Tuesday, 18 December 2012

what will it take to bring about real change inside the wards at Stratheden?

Cultural change is difficult to bring about, especially if it's been going on for a long time, is ingrained and it's in a psychiatric institution.  Where there is compulsory treatment leading to the use of force.  And it is condoned.  When mental welfare commission recommendations are ignored and things go on in the same old way, undisturbed.

Waiting in a queue for medication is one example.  The MWC says in their Adult Acute Wards report 2010, page 5, that "this does not afford confidentiality or dignity to the individual and ward managers should change this outdated practice".  It's still happening in Lomond Ward, Stratheden, for a female patient told me this recently.  She also said that, although not under the mental health act or detained, was told she could go no further than the gate.  And she had no money on her to buy anything from the shop or go anywhere.  

A woman about my age, articulate, employed, with family.  Treated like a child by clinical psychiatric staff.  As if mental distress or ill health means a person has lost their capacity to think or act.  Of course the clinical staff at Stratheden like to think that anyone entering these walls are without capacity.  It means they can do what they like with them, patients and carers alike.  A justification for disregarding the person and bullying them into submission.

Entering Lomond Ward means leaving any autonomy at the door.  Although an open ward the patient is restricted and restrained, and is handing over their freedom.  To think, to act and to be treated as a proper human being.  With rights, an opinion and an identity, apart from psychiatry.  For the regime in this ward is like something out of a fairy tale.  Enter then at your own peril.  It could lead to the locked ward if any signs of resistance or refusing to take the jag in the bum.

It's risky for everyone but especially for women.  In female dormitories overlooked by male patients in single rooms.  Where men are free to enter the female dorms without challenge.  For nurses are nowhere to be seen.  Or so it was last March when I was in the ward.  And I've no evidence or proof that this has changed.  I'd need to hear the testimony of patients to believe that change has happened.  Nurses saying so won't do it for me.

The clinical management are meant to be starting a 'patient safety group' and some of us users and carers are meant to be on it.  I use the word 'meant' because months have passed and nothing has happened about this.  Par for the course.  All talk and no action.  It's been my experience of nearly 5yrs of 'involvement' in Fife mental health matters, psychiatrically speaking.  They say they are listening but nothing changes.  I raised many concerns in 2010, about the acute situation in Lomond Ward.  Result being that I was bullied and intimidated in 2012 by staff at Stratheden, for daring to speak out.

For they have no intention of changing what they do, the clinical nursing staff inside the wards.  Because they are getting away with it.  And have done so for many a year.  Why should they bother putting the mental health act principles into practice?  What's in it for them?  They would have to put patients and carers first.  Heaven forbid.  It would be too much like hard work.  And they would have to move themselves out of the comfortable staff room in Lomond where they have jolly times together.

I'm being cynical and speaking tough words.  But for me the time of action has come.  I'm not speaking out about human rights issues in psychiatric care just for the sake of it.  I am in it to bring about change, real change.  So that patients and carers, service users and family members are respected, treated with respect, listened to and given their place.  Person-centred clinical practice and safeguards that are safe.  Nothing less is good enough, in my opinion.

Sunday, 16 December 2012

music while you work

I stopped by Stratheden today, Sunday, about 1.30pm, and had a chat with some of the folks (patients) who were waiting for the church service to start.  Suddenly there was loud music, sounded like a disco.  I went to explore, it was coming from a car stereo, door open and what looked like a worker, in full uniform, hoovering out their car. 

So I carried on into the hospital canteen, past the new sign for the clinical effectiveness team (mental health quality improvement), bought a can of fizzy.  Noticed a group of catering staff sitting at the tables, enjoying their lunch.  Came back out again, saw the worker backing out of the car, he did have a hoover in his hand.  I asked him to turn the music down as the sound was deafening.  We could hear it a few hundred yards away.  He did as I asked.

A great job if you can get it.  Music while you work and hoovering your car in the break.  No need to change your uniform.  It reminded me of the day hospital staff and the fish van.  I've worked in the voluntary sector, also for the council, in Fife and Perth, and at FE colleges.  And I don't remember it being like this.  Doing your shopping and hoovering your car on the job.  But then I've never worked for NHS Fife.

Friday, 7 December 2012

benches and bins, open doors and wintry weather

IPCU to the left, offices behind
There seems to now be only one bench left in the Stratheden grounds, outside the IPCU, ward 4, front door.  See photo taken recently of bench with paper cups left on it.  The other benches are being refurbished, so I've been told.  I've suggested bins beside all the benches, when they reappear, so that people are able to put any rubbish in the bin.

