Facilitating Self Advocacy in a locked ward environment

Facilitating Self AdvocacyFacilitating Self Advocacy

in a locked ward environmentin a locked ward environment

Parkside Lodge is a 12 bedded acute admission Parkside Lodge is a 12 bedded acute admission service providing MDT care to people with a LD, service providing MDT care to people with a LD, specialist focus psychiatry of learning disability.specialist focus psychiatry of learning disability.

The inpatient service operates a locked door The inpatient service operates a locked door policy and service users are admitted under policy and service users are admitted under sections of the Mental Health Act.sections of the Mental Health Act.

Pre-requisite of service is to provide specialist or Pre-requisite of service is to provide specialist or intensive inpatient assessment and treatmentintensive inpatient assessment and treatment

What Does It Mean?What Does It Mean?

““I can tell you what I can tell you what I want”I want”

- Inpatient at Parkside - Inpatient at Parkside LodgeLodge

““Learning Disability Nursing is a person Learning Disability Nursing is a person centred profession with the primary aim of centred profession with the primary aim of supporting the well being and social supporting the well being and social inclusion of people with learning disabilities inclusion of people with learning disabilities through improving or maintaining physical through improving or maintaining physical and mental health”and mental health”

Good Practice in Learning Disability Nursing DOH (Dec 2007)Good Practice in Learning Disability Nursing DOH (Dec 2007)

PRACTICEPRACTICEInpatient 1Inpatient 1

Self Advocacy FocusSelf Advocacy FocusCommunity Presence & ExposureCommunity Presence & Exposure

Wrote his own weekly MDT reportWrote his own weekly MDT report Wrote his own leave programme weekly following Wrote his own leave programme weekly following

MDT outcomesMDT outcomes Wrote his own community exposure plan with Wrote his own community exposure plan with

nursing staffnursing staff Involvement in time line plan of risk behavioursInvolvement in time line plan of risk behaviours

TimetableTimetableDayDay MorningMorning AfternoonAfternoon EveningEvening

WednesdayWednesday 9.00 get up, shave, make bed, 9.00 get up, shave, make bed, wash laundrywash laundry

Cigarette after jobsCigarette after jobs

30 minutes to local shop30 minutes to local shop

Out to Grans for 1 hour 15.00-16.00Out to Grans for 1 hour 15.00-16.00

20 minutes travel time20 minutes travel time

30 minutes walk30 minutes walk

IroningIroning

ShowerShower

ThursdayThursday 9.00 get up, shave, make bed, 9.00 get up, shave, make bed, wash laundrywash laundry

Out for a 30 minute walkOut for a 30 minute walk


ShowerShower

FridayFriday 9.00 get up, shave, make bed, 9.00 get up, shave, make bed, wash laundrywash laundry


Out for a 30 minute walk to local parkOut for a 30 minute walk to local park Play on PlayStationPlay on PlayStation

ShowerShower

SaturdaySaturday 9.00 get up, shave, make bed9.00 get up, shave, make bed Out for 30 minutes walk to local parkOut for 30 minutes walk to local park


ShowerShower

SundaySunday 9.00 get up, shave, make bed, 9.00 get up, shave, make bed, wash laundrywash laundry


Out for 30 minutes walk to local parkOut for 30 minutes walk to local park


ShowerShower

MondayMonday 9.00 get up, shave, make bed9.00 get up, shave, make bed Out for 30 minute walk to local parkOut for 30 minute walk to local park

Out to Grans for 1½ hrs 15.00–16.30Out to Grans for 1½ hrs 15.00–16.30

30 minutes local shop30 minutes local shop

Shower Shower

IroningIroning

TuesdayTuesday 9.00 get up, shave, make bed, 9.00 get up, shave, make bed, wash laundrywash laundry

Out for 30 minutes walkOut for 30 minutes walk

30 minutes local shop30 minutes local shop

Out to bank to collect cashOut to bank to collect cash

Buy X-Box game Rogue WarriorBuy X-Box game Rogue Warrior

ShowerShower

Wee

kly

MD

T R

epor

tW

eekl

y M

DT

Rep

ort

Section 17 Leave

Section 17 Leave


Self Advocacy FocusSelf Advocacy FocusClinical Assessment & Care Pathway PlanningClinical Assessment & Care Pathway Planning

Wrote in a daily diary / coping strategiesWrote in a daily diary / coping strategies Met with nursing clinicians and discussed Met with nursing clinicians and discussed

contentcontent Actioned planned what she wanted to Actioned planned what she wanted to

happen nexthappen next Wrote up own report for MDTWrote up own report for MDT

Weekly TimetableWeekly TimetableDAYDAY DATEDATE WHAT I WOULD LIKE TO DOWHAT I WOULD LIKE TO DO

