The Harbour has 154 in patient beds over 10 wards catering for different needs. All the wards will be in operation 24 hours a day 7 days of the week
- Churchill and Orwell: 18 bed, male acute mental health wards
- Shakespeare and Stevenson: 18 bed, female acute mental health wards
- Dickens: 18 bed,male advanced care need ward
- Austen: 18 bed, female advanced care need ward
- Wordsworth: 15 bed, male dementia ward
- Bronte: 15 bed, female dementia ward
- Keats: 8 bed, male Psychiatric Intensive Care Unit (PICU)
- Byron: 8 bed, female Psychiatric Intensive Care Unit (PICU)
The functional acute mental health wards accommodate patients from the age of 18 experiencing an acute mental illness requiring inpatient care. This also includes dual diagnosis of mental illness as the primary diagnosis, with personality order, learning disability or drug and alcohol misuse.
The advanced care wards accommodate older patients who are experiencing an acute mental illness that are also physically frail or who are also experiencing physical disability or illness.
The dementia wards accommodate patients diagnosed with dementia who are requiring the relational and physical care and security that an inpatient ward can provide.
The PICU will provide an environment of a higher relational, physical and procedural security, in order to safely care and treat patients who are acutely unwell, posing a higher risk to themselves or others and requiring lower stimulating environment.
Role and functions of the wards
The wards provide multi-disciplinary team (MDT) care for people who require assessment and treatment for mental illness within an in-patient facility. The admission pathway to these wards will ensure a holistic and thorough approach to identify the strengths and needs of each service user, ensuring the service user, and when applicable, their carer or family, are involved throughout this process. The MDT identified for each of these wards, will carry out a daily review of the ward population to ensure the individualised care plans are meeting current needs and that this plan of care reflects the needs and services required for a successful and supported discharge.
Each ward unit consists of bedrooms with en-suite facilities. The design of the rooms reflects the balance between the need for privacy for the individual and observation by nursing staff. Bedrooms have been designed to promote a relaxing environment and fitted out with appropriate fixtures including facilities for TVs and computers and a lockable medication locker (other than in PICU units). Rooms are lockable by service users but can be opened outwards if needed. All en-suite facilities are anti-ligature and accessible to staff if required.
Each ward has a lounge dining area with direct access to an internal courtyard. It is designed to feel light and airy and combine both a living and dining space. A beverage bay is provided to ensure service users have access to drinks 24 hours a day and the dining area is located next to the unit kitchen with food being service from a hatch or trolley. Furniture within this area includes sofas, easy chairs, lockable and open shelving units with space for TV/stereo/ games in the living areas and dining room tables and chairs in the dining areas.
There are also a number of quiet rooms where service users can relax and have some quiet time along with rooms for use by multidisciplinary team meetings, for group work, interviewing and ward administration.
In addition to the en-suite facilities, each unit has several domestic style bathrooms and access to a larger bathroom in which additional assistance can be provided. The dementia and advanced care wards are fitted with bespoke assisted baths to facilitate safe moves of service users with physical disabilities and can be raised or lowered.
Significant attention has been given to fixtures, fittings and aids to everyday living to both facilitate independence and ensure the ongoing delivery of harm-free care.
Technology
Across the Trust, therapy and care is supported wherever possible, by the use of the best technology. For the Harbour this includes the use of electronic care records, patient status at a glance boards, nurse assist system and the planned introduction of an electronic prescribing system and full task allocation system. Technology will also be mobilised to allow service users and their families to stay in touch, including WIFI hotspots on wards to allow access to Skype/FaceTime or other virtual communication opportunities.
Interventions will be sufficiently flexible to meet a wide range of needs and offer opportunities to provide meaningful activities and social inclusion with each service user having an individual therapy programme as agreed with the care team. Within the first week of admission, each service user will have an individualised nursing assessment commenced to address their health and social care needs and an individualised occupational therapy assessment commenced to address their occupational needs. A wide range of treatment options will be available dependent on the individual's care plan at each phase of their mental health recovery. These will include some or all of the following:
- Mental health assessment and intervention which may include the use of pharmacology
- Psychological assessment and intervention
- Occupational assessment and intervention
- Pharmacological assessment and advice including reconciliation of medication on admission and discharge
- Ongoing assessment and intervention by other members of the team
- Ward community meetings
- 1:1 sessions with clinical practitioners
- Physical health checks/ promotion (including physiotherapy)
- Health promotion and information on medication and treatments
- Service user/ carer involvement in care planning
- Group and diversional activities
- Specialist assessment
- Complementary therapies
- Other specialist services.
On admission and regularly throughout the admission, physical health monitoring and health promotion will be implemented. According to individual need, this will include:
- Full blood count, ECG and screening
- Pulse, respiration, blood pressure, temperature, and oxygen saturation
- BMI monitoring
- Physical examination
- Gender specific screening
Any issues identified will be monitored further as required. The wards have facilities to accommodate service users with physical disabilities. Although if the disability is not manageable on one of the functional wards, or the MDT do not have the skills and knowledge to manage and cater for identified needs, alternative care arrangements and transfer will be carried out.
Service users will have individual care plans tailored to meet their needs. However, there are certain elements of care that every service user will receive. These will include:
- Appointment times for their activities
- 1:1 time with a professionally qualified member of staff on a daily basis, which will be identified in the care plan
- To be allocated a named worker who is responsible for their care and discharge planning
- Access to a doctor when appropriate
- To meet with a mental health pharmacist during admission
- To have their care discussed in a multidisciplinary meeting daily.
Philosophy of admission to in-patient services
- All referrals for admission will be accessed through the Crisis Resolution/Home Treatment Teams (CRHT)/ Intermediate Support Team (IST)
- In-patient admissions should be used only when all other potential services and settings have been explored. The in-patient resource is used as a support to community services
- Service users should be admitted for the shortest possible time and treated in a way, which creates least disruption to their lives with access to most appropriate therapeutic, medication and treatment programmes
- In-patients will remain linked, as previously, to their community services and returned to their care as soon as possible.
- Some staff should be able to work flexibly across wards and community settings according to clinical need.
Services will engage clients in appropriate meaningful therapeutic activities.
The aim of medicines management within the Harbour is to ensure high quality safe dispensing and administration of medicines which respects the individual's privacy and dignity while supporting and enhancing skills and confidence in relation to their control of their own medications.
Pharmacists will be available on each unit to advice on medication therapies and all service users will be assessed in relation to their competence, understanding and risk with regards to their medications. Administration of medications will take place in the most appropriate venue to meet the needs of that individual and where possible respect service user choice. Service users will be empowered to retain responsibility for their medication by encouraging self-medication wherever possible.
The building is designed in such a way, that once the main reception have opened the 'street' door leading to in-patient areas, most visitors can walk freely along the main street until they arrive at the entrance reception to the in-patient ward they are visiting. Anyone requiring physical assistance to walk to the ward areas may request an escort at the main reception, who will make the necessary arrangements.
New people being admitted as in-patients, may either be admitted via the main entrance or section 136 suite or will be escorted by the staff accompanying them to the ward to which they are being admitted. Those individuals staying on the in-patient wards will be assessed as to whether they require escorting or not to use facilities such as the patient affairs/general office, contemplation room, sports facilities or cafe.