I also would like to see bins with metal bits for stubbing out cigarettes, for patients who live on the grounds and have to smoke within the grounds.  Of course it's different for staff who don't have to live in the hospital and can go home at the end of a shift or go outwith the grounds to smoke.  Remembering to bin their butts appropriately and not leave them lying around on pavements or outside the hospital gates.

note the ice on the ground
shop counter screen
Then there is the fire door always tied open in the Ceres Centre shop.  Now it's winter and to sit there with a cuppa or having a chat is very chilly, to say the least.  Although the shop assistants now have another screen up which will no doubt keep some of the heat in their bit.  So it's just the patients and visitors who will have to wrap up warmly.

Wednesday, 10 October 2012

new build IPCU planned and renaming of clinical effectiveness department

There is to be a new build IPCU (intensive psychiatric care unit) at Stratheden Hospital with government monies.  I had this confirmed by a high heid yin in Fife, at a meeting the other week and in Emails since.  And not before time in my opinion. Because the Mental Welfare Commission had been describing the present IPCU as "not fit for purpose" for some time.  An old building and ward on different levels, dormitories and layout unsuitable for therapeutic care.

Meanwhile I have been informed that there has been lots of painting and decorating, fixing of showers and other handiwork going on, in both the IPCU and Lomond wards.  Also good to hear as this will improve the environment inside the wards and should have a positive impact on clinical practice of the mental health nursing teams.  Resulting in a more safe inpatient experience and recovery focused attitudes.  Which is my hope and the outcome I'm working towards.

The clinical effectiveness team has been renamed Mental Health Quality Improvement, and I checked out the new laminated sign pointing to their offices above the hospital canteen last week.  I am told this change of name will mean more of a focus on evaluation of practice and services.  From the patient/user/carer/family perspective.  Customer feedback as in other public services.  

And this will correlate to what's written in the new mental health strategy, the first key theme being 'working more effectively with families and carers'.  Although we shouldn't forget the user/survivor voice and its importance.  The strategy has person-centred care in primary place, describing it as:

"Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making."

I am pleased to see the efforts now being made by NHS Fife to work with me, as an equal, in the task of improving services at Stratheden Hospital.  It's not been easy for either of us, as we sometimes thrashed out our relationship, so that each could be heard and understood.  It's still a work in progress and that's how things are in a changing world, in my experience.

Monday, 24 September 2012

disappearing butts and a job well done

Just a quick blog post to say that the cigarette butts are disappearing from the patio area to the back of the Ceres Centre shop.  I passed by yesterday on the way home from Cupar and was pleased to see that there had been a clean up of the area.  So well done to the grounds staff for working away on this!  It can't be easy picking them up from among the gravel, it's not like you can sweep them up.

However I did notice some new butts on the ground and empty coffee cups too.  A poster reminding folk to use the bins might be helpful.  I'll be discussing this and other environmental topics re Stratheden with a high heid yin later this week.  Suggestions from a community development approach that could revitalise the area.  

Photos are of the garden areas belonging to the Horticultural Therapy department and FACET (Fife Arts and Crafts Enterprise) to the west end of the hospital site. 

I'd like to see plants like this in other areas of the hospital grounds as they are a bonny sight and well worth a look.

Thursday, 23 August 2012

dropping by today & the Recovering Eden project

I drove through the hospital grounds this afternoon to see how things were going and noticed some benches had been removed.  Assuming for refurbishment.  In front of the Lomond Ward and near the IPCU at the back of the grassy area.  The bench near the IPCU front door is still there and 2 women were sitting on it chatting.  They weren't in uniforms.

Checked out the patio area behind the Ceres Centre shop, no change there.  I'm hoping there's a plan afoot to improve this area.  It definitely needs it.  Patients were sitting chatting and smoking.  In the shop one of the long stay patients spoke to me, said his arm was better now, asked after my son.  Other patients said hello as I passed on the road back to my car.
old tennis court down from Lomond Ward

Recently I heard about the Recovering Eden project, a plan to develop a 'therapeutic space' at Stratheden Hospital for the whole community.  A recovery theme with 3 aspects:  
  • Recovery of self after illness and developing resilience using the outdoors environment
  • Recovery of the grounds (their restoration)
  • Recovery of the grounds as a more natural green space than is the case now (Eden)
And a quote from Graham Buchanan, Child and Adolescent Mental Health Service (CAMHS) and Clinical Effectiveness (Mental Health), NHS Fife:

It’s great we still have this superb estate and that it is totally devoted to improving mental health and wellbeing. We are starting to take a second look at our Victorian inheritance and are rediscovering some of the ideas that our forbears had about how to improve our mental health. Common sense tells us that contact with the natural environment and making a contribution to someone or something beyond our own desires is good for us and research is starting to produce evidence to affirm this.

