend time with you on the ward to complete one-to-ones, activities and promote recovery and discharge.

Occupational therapists (OT)  

OTs help you plan your day and do activities that help you feel better. They also help you learn and practice everyday skills to help you with your recovery.

Psychologists

Psychologists can talk with you if you need help with your thoughts and feelings. If you'd like to speak to someone, please ask a staff member. 

Things to bring with you: 

• Enough clothing
• Medication you are currently prescribed 
• Nightwear
• Toiletries 
• Reading material / crosswords / puzzles
• Your bank card or money for payphones, vending machines, the café etc. 

Things to leave at home:

• Weapons / knives or blades
• Glass
• Alcohol / illicit substances 
• Matches
• Valuables
• Bedding 

Valuables and mobile phones

Please do not bring valuables with you. If you do have any valuables with you, please hand them to a member of staff, or preferably give them to a friend or relative to look after. We cannot take responsibility for items not handed in.

Mobile phones are allowed on the wards unless there are concerns about patient safety.

Your room

Each patient will have their own room with an ensuite shower. You will be able to keep your personal belongings in your room. There are keys to each bedroom which will be given to you when you arrive to the hospital although there may be times when a key is not given. Staff will be happy to talk with you about this. Room checks may be carried out.

Ward environment

There are many communal areas on the wards where patients can socialise with each other. This includes a lounge, a quiet room, dining room, activity room and the outside courtyards. There is also a laundry room with access to a washing machine and tumble drier. There are 2 self contained kitchens including appliances where you will be encouraged to be independent in meal preparation and all activities of daily living.

There is no CCTV in patient bedrooms or private meeting rooms. Please respect your bedroom and the ward area at all times. If there is any damage to property, this must always be reported as soon as possible.

Whilst you are on the ward, staff will carry out general ward observations. You will be checked on by a member of staff each hour to make sure you are safe and well. At night, you will still be checked on, but this will be done through the hatch in your door.

Meadowbank ward has mutual expectations that have been created between patients and staff and these are displayed on the ward notice boards.

If you have any concerns for your personal safety, please speak to a member of staff.

Smoking policy 
You can smoke in the ward courtyard. There are set times for smoking in this area to keep the area smoke free so that others can use also it.  

You cannot keep a lighter or matches on the ward. You will need to hand these in on admission to the nursing station. This is to make sure that everyone remains safe.

Nicotine Replacement Therapy is available to all service users to help manage their cravings.
Alternatively, patients own e-cigarettes and vapes can be brought in. Please ask staff if you would like more information.

Meet the Matron
The ward matrons will visit you within 48 hours of your admission to talk about your admission and any concerns or suggestions you may have. 

At 9:15am, after your morning routine, a meeting is held on the ward. All service users will be asked to attend. The meeting is attended by the nursing team and the wards occupational therapists too.

We hold these meetings each day to help things run smoothly and support your recovery. The meetings help:

• To give you some structure and routine 
• To help you be involved in your care and treatment
• To encourage you join in activities
• To plan the day ahead together
• To help staff organise their time and make sure everyone gets the support they need 
• To work out a time when you can take any of your leave 
• To give you a chance to ask any questions or share anything important 

What times can you cook?

The kitchens are always open for snacks and drinks, however, we encourage preparing hot meals during the following times to help build structure and routine:

• Lunch from 11am to 2pm
• Dinner from 4.30pm to 8.30pm 

Café vie 

The café stocks a selection of sandwiches, hot foods, snacks and drinks. The café is open 9am to 3pm on weekdays. It is not open at weekends. 

Cash and card are accepted.

There are also local shops should you need to buy basic personal items.

Use of Free Time 
Staff help in promoting social inclusion by encouraging you to access local community facilities for daily living, education and leisure. This could include direct access to volunteering and employment with the support of an employment specialist as part of the core team. 

Personal management routine

Times are given each week to ensure your personal space and communal areas are clean.

For example, some time will be give to you as 'bed linen and tidy room time'. If you need help with these tasks, we can support you. 

During this time you will need to:

• Strip your bed linen and wash the bedding
• Sweep and mop your floor
• Dust surfaces, the top of the wardrobe, furniture, skirting boards, windows sills, lighting and doors.

At 7pm on weekdays, all patients are expected to take turns completing their tasks. These include:

• Sweeping and mopping the kitchen floor
• Emptying the dishwasher and wiping the ovens and microwaves.

All time off the ward (leave) will be discussed with you, your parents or carers, and the team. A joint decision will be made as to how often and how long you spend off the ward and will become part of your care plan and personal timetable. 

Time off the ward could be for: 

• Community activities (with and without staff)
• Appointments
• Time at home

Visiting the ward

The safety of our patients is a high priority. All wards at the hospital operate controlled access. This means that the ward entrance is locked for the safety and security of patients.

For patients and visitors needing access to the ward, you will need to use the ward bell which is near the ward entrance for staff to allow you to enter. Visitors wishing to exit the ward will need to speak to staff so the ward entrance can be opened. 

Patients wishing to exit the ward, should speak to a member of staff about this. Leaving the ward will be depend on whether you are here voluntarily or  detained under the Mental Health Act, agreements of leave between you, your consultant and ward staff. For patients who have an agreement for leave in place with their consultant and wish to use their leave, we ask that you attend the daily meeting to request this. This helps us to plan in any support that is needed throughout the day.

