Providing specialist care and treatment, optimising life beyond illness A specialist service offering person-centred care and treatment for men and women with neuropsychiatric conditions and acquired brain injury. 1
WHO WE ARE St Peter’s Hospital is a specialised centre for the assessment, treatment and rehabilitation of individuals with a wide range of complex neurodegenerative and organic disorders, including ABI. Located on the outskirts of Newport, St Peter’s Hospital offers 51 beds split into single gender units and provides specialist treatment and nursing care that focuses on delivering positive outcomes for our patients, their families and our commissioners.
Trusted partner of NHS since 2005 Incorporating dementia friendly design features recommended by the DSDC, Stirling University
OUR PATIENT PROFILE Part of the established Ludlow Street Healthcare group, St Peter’s Hospital opened in 2013 to provide care for the most challenging of individuals within four core patient groups: •
Acquired Brain Injury (ABI)
We offer treatment to informal patients, individuals detained under the Mental Health Act as well as those undergoing treatment under the Mental Capacity Act. Our hospital also meets the needs of patients subject to Ministry of Justice restriction orders.
OUR MODEL OF CARE Using a person-centred model of care, our highly specialised multidisciplinary team focuses on reducing behaviours that challenge whilst optimising quality of life through three clearly defined care pathways.
Assessment & Treatment Pathway (0 - 16 Weeks)
Recovery & Wellbeing Pathway
Specialist Palliative Care Pathway
The team at St Peter’s Hospital has developed each care pathway to deliver the highest standards of treatment to individuals presenting with cognitive problems, challenging behaviour and both physical and psychiatric comorbidities.
OUR CARE PATHWAYS At St Peter’s Hospital, we reflect the Ludlow Street Healthcare belief that everyone entrusted to our care deserves to be treated with dignity, compassion and honesty. We work in close collaboration with our patients, their relatives and commissioners to achieve the best possible outcomes for all involved.
Assessment & Treatment Pathway (0 - 16 Weeks)
Our Assessment and Treatment Pathway provides individuals presenting in crisis with rapid access to a safe, dementia-friendly environment where they will receive a comprehensive assessment by our specialist multidisciplinary team. This pathway focuses on reducing psychological and emotional distress, treating mental and/ or physical illness and formulating a personcentred care and treatment plan over a 12-week period. Our findings and recommendations are then clearly presented at a care programme approach meeting at week 12, allowing for a planned and coordinated transition to conditions of less restriction (wherever possible) over the following 4 weeks. If enough progress has been made to allow for community discharge, we will provide a comprehensive person-centred care plan to inform future placements of appropriate behavioural management strategies coupled with pharmacological therapies to help maintain the positive results achieved during the patient’s stay with us. We will also work collaboratively with the community placement to deliver a smooth transition. If further care and treatment at St Peter’s Hospital is needed, we offer our Recovery and Wellbeing Pathway.
DEMENTIA HUNTINGTON’S DISEASE
Assessment & Treatment Pathway (0 – 16 Weeks)
ACQUIRED BRAIN INJURY KORSAKOFF’S SYNDROME
Recovery & Wellbeing Pathway
Recovery & Wellbeing Pathway
For those with brain injury and progressive neurological disorders, behaviours that challenge can require a longer period of specialist care and treatment in a hospital setting. Our Recovery and Wellbeing Pathway focuses on formulating and evolving an individualised care plan that provides these patients with enhanced support and responds to risks, whilst maximising their quality of life. People with progressive neurological conditions can often present with complex psychiatric and physical comorbidities: this pathway provides a framework to assess and treat mental illness, enhance functional ability, and promote independence through engagement in a variety of evidence-based therapies.
dignity, bespoke compassion packages of and honesty care close person-centered collaboration model of care
3 Specialist Palliative Care Pathway
Specialist Palliative Care Pathway The behaviour of a small number of our patients can remain challenging as they enter the terminal stages of their illness. In partnership with St David’s Hospice, we have developed a Specialist Palliative Care Pathway that provides for those who are unable to transition to a nursing home or hospice setting. We also work closely with these patients’ families to support them and their loved ones during this time.
ommunity Home Setting
Patients on our Recovery and Wellbeing Pathway are offered a wide range of unit and community-based activities that improve their overall wellbeing - establishing therapeutic alliance and, wherever possible, reducing the use of pharmacological treatments. They also have daily access to specialist communication and swallow assessments, provision of specialist feeds (including PEG), physiotherapy,
specialist GP and dental services, occupational therapy and dietetics. We recognise that each individual is deserving of a bespoke package of care. At St Peter’s Hospital we always seek to find innovative, evidence-based means of providing our patients with a schedule of activity that they will find therapeutic and engaging.
OUR EXPERT TEAM Operating within a bespoke dementia-friendly environment, our highly skilled multidisciplinary team works collaboratively to meet the mental and physical health needs of each of our patients, at every stage of their illness. Working with respect and integrity, our team delivers high quality assessment, treatment and rehabilitation. St Peter’s Hospital multidisciplinary team: Consultant Psychiatrists Registered General Nurses. Registered Mental Health Nurses & Registered Learning Disability Nurses Clinical Psychologist Assistant Psychologist Occupational Therapists Physiotherapist Speech and Language Therapist Dietician Social Worker
The team receives specialist training and support from both St David’s Hospice and the Huntington’s Disease Association, with St Peter’s Hospital being an accredited training centre. We offer both pharmacological and nonpharmacological interventions that focus on addressing behaviours that challenge. Working in partnership with our commissioners, we aim for positive clinical outcomes and a progression in a patient’s care pathway towards less restriction and greater independence. We are committed to reducing the use of antipsychotic medication, wherever possible, and use evidence-based non-pharmacological interventions - including reminiscence therapy, pet therapy, music therapy, sensory therapies, and relaxation and exercise therapies - to treat patients in our care.
