Enter and view: Downhills Ward, St Ann's Hospital

Healthwatch Haringey and Healthwatch Enfield undertook an enter and view visit to Downhills Ward, St Ann’s Hospital, on 19 March and 29 April 2015. The visit was carried out to assess the quality of care provided on the female acute mental health ward, following previous concerns about mental health services at the hospital. Representatives spoke with seven patients during the first visit, received feedback from two additional patients in writing, and met with the ward manager during a follow-up visit. 

The visit found that staff were committed to supporting patients and that many aspects of clinical care were delivered appropriately. Patients had access to medical, psychological and advocacy services, and some spoke positively about the support they received. However, concerns were raised about person-centred care, with some patients reporting that they did not always feel listened to, supported or safe. Patients described incidents of bullying, theft of personal belongings, delays in responding to concerns, and insufficient opportunities for meaningful activities, particularly at weekends. 

The report highlighted significant concerns about the physical environment. The ward operated at very high occupancy levels, some patients had to share four-bed dormitories, and there were recurrent problems with blocked toilets, noise, lack of privacy, limited outdoor space and outdated patient information. Patients also reported that the ward lacked reliable Wi-Fi access and that activities were not always delivered as planned. Healthwatch found that these environmental issues negatively affected patients' experiences and recovery.

The report concluded that Downhills Ward was providing care in challenging circumstances and that staff appeared overstretched. Healthwatch made a series of recommendations covering patient safety, staffing levels, care planning, ward management, activities, information provision and environmental improvements. It also called for reviews of acute mental health bed capacity, staffing arrangements and the availability of suitable community accommodation to support timely discharge from hospital.