Sowenna

Ward programme

A multi-disciplinary group which works collaboratively with mental health, social care, education and physical health teams to meet the needs of the young people in our care.

Therapy team

A specialist team that includes:

• clinical psychologists
• occupational therapist
• child psychotherapist
• family therapist
• dietician
• speech and language therapist

They work with young people and their families to develop a shared understanding of the young person's experience and journey.

Ward staff

Nursing staff work on the ward 24/7 hours a day. The team is made up of staff nurses, senior staff nurses, charge nurses and health care assistants. There are usually 6 members of staff on duty during each shift.

Training hospital

The unit is a training hospital with students from a range of disciplines. Your permission will be sought prior to students attending family sessions or other meetings.

Nursing care

Nursing is the main form of treatment you will receive at Sowenna. The nurses will work closely with you to help you understand some of your difficulties and help you to think about how to make changes.

The day-to-day activities and structure of the unit allow the nurses to make an assessment of your needs. There are also opportunities to try new ways of doing things. This is not always easy and often requires hard work from you. The nurses will support you and your family throughout this process.

Individual work and therapy

This includes talking one-to-one with a nurse or with another member of staff (for example, a psychologist or social worker). One-to-one time provides you with the opportunity to reflect on and make sense of the issues that are important to you. Anything you say in your individual work will normally be kept private from your parents unless there are issues of safety.

Link workers

Your link worker will be a named member of the multi-disciplinary clinical team. They will be responsible for keeping in close contact with you and members of your clinical team. This will be within the framework of your care programme approach, also known as your care plan.

They will ensure that:

• you and your care team discuss and agree your care plan together
• regular reviews take place (approximately every 6 weeks)
• your care plans are monitored and regularly reviewed, ensuring that progress is recorded
• they are a consistent point of contact for you, your carers and other professionals
• they are on request for you to meet with to discuss all issues relating to your care plan

You will also have 2 trained nurses (primary and secondary) who will support you, along with your link worker. One of the nurses will be involved in your family work with the link worker. The other will meet with you for an hour a week for individual sessions.

Your care team may also feel you need to meet with a psychologist, social worker or other member of the wider team. You can also ask your care team if you would like to see any of the above people.

Family work

An important part of your treatment involves meeting fortnightly (unless agreed otherwise) with your parents, carers and or other members of your family. These sessions will be supported by your link worker and a nurse from your care team.

Often, young people find attending these sessions difficult. It is important that all family members or carers develop a greater understanding of your difficulties and needs. They can then better support you during and after your admission.

As a family unit, we understand the difficulties that parents or carers experience when their child is admitted to an adolescent unit. We are committed to offering parents and siblings advice and support around aspects of your treatment. We actively encourage regular contact with family members, and time at home, and believe that families play a crucial role in promoting recovery.

Our trained nursing staff provide frontline support. Parents should feedback to them how weekends have gone so the care team can offer the most appropriate support and advice.

Medical

The medical team provide evidence-based clinical treatment including psychopharmacology for various conditions. Conditions they treat include major psychosis, schizophrenia, bipolar disorder, obsessive compulsive disorder and depression.

The team will oversee the treatment plans, working with the multi-disciplinary team daily and in the weekly ward reviews.

Psychiatrists are available to meet all patients and families. This is to ensure the delivery of the most effective and safe treatment possible.

Clinical psychology

You or your family may meet with a clinical psychologist. The clinical psychologist is often involved in contributing to your assessment while at Sowenna.

The assessment information can help the team to reach a diagnosis of your difficulties. The assessment is also used to formulate an understanding of what is happening for you and what intervention, therapy or psycho-education is personally best for you.

Your time with a clinical psychologist is confidential. However, you will often be encouraged to share information with some family members, where this will support your treatment. Information will also be shared with the team where necessary. An assistant psychologist will sometimes be involved in the assessment, formulation and intervention process.

Family therapy

Family therapy at Sowenna can give patients and their family members the opportunity to talk together, developing ideas around the support they each need, and the support they can give to each other.

We think that talking with a family about their relationships and patterns of behaviour can help them develop and strengthen skills they already have. As well as helping our team to understand what else we may need to do to help.

We sometimes use a one-way screen, as this means we can invite other members of a young person's care team to observe a session without being in the room with us. They can help our thinking in the session by joining us part way through to share their ideas.

