The care at The Orchard - Claire shares her thoughts.

This blog so far has focused on the Lancashire Care NHS Trust and how they are hurting the women they are supposed to care for.

We would like to make clear that the campaign is not against the staff at The Orchard and we’d like to spend a few moments focusing on the care provided by them when you are acutely unwell.  Claire shares her thoughts again.

Earlier this year I was admitted to Ridge Lea hospital and then transferred to The Orchard when that hospital closed.  My full story is here - http://bedsintheorchard.blogspot.co.uk/2014/11/clares-story-near-miss-distressed.html

The Orchard is staffed by a dedicated team of qualified nurses, nursing assistants, occupational therapists, pharmacists, admin staff, doctors and a consultant psychiatrist with a penchant for Cadbury's chocolate.  While I was at the Orchard, I was always impressed by the care and compassion they showed to the service users they were looking after; sometimes under very difficult circumstances.

Whether it was the OTs getting people involved with ‘Wake up and Stretch’, when many preferred ‘Sit down and Smoke’, the nurses taking the time to talk with you despite being snowed under by paperwork, or the nursing assistants taking the time throughout the day and night to make sure that you were OK and had everything you needed, not one made you feel that you were a burden or alone.

Everyone was treated with dignity, everyone was treated according to their needs and no one was left to fend for themselves.  A great comfort when you are acutely unwell.

I am not saying that everything was perfect.  It was clear that many of the nursing staff would have loved to have more time to spend with the patients, if it wasn’t for the reams of admin they were expected to do every day.  Sometimes there was only one qualified member of staff on duty, which was a concern and sometimes communication about appointments was hit and miss, making you feel out of control, but the important thing was that the actual caring was always present.  The level of care was consistent, even with the staff working long 12 hour days.  You would expect that things would slip by the end of one of their mammoth shifts, but it never did and for that alone, they deserve praise.

There were some things that made being at The Orchard unpleasant, the main issue being the food.  This was a never ending stream of pre-prepared meals, shipped in and reheated on the premises, with nothing fresh at all apart from a bowl of fruit.  Because the food was always heated in trays, specialities were crunchy rice, where the re-heating dried out the rice at the top, bottom and sides, leaving only the middle soft, and a seemingly never ending stream of quiche for the vegetarians -  although they occasionally called it a tart or flan, it was pretty much the same thing.  As someone who believes strongly that fresh food is important to health, whether mental or otherwise, it was hard to be somewhere there wasn’t even an oven in the kitchen.

However; the people who served the food were always kind and courteous, even when people like me were critical about what was on offer.  The people who cleaned and looked after the building were also kind and courteous.  No one made you feel awkward or ‘lesser’ for having a mental illness.   For that I am grateful.

The environment at the Orchard was pleasant, although the outside space was disappointing after being in Ridge Lea Hospital where there had been large and pleasant grounds, with trees filled with blossom and wildlife running around.  The rooms were well equipped, with a TV in each room – although the bizarre choice of channels did raise eyebrows.  I didn’t meet a single service user who sat down to watch BBC Parliament in the whole time I was there.

There is a café that served fresh (oh joy!) sandwiches and decent coffee, with staff who could always be relied on to cheer you up.  It was clear that they all loved their jobs and in turn that made the café a very pleasant place to be.  It provided a much welcome rest from being in the ward, and an opportunity to talk to the volunteers; ex-service users themselves, who spent time listening to your issues and helping advocate for you with any complaints or compliments you wanted to pass on.

All of the staff at The Orchard and The Apple Tree Café worked hard to help people get well and supported them through really difficult times.  I am grateful for the care they gave me when I was unwell and I hope that people reading this will appreciate the good work they do too.

For those of you who don't twitter - Our take on the response from Lancashire Care

The Beds in the Orchard Campaign received its first official response from the Trust this afternoon via our Twitter account @OrchardBeds from @LancashireCare.

Here's what they had to say and, of course, our response.

@OrchardBeds The decision to operate male only beds at The Orchard is a temporary measure and is under constant review. (1/5)

We can't argue about whether or not this is true as we only have this statement from the Trust about it.  However; we do know that some Trust staff have been advised The Orchard may revert back to mixed provision once The Harbour opens in March 2015, suggesting that it is not under constant review as the decision has already been made.  We are open to concede there may have been a communication problem if staff have not been informed about it remaining male only until the opening of The Harbour.

Regardless of whether this is temporary or not, it is impacting women and families now.  It is hurting female service users now and there remains no clinical benefit to women from the closure.

@OrchardBeds There is a peak in demand for male beds & a reduction in demand for female beds - we have empty female beds at present. (2/5)

Two responses here.  Firstly, it is likely that the peak in demand for male beds is linked to the trust closing a 15 bed male ward in Burnley and it is rather disingenuous to cite demand for male beds being the driving factor after closing 15 of them.

Secondly, the point about empty female beds is slightly misleading.  The status of beds can change on an hourly basis.  From personal experience a bed can be taken in the time it takes to have a consultation with your psychiatrist about whether you should go into hospital or not.  A freedom of information request has already been submitted to the trust about how many women they've sent out of area in the last 4 years, often to private hospitals that should clarify demand.

We also directed them to this post - http://bedsintheorchard.blogspot.co.uk/2014/10/is-based-on-need-self-fulfilling.html

This isn't about empty beds.  Its about denying a whole group of service users access to local inpatient care solely based on their sex.

@OrchardBeds All Trust facilities have the ability to flex male/female beds in line with demand. (3/5)

This is indeed True.  The Orchard had two 'swing' beds that could change between male and female.  There were 10 fixed male beds and 6 fixed female beds.  Up until recently, the two swing beds were female.  The trust could have swung those beds to male, giving them 12 male and 6 female beds at The Orchard. Instead they decided to deny access to a whole group of service users from a wide area. 

It is rather disappointing that the Trust sees removing access to local inpatient care to all women in the Lancaster area as 'flexing'.

@OrchardBeds The Orchard will revert to mixed sex as soon as this is clinically appropriate. (4/5)

There's nothing we can really say about this other than, how is it clinically appropriate to deny women access to local inpatient care.  No, seriously.  Our twitter handler has replied that we will be happy to discuss this with someone qualified to explain the clinical benefits to women of sending them out of the area for treatment.

 @OrchardBeds We would be happy to discuss this further with you and you can contact us on communications@lancashirecare.nhs.uk (5/5)

One of our team had already emailed the complaints department with the letter we published here

http://bedsintheorchard.blogspot.co.uk/2014/11/not-sure-what-to-write-when-you-complain.html

We will publish their response as soon as they receive it.

There's no trusting the Trust

A Source at the Lancashire Care NHS Trust today said that closing The Orchard to women is a 'temporary measure' until the new hospital "The Harbour" is opened in Blackpool.

This is a step away from the previous reasons of protecting the vulnerable, but could cover their reason of it being 'based on need'.

So why do they need more male beds now?

Following further enquires and investigation, we discovered that just weeks before The Orchard was closed to women, they closed Ward 18, a 15 bed male psychiatric ward in Burnley, with no means to cater for the number of beds they knew they needed.

If the Trust closes male beds, they should mitigate that closure by providing treatment in the community to the men they otherwise should have admitted as inpatients.  Instead, they withdrew inpatient care to women of a large area of the trust. This is not acceptable.

It's the women of North Lancashire who are paying for this cost saving exercise.  It is the women of North Lancashire who are being denied local treatment and its their families who are paying the cost in time, travel and disruption for this decision.

Lancashire Care is failing in its duty of care to the women it is meant to treat and support.

It has to change.