This included a visit to Shackleton ward which is a specialist ward for older people with particular mental health needs. Shackleton ward provides care for up to four patients, all of whom have dementia.
The visits took place unannounced. Senior members of staff at the Isle of Wight NHS Trust were made aware that we would undertake visits related to the mental health work plan and were given a 2 week window but were not informed exactly when, or what the visits would involve.
The focus of the visits related to the environment, activities, staff interaction, general observations and information taken from previous Care Quality Commission reports.
During the visit to Shackleton ward, our enter and view representatives found significant concerns relating to all of the topics of focus, particularly with regards to the environment and to levels of proactive staff interaction.
Of particular concern was the level of restrictions placed on people. Toilet and bathroom doors were locked and patients had to request help from staff if they needed to use the toilets. The general décor was bare and unwelcoming and there were no light switches in the bedrooms, meaning that patients were unable to control the lighting once in their own room. Although staff were very welcoming and caring in their approach, there was a lack of understanding of positive risk taking and proactive support methods observed during the visits.
Following the visit to Shackleton ward, we contacted the IOW NHS Trust to inform them that due to the serious and significant nature of the concerns they would be escalating the issues they discovered to the Care Quality Commission and to NHS England. As a result of the findings contained in the report we have made 5 recommendations to improve the experience of people with dementia on Shackleton ward. A report of the visit was sent to the IOW NHS Trust and they were asked for a response.
The IOW NHS Trust responded:
“We are grateful to Healthwatch for their Enter and View report about Shackleton ward, and fully agree with the assessment. Shackleton ward is a 4 bedded mental health Dementia ward that cares for people who have specialist mental health needs. The environment was not appropriate for this type of specialist service, and we have therefore worked with staff, carers and partners, including Healthwatch, to develop plans to refurbish the ward and create a dementia-friendly environment. The works began at the beginning of April, and the ward is due to reopen in June 2019. We accept all of the recommendations in the report, and are fully implementing all of them. We look forward to welcoming Healthwatch to carry out a follow up review of Shackleton ward once it is reopened to see the improvements made.”
The IOW NHS Trust has accepted all 5 recommendations and have already begun to improve the immediate environment by refurbishing the ward. This has included making the environment more dementia friendly and improving the bathroom facilities. Rooms are also being refurbished to provide a more homely feel.
“We are pleased to see that the IOW NHS Trust has acted promptly to address the serious concerns we raised and Healthwatch is looking forward to working closely with the Trust to ensure that all recommendations made within the report are met and sustained. Good dementia care should be a right not a privilege and we know that with the appropriate support people can live long and productive lives after a diagnosis of dementia. We are aware that there are over 850,000 people with dementia in the UK with numbers set to rise to over 1 million by 2025. We firmly believe that people with dementia have a fundamental right to be treated with respect and dignity and to feel supported so they can live well with the condition.”