Fieldhead Hospital

We spoke with two patients during our visit.

Both patients said they had been shown around the unit when first admitted and had been given an information leaflet about different aspects of the unit. They told us they are able to spend their time doing what they want and are encouraged to make their own choices. Both patients were able to explain why they had been admitted into hospital and said they were involved in regular meetings to discuss their progress.

The two patients commented that they are involved in discussions about their care and are kept up to date with what is happening. One patient told us they chose not to sign their care plan but was aware of its contents. Another patient said; 'The staff are good and we always have a laugh. I have improved a lot since coming here and am now socialising more. The activities are very good and I have been home to visit my family.'

One patient told us their best interests had been protected during their stay on the unit. The other patient said; 'One patient hit me three times last night. Staff intervened and gave me attention afterwards. It shook me up but I was not injured. Staff have reported it.'

Psychiatry includes not only postnatal mental illness such as post natal depression, but also the problems faced by women with pre-existing mental health problems who become pregnant. It includes the effects of the mental illness and their treatment on the unborn and developing child.

Because of the nature of the Intensive Home Based Treatment service, we were unable to speak directly with people who use the service.

We carried out our visit on 6 January 2012 to look at progress that has been made following recommendations that were made from an independent review of perinatal services within Kirklees. The review was instigated after the unexpected death of a person with post natal depression who was using the service. Our inspection team included a specialist practitioner who is a consultant psychiatrist with expertise in treating people with perinatal mood disorders. The specialist practitioner did not visit the Trust but held a telephone conference with key personnel from The Trust.

We spoke with two patients during our visit. They told us that they are able to make most of their own choices about their daily routine. This includes times for getting up in a morning and retiring to bed. Both patients said that they receive good care and support from the staff but neither patient knew about their care plan.

The patients told us that when they were admitted into hospital, they were given an information booklet about the unit. The booklet explains that the unit has a locked door system and both patients were aware of the procedure to follow if wanting to spend time off the unit. Neither patient had their own bedroom key. One patient said, 'I am not bothered about having my own key. If I want to spend time in my bedroom then I just ask staff and they let me in.' The other patient commented 'I am used to having a rest in an afternoon because I can become tired after lunch due to a physical ailment. When I have asked staff if I can go for a lie down after lunch I have sometimes been told that this is not good for me.'

Both patients said they are very satisfied with the care and support they receive. One patient commented 'Staff can not do enough for you, they are very good.' Both said, 'There is plenty to do with activities going off all the time.'

Patients told us that they have not had any concerns since being in the unit. One patient did say 'There is another patient who can get on my nerves but I just move to another area.'

Patients said that staff are always about and easily accessible if support is needed.

Patients spoken with told us that they have been asked to provide their views about the activities on offer and the menu choices.

All of the patients we spoke with told us that they can talk to independent advocates. The patients at Newhaven said that they were happy with the activities that they did. Everyone said they were involved in planning their care and had a care plan. Several patients told us that they had discharge plans and were moving on. The expert by experience who attended the inspection with us said that they thought both Horizon Centre and Newhaven were nice and spacious and had a pleasant atmosphere. Staff appeared to be natural and willing to help. Each patient had an individual timetable of activities and there was also an activities board, so patients knew what they would be doing. Overall what people told us about The Horizon Centre and Newhaven was very positive.

We spoke with one person who said, 'I like it here and the staff look after me. The care and meals are very good, I have no concerns'. The person also commented 'When I want a bath, staff leave me alone to have one'. Another person told us 'I have not been offered the opportunity to go off the ward as yet. There is very little else to do'.

People said that they felt safe whilst on the ward.

People spoken to said that there were always sufficient numbers of staff about and that call bells were answered promptly if they needed assistance.

Appleton ward

We spoke to three patients on Appleton ward. They told us that they receive good support from staff who knew and understood their needs. One person said, 'I am hoping to move towards more independent living and staff are helping me with this'. Another comment was 'I am involved in reviews about my care and discussions about my progress'. People told us that they enjoy having takeaway meals on a weekend. One person did say that on occasions their planned time off the ward had to be cancelled because of the lack of staff on duty.

One patient on Appleton ward said that staff are 'respectful and helpful and that the rules are OK'. This patient had been subject to the use of restraint because of their behaviour. They told us 'This was not excessive and was over quickly'. He also said that he was treated fairly and able to do things that he enjoyed such as painting, cooking and going on the exercise bike.

Another patient commented 'The staff are beautiful here and really help you' and 'Staff listen to what you say and are there for you'.

However patients told us that they had felt frightened and unsettled by a recent serious incident but that things had settled down since the perpetrator of the incident had left the ward.

Chippendale ward

We spoke to three patients on Chippendale ward. They told us that they are fully involved in their care and attend their reviews. They sign their reviews to say they are in agreement with the outcomes from them. One patient said, 'I don't particularly like being in a secure unit, but the staff are really good and treat us well'. Another patient said they like going out and having takeaways. One comment was 'I like going out for a cigarette and going on trips'.

Patients said that staff were helpful and knew the support they needed.

Patients told us that they were asked for their views and opinions and encouraged to make their own choices and decisions.

Every patient spoken to on Chippendale ward commented that they felt safe being there.