Enter and view: Lavender Ward, Queen Mary's Hospital

Healthwatch Richmond conducted an Enter and View on Lavender Ward, at Queen Mary’s Hospital, a mental health service. The visits were conducted on 14th July, 19th July, and 21st August 2017. The service was provided South West London and St George’s Mental Health NHS Trust (SWLSTG).

The visits were arranged as part of Healthwatch Richmond’s Enter and View schedule.

Observations were made by the Enter and View representatives reported. Staff’s attitude was described by patients as ‘friendly’ and ‘welcoming’. However, there was delayed communication to inform patient, upon admission, of their designated key nurse. there was no clear procedure on how to provide feedback. Some patients were not aware of their care plans. Providing housing to patients upon discharge was a major issue that resulted in delays in updating care plans. This is often due to the shortage of housing that was provided or arranged by social services. Activities arranged at the ward were described by staff and patients as ‘not stimulating’, ‘not enough to challenge or interest’, ‘limited’ or ‘regularly cancelled’. The lack of activities was attributed to the lack of funding. Meals provided were described as ‘good’. Dietary requirements were accommodated such as Halal meals. However, patients thought that meals could have extra portions of fruit or vegetables. Ward environment had a mixed experience of safety concerns. Feeling safe at the ward sometimes depended on other patients becoming disruptive or distressed. Some patients were concerned that their room lock was faulty or they were not given a key to lock their room. Some patients felt safe throughout their admission. The ward’s environment was described as ‘clean’ and ‘well-kept’, except for the patio and some outstanding maintenance work. Information and notices on activities and therapy programme were accessible and available, such as hearing aid. Patients generally felt support during the discharge process. However, staff found the discharge planning process increasingly more difficult, with delayed discharge. Social workers will only attend a patient’s ward round under the current arrangement and attendance, which was described by staff as ‘sporadic’. Staff visibility and staffing levels were variable.

The report made 19 recommendations. The first two recommendations included communication:

1. The ward should introduce a system which reinforces the difference between a key nurse and daily named nurse to patients and the roles they play in their treatment and care.

2. The ward should introduce a designated comments box in an accessible location on the ward as a confidential means for leaving feedback

A comprehensive response was received from SWLSTG