During our visit to The Ashwood Centre, we spoke to people on all three wards.People we spoke to felt that their human rights, their dignity and privacy are respected, and that they are given appropriate choices about the care and treatment that they receive.
We asked people at the service about their care plans and the process of care planning in the unit. Some of the people we spoke to were aware of the care planning process and they told us they knew they had one, which most believed they could see if they wanted to by asking either their key worker or the ward manager. One person told us that they did not know what their care plan was though they were aware of a Care Programme Approach (CPA) meeting next week (a formal, regular and scheduled care planning meeting with all the key participants such as the person and their representatives or families, the care managers, ward staff and consultant psychiatrist) and that they would be involved in that CPA meeting.
However we were concerned that other people we not involved in the care planning process. For example, one person said they were given their care plan at 10.30pm at night and asked to sign it by a nurse who said, 'I've written your care plan - if you don't sign it and don't do what we tell you, that's up to you'. Similar comments included, 'I have a care plan but I would not sign it because it was not done with me and I didn't agree with what was in it'. 'I have a care plan, someone draws it up for me. They dictate to me exactly how I should be run. My opinion more or less does not count for anything'.
We also asked people if they understood their rights and had access to their solicitor and advocacy services. One person told us, 'Only seen solicitor once. Think you get an advocate. Told me about my rights when I first came in.' Another person said, 'know what section means, got information about my rights.'
Two people told us that there wasn't enough to do, but gave examples of activities such as yoga, painting, baking, current affairs group, horticulture, music group, trips to the sports centre for badminton, netball, football, and to the cinema or bowling at weekends.
Many of the people we spoke to talked about feeling they were under threat of their leave being curtailed if they were "naughty" or "kicked off on the ward" or did not take their medication. They expressed the view that leave was dependent on 'good' behaviour and that leave was withheld as a 'punishment'. For example people said,
'Just recently wrote out escorted leave. Its obvious staff don't like going out.'
"Get leave, can take it, but staff will take it away if kick off.'
One person told us that they 'Treat you like kids. Not reasonable.' Another raised concern that they were 'Becoming institutionalised'.
People who live at the service told us they regularly attend appointments with various health care professionals, including access to their doctors, dental services, and consultant psychiatrists. One person was visiting the dentist on the morning of our visit.
Most of the people we spoke to told us that they enjoyed the food provided on the unit. All of the people we spoke to told us that when they would like changes to the menu this is acted upon and changes to the menu are made. Other people told us that they participate in cooking sessions with the occupational therapist and got to cook and eat meals they enjoyed.
During our visit to the service we asked people about whether they felt safe living at the Ashwood Centre. The feedback we received was mostly positive and included comments such as, 'If I have a problem I tell my key worker', and [I] "feel safe on the ward'. One person said that they are able to raise issues at their meetings with staff as well as the informal dialogue that they are able to have with staff on a daily basis and with their key worker.
However other people told us, 'Staff turnover here is massive and it's difficult therefore to develop trust with the staff here because just as we get to know them they move on'. 'Don't feel safe on the ward, patients and staff keep coming up to me and pushing past me.'
People told us that they were generally happy with their rooms and that they are allowed to have some personal possessions that they want in their rooms. One person told us that they would like a table to sit at in their room. Two people also expressed a preference for laminate flooring in their rooms for personal reasons.