Our patients are also offered on-site clinics from: General Practitioners, Chiropidists, Dentists, Opticians and Independent Mental Health & Capacity Advocates.
Taking a neurobehavioural approach, we are experienced at using psychological assessment and behavioural analysis to deliver positive behavioural management plans that support the successful transitional rehabilitation of the patients in our care. St Peter’s Hospital Director
OUR INNOVATIVE AND PROACTIVE ENVIRONMENT The innovative and considered design of St Peter’s Hospital incorporates many dementia-friendly features, as recommended by The Dementia Services Development Centre, University of Sterling - and is regularly audited to ensure it meets the needs of our complex group of patients. Specifically designed to reduce stress and to help those who have difficulty with new learning and memory impairment, our hospital has a dedicated therapy and activities wing. Here, our patients can access a: •
Physical Therapy Room
Hair Salon & Nail Bar
Occupational Therapy Kitchen
Sensory & Relaxation Room
IT Suite, and
Our semi-rural location - and fleet of specialist adapted vehicles - also allow our patients to engage in a range of community-based therapeutic and leisure activities. We actively encourage the involvement of family through on-site visits, home visits (where appropriate), and also support our patients to engage with their families in community settings, such as local cafes and garden centres. Every member of our friendly and approachable onsite team understands the challenges faced by our patients’ families and frequently provide opportunities for them to come together and share their feelings.
I would give you all medals for what you are doing. You all have a way of welcoming me on my visits which I always look forward to. I always feel a part of your family and thank you for that. Mother of a patient
COLIN’S* JOURNEY - A PATIENT CASE STUDY Referred to us after being detained under Section 2 of the Mental Health Act, Colin, 53, presented with increasing agitation and aggression during his admission to an acute psychiatric ward - resulting in a number of serious assaults on staff members which led to his transfer to a psychiatric intensive care unit (PICU). There, Colin was commenced on an antipsychotic before being transferred back to an acute psychiatric ward. He remained agitated and aggressive, which saw him having to be nursed on continuous 2:1 levels of observation and meant he had to be segregated from the rest of the patients due to a high risk of violence towards others. Whilst on the acute unit, Colin rarely engaged with therapeutic activities and was not able to safely access the rest of the community. Colin’s condition was further complicated by him requiring ileostomy care.
Assessment & Treatment Pathway (0 – 16 Weeks) DEMENTIA
*Patient’s name changed to protect identity
How we met Colin’s needs Following his transfer to St Peter’s Hospital, Colin underwent a comprehensive assessment with our multidisciplinary team who confirmed a diagnosis of Frontotemporal Dementia. His clinical needs were clearly identified and he was assessed as being in need of treatment for emotional dysregulation, disinhibition, and difficulties with speech and swallowing. Using a neurobehavioural approach, together with optimisation of Colin’s psychotropic medication, we achieved a number of positive outcomes during Colin’s time on our 16-week Assessment and Treatment Pathway.
The outcomes for Colin, his family and commissioners; •
A significant reduction in the frequency and intensity of Colin’s physical violence and agitation: •
99 incidents in the first 4 weeks of his 16 week admission > 4 incidents in the last 4 weeks
Colin engaged in a programme of activities which included community access when accompanied by 2 members of the team: •
A reduction in Colin’s level of observation: •
2:1 levels of staffing > 1:1 levels of staffing (1 staff member was deemed appropriate due to Colin’s physical ill health, which included difficulties with his speech and mobility)
Colin’s improved mental state allowed him to be actively involved in decisions regarding his treatment: •
Colin was able to consent to his treatment with an anti-depressant and sign his CO2 form
Colin was able to take regular walks in the community - something he’d enjoyed in the past
Colin could be successfully managed within a general ward setting at St Peter’s Hospital
Colin’s level of independence improved with the use of a bespoke communication book designed by our speech and language therapists
Colin ultimately returned home to live with his wife, supported by a carefully planned transition outlined by our team and coupled with a long-term care package that was built upon behaviour management guidelines formulated at St Peter’s Hospital.
Community / Home Setting
OUR SERVICES AT A GLANCE •
Treatment of degenerative neurological conditions
Treatment of mental illness with behaviours that challenge
Risk assessment and management
Occupational and Physio therapies
Speech and language therapy
Specialist nutritional assessments and managements
Reacquisition of daily living skills
Assessment and management of executive dysfunction
Assessment and management of complex physical health issues
St Peter’s Hospital H Parc Seymour Caerleon
HOW TO REFER For planned referrals and admissions, we offer an initial assessment within a 48 hour period. We also accept emergency placement and crisis admissions, subject to clinical discussions. Please contact our Referral Co-ordinator on 029 2039 4410 or email@example.com. Assessments are undertaken free of charge.
I was very impressed by the overall communication by the team to both the relatives and myself. Commissioner
You’ve got to keep an eye on him because he’s still got that little wobble... maybe he’ll always have that little wobble... but, honestly, you’ve given him back to me. Wife of a former patient
St Peter’s Hospital Chepstow Road, Langstone, Newport NP18 2AA
Ludlow Street Healthcare Group Unit 1, Castleton Court, St Mellons Business Park Cardiff CF3 0LT
029 2039 4410 firstname.lastname@example.org