Social work

Our social worker works with families and young people experiencing a range of social difficulties and is in close liaison with children's social service's teams.

The social worker offers carers' assessments. The assessments aim to identify strengths and difficulties within the young person's carer system, and consider how these can be addressed to best support the young person in their treatment.

Occupational therapy

Aims to help young people establish a balance of purposeful activities that allow for creative, physical and social development.

Occupational therapists work closely with the teaching and nursing staff, through group activities and the ward timetable. They can adapt an activity to make it manageable for you and can problem solve with you to overcome obstacles.

The structure of the unit and range of group work activities provide many opportunities for you to develop your life skills, equipping you for life beyond the unit. We ask young people to engage in opportunities to participate in the group activities on the unit, though we recognise that this can bring challenges. The emphasis is on what young people can get out of an activity rather than necessarily being brilliant at it.

Engagement in groups is also essential for us to be able to get a clear picture of your skills. It can also lead to benefits for future planning and in terms of your being better understood. Other benefits you may get from being with others in groups include socialising, working together towards a group goal, creating something unique and generally gaining confidence in your peer group.

In the holiday periods, occupational therapists, along with the nurses, continue to provide a unit programme of purposeful activity for young people.

Individual work

Occupational therapists also work with young people individually to assess how you manage and your skills to cope in each area of your life. They may then work with you to develop the skills that will help you achieve your goals. This assessment work might also be useful to promote others' understanding of your needs or to help you to adapt to your future environment.

Community meetings

These happen on the unit each day and are an important opportunity for all the young people and staff to get together. There are meetings at 9.45am and 8.45pm, which you will be expected to attend.

The morning meeting provides a formal start to the day, whereas the afternoon meeting is a less formal opportunity to reflect on the main part of the day.

The aim is to:

• discuss any important information that affects the unit atmosphere
• discuss any concerns or issues related to the unit
  provide a place where young people and staff can find out what is happening on the unit
• allow you to express how you are feeling and share this with the group
• work together to resolve problems related to the unit

This is a developing component of the care being provided at Sowenna. It acknowledges the crucial yet challenging part parents play in the life of any young person encountering a serious mental health difficulty.

Rather than assessment and treatment for a young person being seen in isolation, we strive to include parents and carers in the care of young people.

Our parent and carer liaison team includes:

• outreach workers
• management of violence and aggression leads
• dedicated outreach nurses
• family liaison nurse to ensure there is support for parents and carers from admission through to discharge

When a young person is admitted, you will be contacted by one of the staff listed above to provide support and explanation at that point. They can ensure your questions are answered and provide you with an admission information for parents and carers (PDF, 1 MB).

Part of this pack will be a parent and carers assessment sheet to go through with you in order for us to understand how we can support you the best through this admission and to include you in the care being provided for your young person. This will assist in ensuring regular communication and your collaboration with the team whilst directing any more specific support that you identify that would be helpful to you.

We try and consult all young people about decisions that are made at Sowenna. We do this through a number of forums.

Sunrise and sunset meetings and patient forum

In these meetings, there is an opportunity for young people to discuss improvements that could be made to Sowenna.

Sunrise meetings are at 9.45am and sunset meetings are at 8.45pm.

Staff interviews

Young people are part of the staff recruitment process. During interviews young people show the candidates around and then have the opportunity to ask the candidates questions. The young people then feedback to staff about their feelings regarding the interviewee.

Policies

All of the policies related to Sowenna can be found below. Contact the unit if you cannot find the policy you are looking for.

• CG/105 Responding to and managing self-harm within Sowenna (PDF, 1 MB)
• CG/113 Sowenna eating disorder policy (PDF, 591 KB).
• CG/114 Sowenna seclusion and long-term segregation (PDF, 683 KB).
• CG/115 Sowenna blanket restrictions policy (PDF, 253 KB).
• OP/074 Sowenna standard operating procedure (PDF, 423KB).
• SEC/010 Sowenna CAMHS inpatient service security policy (PDF, 2 MB).
• SG/016 Sowenna young people's anti-bullying policy (PDF, 251 KB).

Spiritual and cultural needs

Our multi faith room can be used to pray, worship, reflect and participate in religious practice. When the room is not in use, it will remain locked. Based on individual risk assessment and level of observation, young people will be able to use this room unsupervised for short periods of time.

