Enter and view: Lilacs Ward, Tolworth Hospital

Healthwatch Kingston upon Thames undertook an enter and view visit to Lilacs Ward at Tolworth Hospital on 23 October 2015.  They spoke to 17 people.

The ward is a secure psychiatric unit for adults aged 20–40, and the visit aimed to gather feedback from patients, staff, and visitors about their experiences in order to identify strengths and areas for improvement. 

Overall, the report found that staff were friendly, approachable, and generally maintained good relationships with patients, contributing to a positive atmosphere on the ward. However, staffing levels were identified as a significant challenge, with shortages affecting staff availability, patient interaction, visitor access, and the ability to run activities or supervise outdoor spaces. Staff also reported spending excessive time on administrative tasks, limiting their engagement with patients. 

The physical environment of the ward showed several limitations. Issues included poor accessibility for people with disabilities, such as unsuitable furniture, lack of handrails, and inaccessible notice boards. There were also maintenance concerns, including a leaking roof, smoke smells, insufficient curtains, and inconsistent cleanliness, particularly in bathrooms and shared spaces. 

Patients’ awareness of their rights and available support was low. Many did not understand their rights, know how to make complaints, or have access to advocacy services. Information materials were outdated or poorly.

Concerns were raised about treatment and therapy provision. Although some patients felt able to express their views, access to psychological therapies appeared limited, and none of the patients interviewed reported being offered one-to-one sessions. Medication timings were inconsistent, and some patients and visitors felt that concerns about treatment were not always adequately addressed. 

Patient involvement in discharge planning was minimal, with no interviewed patients aware of plans for their discharge. Safety issues were also identified, including unclear alarm systems, occasional breaches of gender separation on the ward, and some patients feeling unsafe. 

Food provision was mixed, with some dissatisfaction about quality, lack of menu information, and limited access to snacks outside certain hours. Access to outdoor space was restricted due to staffing shortages, despite the availability of a large garden, and the smaller accessible area was poorly maintained. 

The report also highlighted limited opportunities for activities, especially at weekends, contributing to boredom among patients. Visiting arrangements lacked privacy and could be noisy and disruptive, making it difficult for patients and visitors to communicate effectively. 

The report concludes with a range of recommendations aimed at improving staffing levels, patient engagement, accessibility, communication, safety, cleanliness, and the availability of activities and therapy. It emphasises the importance of involving patients and carers more fully in care planning and ensuring that the ward environment supports recovery, dignity, and wellbeing