Mental health and rehabilitation

In August 2023, Central North West London Foundation Trust commissioned Healthwatch Hillingdon to research the in-patient experience across its acute adult mental health site in Hillingdon.  They  conducted interviews and focus groups in-person with patients who were either informal or formally detained ('sectioned') under the Mental Health Act.  They spoke to 40 people in total.

What's working well

Access to physical activity was strongly highlighted by patients as a key factor for improving their mental health and supporting their recovery. Healthwatch recommends that the gym is made widely available and accessible for patients when they wish to use it, with a full timetable of activities to help them maintain a healthy weight and improve their overall health outcomes whilst in residence. 

On Crane and Frays wards Healthwatch observed the positive relationships between patients and the peer support workers employed by the trust. The peer supporters, with lived experience, played a valuable role in providing insight to the service and practitioners, supporting communication with patients and enabling greater understanding between patients and staff.

Whilst meal provision would benefit from some improvement, overall, the feedback  from patients across all units was mostly positive regarding quality, quantity, and choice.

Generally, staff across all the units visited received high praise from patients regarding the care and support they provided, with patients saying that the staff are friendly and helpful. There is no doubt that the attitude of staff has a significant influence on patient experience and in these cases, where patients may be detained or admitted for months (even as long as a year in some cases), fostering positive relationships between staff and patients is extremely important. 

Patients told us the wards at Hawthorne, Oaktree and Colham Green are spacious, warm, filled with natural light, and with easy access to communal garden areas. The atmosphere in each of these wards was also calm and peaceful. In the units for older adults, the furniture and décor are dementia friendly and considerate to those with visual impairments. There were also handrails in the main ward areas in Hawthorne and Oaktree, and mobility aids in the Hawthorne unit.

What could be improved

• Provision of places where patients can vape without disturbing others who find vaping disturbing
• Improving the security of personal items
• Support to improve sleep and sleep hygiene
• Increased access to the garden on Crane ward
• Review interventions and adaptations on Oaktree ward to prevent falls and frailty
• Improve access to activities on Crane, Fray and Oaktree wards and review existing activities on all wards
• Review current food menus
• Promote greater involvement of patients and their Carers/family members in care planning and plan care for the whole person
• Explore options to better facilitate Section 17 accompanied leave, or access to outside space on Crane and Frays Wards
• Review restraint practices and emotional support following use of restraints
• Increase the visibility and communication of meaningful information about rights and access to support on Crane and Frays Wards
• Improve communication and advice about medications, their purpose, and common side-effects
• Improve information and communication regarding advocacy and access to local advocacy services
• Improve the information provided to support preparation for discharge
• Improve security and privacy for visitors on the acute wards
• Develop wider opportunities for regular and systematic patient feedback