Alnwood Keeping It Real Group is a service user led forum in a medium secure hospital for Children and Young People with Mental Health and/or Learning Disabilities in Newcastle. Each ward runs their own community meeting every 2 weeks where young people are able to highlight local issues and needs such as their timetables, living environment, resources and food. These actions are then brought by the young people to the larger Keeping It Real group where all wards attend.
What We Did
Alnwood Keeping It Real Group is a service user led forum in a medium secure hospital for Children and Young People with Mental Health and/or Learning Disabilities in Newcastle. Each ward runs their own community meeting every 2 weeks where young people are able to highlight local issues and needs such as their timetables, living environment, resources and food. These actions are then brought by the young people to the larger Keeping It Real group where all wards attend. This group comes together once every month to share their actions in order to resolve or escalate these to senior management. In this way the young people are actively taking responsibility and leading on enhancing the quality of care and treatment they receive. The young people have shown their commitment and motivation to ensure their voices are heard and listened to. Their attendance and contributions has been exemplary and inspiring given the complex nature of their difficulties during their time in hospital and being away from their families, carers and home.
Over the past 3 years the young people have experienced and contributed to transforming the culture of this inpatient service. This shift has been a result of service users speaking out so that they are recognised as equal shareholders in developing the service. The Keeping It Real Group has achieved the following;
– Investors In Children Award 2017/2018; This award has given the service national recognition for the good practice and active inclusion of young people in dialogue resulting in change.
– Environmental Developments; The young people have influenced the way that their environment is decorated. Examples include the aesthetics of quiet rooms, visitors rooms, meeting rooms, corridors, the gym, activity rooms and bedrooms. The changes have come form in the form of decorative art work, home entertainment systems, and leisure facilities such as a pool table and outdoor gym. This demonstrates how our inpatient culture has changed to being less restrictive and more young person friendly.
– Healthy Lifestyles; The young people have communicated with our NHS Trust’s catering management in a bid to enhance the quality and variety of food they are provided with. They have achieved an open dialogue and their views have been recognised which has resulted in access to more fresh food and alternative menu choices. The group has actively put forward suggestions for increasing their physical activity such as bike riding, swimming, trampolining, wall climbing and joining a local football team and gym. In this way they have expanded their opportunities to better their physical and mental health both within the clinic and local community.
– Well-Being; Some young people have brought to the group their spiritual needs and in doing this they identified a gap in the service for chaplaincy to be provided. Through consultation with chaplaincy in the Trust support is now offered on a weekly basis to those who find it beneficial. This is provided through 1:1 sessions and/or visits to churches in the local community. Other support services that the young people actively communicate with include advocacy, the Trust Personal Advisory Liaison Service, Volunteer and Befriending services, and Recovery College. This has led to the young people identifying peer support as a need in their service, and our managers are responding to this. Recently a young person from the group experienced the impact of Cancer in their family, and led a fundraising campaign for Cancer Research UK. The young person challenged herself to a sponspored head shave and raised a total of £500 for this National Charity. Other group members have identified meaningful fundraising campaigns to them, organised and promoted their fundraising activities, and achieved great success which has in turn promoted their own well-being.
– Structure; In the medium secure environment the young people show improvements in their mental health and skills development when they are provided with an appropriate structure to their day. A staged approach is negotiated with the young people from admission to stabilisation to skills development and finally transition. To be fully involved with this the young people attend their clinical meetings with professionals and co-produce their own goals for therapy, education, activities and nursing care. By identifying this through Keeping It Real, the young people have achieved positive dialogue with professionals and have the opportunity to learn how to challenge appropriately. Part of this process allows the young people to organise and plan their leaves out of the hospital and identify what is important for them in terms of skill development.
– Recruitment; Young people have a say in the staff who support them by creating their own interview panel alongside the staff panel. The young people ask interviewees the questions they feel would be important for choosing staff they believe have the right skills and attitudes to be able to support them. The young peoples score is added to the staff score and comments are reviewed with the young people to ensure they feel valued. In doing this the young people have shown their contribution to staff retention as relationships are formed positively from the beginning. This development is an empowering experience for both young people and the interviewees.
– Technology; Young people in the group continuously raised how being in hospital can be isolating, especially for those who have come from across the country and other countries. In response to this, a patient network KIT has been established which provides graded access to the internet and Skype for all young people to contact family, carers and friends. With the group’s innovative suggestions being escalated to management, they have achieved recognition that computer rooms need to be readily accessible so that they can remain in contact with their support networks through technology. This demonstrates how the young people’s collective movement has reduced restrictive practices related to technology and identified the need for staff to be trained to support them appropriately.
Over the past 3 years this group has made significant improvements to service user and carer experience of being in and visiting this Hospital. The relationships with staff are much improved which can be attributed to the young people having an equal voice in the service. By having frequent open and transparent discussions, staff and the young people are replacing power imbalance with collaborative planning.
The Keeping It Real movement has encouraged more opportunities for families and carers to be involved through clinical meetings, visits to the hospital and their bedrooms, and meeting professionals, to discuss their progress at Open Day Events. All families and carers are invited to attend Open Days bi-annually. The group set up how they would like the open day to run and facilitate their own tours and refreshments. Families and carers can now meet each other in an informal relaxed environment to share experiences and form support networks. The service has received extremely positive feedback from both families and young people in relation to this change in practice.
The service has been reviewed by Investors In Children, the Care Quality Commission and Quality Network for Inpatient CAMHS – all of which have commended the standards of involvement and equal participation to ensure the most positive practices are delivered in this mental health setting. The group’s influential presence in the hospital continues to embed a positive culture of change so that future service users will benefit and follow in their footsteps. Across Inpatient CAMHS Network this group can share their innovative practice and be influential to other services.
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The level of commitment and motivation by this group has been outstanding and we feel deserves recognition given their complex difficulties and stay in a medium secure environment away from home. Without this group, progress in positive practices would not have been as person centred or achieved in such a timely way.