"Group Feedback session - Day Service"

About: Specialist services / Eating disorder service

(as a staff member),

Care Opinion Group Session 7th May 2019

We met a group of service users at St Georges Eating Disorder Day Service. It was a pleasure to chat with them about their experiences and thoughts about the service.

Initially we ran through what activities the day service covers, this gave us a starting point to see which sessions they enjoyed and to see if there were any challenges with any of them. They thought all the activities were useful and had a place on the activity programme. Some of them were felt to be more intense and felt more full-on though everyone agreed they should stay on the programme as they are beneficial even if they could be draining.

The key worker session received particular praise as it is a chance for some one-to-one time which was appreciated as occasionally you want to discuss things out of the group setting.  The new form for weekly review/meal planning which helps act as a prompt was also seen as positive. 

The creative session was thought to “give you time to breathe, it’s less hard-core than other groups, even though I know the others are useful”. An example of some of the creative work they did was taking photos of nature and then making them into a collage.

The OT Cookery Group  was seen as a really valuable and very enjoyable session. It has shown them how to make cooking fun again….. “I use to love cooking and this is getting me back into it” “It gets you over the fear of using certain foods” “It’s changed my mind-set on foods, which was daunting at first” “I’ve started cooking again and I never thought I would”. There is a real team work approach to making the meal as you are split into pairs and assigned a staff member and you concentrate on one part of the meal – such as the main or desert. It was thought to be beneficial that you get practice cooking for groups and that you have practice of a meal you don’t have complete control over as well as just being a really enjoyable session.

Some of the young people in the group said they find weigh-in difficult and anxiety provoking saying that weigh-in at the start of a day can either ‘make it or break it’. Some people said they might prefer not knowing what they weight was and others discussed whether service users can decide about it themselves. They all agreed that some form of ‘fun’ interaction helps before and after weigh-in describing one peer setting up games for all to join in. Some members of the group also felt like Tuesday was a bit ‘full on’ and can be draining, although others did not find it that challenging.

We discussed the pattern of activities across the week, Tuesday was seen as a more intense day and talking about Wednesday brought smiles to everyone’s faces as the cooking club is the main activity then as well as finishing with the key worker session. The last session on a Friday; the motivation group, they felt was a perfect way to end the week.

The interactive App Recovery Record was seen as a great addition to the Service as a whole and is also used in day service. It’s useful to be able to photograph your meals and upload them. The interaction with staff via the app was seen as beneficial, plus the fact you can upload your emotions.

One service user commented that the fact that the service doesn’t have “maintenance stage” was  helpful, accepting you at whatever size your body naturally is.

The group couldn’t speak more highly of the staff, they were full of praise stating they were very supportive and friendly and that they make it as good as it can be. “The staff are amazing, super helpful, it doesn’t feel like they are in charge there isn’t a feeling of them and us” “They are supportive, not forceful, they make you understand why you need to do something rather than just tell you to do things”. “Very Very nice lovely staff”.  Someone made the comparison between the day service and their hospital stay; they thought the approach of the hospital staff was too rigid and that it didn’t feel like that at the day service, that the day service felt very supportive, was more flexible and more positive “You learn it’s ok to be free around food, getting what you need”.

To round up the session we asked everyone the “million dollar question” getting them to write down anonymously: “If you could change anything about the day service what would you change”:

- More relaxation group. Maybe like 10 or 15 minutes on Tuesday and Wednesday (keep the big relaxation group on Friday though)

- A group help with shopping for clothes and be blind weighed when at a certain stage

- Portioning consistency between staff (i.e. one staff member has said ‘that’s enough’ while another has said: ‘you need more about the same meal’) Staff are all amazing though!

It was lovely to spend time with the group and we appreciate them giving up their time to tell us their views on the service.

Responses

Response from Maggie Young, Head of Eating Disorders, Sheffield Health and Social Care NHS Foundation Trust We are preparing to make a change

The comments made by the Day Service users are really positive. It is very rewarding that the Day Service users benefit so much from the group ethos of the programme. The emphasis placed on the importance of the OT Cookery group and the practical benefits of handling food and making meals is really valuable feedback. I'm also pleased about the positive comments about staff and service user relationships and the key work sessions the fact there is not a them and us mentality. However clear rules, structure and boundaries are maintained to ensure the smooth running of the programme.

The Service users mentioned that being weighed weekly is stressful and sometimes the option not to know one's weight could be beneficial. Although this is not what usually happens this can be negotiated, if appropriate, on a one to one basis. Staff are aware this is a stressful time and will work with the service users to ensure a positive and fun atmosphere is maintained.

Regarding wider changes the staff team will review the Tuesday timetable and look at the balance of activities to see if tweaks to the timetable would be beneficial. The staff Team will try and build more short relaxation sessions into the overall programme.

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Response from Amy Wicksteed, Lead Clinical Psychologist, Sheffield Eating Disorders Service, Sheffield Health and Social Care We have made a change

Update: Following this feedback staff reviewed the timetable and since July 2019 we have made changes to the Tuesday day-service time-table by moving a group to the Wednesday and introducing a relaxation session.

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