"Expect the worst"

Dear J.Mclelland

I was saddened and disappointed to read of your recent experience of the care and treatment received by one of your parents on Ward 1 at The Mount and to be frank there were aspects that were professionally really difficult to hear.

The issues you describe do not demonstrate the values and underpinning behaviours that are to be expected from any of our staff or services and if anyone has reason to raise concerns about such behaviours I certainly want to know about them so that appropriate improvements or actions can be taken.

Your experience prompted me to go and meet with the Matron and the Ward manager responsible for this area yesterday as I felt it important to ensure that they were allowed to account as registered professionals themselves to the concerns you raised. Through discussion, I asked them to talk me through your concerns and be clear about what is expected of staff when they arrive on duty and how standards of care and treatment are tested.

Ward 1 at the Mount is a 17 bedded male acute dementia inpatient ward. The nature of the ward and patient group, does mean that some of our patients present with behaviours that others may find challenging; and for our staff, managing these behaviours, there are occasions such as with helping people with washing and dressing where we have to make best interests decisions which both staff and patients can find distressing; as it may involve placing restrictions on people who do not want us to intervene with their choices.

I expect good communication to be based around staff talking to each other, using handovers productively and being clear about what people need through individualised care planning and risk assessment. We know that the best way to achieve good care is to involve patients, carers and relatives to help us to agree and pull care packages together. I believe that communication and involvement is an area of improvement for us and we will work on this on ward 1 and across the organisation.

There is also work to do to improve cleanliness on the ward. The service is working closely with our service provider to improve standards. Previous actions have been the removal of carpets and ensuring the purchase of furnishings that we are easily able to clean; whilst trying to maintain a comfortable and homely environment. I have also asked the Ward manager and Matron to consider whether they require additional cleaning support to maintain the appropriate standards.

Previous feedback has clearly identified lack of activity as a concern. The Ward manager has had direct discussions with staff to feed this back to them and the team are actively looking at ways of using observation and engagement time more constructively. In response, some of our team members have been given protected time to ensure that patients receive one to one time for activity sessions that are meaningful to the individual and a new therapy assistant has also been employed to support an increase in activity.

Finally, the garden was out of action as a significant amount of improvement work took place in the summer of 2017 and this did cause some disruption. It reopened approximately 3 weeks ago and patients and families are once again able to enjoy fresh air in a safe and comfortable space.

I hope I have been able to provide you with some reassurance that I have taken your concerns seriously and I hope that things have improved for you and your family. Staff would really value your input into your parents care and ask that you share your concerns with them at the point of care whenever possible as they are open to feedback even if that feedback challenges their practice. Could you please contact us through the PALS office and leave your details if you would be happy for the Matron and Ward manager to be in touch with you. The number is 0800 052 5790.