Inpatient Environments


One of the facilities Lisa Rodrigues said she was most proud of was the Selden Centre at Swandean, Worthing, for people with learning disabilities.


‘We were therefore expecting people who had never worked together to share the space’


users with learning disabilities should be admitted to mainstream mental hospitals,


arguing that admitting them to a different facility was ‘discriminatory’. That may be right in theory, but often such individuals are in hospital for very particular reasons, displaying very challenging behaviours, requiring considerable one-to-one care, and needing privacy and dignity, all of which requires different sorts of facilities. Here, against the grain, we opened a beautiful new hospital in 2012.


IMPROMPTU SPEECH “Probably the best working day of my chief executive career came when a young woman called ‘J’ joined me in an impromptu speech at the official opening. At least half those in the room had tears in their eyes when she said: ‘I wouldn’t want to be in a hospital, but if I had to be, this is the sort of place I would want to be in.’”


The speaker next told how, in 2002, ‘as a rookie chief executive’, she was presenting to local people in a hall in Crawley and made the ‘perhaps foolish promise’ that her Trust would replace three ‘dreadful mental hospitals’ with a new facility. She said: “Against all the odds, we got some


money, land, and a sense of priority, from all concerned, and opened the hospital in September 2008.


“It was officially opened by Professor Louis


Appleby (Professor of Psychiatry at the University of Manchester, and national clinical director for Health and Justice between 2010 and 2015, who is now a Board Member at the Care Quality Commission). Having flown down from Manchester, the Professor said in his speech that he had spotted Brazilian footballer, Robinho, at Manchester Airport, who had just


30 THE NETWORK J u l y 2 0 1 5


The Selden Centre’s sensory room has proved highly popular with service-users.


been ‘purchased’ by Manchester City for over £32 m – exactly twice the build cost of this mental hospital – as the Professor put it, ‘showing the relative value we place on things within our society’.”


DIFFICULTY ‘CHANGING THE CULTURE’ Lisa Rodrigues added:


“The new hospital incorporated 69 beds in four wards. However, despite it being a beautiful facility, we didn’t manage to introduce a new culture from the outset, despite considerable input and attention. We could never quite put our finger on it. Responses to things that went wrong were not as they should have been. We had more complaints than we should have had. It was unwelcoming somehow, and the local population was not encouraged to become involved in the way we had envisaged during the facility’s design. “Then, in August 2012,” she continued, “there was an extremely serious incident.” In subsequently reviewing care, the Trust discovered that senior staff responsible for running the hospital had ‘colluded’ to change patient records ‘to try to make the care given appear better than it had actually been’. Lisa Rodrigues said: “This is public knowledge; when we found out, those people were dismissed, and either struck off, or voluntarily removed themselves from their professional registers. It was an extremely difficult time for the patients, families, and staff affected, but I am pleased to say that a significant number of positive changes have been made since that awful time.”


‘TOP TIPS’ OUTLINED


Here, as her presentation neared its close, Lisa Rodrigues said she would outline some of her ‘top tips’. She said: “You can have a really beautiful facility, but what matters most to me are the staff. A good hospital/good clinic plus good staff equals great services. You can have one without the other, but it’s the good staff I would always prioritise. Secondly – in terms of


my own experience of mental illness – I was very lucky. I did feel suicidal, but I had wonderful support from my family, psychiatrist, and GP. That meant that I did not need to go into hospital; otherwise I might have needed to. “We need mental hospitals that are fit for the 21st century, and to keep on with the work that John Short mentioned. This means having enough hospital beds, but also to keep the number under review, and to provide alternatives to admission, including a 365 day- a-year, 24-hour-a-day, crisis service, which is still not universally provided, and in some parts of the country has been reduced by commissioners to save money. “We also need alternatives to hospital


admission for people who do get into crisis. In some areas, Trusts are beginning to develop services with third sector partners as an alternative to hospital admission for those in crisis, but who lack the sort of personal support I had. However, coverage is patchy, and they are often funded ad hoc. Again, more investment is needed.


SAFETY AND SECURITY “My third point is about safety: you cannot design a completely risk-free service, because the people who are in our hospitals are very ill. The point of admission and discharge can be the most risky times. People are extremely inventive; if they become desperate, they will go to desperate lengths. The most important thing about safety is to have great staff who are trained, challenged, supervised, and supported, to be skilful and compassionate when caring for people who are very unwell.” In concluding, Lisa Rodrigues thanked those working in mental healthcare in the audience for ‘helping to keep people safe in hospitals and at home’, and ‘for all the work you do to reduce the stigma of mental illness, and for making mental health a priority’. The entire mental health community needed, she said, ‘to continue to do all it can to raise the profile of mental health being everyone’s business, not just immediately post- the recent General Election, but for the next 20-30 years’. She added: “I am one of the one in four who have experienced mental illness, so I am absolutely indebted to you for all the work that you do.” •


Photos courtesy of Barker Evans Photography.


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