Wednesday, 15 August 2012

keeping Stratheden tidy - bin the butts campaign?

I came by the Stratheden grounds to check on the areas I'd highlighted recently.  In particular to see how the clean up of cigarette butts was progressing.  There's no doubt that this is a challenging issue.  Not just the removal of piles left long ago but ensuring that more butts are not dropped.

petrol leaf blower/vacuum
I noticed that the area just outside the gate at the back of the IPCU was tidy which was encouraging.  However the area to the back of the shop still had accumulations.  A hoover could be useful, like a leaf blower/vacuum.

The habit of dropping cigarette butts, like the smoking habit, will be difficult to turn around.  But I believe that it can be done and should be done.  It's a matter of respect, in my opinion.  Respect for property and for other people who walk in the grounds and want to see a litter/butt free environment.  

From Falkirk Council website's 'cigarette litter facts':
  • Cigarette ends can take 5 to 12 years to fully biodegrade due to the cellulose acetate they contain 
  • Discarded butts can be harmful to birds and marine life
  • Because they are so small, cigarette butts easily get caught in paving stones and gullies and are therefore difficult to clean away effectively 

I think that a campaign to 'Keep Stratheden Tidy - Bin the Butts!' could be a useful way of highlighting the issue and involving the hospital community in a team effort.  Educational activities around the environmental impact of careless disposal of butts alongside support for stopping smoking.  

The cigarette packets tell us that 'smoking kills' so it makes sense to give people opportunities to take positive action.


Wednesday, 8 August 2012

therapeutic horticultural views

welcome to the Horticultural Therapy
At the far end of the hospital grounds, near the IPCU building are the Horticultural Therapy gardens and FACET project.  

The Horticultural Therapy department at Stratheden has been around for 25yrs, helping patients progress towards rehabilitation.

FACET (Fife Arts and Crafts Enterprise) is run by Fife Council and offers participants a range of horticultural skills and garden craft.

view over HT gardens
An oasis of green space where patients and others can potter, plant and experience the beauty of the landscape.

pond in the distance and greenhouse
I'm not sure that all visitors will be aware of these gardens.  I've always lived quite near the hospital, for the last 20 years or more, so have often walked through them, enjoying the plants, the view and the wildlife. 

Rabbits can be seen running around, no doubt a challenge to growing vegetables and other tasty plants.

I'd like to see the HT gardens replicated, in small pockets, throughout the hospital site.  With flower beds and patio tubs.  Shrubs and fruit trees.  Therapeutic views near wards and other buildings. 
hanging baskets looking up towards hospital

The Smokie hut, a good idea

FACET grounds

Tuesday, 7 August 2012

more cigarette butts

at back of shop in Ceres Centre
Walking around the grounds today I noticed the cigarette butts at the back of the Ceres Centre shop, in the patio area, had not been cleared yet.  I'd raised awareness of this recently.

There are various piles, under the shelter and near the back door, that must have been there for ages.  

Although this area is not seen from the road through the grounds it would be good to see it kept tidy, for the patients, visitors and staff who sit here.

close up of butts

other post

The shrub area is also looking neglected and would benefit from fresh planting and weeding.

shrub area back of shop

Friday, 3 August 2012

photos of patient spaces received

Thanks to Jim Leiper, Director of Estates, Facilities & Capital Services at NHS Fife, for Emailing me photos today of patient spaces at Stratheden Hospital.  

Not sure as yet of where they are, what wards or settings, so have asked for clarification.  I've uploaded a couple of photos then will put the rest on when I know.
I am informed that outside agencies have been helping with encouraging biodiversity at Stratheden, attracting wildlife, for the benefit of everyone using the paths throughout the hospital grounds.  Plans for refurbishment of all benches are ongoing.  Sweeping duties increased and improved recycling levels.

It's a "work in progress", according to Jim Leiper, and encouraging to hear of the commitment and determination of his Stratheden team to work on the necessary improvements.  With the input and support of clinical staff on site.
I look forward to seeing the results.

resisting the temptation

I'm resisting the temptation to post something about the environment inside the wards at Stratheden Hospital.  After something that happened yesterday.  

To do with notes.  

Instead I wrote another Blog post on Mad in America .

