Psychiatric Intensive Care (PICU) services at Clock View Hospital
Contents About Clock View Hospital - creating the perfect space Facilities Referrals Assessment Twelve bed mixed unit Services available Outcomes and benefits Our staff Our performance Rates Impressions from service users and staff Getting to Clock View Contact us 2
Mersey Care unveiled a new generation of mental health facilities with the opening of Clock View Hospital in 2015 Years of careful planning and 22 months of construction produced a £25 million 80 bed hospital built across five wards and an assessment centre. Every patient has their own room, all with en-suite bathrooms and on the ground floor in a landscaped setting to enable access to garden courtyards plus lots of internal space and light. Clock View, situated in Walton, Liverpool is Mersey Care’s solution to providing therapeutic inpatient environments and approaches to care designed to improve recovery, wellbeing and reduce lengths of stay. Clock View treats local people for a range of mental health issues including depression, anxiety and dementia.
Clock View was in the news - as the photos show, the media came to see what the next generation of mental health hospitals looks like. Deputy Prime Minister Nick Clegg visited during Clock View’s first week of being fully operational. “One patient I met in a previous facility was sharing a room with five other people and is now in his own room, has privacy, and said he was excited he could use the internet in his room. These might sound like small details, but they are very, very important for people who are dealing with mental illness and need a calm, clean and modern environment to recover.” 3
“I love the window bays because services users and staff can interact continuously.”
Who built Clock View? • • • • • •
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The architects were mental health specialists, Medical Architecture (MA) Landscape Architects Camlin Lonsdale designed the gardens A joint venture between Farrans and Heron Brothers led the construction 1,500 tradesmen and 100 local people were employed 11 apprentices in eight different trades Hugh Baird College, Bootle, adopted Clock View for students on their Construction Extended Diploma Programme.
Mersey Care NHS Foundation Trust is committed to the development and delivery of high quality mental health services across a wide variety of settings both inpatient and community. With the recognition of foundation trust status, the Trust now has the opportunity to deliver these services across a wider geographical footprint.
Facilities
The building was designed to provide light and airy spaces all contained in attractive low level buildings surrounded by landscaping. The facilities include: • • • • • • • • • •
Individual bedrooms of the highest standards for privacy and dignity Communal activity areas Safe inner courtyard gardens to aid people’s recovery Learning and education spaces Café Range of individual and group therapy/activity spaces Space for self-help, advocacy and voluntary organisations Spiritual space Family visiting rooms Meeting rooms.
Smoking anywhere on the Clock View site by staff and visitors is not permitted under Mersey Care’s policy. Patients are supported and encouraged to give up smoking for health reasons.
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To illustrate the idea that recovery is a journey we travel on, many aspects of artwork were incorporated in the design and fabric of the building. At the front of the hospital is an art installation made up of granite blocks, similar to the stone of Liverpool docks, where people can sit. On the stone plinths there are imprints of boats that have been filled with objects and things that people said they would like to take on a journey and that keep them well. The theme of boats and rivers continues through the hospital. Many of the glass dividing panels, doors and windows have been etched with boat shapes. There is also wall art on all of the ward areas on a theme of boats, with precious things inside them. All of the artwork was produced in art workshops by patients, staff, local school children and community groups.
Services available at Clock View
• Clock View provides short-stay treatment for service users with a range of mental health issues including depression, anxiety and dementia • Clock View provides a psychiatric intensive care unit (Newton ward) for those most in distress and in need of urgent inpatient care • A Section 136 suite provides a place of safety for people detained by the police under the Mental Health Act • The hospital is also the base for a local assessment and immediate care service that provides emergency, urgent and routine assessment, enabling better support for people between inpatient and community services • Access to a wider divisional resource and support from our specialist secure services division.
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“Bigger, brighter, a more relaxed atmosphere.” Referrals
The Psychiatric Intensive Care Unit (PICU), offers a structured environment to support service user needs and referrers should consider referrals within the following criteria: • Experiencing acute behavioural disturbance that seriously compromises the physical/psychological wellbeing of themselves and / or others • At notable risk of aggression, suicide and/or serious self harm • At risk of increased vulnerability because of sexual disinhibition or over activity in the context of mental disorder • Posing a level of risk which means they are unable to be safely managed within an open ward setting • Presenting with a high risk of absconding associated with increased risks of aggression or self injurious behaviour • Service users will be detained under an appropriate completed assessment/treatment section of the Mental Health Act. The PICU will consider referrals for service users who are detained/in the process of being detained under the following sections of the Mental Health Act (1983): • • • • •
Sections 2 and 3 Hospital orders Section 37 Section 37/41 Prison transfers.
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“Nice lighting with an ‘inside outside feeling’ in the communal areas.” Assessment
The PICU specialises in the assessment and comprehensive treatment of people with a broad spectrum of acute and enduring mental health needs. Newton ward PICU conducts a robust referral system and aspires to complete assessments within 24 hours of receiving an appropriate referral. Senior staff are on hand to offer clinical advice and consultation to acute wards 24 hours / 7 days per week. The PICU team is available to do face-to-face assessments but will predominately do telephone triage with referrals to ensure a prompt response. The referer should complete a referral form including current presentation and risks. On receipt, the referral will be discussed within the PICU team and a decision will be made on review of the information and relevant documentation.
