1. Linden House Hospital Women's enhanced secure services (WESS) Engaging patients

2. Patient group Female patients All patients held on section under mental health act All with a Learning Disabilities Some with a Personality disorders Some have a Mental illness/disorder

3. All patients also have some challenging behaviour Self harm/life threatening behaviour Physical aggression Verbal aggression Sexually disinhibated Socially dysfunctional Disruptive behaviour Self isolation

4. What did I do? Meeting with patients to discuss changes and listen to their views Implemented a standard and easy read timetable Weekly meeting to review/amend timetable, feedback from patients and discussion on future sessions Encourage and promote chooses Developed session plans with set of aims and objectives Provided work sheets for each session to evidence learning Provide standard and easily read hand outs for each session Used resources from other agencies, i.e DVD, quizzes, cook books Feedback from patients after a course i.e Looking after your heart Ensure session are enjoyable, fun with incentives i.e cook books

6. Patients engagement Attending meetings Supported to make a choose Use a time table Patients perception that topic is child like i.e personal hygiene Not accepting their own limitations i.e taking information in a form their do not understand Work folders to sessions/mislaying of work All wanted to be rewarded with presentation of certificates for a completed course of sessions Agree to group rules for each session. Agreed to sign contracts for drug and alcohol awareness sessions

7. Putting this into practice Healthy eating group-First 8 weeks tasting and experimenting with different healthy foods. If you don’t know what a food taste like are you going to buy it? Each week a sample of these were tried, patients were given a chart in which they could record if they liked it or not and any comments. During the session before trying food we looked at the labels and what there meant, fats, sugar, salt, calories. Sessions were fun, relaxed, and informal with patients coming in and out of the group Gradually over the weeks the patients became more interested in what they were eating This lead to session on food groups i.e Eat well plate Used art work and colourful work sheets to promote learning Colourful easy to understand hand outs

8. Looking after your heart- used information and resources from the British heart foundation (BHF). Watched DVD from BHF which lead to patients agreeing to start a walking group. Relate these sessions to the sessions on healthy eating Certificate of attendance BHF recipe book

9. Useful web site www.easyhealth.org.uk Bhf.org.uk/publications Drinkaware.co.uk www.lookupinfo.org www.eatwell.gov.uk www.clearthoughts.info Change4life