Enter and view: East London Foundation Trust Mental Health Wards - Brett Ward

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Summary of report content

Healthwatch Hackney visited Brett ward to evaluate the quality of mental health care, focusing on patient experience, staff feedback and overall ward conditions. During the visit, they spoke with 8 patients (50% of the patients on the ward) ranging between the ages of 27 and 61. They also interviewed the ward manager, a social therapist, one junior doctor, the occupational therapist and two care workers.

Patients have varied feelings about their safety on the ward. Some feel secure and appreciate staff responsiveness to incidents, while others feel unsafe, especially around certain individuals. Issues like theft of personal items, including vapes, highlight challenges in maintaining a secure environment. 

The quality of care varies due to differences in staff attitudes and skills. Staff shortages from sickness affect patient care and workload, particularly in situations requiring 1to1 care or seclusion. Despite these challenges, staff generally feel supported by their managers and value regular training opportunities. 

Efforts are made to accommodate cultural and religious preferences, such as providing Kosher food and arranging religious visits. However, staff responses to these needs vary, leading to mixed experiences among patients.

The activities available on Brett Ward vary and some patients choose not to participate due to personal preference or lack of interest, despite staff encouragement. The activities are not always engaging or accessible, often failing to meet patients' preferences. Additionally, the schedules do not always accurately reflect the available activities. 

Visits appear accessible, with positive feedback on ease of visitation and room availability for family and friends. However, discrepancies in understanding visiting hours were noted among patients. 

Patients have mixed awareness and satisfaction with their care plans, with some unaware of their contents or even the existence of a plan. Discussions about discharge were often uncertain. Several patients lack clarity on their discharge dates or face housing challenges upon discharge.

Patients shared varying experiences with providing feedback and raising complaints, with some uncertain about how to do so effectively. While there are mechanisms like comment boxes and local complaint forms available, clarity and guidance on how to use these effectively are lacking for some patients. 

Awareness and access to advocacy services vary among patients, affecting their ability to navigate mental health care decisions effectively.

The staff at Brett ward generally feel supported, listened to and valued by their managers. However, concerns about staff shortages, particularly due to sickness, impact their ability to provide consistent care and support to patients. Staff also highlighted the need for additional support to manage workload pressures and improve patient care. 

Inconsistent engagement leads to unequal patient experiences and care gaps, affecting continuity of care. 

Patients are experiencing long waits to leave the hospital because of problems finding housing, made worse by different rules among different councils. This is affecting how quickly patients can move through the hospital and adding to the staff’s workload. 

 While staffing is generally adequate, shortages during peak times affect patient care. 

Absconding cases are rare but, when they occur, they strain staff resources due to limited police involvement and legal constraints, impacting patient safety and staff morale. 

There are ongoing concerns about rodent infestations, with reports of mice chewing through walls and creating an uncomfortable environment for both patients and staff. There are also issues with slow response times from NHS Property Services for building maintenance requests, worsening problems. These conditions contribute to a stressful environment for both staff and patients.

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General details

Local Healthwatch
Healthwatch Hackney
Publication date
Date evidence capture began
Date evidence capture finished
Key themes
Building, Decor and Facilities, including health and safety
Caring, kindness, respect and dignity
Cleanliness, Hygiene and Infection Control
Complaints
Communication with patients; treatment explanation; verbal advice
Consent, choice, user involvement and being listened to
Discharge
Food, nutrition and catering
Health inequality
Lifestyle and wellbeing; wider determinants of health
Patient/resident safety
Service organisation, delivery, change and closure
Staffing - levels and training

Methodology and approach

Was the work undertaken in partnership with another organisation?
No
Primary research method used
Observation (eg Enter and View)
If an Enter and View methodology was applied, was the visit announced or unannounced?
Not Known

Details of health and care services included in the report

Details of health and care services included in the report
Hospital-based psychiatric care

Details of people who shared their views

Number of people who shared their views
14
Gender
Men
Religion or belief
Jewish
Types of disabilities
Mental health condition
Types of long term conditions
Mental health condition
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