"Lack of staff in the lobster pot?"

(as a relative),

Why is it that in Nottingham mental health inpatient settings the most common catch phrase seems to be “we haven’t got enough staff to...”.

For a relative who was in a rehabilitation unit, staff often said that they didn’t have the staff to accompany him to the shop, assist with him renewing his bus pass, arrange care plan meetings or manage difficult behaviour etc, etc.

And so the relative was transferred to an acute mental health setting, with apparently a higher level of staff. Except at the weekends there are no consultants and nobody to assess any necessary changes in treatment.

The relative didn’t improve and the staff said they were too busy to keep the family informed and they said that they didn’t have the staff to manage difficult behaviour.

The relative was moved again within days, this time to an “intensive” unit with fewer patients and more staff. The family were not informed and guess what? there still aren’t enough staff to update the family and the relative still hasn’t seen a doctor. The unit our relative originally came from said they can’t even get an update, because of lack of available staff despite a number of attempts.

The common practice seems to be to get students to fob off enquiries with “ring back later” and “I am just a student” and in the meantime our relative is passing through the mental health system, being moved from “pillar to post” without any clear plan and without involving close family and carers.

Somebody recently said that the mental health system is like a lobster pot.....easy to get into but impossible to get out of! How right they were. Is it really a staffing issue? I don’t know the answer to that, but somewhere along the line someone needs to look at what is going on in mental health inpatient services in Nottingham.

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Responses

Response from Steven Daykin, Ward Manager , Redwood 1, Nottinghamshire Healthcare NHS Trust

To it'salwaystherighttimetodotherightthing,

I have read your posting and am sorry to hear of your negative experience of in-patient services. In response to staffing levels although it may seem higher levels on admission to an inpatient ward, there is also an increase in the number of people staff have to nurse when on inpatient units. Unfortunately you are correct in that there are no regular based medics on wards at weekends, however there are on-call medics to contact and would always clerk someone onto the ward on admission and attend the ward if staff saw fit. The nursing team are there to assess changes in need and treatment and would liaise with the medics if they felt necessary.

I’m sorry if you felt that staff came across as ‘too busy' to keep your family updated and informed, if there were major changes to a patients circumstances/behaviour initially it would be staff’s first concern to maintain the patients safety and treat their mental health, and then contact the family if their were major concerns. If people need moving from one ward to another we, as a nursing team would contact the named nearest relative unless other names were documented to be contacted and that the patient agreed for this to happen.

I am sorry if this did not occur and can only apologise again to you.

In response to you being dealt with by a student nurse, it is part of their nurse training to liaise with carers and families alike under supervision by staff nurses, and I am sorry if you felt that no clear plan could be explained to you.

Staffing levels on wards are a contentious subject and are attempted to be maintained at a level which is safe and assists our patients in being safe and having therapeutic interactions and facilitating escorts. Unfortunately due to covering and supporting other ward patient needs, unforeseen reduced staffing levels E.g. such as sickness, staff teams have to be moved where need necessitates which can have a huge impact on addressing immediate patient need.

Finally I want to say thank you for feeling you can put your concerns across on this site, where we as a Trust read and listen to opinion and feedback in the necessary management meeting using your comments to improve our service.

If you would like to meet with myself or someone else within the management structure of Nottinghamshire Healthcare NHS Trust then please feel free to contact me on 0115 9691300 ex 16364 where I am more than happy to meet with you to discuss this in more detail.

Thank you again.

Steven Daykin

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Update posted by it'salwaystherighttimetodotherightthing (a relative)

Thanks for your response. I did try to phone you but the contact details you gave just says the number is unavailable.

I would love to say that our experience was a 'one off' but it really isn't. My relative has transferred again since my posting - moving full circle. To be fair I have spoken with a true gem of a nurse on your ward (Sam) which proves that it is possible to communicate and keep family involved and informed. Generally though the problems continue...being told by another student, after she had spoken to the nurse in charge, that the family can't attend the next review meeting, because it's for doctors only apparently..then finding out this wasn't the case at all. External parties were invited to the review to talk about my relative's care - it was only the family who were excluded. And trying to get any sense of what the plan is for my relative, well that is a different story all together.

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