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Our programme of care and therapy
On Newton ward the emphasis is intensive treatment combined with a range of physical, procedural and relational security measures that are designed to reduce risk, disturbance and vulnerability. By providing transparent, collaborative and timely assessments the ensuing treatment plans enable the team to focus on promoting recovery. Multidisciplinary working is at the heart of Newton ward practice which enables the provision of effective, comprehensive, care. The MDT on Newton ward have a wide range of skills and are approachable, empathic, courteous and able to develop positive relationships with service users that are founded on recovery. Newton ward staff are committed to the principles of ‘No Force First’ as part of an ambitious strategy to dramatically reduce the use of coercive interventions. ‘No Force First’ was originally an initiative within mental health inpatient units in the USA to dramatically reduce, and ultimately eliminate the amount of dangerous restraint and seclusion events. It has a proven record of success in transforming healthcare environments and enhancing safety for both service users and staff. On Newton ward a least restrictive approach is promoted and the aim is to ensure that all service users have a positive experience during their recovery.
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Outcomes and benefits
Our proven programme of care and therapy develops the living skills, insight, education and confidence required for patients to return safely to an open ward or to the community. The ward allows for service users, at their most distressed, to access meaningful activity with a ward based, experienced, occupational therapist and activity worker. There is also access to a gym space in close proximity to the ward with trained gym staff - being on a PICU does not exclude service users from attending.
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Our staff
Newton ward has a highly skilled and experienced multi-disciplinary staff team. This encompasses the lead consultant psychiatrist for inpatient services, specialised doctor including four senior nursing staff. There is also access to ward based psychologists, occupational therapist and activity worker. There is a chaplaincy service for all denominations - as well as those with none. Junior doctors and student nurses work alongside the permanent staff team. Newton ward has dedicated facilities management staff.
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“It’s great, I can sit at my window and watch the world go by....”
Our performance
The Trust values – CARE (Continuous improvement, accountability, respect and enthusiasm) inform all of our work and the ward works closely with staff in the Trust’s Centre for Perfect Care. The unit recognises and adheres to the No Force First culture at the Trust and has recently been involved with the Dynamic Appraisal of Situational Aggression (DASA). This is predictive and helps staff to intervene at the earliest possibility to help to prevent a situation from escalating. Staff continuously update their training in order for them to work at their optimum level and be in a position to give the best care possible. Training is diverse in nature from infection control, mental health act and psychological training, for example, formulation training and level two suicide prevention training.
Rates
Tailored packages of care are provided to meet the specific needs of individuals and will be made available on request.
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“Nice open space, garden is big, lots of natural light.” Service users, carers and staff helped shape the building’s design and feel. Service user and carer lead for Mersey Care Catherine Mills recalls the total contrast of Clock View compared to her experience when admitted to an inpatient unit 15 years ago. “I was very unwell, which in itself was very frightening. I was taken to a room which was bleak and soulless with bars on windows that I couldn’t see through because they were so dirty. It was like a prison cell, it said to me ‘this is all you are worth’. The experience that people coming to Clock View have is bright en-suite bedrooms, artwork, gyms, family rooms, activity spaces, and the food. They all say: ‘we value you; we care for you; we are going to help and support your recovery; this is going to be a positive experience for you and your family’.”
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Getting to Clock View
Clock View is situated on the site of the former Walton Hospital, off Rice Lane, Walton (A59) and close to Liverpool’s ring road Queens Drive. The hospital is visible from Rice Lane and is on the opposite carriageway to a large Sainsbury’s store, situated at a set of traffic lights. By public transport: there is a bus stop immediately outside the hospital on Rice Lane, with others close by at Queens Drive/Breeze Hill, Walton. Walton train station is a 15 minute walk. We ask drivers to respect the parking area and park only within designated marked parking bays. Please do not block any of the access roads in and around the site as these are used for essential deliveries and services. People with mobility issues are permitted to use the paved drop-off area at the main entrance, but vehicles should not wait there as it is used by pedestrians. Please ask at reception if assistance is needed. There is other free parking nearby the hospital.
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“People in Merseyside deserve the very best mental health services in the country and we are proud that Clock View makes a bold statement that second rate facilities are simply just not good enough.” Joe Rafferty, Chief Executive
“The passion and commitment around the sculpture and art, shows that we are not just doing a job, not just ticking a box, not just delivering a building to price, but that everybody who has been involved in it has been committed to more than that, it’s about the absolute quality of environment and space.” Beatrice Fraenkel, Chairman. Rated Good by CQC in 2017
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Clock View Hospital 2a Oakhouse Park Liverpool L9 1EP Phone: 0151 330 7211 www.merseycare.nhs.uk 16