Enter and view: Amblescroft South

Healthwatch Wiltshire carried out two planned Enter and View visits to Amblescroft South, a specialist dementia hospital unit in Salisbury, in April and December 2016. The unit, managed by Avon and Wiltshire Mental Health Partnership NHS Trust, provides assessment and treatment for people with severe dementia who require a hospital stay before returning home or to an appropriate community setting. The service has 20 beds and aims to provide short-term care, typically lasting six to eight weeks

Overall, Healthwatch found Amblescroft South to be a caring, well-managed service with a committed staff team and a positive atmosphere. Patients and staff were welcoming and open during both visits, and the visiting team's overall impression was that the unit delivered compassionate care in a clean and safe environment. 

The physical environment was found to be clean, well maintained, and free from unpleasant odours. Patients had single bedrooms with en-suite facilities, and there were several comfortable communal lounges, as well as a secure garden that patients could safely access. However, the visiting team felt that bedrooms and some areas of the ward could be made more homely and dementia-friendly through greater use of colour, signage, pictures, clocks, and orientation aids. The ward manager was already exploring funding opportunities to improve the environment. 

Healthwatch observed many positive interactions between staff and patients. Staff were seen responding to patients with kindness, patience, and compassion, while patients appeared relaxed, settled, and well cared for. The atmosphere on the ward was described as calm and safe, and patients were observed responding positively to staff and the ward manager. 

Patients who were interviewed spoke positively about the care they received. They said staff treated them with respect, listened to them, and communicated well. Many felt cared for and valued, describing staff as kind and supportive. Patients also reported being given choices about what they ate, what they wore, when they got up or went to bed, and how they spent their day. 

One recurring theme was a desire for more social interaction and activities. Several patients said they would like more opportunities to chat with people and have more meaningful activities during the day. While some enjoyed gardening and other activities already available, others felt there was not enough stimulation and that more could be offered. 

Feedback from relatives was limited because few family members were present during the visits and only one questionnaire was returned. However, the feedback received was positive about the quality of care and staff attitudes. The main concern raised was the difficulty of visiting due to the long distances some families had to travel, with one relative describing a 100-mile round trip. Relatives also felt that patients would benefit from additional stimulation and activities. 

Staff members generally spoke positively about working at Amblescroft South. They highlighted the respectful approach to patient care, strong teamwork, supportive leadership, and involvement of families in care reviews. Staff believed that patients often became more settled and healthier during their stay. However, they also identified challenges, including recruiting experienced staff, dependence on agency workers, limited time for activities and conversations with patients, and occasional delays in discharge caused by difficulties accessing suitable community support. 

Some staff expressed a desire for additional dementia training, while also acknowledging improvements in reducing lengthy hospital stays and improving discharge arrangements. The ward manager was praised for demonstrating a strong commitment to quality improvement and had introduced initiatives such as patient community meetings and plans to undertake further dementia care quality assessments. 

Healthwatch concluded that Amblescroft South provided good-quality dementia care delivered by a dedicated and compassionate team. The report recommended making the ward environment more dementia-friendly, securing funding for additional equipment and orientation aids, expanding activities and opportunities for social interaction, improving information and support for visiting families, and continuing work with partner organisations to reduce delays in patient discharge. 

The provider welcomed the report, agreed that it accurately reflected the service, and stated that the feedback was valued.