Young people can receive spiritual and pastoral care if they wish. A chaplain who visits the unit regularly. Chaplains are available for all service users of any faith or for those with no specified faith. The chaplain can offer confidential listening and support. Patients can be put in touch with local faith community representatives and resources provided to practice their faith during their stay.

Interpreter service

Sowenna has access to an interpreter service if required. Speak to a member of our staff for more information or pick up an information leaflet from reception.

Support with gender needs

If you would like support with any difficulties you may be having about gender, speak to a member of staff that you feel comfortable with. We can assist you into linking you in with other services or charities that may be able to provide support.

A nurse from the team will meet you in reception and help you bring your bags to your room, after searches have been completed.

If you are well enough, we will ask you a few questions, such as confirming personal details, mood, and what you expect from your admission. This is part of our core inpatient treatment. We will continue this assessment over the following 2 to 3 weeks.

Medical check-up

A member of the nursing staff will take your height and weight, your pulse, blood pressure, temperature and respirations. A doctor will see you within 24-hours for a medical check-up.

Any open wounds or wound sites will be reviewed and you will be asked to keep these covered. This follows effective infection control procedures.

Bag and clothes search

All new patients have their bags searched on admission and any sharp objects, medication and hair straighteners or curling irons removed. These will be kept in the property box in the nursing office. You can request to use these items, but, it is at the discretion of staff for how long and if you need supervision.

We will also search your bags after home leave, or leave with friends or family. Any inappropriate items will be removed and stored in your property box, or, given back to your family to take home with them.

You will also be body searched using a metal detector (if deemed necessary) when you return from any leave, including unescorted walks and leave of any kind. This it to help keep you and other young people, staff and visitors on the unit safe at all times. This search will take place before you enter the main ward environment.

Please bring enough clothes for 7 days and remember to include:

• pyjamas and slippers
• wash bag
• clothes including a coat or warm jacket and weather-appropriate shoes.

There is a laundry room on the unit.

Because of infection control, young people are not permitted to go bare foot on the unit.

Young people are asked to wear clothing that is appropriate and to be aware that they are in a mixed gender environment. It is important to remember that all the young people are here for their own reasons and that some people can be shocked, surprised or their distress triggered by seeing things. You are asked to wear clothing that is not excessively revealing and that does not expose too much of your skin, for example being shirtless or hot pants. If staff believe that your clothing is inappropriate they will discuss this with you, ask to you change and may ask that those items of clothing are taken home.

You can bring posters and other personal items to decorate your room and a small battery operated stereo (with no cable or lead). You can also bring books, an MP3 player, craft materials, small musical instruments and other appropriate items to keep you busy during any spare time.

Any items that contain a camera will need to be discussed with the team, and may have to be returned home, or the camera disabled.

We want to maintain a safe ward. The items listed below are not allowed on the ward at any time. If you bring any of the items listed, they will be removed and returned to you at the end of your stay with us. If any illegal items are found, they will be handed to the police.

This list is not exhaustive and other items may still be restricted depending on circumstances and assessed risk. Restricted items may be stored separately.

• Knives, pointed sharp objects, razor blades and firearms.
• Plastic bags.
• String, cables or straps.
• Hair dye or hair bleaching products.
• E-cigarettes, matches and lighters.
• Modems, network cards and memory sticks.
• Blue and white tack, chewing gum and sticky tape.
• Energy drinks containing caffeine, such as Red Bull.
• Hot water bottles.
• Herbal remedies and green tea.
• Alcohol, illicit substances and legal highs.
• Medication and tablets.
• Glue and paint (except if supervised by occupational therapist).
• Lighter fuel, turpentine substitute, white spirit, surgical spirit, other solvents and flammable substances.
• Tins, cans, china and tobacco tins.
• Heavy jewellery, tweezers and magnets.
• Pornographic material.
• Heavy duty or steel toe capped footwear.
• Aerosol products.
• Any type of recoding systems such as video (including cameras) and audio.

Meal times:

• breakfast is 8.30am to 9am
• lunch is 12.15pm to 12.45pm
• evening meal is 5.30pm to 6.30pm

Break times:

• morning break is 11am to 11.15am
• afternoon breaks are 12.45pm to 13.15pm, 2.15pm to 2.30pm and 3.30pm to 3.45pm

You will have a choice of meals. If there are any foods that you cannot eat or you need a special diet, the dietician and nursing staff will help to formulate a meal plan with you that as far as possible, will meet your needs. This information will be put on your admissions file so that all staff are aware.

