(July2023) Peer Support Workers

‘‘We would like to ask whether other secure services have experience of successfully employing peer support workers. If so:
 
What does their role involve in terms of day to day tasks?
What are particularly valued aspects of their role and what are the challenges?
 
If there were any unsuccessful employments, what was learned from that experience?
 
If other services feel that they can share an example of person spec/job description, generally, any learnings or advice, it would much appreciated.’’
We have just appointed two peer support workers and we await the long recruitment process to be completed and they are hopefully starting soon. There are jobs out there with job descriptions attached which are worth looking at. Wathwood Hospital, Respondent 1

 

At Wathwood, we have followed the model that was successful in our other medium secure hospital in Trust, Arnold Lodge, in that the posts sit with the occupational therapy service. We have an established peer support service within Trust and there is an identified link person from this team to provide supervision and support in addition to what I will provide as their line manager, which I feel is very important. Having recently done IMROCs peer supervision training, this was something that was discussed a lot and highlighted as being important. Although not yet in post, day to day their main role will be offering 1:1 peer support to patients on the wards (recovery focused conversations, goal setting etc). They will also support involvement and the recovery college at Wathwood. For me, a challenge, given that peer support is something new here at Wathwood is how we educate both patients and staff about peer support and the role of a peer support worker. The Trust peer support team are helping with this and we have some sessions planned in where they will come and talk about the role. Wathwood Hospital, Respondent 2

(Oct 2023) Patient Property

 

“What restrictions do you have on how much property can patients have at site and in their bedrooms. How is this managed both during their stay and before admission. How is this communicated to your patients…

 

We are currently reviewing our local procedures for patients’ property. I would be very interested in hearing from any secure (low or medium) units. I would be very grateful if units could share any local procedures / polices they have around this issue.”
We really struggle to manage property too and have tried various amounts, but it is difficult to manage. Newton Lodge
At the moment none, there is one patient on the ward whose bedroom is full of items, and where other bedrooms are full off boxes and wires and other things, the fire officers are aware of the bedrooms, things like glass bottles or deodorant are all kept in the security cupboard. Moorlands View

(Oct 2023) Random Searches after Unescorted Leave

“We are a Low Secure Unit, seeking advice from other services who conduct random searches upon patient who return from unescorted leave.
 
  1. How and what methods do you use to ensure that searches are random?
 
  1. What are the pros and cons?
 
  1. Have you noticed an increase or decrease in contraband coming onto your wards?”
At the Newsam Centre we use an electronic randomiser button that all SUs press when returning from leave. Pros – random, SUs know that they could be searched, fair. Cons – still restrictive, could mean someone still brings contraband onto the ward. Overall, I think the rate of contraband being brought onto the ward has decreased as everyone is randomly searched meaning no one is targeted/ pressured to bring something onto the ward. Newsam Centre
We did operate random searches before our CQC inspection, though were informed that there was no such thing as random, and therefore all searches must be based on suspicion of illicit activity and documented as such. All SU’s must have a care plan which reflects the units search policy, and searches are only conducted if we have cause. We do not have random searches; we have searches based on evidence or suspicion. Though if we have suspicion before a leave takes place then we would change the leave to being escorted. So really it is only if someone sees something or reports something during the SU’s leave, at that time we would complete a person search. Pros, more leaves as the process is now shorter and less staff intensive. Cons, I’m sure things are brought to the ward which shouldn’t be. We have not seen a change in the amount of contraband on the ward, though we do complete ward searches more frequently than before. I am sure things do get missed as SU’s know that our searches are infrequent, but we have also worked hard on restrictive practices, so what used to be contraband such as tobacco, lighters, and vapes, are now able to be kept on a Service Users person. Moorlands View
To ensure our searches are random of patients returning from unescorted leave, we have the named nurse of the patient take the lead, as well as reviewing the care plan they go through and plan the searches and if any random alcohol or drug tests are needed into the ward diary. This enables them to ensure they are random. We also have a log of each time the searches or drug and alcohol tests are completed and if there was any issue, this then acts as evidence when updating the ministry etc if there isn’t an issue, we always reinforce this point to the patient when conducting the searches too, and generally we have found they want to do well and prove this.  they also understand the consequences should they be found with anything they shouldn’t have. (e.g. Leave review etc) We have had no issue up to press of any contraband items being brought into the unit. Amber Lodge

(Oct 2023) Patient and Family Involvement

“I am wanting to find out as much as I can about what other places have done, are doing or have in place to have families and patients involved more, any information would be greatly appreciated.”

 

We organised a carers event for Hepworth, this involved inviting families/carers in to meet the nursing team, gather a feel for the unit and speak to service users. We did some introductions and invited service users from the ward to also meet them. This was done based on an individual risk assessment for each service user. We provided tea coffee and cakes, which were also sent back to the ward to ensure all service users felt included. Patients from the rehabilitation pathway were invited to speak about their own personal experiences to provide re-assurances to our families. We invited the gym therapists to speak about the work they are currently doing and the plans for the future, who also gave a tour of the gym and sports hall facilities providing demonstrations. Staff showed carers around the unit including primary care suite, art rooms, therapy kitchens, diamond shop and the multi faith room. Families were invited to have their pictures taken with loved ones which were then printed for them. Due to the acuity of the ward, we were unable to include this in the tour, however we did a presentation with photographs, from feedback this was found to be helpful for service users’ families as they felt they could be assured loved ones were comfortable. Members of the nursing team spoke about their experiences of Hepworth, the role of primary nurses was explained in detail, process for CPA’s, ward rounds, CTM’s, care planning and information around medication. As a team, Hepworth wanted to ensure carers and families felt involved in their loved one’s care. This could be something as simple as been able to put a face to a name/voice that they speak to on the phone. Also, as we are a secure unit it can seem daunting to people visiting, we wanted to provide them with an understanding of the environment. We are currently waiting for feedback from families and carers on this event, but it did appear to have a positive response. We are planning on setting up a carers ‘support group’ and aiming to do visits/meetings every 12 weeks, this will be led on information families and carers will find useful.  A plan for the future would also be to invite carers whose family members have moved on to speak about their experience. We also aim to formulate a leaflet with guidance from our current carers and families to provide information to new admissions families. Newton Lodge
 
Currently at Moorlands View we are working on a carers pack with information with regards to wards and what they will provide for the service user. Moorlands View

(Oct 2023) Bikes for Service Users

“Does anyone’s service have bikes for service users to use in the community? What is the procedure for service users using them? Do they need to complete a proficiency course/ test? How are the bikes maintained?”
We have 2 bikes that patients can use, however we’re lucky because we have the bike shack on grounds who service our bikes for us at a discounted price and offer cycling proficiency lessons and assessments for free. We refer any patients to them that have an interest and they have to complete their proficiency before they can use the bikes with staff. Also, any outings have to be planned in advanced, everyone has to wear a helmet and obviously we have to know what route there planning to take. Amber Lodge
We have a number of bikes at Forest Lodge for service users to use on leave. They complete a cycling proficiency test with an OT or a fitness instructor, they sign a document which covers things such as wearing a helmet, staying on bike paths etc. Bikes are maintained by our OT staff in house who are competent with bikes, however Halfords are always an option to use as I think they do free bike checks. Forest Lodge
Lynfield Mount does not have any. We have some electric bikes that the service users use when they go out with the OT. Moorlands View