Archived: The Linden Centre Mental Health Wards

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. For example we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Where people were unable to provide a verbal response or tell us verbally their experiences, for example as a result of their limited verbal communication or poor cognitive ability, we noted their non verbal cues and these indicated that people were generally relaxed and comfortable and found their experiences in this service to be positive. We saw that individual interactions with staff were warm and friendly, with an open, positive atmosphere in evidence.

When there were occasions when some people presented with behaviours that may challenge. We saw that staff defused the situations gently and skilfully, diverting people's attentions and engaging them in constructive activities or conversation and on one occasion re- engaging them with their meal. Staff throughout spoke calmly, quietly, and without any confrontational or directive tones in their voice.

We were able to speak with a total of five people who were using this service and they confirmed that the staff treated them with respect and provided them with choices wherever possible. For example, people told us that, "They are kind to me and listen to me." and, 'They come quickly when needed." We spoke with one visitor who told us, "They really look after my relative." and, 'You can address anything with the staff they let my relative make the decisions generally."

We saw that staff treated people with respect and warmth in the service, and offered

choices throughout, and gave gentle encouragement and support when needed. We noted that the support provided did not impinge on people's dignity. We saw lots of examples of positive and considerate interactions between staff and the people using the service. Staff frequently checked on individuals' well-being, and ensured, for example they were not cold, or wanted a drink, with choices offered.

We saw that people enjoyed a calm and settled lunchtime, with support and prompts

available for those who required it. Well designed and coloured dishes assisted people

in eating without any undue mess or difficulty. There was plenty of choice offered;

where individuals had decided that a particular meal was not for them, alternatives were quickly offered. Staff showed a good awareness of individual likes and dislikes and of their eating patterns and preferences. Alternative choices were offered at or just prior to meals, as staff were aware that people may only have short term memory recall.

We spoke with people and asked them about the meals they received they told us: "The food is OK.", "I am easy to feed, l eat anything.', and 'We have lots of food. We have tea and biscuits in the morning and afternoon."

We observed lunch being served and found the meal to be nutritious, hot enough and well presented. We saw that people were able to have a drink whenever they wanted and we saw staff offered drinks at regular intervals throughout the day.

We spoke with a visitor who told us that, "Staff will give another choice of meal or a sandwich if they do not like the food available so they never go hungry. They always seem well fed "

People reported that they felt safe in the service and that the staff were kind and attentive. For example, one person told us, "I feel very safe here, staff are very kind to me", then, having assured us there was no abuse, they told us that they had, "No concerns about ill treatment, staff always have time for me". Another person told us, "I have no concerns but if I had I would speak to staff and I am confident they will help me".

Visitors spoken with reported that there was always plenty of staff around and that they were supportive towards the people using this service. For example one person told us, "They have a very stable and well trained staff team which I think is a good thing. I'm happy with the level of care." Someone else said, 'I have had no occasion to raise any concerns, I am quite happy with the care for my relative here."

Those people who were detained under the 1983 Mental Health Act reported that they understood why there were in hospital. Some of these people confirmed that there had been informed of their rights under the 1983 Mental Health Act whilst others couldn't remember. Those informal (voluntary) patients spoken with told us that they understood about their rights as an informal patient and that staff were supportive. People confirmed that they were encouraged to attend their weekly multi-disciplinary meeting and that they were asked for their views during these meetings.

People confirmed that they were generally satisfied with the support and treatment provided by staff. However two people expressed some concerns about how they perceived their own care and treatment and these individual concerns were bought to the attention of senior managers who confirmed that these concerns would be reviewed on an individual basis with the person and their key worker.

Some people said that the system for accessing Section 17 leave under the 1983 Mental Health Act was 'Quite good'. All of the people spoken with stated that they felt able to approach staff if they had any concerns and were confident that these would be addressed wherever possible.