The unit provides 24-hour access to food and drink. If the kitchen is locked, a member of the nursing team can unlock it for you.

On admission it is important that you let staff know if you have any allergies, such as nuts or penicillin. This will be included in your care plan and necessary precautions set in place.

You will have a bedroom of their own with an en-suite shower room. There is also a bathroom with a bath available.

With the exception of restricted items, you can choose what you have in your bedroom as long as you are safe and responsible with these items. Housekeepers will clean your bedroom, but you will be expected to keep your room tidy yourself. Staff will be able to help you with this if necessary.

There are lockers for each young person to keep belongings in.

You are not allowed to bring your own televisions or computers onto the unit. There are lounges and common rooms on the unit where you can meet with others in your free time. You can watch TV, listen to music, read and play computer games.

Boys and girls are not allowed into each other's bedrooms. Carers and family members are also not allowed in the bedroom areas.

At times due to safety issues we may need to move your bedrooms. We will try to inform you of this prior to it happening.

Shortly after you are admitted, you will meet your teachers. Together, you will work out what sort of timetable will best meet your needs, taking into account what you may be studying at your home school, what your interests are and how much learning time you can manage.

Your key teacher will link with your own school, college or training provider. Together they will agree how you can most effectively continue learning and avoid falling too far behind while you are an in-patient.

Throughout your stay, your key teacher will meet with you every week so you can discuss how things are going. They will be part of your care team and will also go to meetings to report on how you are getting on.

The key teacher will also link up with your parents or carers and professionals who may be involved in your work or learning, like careers advisers or work experience placement supervisors.

We have a head teacher, teacher and 3 higher level teaching assistants. They can support your studies in most subjects. Sometimes you may learn online (for example for languages) or we may try to find specialist teachers for particular subjects. You may be taught on your own, in pairs or as part of a group. If you have public exams like GCSEs or A levels coming up, they can be taken at Sowenna.

Your learning experience

The learning day runs from 10am to 3.30pm and your learning timetable at Sowenna is personal. It will change week by week to reflect how able you are to learn, to work with others and to take part in various activities on and off site.

You can opt-in to various groups including at least 1 physical activity a week as your health permits (such as PE, swimming, gym or climbing) and at least 1 creative group (such as music, art, drama or pottery). There are other options such as cooking, gardening, critical thinking.

There is usually a weekly trip off site to places of interest. As your needs, interests and capabilities change, you may well want to talk to your key teacher about which groups you are part of. Teachers and occupational therapists tend to run many of these groups together.

As you approach discharge, your key teacher and your case team will plan carefully with you for reintegrating into your own school, college or workplace. Whenever possible, you will be able to benefit from supported visits back and experience a gradually increasing timetable.

If you are not in education, employment or training, teaching staff and occupational therapists will work closely with you to help you think about what you might want to achieve in the next stage of your life, support you in preparing for that and link with community workers to start making that happen.

Part of your treatment takes place in groups. If you are under 16 a teacher will advise you of the groups you will be expected to attend throughout your stay. If you are over 16, an occupational therapist will meet with you following your admission to find out what your hobbies and interests are. They will also support your future plans for work or within education.

They offer you a chance to talk about your worries and to hear the concerns of other young people. Through groups you can learn that many people have similar problems and together you can help each other to overcome them. Your team will help you to find out what groups may be beneficial to attend.

Skills group

These groups give young people coping skills to help manage stressful situations, difficult relationships, and to help cope with strong emotions.

Expressive groups

These give you an opportunity to express yourself in different ways. This includes pottery, art, photography, and graffiti, subject to availability.

Talking groups

The emphasis of these groups is on supporting each other, discovering that other people have similar problems and that you are not alone.

Leisure groups

These groups look at exploring different recreational activities, hobbies and leisure activities and interests that you can do in your own time. They include the gym, swimming, and art and crafts.

Eating disorders groups

This group is for young people who have an eating disorder. The group will cover themes such as psycho-education, motivation for change and CBT formulations which will help you gain an understanding of your eating disorder.