MONDAYMONDAY Go to shops to buy a card making kitGo to shops to buy a card making kit

Make cards for friends and familyMake cards for friends and family

TUESDAYTUESDAY 11am – 4pm11am – 4pm Meet with mum and advocate and go and see flat, return at Meet with mum and advocate and go and see flat, return at 4pm4pm

WEDNESDAYWEDNESDAY 2 – 3pm2 – 3pm

PMPM

Ventures cooking sessionVentures cooking session

Go and buy a top up card for phoneGo and buy a top up card for phone

THURSDAYTHURSDAY AMAM

PMPM

Psychology session at 12.30pmPsychology session at 12.30pm

Get a take-away for tea / supperGet a take-away for tea / supper

FRIDAYFRIDAY Enquire about swimming lessons at the local swimming Enquire about swimming lessons at the local swimming baths baths

Get ingredients and make own mealsGet ingredients and make own meals

SATURDAYSATURDAY AMAM

PMPM

Access the local community to buy some shoesAccess the local community to buy some shoes

SUNDAYSUNDAY Go for walkGo for walk

MD

T M

eeting

MD

T M

eeting


Recovery & RehabilitationRecovery & RehabilitationRe-lapse PreventionRe-lapse Prevention

Weekly activity planningWeekly activity planning Social skill developmentSocial skill development Self esteem / confidence buildingSelf esteem / confidence building Exposure to interactions with others Exposure to interactions with others

outside hospital settingsoutside hospital settings

Weekly Timetable TemplateWeekly Timetable TemplateDayDay MorningMorning AfternoonAfternoon EveningEvening

MondayMonday Please refer to Daily Routine Plan – complete Please refer to Daily Routine Plan – complete daily routine with support from staffdaily routine with support from staff

Order and collect moniesOrder and collect monies

Healthy lunch then go out for ½ hr to hour Healthy lunch then go out for ½ hr to hour walk around local shops. Go to shops to walk around local shops. Go to shops to buy non food related items. Staff to buy non food related items. Staff to encourage activities on the unitencourage activities on the unit

Healthy TeaHealthy Tea

FREE timeFREE time

Ring parents either 18.00 or 20.30Ring parents either 18.00 or 20.30

TuesdayTuesday Please refer to Daily Routine Plan – complete Please refer to Daily Routine Plan – complete daily routine with support from staffdaily routine with support from staff

Go out for walk in the local areaGo out for walk in the local area

Healthy lunch the walk into town along the Healthy lunch the walk into town along the canal to go to the market to buy veg / fish / canal to go to the market to buy veg / fish / meat (only buying enough to constitute meat (only buying enough to constitute one meal). Prepare the veg / fish / meat one meal). Prepare the veg / fish / meat and cook HER OWN teaand cook HER OWN tea


FREE timeFREE time

Ring parents either 18.00 or 20.30 Ring parents either 18.00 or 20.30

WednesdayWednesday Please refer to Daily Routine Plan – complete Please refer to Daily Routine Plan – complete daily routine with support from staffdaily routine with support from staff

Healthy lunchHealthy lunch

Ventures 13.30 – 16.30Ventures 13.30 – 16.30


FREE timeFREE time


ThursdayThursday Please refer to Daily Routine Plan – complete Please refer to Daily Routine Plan – complete daily routine with support from staffdaily routine with support from staff

Healthy lunch the walk into town along the Healthy lunch the walk into town along the canal to go to the market to buy veg / fish / canal to go to the market to buy veg / fish / meat (only buying enough to constitute meat (only buying enough to constitute one meal). Prepare the veg / fish / meat one meal). Prepare the veg / fish / meat and cook HER OWN teaand cook HER OWN tea


FREE timeFREE time


FridayFriday Please refer to Daily Routine Plan – complete Please refer to Daily Routine Plan – complete daily routine with support from staffdaily routine with support from staff

Healthy lunch then go for a walk to the Healthy lunch then go for a walk to the Travellers pub for a drink and a game of Travellers pub for a drink and a game of pool or to Kirkstall shops / Crown Point to pool or to Kirkstall shops / Crown Point to buy non food related item. Walk back if buy non food related item. Walk back if from Travellers or if from town can get the from Travellers or if from town can get the busbus


FREE timeFREE time


SaturdaySaturday Follow her morning routine from 10.00Follow her morning routine from 10.00

Prepare for parents visit – buy single Prepare for parents visit – buy single biscuits/buns from Greggs or supermarket biscuits/buns from Greggs or supermarket and take a walk around local shops for ½ hrand take a walk around local shops for ½ hr

Out for a walk ½ - 1hrOut for a walk ½ - 1hr

Parents visit @ 3pm – walk Bobby the dog! Parents visit @ 3pm – walk Bobby the dog!


