Carers / Visitors :: Midlands Partnership Foundation Trust

The involvement of Family, Friends and Carers is incredibly important for service users who are in-patients in our Secure settings. We have a commitment to ensure Family, Friends and Carers are valued, recognised and included as partners in care, we will listen to their contributions, and try to communicate effectively with them, and we will help support them to maintain their wellbeing.

We are part of forensic service; a service where people with mental health problems or learning disabilities who have committed offences or been involved in the Criminal Justice system, are offered assessment and treatment in an environment that is safe and secure. On rare occasions, we also treat people who have not committed an offence, but are considered a risk to others due to their behaviour when unwell.

We operate a Recovery model of care and our aim is to help people recover from their illness, to help address their offending behaviour to reduce their risk of re-offending and enable their re-integration into the community. The guiding principle of Recovery is hope – the belief that it is possible for someone to regain a meaningful life.

Most carers recognise that there is a three-way partnership between service user, carer and clinicians, we call this the 'Triangle of Care', with all the voices being heard and influencing care treatment decisions which will produce the best chance of recovery. The responsibility is on the professionals and services to actively encourage partnership with you as family and carers.

Effective carer engagement will develop by adopting positive practice. This relationship can be reinforced by putting in place key components which invite carer participation, giving information, support and advice in a considered manner. This approach should involve carers in all stages of the process including assessment, care planning, and eventual discharge.

A typical forensic carer has been on a very eventful journey before their cared for even reaches secure services. Most will have been through the process of their cared for becoming so unwell a crime has been committed and the police and/ or courts have been involved. Often our experience of mental health services has been less than ideal. Often people will say that if only we had received the right support, earlier in the journey, then the offending may not have happened.

It’s a very bewildering experience to come into contact with secure services/ forensic services. Your loved one/ friend will be coming into hospital under a section of the Mental Health Act. There will be other people on the ward on a variety of mental health act sections. Some of our patients/ service users are transferred prisoners, some are awaiting trial and other people come from general mental health wards who need specialist support.

The hospital is a therapeutic environment to help treat people’s illness and help them move on.

Working with carers, friends and families of people in secure mental health services - Youtube

We try and encourage visits as they can be extremely helpful for our service users. Requests for visits go through the regular Multi-Disciplinary Team Meeting.

All visits should be pre-arranged with ward staff

In advance of visits taking place, the ward staff should be informed of the names and contact details of each visitor. This is in order that they may be contacted if for any reason the visit cannot take place.
The maximum number of visitors per service user is limited to 3 (2 on Newport), unless a prior agreement has been sought via the ward manager or nurse in charge of the ward.
Disabled access is available throughout the secure wards.
Upon arrival at Reception, all visitors will be asked to produce an item of photographic identification
(e.g. passport, driving licence).
Failure to provide sufficient proof of identity will result in visitors being denied entry to the unit.
How to arrange a visit – this is fully explained in the attached leaflet but in general it involves contacting the ward first once your family member/friend has agreed to the visit.
Visiting hours –core protected hours are around meals and therapeutic activities. We will however try and be as flexible as possible. Please note visits could be subject to change depending on the priorities and demands of the ward. However we will always try and facilitate visits as best we can.
Observation levels during a visit - please be aware that it is unit policy for visits to be observed by staff. Your name will be added to our approved visitor list.
Staff have to manage the security of service users/ patients and visitors. Lots of everyday/ ordinary items are not permitted, please look carefully at the contraband list and familiarise yourself with it
Contraband List – there are certain items you are not permitted to bring on to the ward on visits or send to the ward via post. Contraband Items List (pdf). Please refer to the security section on the websie for more information: Forensics - Security Information.
Funding for visits is the responsibility of friends, family and carers.
You can keep incontact in the following other ways: pay phones, (in some cases mobile phones), letter, parcels, in some cases video calls and emails are available.
Giving gifts/ bringing items

It can be hard to buy gifts and know what to bring in because of the restrictions due to the security measure in the Contraband Items List (pdf). Previous carers have told us that some good suggestions are: clothes, magazine subscriptions food (must be in original packaging), please ask the ward for advice before bringing food items. The service is trying to encourage healthy options wherever possible.

You must notify the ward staff / ward social worker if you intend to visit with anyone under the age of 18, in order that the formal process can be followed. All child visits happen outside the secure perimeter in a specially designated child visiting room. A child includes anyone under the age of 18, to set up a child visit we will need to meet with the person with Parental Responsibility and we are also required to contact the Children's Social Work Department in the child's home area. All child visits are supervised by hospital staff.

Carer support and involvement in secure mental health services - NHS England aims to provide clear information for carers, service users, service providers and commissioners about how carers of people who use secure mental health services should be engaged with, supported, involved and empowered. I has been developed by NHS England in partnership with The University of Central Lancashire. It has been co-produced by a steering group involving a wide range of experience and expertise and, most importantly, carers themselves.

