The Glenbourne Unit

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The Glenbourne Unit

• 50 beds spread over 2 acute wards structure of
  staff
• Accepts admissions for adults of a working age
  with acute mental health problems
• Links with HTT, PCLTs, AOS Teams, Insight,
  Icebreak and voluntary organisations
• Works with Plymouth and Devon Partnership service
  users.

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• Unit staff have worked to make positive changes
  to acute inpatient care
• The work has involved CSIP and RCPsych
• Alongside this staff have worked through the
  Trusts Clinical Governance agenda to improve
  standards
• Staff are trained in SFBT.

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The purpose of an adult acute psychiatric
inpatient service is to provide a high standard
of treatment and care in a safe and therapeutic
setting.Inpatient care is a key component of the
National Service Framework for Mental
Health.Service users report that previous
experience of acute inpatient wards were a
negative experience.
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The Mental Health Policy Implementation Guide
2002 aimed to address some of the concerns- Poor
Physical environment- Lack of information on how
the ward works-Lack of involvement in how the
ward is run- Lack of 11 staff contact- Lack of
something to do, especially activities that are
meaningful to recovery- Lack of clear
policy/admission criteria
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The search for acute solutions improving the
quality of care in acute psychiatric wards.The
Sainsbury Centre for Mental Health 2006 set up a
three year project and asked focus groups to
describe what an ideal acute inpatient unit
should be like.
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Short focused admissionsCompassionate,
understanding and skilled staffActivities
available in all wards in the evenings and
weekendsMore information about the wardBetter
facilities,including being able to make drinks
whenever they likedLess emphasis on medication
and more on therapeutic activities
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With these things in mind a Process Mapping day
was set up with the emphasis to look at what
patients and staff do with their time throughout
the 24 hour period and what changes could be
made.These are some of the changes
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Community MeetingsProtected TimeEating with
PatientsEnvironment
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Process Mapping Day March 2006

• Facilitated by NIMHE
• 2 groups patients and staff
• Process map were developed looking at tasks,
  feelings, problems and solutions
• Staff group identified the key points from the
  process map and then 9 priorities
• Process Mapping Group developed

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Quick Wins

• Daily newspapers on both wards
• Torches when staff do night checks
• OT equipment on both wards
• Ensuring Patient involvement in refurbishment
• Information photo-boards, Unit leaflet
  developed
• Group had a chance to think outside of the box
  when planning care and making changes

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Longer Term Wins

• Protected therapeutic time (CNO 2006, DOH 2002,
  Kent 2005, Soong et al 2007)
• Protected Meal Times
• Community Meetings
• Information available on the wards/OT
  medication, illness, computers
• Ward and OT Staff starting to co-facilitate groups

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Process Mapping June 2007

• Action Plan includes
• Development of career pathways
• Physical wellbeing work
• Cultural change sharing the vision
• AIMS Accreditation policies, admission/discharge
  pathways
• Review of protected time patient focussed

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Improving Ward Rounds

• Found by service users to be disempowering and
  traumatic
• Ward rounds should be a service user centred
  decision making process
• Changes were implemented and then reviewed by
  consultation with service users
• Staff were flexible in how they took forward
  improvements

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The main improvements were ..

• Allocating a ward round nurse
• Setting quality standards for ward rounds
• Giving service users the chance to give feedback
• Listening to what service users say about their
  experiences
• Supporting service users in achieving what they
  want from ward rounds
• The future .

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Information Leaflets
Photo-boards
Protected Therapeutic Time
Home Treatment Team Interface Meeting
Bed / IPP Management Meeting
Staff Supervised Mealtimes
PEAT Inspection
Solution Focussed Therapy Approach
Development of 136 Suite
Senior Staff Meetings
Ligature Audit
Achievements
Heads of Department
HCR Audit
Acute Care Forum
CPA Audit
Environmental Refurbishment
Co-facilitated OT Groups
Audit of Violence
Activities Co-ordinator
Hearing Voices
Teaching Facilities
Community Meetings
Glenbourne Development Group
AIMS Staff Accreditation
Training Strategy
ECTAS
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DOH (2006) From Values to Action The Chief
Nursing Officers review of Mental Health
Nursing DOH (1999) National Service Framework for
Mental Health Modern Standards and Service
Models, DH, London DOH (2002) Mental Health
Policy Implementation Guide Adult Acute
In-patient Care Provision, DH, London DOH (2004
National Mental Health Workforce Strategy, DH,
London Sainsburys Centre for Mental Health The
Search for Acute Solutions (2006)