Thursday, 2 August 2012

and another bench replaced

Noticed another bench replacement at the Lomond Ward where the view stretches out over the fields and the new build wards.  In this summer weather it should be useful for patients and visitors to sit a while.

Walking up by the back of the shop to the patio area I saw there were still many cigarette butts on ground.  A few new plants and shrubs wouldn't go amiss.  Maybe the horticultural therapy in the hospital grounds could help with this?

Tuesday, 31 July 2012

unofficial bench now back where it belongs

Just been into Cupar via Stratheden and noticed the 'unofficial' (smoking) bench missing from outside the hospital gates near the back door of the IPCU.  

I think it's now inside the grounds, on the grass under a tree, near the front door of the IPCU.  Or one like it.

Good stuff.

Monday, 30 July 2012

£50 fine for dropping cigarette butts

"Fines of £50 have been ordered on smokers who discard cigarette butts on the streets of Fife." from a 2006 BBC News article.  It goes on to say:

"For many smokers it has been the habit of a lifetime to discard their cigarette butts on the road or pavement without any thought of the consequences to the amenity of the local environment.  With the new bins and handy pocket ashtrays, people really shouldn't have an excuse for dropping cigarette ends. "
Maybe we are needing some environmental wardens to patrol the roads outside Stratheden Hospital?

smoking outside hospital gates by staff is allowed

I have received an Email from NHS Fife management about their smoking policy:
  • Smoking inside our buildings is illegal. 
  • Smoking in our grounds is not allowed, any staff breaching this will be dealt with under our Staff Conduct policies.
  • If staff wish to smoke they must do so in their break time and outside our grounds
Therefore smoking just outside the hospital gate is allowed.  In their staff uniform and in full view of patients, visitors, passers-by, in cars and buses.  I suppose it depends on the conscience of each nurse or member of staff as to whether they are OK with doing so.  And whether by their actions they are promoting smoking and encouraging patients to do so.

Sunday, 29 July 2012

'Land that time forgot!' article

'Land that time forgot!' is the article on the Fife Herald/Fife Today website, published today, with my photo of the recycling yard, quotes and a response from Jim Leiper, NHS Fife Director of Estates, Facilities and Capital Services.  

I had sent the photos to the press on 17 July, having had no response to my concerns and earlier photos sent on 22 March to NHS Fife management.  

It is encouraging to see that my concerns about Stratheden are now being listened to.

Saturday, 28 July 2012

more cigarette butts beside bench

Later on Thursday after meeting with the NHS Fife Chief Executive, I was driving by Stratheden, on my way home, and noticed more cigarette butts on the ground at the gate.  Beside the metal bin for butts. 

butts, bin and bench outside gate at back of IPCU
Yesterday, Friday, I had a meeting in the hospital, to discuss the environmental improvements to the grounds.  I took my camera with me to record the butts if they were still there. They were still there.  And so were 2 IPCU nurses, smoking, just outside the gate, one sitting on the bench, the other standing.  I took the photo of the butts beside the bin beside the bench.

newspaper article 19 July 2012

Courier article 19 July 2012
I sent the photos to the local press, was contacted by reporter Cheryl Peebles and this article appeared on 19 July in The Courier.  That very day I was contacted by NHS Fife Chief Executive John Wilson's secretary and invited to a meeting on Thursday 26 July. 

On Tuesday 24th, to prepare for the meeting, I walked round the hospital grounds and noticed that all the issues I had raised through photos had been addressed - cigarette butts cleaned up, a metal bin put beside the bench at the gate, old bench removed from grass at front of the IPCU (intensive psychiatric care unit), glass pane and bell on back door of IPCU, recycling yard tidied up.  This was encouraging.  I noticed other areas in need of attention and took note.

The meeting with Mr Wilson went well.  I felt that my concerns about the hospital grounds were taken seriously.  There was mention of improvements to the IPCU and of proposed environmental developments in the grounds.  I left the meeting very hopeful.

photos taken 16 July 2012

First post on a new blog about Stratheden Hospital, near Cupar, Fife, and near where I live.  With the aim of detailing improvements to the grounds.  For the benefits of patients, carers, visitors and staff.

Here are photos taken in the grounds and at the gate of Stratheden Hospital on Monday 16 July 2012.  I'd taken similar photos back in March when visiting the hospital.

bench at gate near back door of IPCU (intensive psychiatric care unit) with cigarette butts below

dilapidated bench outside front of IPCU

back door of IPCU where visitors enter

recycling yard on way to restaurant

grit box filled with empty bottles and cans not far from IPCU front door

abandoned toilets at side of recycling yard not far from main gate