If, as a patient, you have concerns about someone visiting you or do not wish to be visited by certain people, please make a member of staff aware.

Community activities (with and without staff)

Appointments

Home leave

Your physical health

As part of your stay in the hospital you will be seen by a doctor. They will carry out a physical examination to check your physical health. After admission, you will have an ECG (electrocardiogram) so that we can see how your heart is functioning and a blood test to check organ function.

Your physical health is very important to us. We carry out daily checks which means you will need to visit the wards clinic room. The nursing staff will measure your oxygen saturation, your temperature, pulse, respirations, blood pressure and your weight and height if it has not already been done. 

We do understand that some of the medication that is prescribed for you to take can increase your appetite and this may affect your weight. If you have any concerns about this, then please speak to a member of staff who can advise how to manage this.

The physical health nurses and sports technician will work with you to achieve any specific health goals.

Medication

Please bring all the medicines you're currently taking with you when you come to the hospital. This helps our staff check them and make sure they're safe and right for you during your stay.

During your stay, your needs regarding treatments including medicines will be regularly reviewed and discussed with you and your carer. 

Any newly recommended medication during your stay will be given to you and we will also make sure you do not run out of your previous medicines.

While you are on the ward, a member of staff will let you know when to take your medicines.  

We will give you information that will help you safely use your medication. The Trust has a dedicated website for choice and medication which you can access here.

You may also request help to access this link or request pharmacy staff to provide you with specific information on any detail of your medicines.

When you leave hospital, we will make sure that you have enough medicines recommended by your doctor and that you have the right information for safe use. 

What can you do to prevent the spread of infection?

• Wash your hands before preparing or eating meals and after using the toilet
• Ask your visitors to wash their hands before and after seeing you
• Ask any member of staff if they have cleaned their hands before they have any direct contact or care with you
• Expect staff to wear gloves and aprons when carrying out some tasks, such as, dressing a wound, cleaning up spills of bodily fluids or handling dirty linen
• Keep your toiletries for your personal use only
• Try to keep clutter within your bed area to a minimum
• Expect your bed linen to be changed as often as necessary and if you move rooms
• Cover any exposed cuts or grazes with a waterproof dressing and ask staff to change any dressings if they become dirty or blood-stained
• Tell a member of staff immediately if you have episodes of diarrhoea or vomiting

Being in hospital could affect your benefits. 

Disability Living Allowance (DLA) 

You must let the benefits agency know that you have been admitted to hospital. Your benefit will continue to be paid for a further 28 days and will then stop. You must also let the benefits agency know when you leave hospital (your discharge) so the benefit payment can start again.

If you do not do this, it may result in a fine. 

Disability Living Allowance telephone number: 0845 712 3456 
Monday to Friday, 8am to 5pm.

Housing Benefit

This will be paid for up to one year. 

Employment Support Allowance (ESA)

This won't change.

Community Law Service 

Community Law Service is an independent advice provider in Northamptonshire. They can offer free advice on welfare benefits, housing and debt. An advice worker visits the wards on Monday afternoons. If you would like to speak to them, please let a member of the nursing team know. The contact details are below:

• Northampton - 01604 621 038
• Rushden - 01933 313 020
• Wellingborough - 01933 278 248

Patient Advice and Liaison Service (PALS)

PALS is a helpful and friendly service which can provide you with information on services, places, and people in the Trust. PALS can also liaise with you and the people involved in your care to resolve problems.

PALS wants to know what you think about the service you are receiving. Any comment you make is valuable in helping us improve our services. 

Ask a member of staff for a comment card.

If you have any concerns about the care and treatment, you can contact the ward manager or the PALS service. Likewise, if you would like to give a compliment about the service you can contact PALS as well.

For contact details and more information visit the PALS website page. 

Interpreting Service 

If English is not your first language and you need some help, please ask your keyworker for more details about support available to you.

We can arrange a telephone translation, or face-to-face translation support if you need help for things like your Care Programme Approach (CPA) meetings or Tribunals.

You might be staying on the ward because you've been kept in hospital under the Mental Health Act (1983). This means doctors believe you need care and support to help you feel better. Soon after you arrive, staff will meet with you and explain your rights to you and also give you written information about your rights.

This information will explain:

• Why you are staying in hospital
• What treatments you can agree to or refuse
• That your stay won't automatically end when the current time is up
• That your stay won't automatically continue either-you'll be reviewed
• That your opinions will be listened to before any decisions are made
• What a Tribunal is and how it can help you leave hospital
• That you can get free legal help from a solicitor
• What the hospital managers and Care Quality Commission do
• That you have the right to speak to an independent advocate - someone who can help you understand things and speak up for you

If you want to know more, just ask your named nurse or keyworker.

Your Tribunal

The Tribunal is an independent panel which can decide whether you should be allowed to leave the hospital. It will hold a meeting with you and with staff from the hospital who know you. This meeting is called a hearing.

You can ask someone else to come to the hearing to help you, if you want. This may be a family member or advocate. Before the hearing, the members of the Tribunal will read reports from the hospital about you and your care. You should receive a copy of these reports.

You will be asked some questions by the Tribunal panel, along with your doctor and others who have been involved in your treatment. They will then make a decision about your appeal. You will then be informed of this decision.

You can ask a solicitor to write to the Tribunal for you and help you at the hearing. The hospital and the Law Society have a list of solicitors who specialise in this. It is free of charge under the Legal Aid Scheme.