The Care Act 2014 outlines new rules about individuals who are carers.
You now have a right to an assessment of need and a support plan for yourself and the threshold for being viewed as a carer has lowered to 'Having needs for support, whether this is now or in the future' we can support you in getting the correct carers assessment in your local area. Please ask the ward Social Worker about how to receive an assessment of your support needs.

The Care Programme Approach (CPA) is there to support recovery from mental illness.

CPA is a framework used to assess the needs and make sure that they have the support they require.

Community Mental Health Teams, Assertive Outreach Teams and Early Intervention Teams are likely to use CPA.

Under CPA they will get a care coordinator who monitors thier care and support.

Care coordinator will review plans regularly to see if any needs have changed.

Rethink Mental Illness - Care Programme Approach (CPA) has the Rethink care programme approach factsheet.

As a friend or family member that has been approved to visit, you can attend CPA meeting if your friend or family member agrees. If they do not agree you can provide information.

Seeking views / getting back story. Info on trigger points / explain about diagnosis and medication.

Please click on links below to look at the full welcome pack. This pack includes photographs and information on:

Location of ward/ hospital
Named contact
Parking/ public transport
Visiting information – times/ places and there will be an escort at all times.
Different ways to keep in contact.

Welcome packs:

The Hatherton Centre and Clee: Forensic Mental Health Services Directorate Information for Family, Friends and Carers (pdf)

Ellesmere Friends and Family Information (pdf)

As our service user's rehabilitation and treatment progresses, and they gain insight into their illness or condition and complete work to prevent re-offending, having leave can be an important part of their Recovery.

For patients on a Section 3, leave can be granted by the Consultant (Responsible Clinician).
For Restricted patients such as a Section 37/41, Section 47/49, or Section 48/49, leave can only be granted by the Ministry of Justice.
For patients who are detained on a prison transfer such as Section 38, Section 47/49, or Section 48/49, leave is generally not given unless the patient is coming to the end of their sentence.
Leave is generally given in steps, so firstly service-uses would have escorted leave with staff and then eventually they may progress on to unescorted leave. In general we like to ensure that leave serves a therapeutic purpose and provides a structure to help with Rehabilitation and future discharge.
Progressing to unescorted leave/ discharge plans
Categories of step down
Funding
117 entitlement
Support team

There are discharge options, one of which is the Forensic Intensive Recovery and Support Team (FIRST).

Other pathways will be discussed with you and your friend or family member.

Here is the Mental Health Community Services website.

We take the safety of your friend/ relative very seriously. We have adult Safeguarding procedures in place so that we can reduce the potential for any form of abuse, and prevent abuse from occurring.

Preventing abuse should occur in the context of person-centred support and personalisation, empowering individuals to make choices and supporting them to manage risks. If your friend or relative makes a disclosure of abuse, they will be listened to and the correct protocols followed. You will be informed if the service user gives their consent.

Patients have the right to choose how much information is shared with you as a significant person in their life. For example, they might decide you can come to their Care Programme Approach review meetings, or to just be part of these meetings. Confidentiality can be a difficult area. Sometimes a patient will share information with you then suddenly they stop doing so. When this happens it may be because they are unwell.

If you want to ring to see how your relative is you will need to call the ward; however there may be information we cannot share with you, we can only share information that your family or friend has consented to; we are allowed to receive information from you regarding the patient and this will be recorded as Third Party information. You can tell us if you do not want certain things sharing with your relative.

Below is a quote from one of our carers:

“Once your friend or family member is settled on their ward, you may start to experience delayed reactions to what has gone on up to this point and now look to your own needs. This could be counselling, or other psychological therapies. Time out doing hobbies and pursuing other interests, finding times to visit friends or even a shopping trip, that you haven’t been able to manage for some time. You need to recover too. “

It may be that you need to visit your G.P for a referral to the most appropriate support, but below are a list of some helpful contacts and sources of information:

Emergency help can be found here: Urgent Help

Here is some other general information you may find useful to know about the service.

The grounds and site of St Georges Hospital is non smoking.
If you send your friend or relative a letter or parcel please note these may be checked by a member of staff before being handed over mail etc. is opened in front of staff.

Here are some useful contacts that you may need whilst your friend or relative is in hospital:

North Staffs Carers Association
Carers Centre, Fenn House, Duke Street, Stoke-on-Trent ST4 3NR
01782 793100
Carers Hub
Details Needed
Asist Advocacy for Stoke and Staffordshire
Winton House, Stoke Road, Stoke-on-Trent ST4 2RW
01782 845584
Stafford and Cannock League of Hospital Friends
New Burton House, Burton Bank Lane, Stafford ST17 9JW
01785 221372
First Point of Contact, Shropshire
03456 789044.
A dedicated call centre for Adult Social Care where people can contact for advice and signposting. Appointments for a Care Act assessment or a chat with a Social Care Practitioner can be made through them.
Carossroads Together
01743 341995 or 0333 323 1990 opt 1 opt 6
The Carers Centre, Telford
01952 240209