St Andrew's blog posts 2017
Five minutes with: Angela Shaw, Advanced Nurse Practitioner
How long have you been with St Andrew’s and what did you do before?
For a year - previously I worked in the NHS for eight years in secure and complex care. I completed my MSc in Forensic Mental Health Studies, and applied to work for St Andrew's because I felt it would give me the opportunity to work with a diverse population of patients - including people with diagnoses that I haven’t nursed before.
What’s the main function of your role as an Advanced Nurse Practitioner?
I support male mental health wards and also cover the women’s low secure ward in Birmingham. My role involves service improvement, research, training and development. I also carry a patient caseload which focuses on least restrictive practices and positive behavioural support.
Can you describe a typical day?
There is no typical day for me as my week varies so much - but an example of a day could be:
1. Attending a morning handover meeting for the Birmingham site. Within this meeting I'd be identifying areas of risk, concern or of restrictive practice.
2. I carry out a seclusion audit following this meeting and look at the documentation standards for each seclusion. I spend time with staff making plans and de-briefing.
3. I attend research meetings in which we will discuss and review the research we are currently undertaking. I am currently looking into patients’ quality of life though the psychosis sub group. I also chair the positive and safe meeting, in which the ward managers look at reducing restrictive practices.
4. I also usually hold either reflective practice teaching sessions or formal teaching. An example of this would be teaching and leading an induction for new starters.
5. I am also usually rolling out an intervention. Currently I am rolling out the new care plans and Safewards. Safewards involves spending time with staff and patients to monitor and put interventions in place. For example, ‘getting to know each other’ is a process where staff and patients complete an information sheet based on their likes and dislikes.
6. I also have a clinical case load so each day I will usually see one of my patients, and might look at their relapse prevention plans.
What do you like best about your job?
I enjoy my role because I am able to support staff and patients over a number of wards. I take ownership of my time so I can make the best use of the resources I am able to offer. I also enjoy the challenges of role modelling and building relationships with MDT teams.
Can you give an example of how you've personally made a difference to patient care?
Just this week I have used a Positive Behavioural Support intervention to make plans with a patient who has specific delusions regarding a staff member. This patient and staff member have not been able to engage for months. I was able to explore and resolve this with the patient to the point where the patient shook the staff member’s hand. He has agreed to follow a plan where staff can help him challenge his thoughts. He acknowledges that at certain points he has no insight into his thoughts and at this point we will intervene to ensure the staff member is safe.
Speech and Language Therapy in mental healthcare
by Specialist Speech and Language Therapist, Carol Reffin
6 February 2017
This blog first appeared on http://blog.ican.org.uk/ - published by ICAN, the children's communication charity.
Speech and Language Therapy in Mental Health can be challenging, but it is incredibly rewarding and allows SLT to add value to children’s and young peoples’ lives.
I work as a Speech and Language Therapist at St Andrew’s in Northamptonshire. Our Child and Adolescent Mental Health Service is the largest facility of its kind in the UK for young people between the ages of 12 and 18 on admission. It looks after complex young people with a developmental disability who have significant psychiatric, emotional and / or behavioural needs.
We have recently moved into the brand new adolescent building – FitzRoy House and it’s amazing!!
The young people have recently moved into new wards and are busy unpacking their belongings and settling into their new environment. They have been excited about their new bedrooms and are really looking forward to making their ward a proper home. FitzRoy House provides specialist care for up to 110 young people and offers:
A multi modal approach to care and treatment for young people, with art and music suites, a sensory therapy room, outdoor animal care courtyards and fitness rooms, together with therapy kitchens and a light workshop. An indoor sports hall and outside multi-use games area provides space for team games.
A TEACCH classroom that has been specially designed to provide a supportive environment for students with autistic spectrum disorders.
As part of the speech and language therapy team we assess the young peoples’ speech, language and communication needs and then offer one to one sessions, and social skills groups, including Chat and Chill, Social sharks and Let’s get together.
