Enter and view: Rivington Unit

Healthwatch Bolton undertook an Enter and View visit to the Rivington Unit Mental Health Inpatient Services, including Beech Ward, Oak Ward and Maple House Ward at Royal Bolton Hospital, on 11 September 2017. The visit found that patients were generally positive about the care and support they received from staff, describing staff as caring, approachable and supportive. Patients across all three wards were also broadly satisfied with the food provided and many reported feeling safe, although some described incidents of aggression between patients and found aspects of the ward environment unsettling. 

A key theme was the lack of meaningful activities, particularly on the female Oak Ward. Patients frequently reported boredom and felt there were insufficient opportunities to take part in activities they enjoyed or help shape the activity programme. While facilities such as gyms, sensory rooms and activity spaces existed, patients and staff felt there were not always enough staff available to support their use. Patients on several wards also expressed a desire for more opportunities to leave the ward, access exercise, take part in daily living activities and engage in hobbies and social activities. 

The visit also identified issues around communication and care planning. Some patients were unclear whether they had been involved in developing their care plans or did not fully understand what a care plan was. Patients were generally aware of their legal rights and access to Independent Mental Health Advocates (IMHAs), although some were unsure about how advocates could help them. Staff highlighted the impact of using bank and agency workers and felt that a more stable workforce would allow more time to build relationships with patients and support their recovery. 

Healthwatch Bolton recommended improving the range of activities available, ensuring patients are fully involved in creating and reviewing their care plans, and improving understanding of IMHA services. Additional concerns were raised about access to dental care, opportunities for hairdressing and self-care activities, and the need to protect vulnerable patients from exploitation by others on the wards. Greater Manchester Mental Health NHS Foundation Trust accepted the recommendations and outlined actions including improving activities, strengthening care planning processes, increasing permanent staffing and improving communication about support services.