"The Cassel"

Widely accepted to be 'the best the NHS has to offer' I was willing to give this largely alien environment a chance. 

The assessment process should have flagged to me the rigidity and uncaring nature of what was the worst 9 months I have experienced. I live over 250 miles from the hospital yet the absolute latest they could offer me an appointment in the day was midday. However with no other local options I was willing to try to give the place a chance. I regret this decision with every fibre of my being.

I was told I would receive a minimum of 9 months treatment. They neglected to mention the wholly unacceptable 'holiday' that therapists would take for an entire month late summer. Or that despite such an enormous holiday every therapist would take an large amount of other annual leave, often on the day they had sessions, despite them all (to my knowledge) working on a part time basis. Upon questioning the Cassel would defend this with 'this is what has always happened'.

The Cassel was for the majority of my time in my view, grossly understaffed and dangerous, thus presenting a danger to both staff and patients. There was one occasion where a medical emergency was dealt with by patients because staff were in handover or the meds room. The patients involved were told they over reacted by the nurse that eventually strolled down the corridor despite myself screaming for help loud enough that people behind two closed fire doors heard me.

I felt that there was also physical neglect. it took over two and a half weeks of me telling everyone I had severe nausea and stomach pain leading to me only consuming around 3 biscuits a day to even be seen by the doctor. I was told that my stomach pain was a mental manifestation or behavioural problem. I was told off for not eating before I was even asked why. It turns out it was a medication interaction that was easily treatable and with the correct medication resolved in under 2 days.

The healthcare needs of the patient group is tended to by a junior doctor in training to be a psychiatrist. Not a GP, Not even a trainee GP. Someone without the legally required minimum training to be a GP. I questioned this. I exposed this. And unless I am very much mistaken a senior clinician could not even seem to grasp how this could be an issue.

 The Cassel did not listen to continual patient feedback and thus wasted precious NHS resources. Particularly in regards to what I shall loosely call 'movement therapy'. If you could even begin to believe that this regularly contained 0 movement you will begin to understand the nature of the problem. Walking out of the session provided greater movement and therapy than staying in it. Conversely a pilot program of art therapy took place in my time there. It was concluded by the majority of people there that if it did not take place directly before the patient group left for the weekend it would be beneficial. Literally nothing came of this pilot.

Another example of senior staff not listening to patients was in the admission of new patients. After a disastrous round of admissions senior staff said they will not admit new patients on sequential weeks. A few months later there were I think 7 admission over the course of 8 weeks. If new patients are admitted extremely closely together neither that new patient nor the existing cohort get the adjustment time and talking time they require. Which is damaging to everyone. As is a situation where the patients say they can not work with a person but that person is admitted anyway. Either ask for feedback and listen to and act upon it, or don't ask for feedback. If it is a cae of we need patients for funding to stay open, admit that to the patients when asked so.

The process of half day visits occurring twice a week and professional visits occurring at least once a week was again a damaging and invasive practice. For each type of visitor an existing patient is expected to volunteer to host. We do not go to the Cassel to live out or life in a goldfish bowl nor to be a tour guide- each would be less distressing and better paid. It comes to a point where all that seems to be discussed is people who aren't even at the Cassel? Or for that matter the development of a garden, none of the patient cohort cared about the installation of a sensory garden. Yet it was talked about more frequently than our wellbeing for at least 2 weeks. 

One of their largely touted treatments is the psycho-social nursing approach. On the whole the staff were amazing people, people who were quite obviously stressed and undervalued by their employers who voted with their feet. How can you expect  therapeutic relationship to develop if the staff chop and change every 2 minutes and HCAs who are drafted in from the bank tell you to your face you are hard to work with and they hate coming to the Cassel? 

During my time there I made an official complaint. Several recommendations were made and absolutely none of them followed up on. I beg of you will things change at this poorly staffed, poorly run and frankly inadequate facility if they do not act upon the recommendations made by their own trust? 

The transition from 9 months in one environment to another setting would be taxing upon anyone. The Cassel however really do not do anything to help you out. I had to seriously blackmail my allocated nurse into a transition meeting. Their reasoning was partly the distance, a distance I was expected to travel every weekend without complaint. The meeting in which I pressured them into setting up this meeting was attended by other staff who seriously could not believe the excuses. In your last month or so you can choose to cut your time at the Cassel down to 4 days a week to help you integrate back to your home life. Great. Except the Cassel then literally does not care how your 3 days away went and won't ask you or even listen when told. Nor will the Cassel help you explore and contact activities or employment in your home environment unless you are lucky enough to live in London. They do not seem to understand that if you are willing to take in people from outside London you have to be willing to ensure their happiness and well-being also.

There are and probably still remain many further issues but this is not a book and months and life have passed since my sentence  Thus in short:

-As a patient they will tell you that you matter and that your opinions matter. In my experience It didnt.. 

-I felt blackmailed into doing things.

- My view would be to shut it down until it is safe. 

-I would suggest better shut it and fund more intensive therapy in a community setting.