We get involved in joint goal setting for community visits and trips, including local charity work. Examples are Age Span which helps the elderly with gardening projects. and Tools for Self Reliance - recycling tools for third world countries.
We work collaboratively with occupational therapy and psychology staff in delivering Café Club, and All About Us – focusing on growing up as well as community leisure sessions.
Functional therapy including jointly delivered meal cooking sessions with Occupational Therapy (OT). The young person cooks breakfast, lunch or dinner with OT staff and the SLT helps with the sequencing of the meal and provides visual support. This culminates in a group eating their meal together, as well as animal care and pets as therapy.
We'e also actively involved with themed activity weeks and the spiritual journey group. The young people also have the opportunity to take part in fabulous music events including African Drumming, a band called Section 17 and visits from the Royal Philharmonic Orchestra.
We are careful to provide a safe environment that is secure but provides a balance between intrusiveness and openness; creating trust between the young people and professionals.
FitzRoy House aims to be a setting that allows the young people to continue to have access to the same opportunities that their friends and families might have in the community. The young people continue with their schooling, college and even university, and have the opportunity to go home on leave, to visit the local shops and theatre, and to participate in a range of creative therapies and activities such as horse riding, horticulture and woodwork. Developing young people’s communication skills really helps them to make the most of these opportunities.
The team of professionals working with them are dedicated to providing support. It is about providing therapies and guidance through a dedicated team of healthcare specialists and teachers, and giving young people care and treatment to aid their recovery.
As SLTs we are privileged to work with a team of other professionals in preparing the young people for the next step in their life, whether that’s at home or in supported living, and that’s a wonderful goal to work towards. The young people at St Andrew’s have described the story of their recovery as part of a touching short film that offers insight into mental health, ‘In Our Own Words’. This was created with the aim of giving the young people a voice and can be viewed on YouTube. It demonstrates that for those young people struggling with mental illness, being at St Andrews is a step towards recovery and it' possible to have fun along the way.
A flavour of dietetics
By Sam Bailey, Lead specialist dietitian, CAMHS Pathway
2 February 2017
We spoke to Sam Bailey to understand the role of dietetics and nutrition within St Andrew's care pathways.
What does a dietitian do?
Registered dietitians are qualified health professionals that assess, diagnose and treat diet and nutrition problems at an individual and wider public health level. Uniquely, dietitians use the most up-to-date public health and scientific research on food, health and disease, which they translate into practical guidance to enable people to make appropriate lifestyle and food choices.
How did you start your career?
I spent four years completing a degree in Human Nutrition and Dietetics. To become a registered dietitian you study food, nutrition, how the body works, diseases and medications, but the degree also teaches you about catering, food science, food industry and even politics.
What brought you to St Andrew’s?
I first came to St Andrew’s in 2008 to see a patient on one of the Adolescent Units. I was working as a freelance dietitian alongside my NHS job in an acute hospital. In the NHS role I saw patients on wards, in clinics and out in the community at GP surgeries and care homes.
After seeing that first patient here at St Andrew’s I was asked to see lots more. In 2010 I came to work here permanently, because I really enjoyed working with the young people and the different teams. I realised that there was lots I could do to support the catering staff, ward teams and of course all the patients who wanted guidance with their diet and health.
What do you like about your job?
I love how different my days are here. There’s always plenty to do, whether it’s seeing patients, developing resources, doing health promotion activities or working with colleagues on shared projects. There are many strands to my role at St Andrew's: clinical assessments, group or 1:1 sessions with patients, health promotion, working with catering teams on menus, nutrition education, ensuring compliance with clinical guidelines and food standards to name just some. The diversity is one of the things I like about my job. I also link in with other dietitians working in similar settings across the UK to share experience and resources.
What’s the main purpose of your work with our young people?
It’s to ensure our young people have access to food that supports their physical and mental health and that they have a healthy relationship with food.
The most rewarding part of my job is seeing patients on their recovery journey. I do get moaned at a lot about food issues – and I do understand why these need to be addressed. Food is such a big part of our lives and something we should enjoy whilst keeping fit and well. It’s my job to support and guide others to get that balance by understanding the science behind nutrition and health.
