Facilitating Self Advocacy in a locked ward environment

 Parkside Lodge is a 12 bedded acute admission service providing MDT care to people with a LD, specialist focus psychiatry of learning disability.  The inpatient service operates a locked door policy and service users are admitted under sections of the Mental Health Act.  Pre-requisite of service is to provide specialist or intensive inpatient assessment and treatment

What Does It Mean? “I can tell you what I want” - Inpatient at Parkside Lodge

“Learning Disability Nursing is a person centred profession with the primary aim of supporting the well being and social inclusion of people with learning disabilities through improving or maintaining physical and mental health” Good Practice in Learning Disability Nursing DOH (Dec 2007)

PRACTICE Inpatient 1 Self Advocacy Focus Community Presence & Exposure  Wrote his own weekly MDT report  Wrote his own leave programme weekly following MDT outcomes  Wrote his own community exposure plan with nursing staff  Involvement in time line plan of risk behaviours

TimetableDayMorningAfternoonEvening Wednesday 9.00 get up, shave, make bed, wash laundry Cigarette after jobs 30 minutes to local shop Out to Grans for 1 hour minutes travel time 30 minutes walk IroningShower Thursday 9.00 get up, shave, make bed, wash laundry Out for a 30 minute walk 30 minutes to local shop Shower Friday 9.00 get up, shave, make bed, wash laundry Cigarette after jobs Out for a 30 minute walk to local park Play on PlayStation Shower Saturday 9.00 get up, shave, make bed Out for 30 minutes walk to local park 30 minutes to local shop Shower Sunday 9.00 get up, shave, make bed, wash laundry Cigarette after jobs Out for 30 minutes walk to local park 30 minutes to local shop Shower Monday 9.00 get up, shave, make bed Out for 30 minute walk to local park Out to Grans for 1½ hrs 15.00– minutes local shop ShowerIroning Tuesday 9.00 get up, shave, make bed, wash laundry Out for 30 minutes walk 30 minutes local shop Out to bank to collect cash Buy X-Box game Rogue Warrior Shower

Weekly MDT Report

Section 17 Leave

PRACTICE Inpatient 2 Self Advocacy Focus Clinical Assessment & Care Pathway Planning  Wrote in a daily diary / coping strategies  Met with nursing clinicians and discussed content  Actioned planned what she wanted to happen next  Wrote up own report for MDT

Weekly Timetable DAYDATE WHAT I WOULD LIKE TO DO MONDAY Go to shops to buy a card making kit Make cards for friends and family TUESDAY 11am – 4pm Meet with mum and advocate and go and see flat, return at 4pm WEDNESDAY 2 – 3pm PM Ventures cooking session Go and buy a top up card for phone THURSDAYAMPM Psychology session at 12.30pm Get a take-away for tea / supper FRIDAY Enquire about swimming lessons at the local swimming baths Get ingredients and make own meals SATURDAYAMPM Access the local community to buy some shoes SUNDAY Go for walk

MDT Meeting

PRACTICE Inpatient 3 Recovery & Rehabilitation Re-lapse Prevention  Weekly activity planning  Social skill development  Self esteem / confidence building  Exposure to interactions with others outside hospital settings

Weekly Timetable Template DayMorningAfternoon Evening Evening Monday Please refer to Daily Routine Plan – complete daily routine with support from staff Order and collect monies Healthy lunch then go out for ½ hr to hour walk around local shops. Go to shops to buy non food related items. Staff to encourage activities on the unit Healthy Tea FREE time Ring parents either or Tuesday Please refer to Daily Routine Plan – complete daily routine with support from staff Go out for walk in the local area Healthy lunch the walk into town along the canal to go to the market to buy veg / fish / meat (only buying enough to constitute one meal). Prepare the veg / fish / meat and cook HER OWN tea Healthy Tea FREE time Ring parents either or Wednesday Please refer to Daily Routine Plan – complete daily routine with support from staff Healthy lunch Ventures – Healthy Tea FREE time Ring parents either or Thursday Please refer to Daily Routine Plan – complete daily routine with support from staff Healthy lunch the walk into town along the canal to go to the market to buy veg / fish / meat (only buying enough to constitute one meal). Prepare the veg / fish / meat and cook HER OWN tea Healthy Tea FREE time Ring parents either or Friday Please refer to Daily Routine Plan – complete daily routine with support from staff Healthy lunch then go for a walk to the Travellers pub for a drink and a game of pool or to Kirkstall shops / Crown Point to buy non food related item. Walk back if from Travellers or if from town can get the bus Healthy Tea FREE time Ring parents either or Saturday Follow her morning routine from Prepare for parents visit – buy single biscuits/buns from Greggs or supermarket and take a walk around local shops for ½ hr Out for a walk ½ - 1hr Parents 3pm – walk Bobby the dog! Healthy Tea FREE time Ring parents either or Take-Away night Sunday Follow her morning routine from Choose an activity of her choice – out on the bus / pictures / bowling / walk Healthy Tea FREE time Ring parents either or 20.30

Achievements  Attend college course  Engaged with day care services  Attends own CPA meetings  Attends own Manager’s / Tribunal meetings  Parents contact / visits increased and expanded into activities within the community  Lowered supervision levels  Actively participating in her own PCP with support from her advocate and ‘Connect in the North’

PRACTICE Inpatient 4 Self Advocacy Focus Future Planning  CPA involvement / participation  Service user involvement representative  Service user CPA focus group representative  Developed his own website

Person Centred Approach Securing future placement  Where would I like to live? I would like to stay in Leeds. I would like to remain living in Leeds city itself  What kind of place would I like to live in? Ideally I would like to live in a flat. I would also like to live in a residential home with other people.  Who would I like to live with? I don’t mind living with other people. I would like to live with people my own age. I don’t mind living with men or women.

Person Centred Approach Securing future placement  What kind of support would I need? I would like staff support every day. I would like to know that people would be checking on me daily and giving me support in my daily living. I would like help in managing my medication and to help complete my daily chores. I would need help to do my shopping and manage my finance. I would also like help in accessing and maintaining day services.  Where would I NOT like to live. I do not want to live in Wakefield. Other places I do not want to move to are; Scotland, London, Birmingham and Chester  Any Other Considerations I don’t want to live too far away from my father who lives in Leeds.

Weekly Planner DayMorningAfternoonEvening Monday10-12noon Art Class Photography Tuesday10-12noonGym Gardening Gateway Club Wednesday Hollybush Farm Conservation Work Thursday10-12noon Confidence building Gym Friday Art Saturday Activity of choice Sunday Cook on unit To add any other activity he wishes to do in the blank slots

Future Developments AIM – To set up a nurse lead patient therapy group group Supported By – Consultancy from psychiatry and psychology with links to and psychology with links to CBT Consultant Nurse CBT Consultant Nurse

Focus On  Patient to Patient Support  Self expression  Self awareness  Shared experience  Future planning