Using Care Opinion in high secure services

Update from Nottinghamshire Healthcare NHS Foundation Trust

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About: Rampton Hospital

We recently used Care Opinion in the Learning Disability Directorate to ask patients about the service and involved both patients and staff in service improvements.

Why did you choose to use Care Opinion as the place to collect feedback?

The feedback we traditionally receive was not always very useful we wanted to ask patients about what it was like to live on the ward. I contacted the involvement team to come in and speak to patients. I thought that through talking to volunteers, as opposed to staff, that people would feel safe enough to be honest in their replies.

Using Care Opinion also meant that patients could get individual replies. Feedback that is posted on Care Opinion is responded to, then the stories and replies are put up in the day centre so people can find their comments and read the replies. Normally when we collect feedback it is accumulated it someway so people do not get a direct response.

Rampton Hospital is a high secure service and patients to not have access to the internet. How did you get around this and collect stories?

The involvement team (Nigel Groves and two volunteers who we have worked with before) came and visited all the wards over the space of a week. They also visited the day centre, this meant all our patients had a chance to speak with them.

I asked the involvement team to have a conversation with patients, but if they could, to focus around some key themes. These themes came out issues raised at the Patient Experience Forum and also from any complaints. We were keen to know:

  • Do you feel safe?
  • If you don’t feel safe, what do you not feel safe about?
  • What can we do to make you feel safe?
  • Do you feel cared for?
  • Do you have appropriate support around you?
  • What are your good experiences?
  • And what would you like to not see as much?


We hoped that by chatting with independent people, who have also had mental health experiences too, that patients would open give us some honest feedback.

How did you use the stories collected and added to Care Opinion by the involvement team to improve how things work in learning disability services?

Two key themes came out of this work. Lots of patients were saying how they felt supported by members of staff which was brilliant and we also received lots of feedback about bullying from staff members and other patients.

Regarding the positive feedback about how supported people feel, we have been thinking about how we can celebrate this and find out more about who has helped them and why. Because of this we have created a co-produced newsletter between staff and patients. I have asked patients to nominate staff that have made a difference to them and have also provided the opportunity for staff to nominate other staff too. I am just finalising the first newsletter and I thought I would only get a couple of nominations to include but I have two pages full! It has been great to hear about the work staff do and how this had made a difference to patients. We plan to make this a regular newsletter.

With the comments about bullying we are keen to know if people felt bullied by staff because of their attitude or as a result of staff having to enforce restrictions that people do not like. Some of the comments also mentioned feeling bullied by other patients and we thought this might be more about everyone living together. I appreciate it must be difficult for people to live together so we were keen to explore how people can live better together and tolerate everyone’s differences.

Because of the feedback we are running a bullying awareness day to discuss what bullying is and how it makes people feel.

We are also planning to devise a co-production event on the theme of anti-bullying through the recovery college, presented by staff and patients. We hope to include some role play within that and some awareness training. We are hoping the event will give ideas for new ways of doing things. By involving the patients in this they can bring a different point of view, the staff have the theory and the patients have the lived experience.

How has this work impacted patients?

We have had feedback from the Patient Experience Forum that they are pleased something came out of it this piece of work and that they felt listened to. They were keen to know what was next after the stories had been responded to and they were glad to be involved in the anti-bullying work

What next?

I would like to thank Nigel and his team so working so closely with us and supporting the patients to ‎have the opportunity have their views heard.

The patients really look forward to seeing them and they have made a real difference ‎in breaking the stigma associated with Mental health and have shown our patients that recovery is possible.

Using Care Opinion and working with the involvement team works for us. I have read and responded to every story and have put them into an improvement plan.  Thanks to the success of this piece of work with the LD service we plan to do again in the mental health service.

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