FREE timeFREE time


Take-Away nightTake-Away night

SundaySunday Follow her morning routine from 10.00Follow her morning routine from 10.00 Choose an activity of her choice – out on Choose an activity of her choice – out on the bus / pictures / bowling / walkthe bus / pictures / bowling / walk


FREE timeFREE time


Client 2

0

5

10

15

20

25

Month

No

. of

Tim

es

Te

ch

niq

ue

Us

ed

PRN INA Restraint Seclusion

AchievementsAchievements

Attend college courseAttend college course Engaged with day care servicesEngaged with day care services Attends own CPA meetingsAttends own CPA meetings Attends own Manager’s / Tribunal meetingsAttends own Manager’s / Tribunal meetings Parents contact / visits increased and expanded Parents contact / visits increased and expanded

into activities within the communityinto activities within the community Lowered supervision levelsLowered supervision levels Actively participating in her own PCP with Actively participating in her own PCP with

support from her advocate and ‘Connect in the support from her advocate and ‘Connect in the North’North’


Self Advocacy FocusSelf Advocacy FocusFuture PlanningFuture Planning

CPA involvement / participationCPA involvement / participation Service user involvement representativeService user involvement representative Service user CPA focus group Service user CPA focus group

representativerepresentative Developed his own websiteDeveloped his own website

Person Centred ApproachPerson Centred ApproachSecuring future placementSecuring future placement

Where would I like to live?Where would I like to live?I would like to stay in Leeds. I would like to stay in Leeds.

I would like to remain living in Leeds city itselfI would like to remain living in Leeds city itself

What kind of place would I like to live in?What kind of place would I like to live in?Ideally I would like to live in a flat.Ideally I would like to live in a flat.

I would also like to live in a residential home with other people.I would also like to live in a residential home with other people.

Who would I like to live with?Who would I like to live with?I don’t mind living with other people.I don’t mind living with other people.

I would like to live with people my own age.I would like to live with people my own age.

I don’t mind living with men or women.I don’t mind living with men or women.

Person Centred ApproachPerson Centred ApproachSecuring future placementSecuring future placement

What kind of support would I need?What kind of support would I need?I would like staff support every day. I would like to know that people 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 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 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 complete my daily chores. I would need help to do my shopping and manage my finance. I would also like help in accessing and manage my finance. I would also like help in accessing and maintaining day services.maintaining day services.

Where would I NOT like to live.Where would I NOT like to live.I do not want to live in Wakefield. Other places I do not want to move I do not want to live in Wakefield. Other places I do not want to move to are; Scotland, London, Birmingham and Chesterto are; Scotland, London, Birmingham and Chester

Any Other ConsiderationsAny Other ConsiderationsI don’t want to live too far away from my father who lives in Leeds.I don’t want to live too far away from my father who lives in Leeds.

Weekly PlannerWeekly PlannerDayDay MorningMorning AfternoonAfternoon EveningEvening

MondayMonday 10-12noon10-12noon

Art ClassArt Class

13-15.0013-15.00

PhotographyPhotography

TuesdayTuesday 10-12noon10-12noon

GymGym

13-16.0013-16.00

GardeningGardening

19-20.0019-20.00

Gateway ClubGateway Club

WednesdayWednesday 09-17.0009-17.00

Hollybush Farm Conservation WorkHollybush Farm Conservation Work

ThursdayThursday 10-12noon10-12noon

Confidence buildingConfidence building

13-19.0013-19.00

GymGym

FridayFriday 13-15.0013-15.00

ArtArt

SaturdaySaturday 10-16.0010-16.00

Activity of choiceActivity of choice

SundaySunday 13-19.0013-19.00

Cook on unitCook on unit

To add any other activity he wishes to do in the blank slotsTo add any other activity he wishes to do in the blank slots

Future DevelopmentsFuture Developments

AIM – To set up a nurse lead patient therapy AIM – To set up a nurse lead patient therapy

groupgroup

Supported By – Consultancy from psychiatrySupported By – Consultancy from psychiatry

and psychology with links toand psychology with links to

CBT Consultant NurseCBT Consultant Nurse

Focus OnFocus On

Patient to Patient SupportPatient to Patient Support

Self expressionSelf expression

Self awarenessSelf awareness

Shared experienceShared experience

Future planningFuture planning

Documents

Facilitating Self Advocacy in a locked ward environment