How do you know when you are making progress with a patient, and how long does that usually take?
One of the big differences I have found between working in an acute setting focusing on physical health and within a mental health inpatient setting is the time you get to develop a therapeutic relationship.
Previously I may have seen a patient once or twice either on the wards or in a clinic. Now I have the opportunity to be a part of their journey to recovery and this can take months, even years. The time taken to make progress with a patient can vary - but I’ve learnt to recognise that small steps can be very significant.
What advice would you give to someone thinking about a career in dietetics?
If you have a keen interest in food, nutrition and human biology then go for it! Dietitians work in the NHS, private practice, industry, sport, media, research, education, public relations, publishing, government and non-government organisations. These areas of work are very different so you can specialise using the skills you have and work in the environments in which you thrive.
When I qualified, working in mental health was not on my career plan as I didn’t think I would enjoy it. I was introduced to it as a freelancer and it really surprised me how much dietetics had to offer in this area. I’ve now been working in mental health for 9 years and each week brings new challenges. I also feel part of the most amazing team here, both within dietetics and the whole MDT. There are constant opportunities to learn from others and develop as a clinician which is important to me. So my advice would be don’t rule it out before trying it!
What it means to be smoke-free at St Andrew’s
By Simon Lloyd, Deputy Director of Nursing and Quality
10 January 2017
New Year is traditionally a time to make changes for the better, so it’s fitting that St Andrew’s became officially smoke-free across all its sites on 1 January 2017.
It was an important decision for St Andrew’s to ban smoking and it’s one that I’m proud to have been involved in.
At the heart of how we care for our patients at St Andrew’s is a holistic approach. We don’t just treat people’s mental health needs, we focus on their physical health and spiritual wellbeing too. It’s a method that’s been proved to work for thousands of patients over the years.
So, with everything that we know about the dangers of smoking, it was a natural step to protect our patients and staff by giving them the incentive to stop.
People with mental health problems are already at greater risk of developing physical illnesses, so helping them to stop smoking while they’re at St Andrew’s is a big opportunity to improve their health.
Stopping smoking also increases the effectiveness of some medication and reduces side effects, so it helps our patients to keep well.
That said, it wasn’t a decision that was taken lightly. The potential impact on patients was our top consideration in making the move.
We first announced plans to become smoke free on No Smoking Day in March 2016, and Smyth House and our Nottinghamshire site were the first to kick the habit, following William Wake House which was already smoke-free. Our Birmingham site made the move in October 2016. Very encouragingly, people accepted the change willingly and adapted to the new policy calmly and positively.
All patients and staff have been given tailored support to kick the habit, using nicotine replacement therapies where needed.
Now, just a few days on from becoming fully smoke-free, I’ve been hugely impressed by how calmly and responsibly people have adapted to the change – both patients and staff alike. Several people have told me that the new policy has given them the motivation they’ve needed to give up, and those that have stopped for a while are already feeling better as a result.
So, for anyone that still needs a final incentive, here are five excellent reasons to stop for good:
1. Extra energy. Giving up will improve your lung capacity by 10 per cent in just nine months. Within weeks your blood circulation will improve. More oxygen in your body means less tiredness.
2. Boost your bank account. The average smoker spends £250 a month on their habit. Giving up mean you have an extra £3,000 per year – what else could you spend that money on?
3. Stress less. Rather than relieving it, smoking is a cause of stress. Nicotine withdrawal is a big factor in creating feelings of tension and worry. People that give up soon report lower stress levels.
4. Look good. Stopping smoking makes a difference to how you look – reducing skin ageing and improving the appearance and health of teeth.
5. Live longer. Half of long term smokers die early – but giving up will add years to your life. 30 year-olds that give up will add around 10 years to their life, and even at age 60 you stand to gain an extra three years.
If you’re taking the plunge, there's plenty of support on offer. You can do it - good luck!