"Discussion around the Rehabilitation Strategy"

About: Inpatient care (Forest Close)

(as a staff member posting for a patient/service user),

The focus group met to discuss and get service users opinions about the draft rehabilitation strategy which is out for consultation.

Initially the strategy was explained to the focus group members then questions asked after that:

What do you think about the idea that people should not be placed in hospital too far from where they live?

One client described the experience as “horrible” and being “right out of my comfort zone”.  The client described having been given no choice with regards to her placement.  The group discussed how being away from family and friends at a time of distress is not an environment to recover in and everyone reflected that they would rather stay in Sheffield.

The aim of the CERT team is to reduce the intensity of their visits over the period of time they are supporting a service user and increase the number of people moving through the service.  What do you think about this aim?

The group thought that the length of time should be flexible depending on the person and that they should be at a stage where they feel ready to move from service to service.

An aim of Forest Close is that people should be seen within 1 month of being referred.  Do you think it is better to be seen as quickly as possible once you have been referred to Forest Close?

The response to this question was mixed.  Some felt that they would prefer to do in reach with staff from the referral point but also reflected that in their own experience this did feel frustrating and unsettling at times.  Others commented that they would like to move to Forest Close as soon as possible after referral and wouldn’t mind less contact from the site.

The team would like to reduce the amount of time that you are at Forest Close.  Do you think this is something you would want?

The group reflected on the current average length of stay and the proposed length of stay as per the rehab strategy.  One person commented that they had expected to be here for 2 years but has already been found a housing placement and is starting overnight leave after just 7 months.  Someone else reflected that they liked the fact that you could take things slowly here and that there were groups you could complete to help you learn about your mental health so you can “self manage” when you leave.

The team want to review the workforce/staff – different professions and the culture of the teams and values of the staff.  What do you think about this?  How are things for you at Forest Close?

Staff are always there to talk and offer 1:1 time.  The attitudes of staff are friendly, supporting and encouraging.  One member of the group commented that compared to other hospitals Forest Close offers more trust, help with moving on and encouragement to do things on my own.  It was also mentioned that some people would prefer it if staff would “give us a break” when they didn’t do planned activities.

What is the aim in your view of the service at Forest Close?  Did you know why you were referred here and what was expected?

The group provided the following reflections;

“Get us well”

“Get us independence”

“Get us ready to leave”

“I didn’t know why I’d been referred here,I just thought it was a different hospital.  I was given leaflets but didn’t read them”

Did you know when you came to Forest Close what you wanted to do/aim for and what you wanted to achieve?

People in the group mentioned wanting their own accommodation in the community.  We discussed vocational activity and jobs that people had done before and on the whole people were keen to get back into employment or volunteering.  Other aims identified were getting help with moving on, self catering and going out on my own.

Both teams want to look at how people are supported to move on after leaving the service.  In your view what do you think is needed?

The group agreed on the practical elements of moving on from Forest Close such as finding accommodation and purchasing the necessary items required for independent living.  Additional support when at home around keeping a tenancy, budgeting skills and “not being left to fester on your own” were also identified as being important. 

The group said they felt lonely living alone.

The group reflected on the groups and activities provided in the community that are open access and thought this was going to be helpful in terms of staying connected however, they all agreed that they would need encouragement to go and regular reminders.

In terms of comparing Forest Close with living in the community it was mentioned that you should be able to go out and have a drink if you wanted to as long as it’s off the premises and you are in control of yourself.

Someone mentioned that the discharge plans aren’t always clear and it can be frustrating not knowing what the plans are.  One member of the group reflected on just wanting someone to sit down with and make a plan.

Some members of the group reflected on it taking a long time after being referred on from Forest Close - taking some time to be assessed and accepted for tenancy or placement which is anxiety provoking.

Other key factors for staying well when discharged from Forest Close included staying on my “medication”, “keeping busy”, “being around people” “someone visiting me a couple of times a week”.

The team also want you to look at the purpose of the interventions they are offering.  What do you think you could get help with from the teams that you haven’t had assistance with?

Discharge planning from admission was mentioned even if it was slow paced and regularly reviewed.

I would like to have more time in the kitchen for self catering.  I sometimes feel rushed to prepare something and I like cooking from scratch so I only self cater once each week.  I don’t like keeping the support workers from doing something else they could be doing when they are with me in the kitchen.  One person said they would like to cook with housekeepers.  They have a good relationship.

General closing comments were that people feel that everything is covered in terms of discharge planning, providing a place of safety and stability, encouraging independence and insight into mental health conditions


Response from Julie Smalley, Clinical Nurse Manager, Sheffield Health and Social Care NHS Foundation Trust 9 months ago
Julie Smalley
Clinical Nurse Manager,
Sheffield Health and Social Care NHS Foundation Trust
Submitted on 12/12/2019 at 12:13
Published on Care Opinion at 12:13

Its good to hear that service users are pleased with the idea that the care they receive is better delivered locally as this was at the heart of the rehab strategy for Sheffield. We are keen to work with individuals in an individual way and length of stay can vary dependent on needs. We do experience some delay in discharges for some service users and this can be about external factors outside of our control such as vacancies in supported or residential accommodation or the mental health act restrictions.

In terms of service pathways I agree that the length of time within a service should be done in collaboration with the service user and the Multi Disciplinary Team based on expressed needs and wishes. However, we do recognize that transitioning from one service to another can be difficult and can feel like rejection. It’s important that all of this is taken into consideration.

Forest Close holds a weekly referral meeting and aim to feedback to the service users and their team within 2 weeks at the most. The length of time from admission to referral can vary as sometimes it is a question of waiting for another service users to be discharged. We do like to engage with the person from the point of referral and get to know them so that the care and support we deliver is in line with the service user recovery goals. I appreciate all service users are individual and what feels right for one person may not for another.

We never rush service user discharge but we do encourage more and more independence and growth during their admission with us and we don’t want service users to feel too dependant on the service as this doesn’t fit with growth and recovery.

It is good to hear that service users feel supported by the staff team and that they think we support them:,

Get us well”

“Get us independence”

“Get us ready to leave

I think we need to do more focus groups so we can really target the service to deliver the interventions and support provided at Forest Close to meet the needs of the service users who are admitted here. I note that more self catering is something people would like and I will share all of this feedback with the team. Its really good to hear that service users have good relationships with the housekeeping team and I will feed this back to them. It is very much part of the support workers jobs to cook with service users so I wouldn’t want anyone to feel that they were preventing them from doing other things. We can talk about this at the staff meetings.

Thanks for this feedback I appreciate all the comments and aim to discuss this with the staff teams in order that we can really deliver a service that promotes independence and instills hope and recovery

Best wishes

Julie Smalley

Clinical Nurse Manager

Forest Close

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