Your Carer’s Guide
If you need help to understand this information
please ask the Patient Experience Team.
Tel: 01604 616000 (text relay calls welcome)
Email: patient.experience@standrew.co.uk
May 2015
Version 1
Sophia Feurtado,
Head of Patient Experience.
Developed with patients, carers and
staff at St Andrew’s Healthcare.
1
Introduction
This guide is to help you understand how
St Andrew’s Healthcare can help the person
you care for.
It is an Easy Read version of our “Your Carer’s
Guide”. It has all the main points that are in
that version of this document.
If you have any questions about this guide, or
about St Andrew’s Healthcare, please ask your
Social Worker.
If you use our website, you will find more
information to help carers, families and friends
at: www.standrewshealthcare.co.uk/carers
2
Contents
Before treatment starts
 About St Andrew’s Healthcare
pages 4 to 6
 Becoming a patient
 The patient’s first day
Our care and treatment approach
 Treatment
 Reviewing care
 Preparing to move on
 The multi-disciplinary care
team (MDT)
 Education and learning
pages 6 to 11
Keeping in touch
 Ways to keep in touch
 Visiting
pages 12 to 14
Family and Carer involvement
 Keeping people safe
 Listening to patients
 Compliments and complaints
pages 15 to 17
Other useful information
 Useful groups and information pages 18 to 27
 St Andrew’s locations
 Glossary
3
About St Andrew’s Healthcare
The people we look after (“patients”) are aged from 13
years to adults including older people.
We provide specialist care for people who have a
range of difficulties and disabilities. These include
people with:
 mental illnesses such as schizophrenia
 personality disorder
 learning disability
 autistic spectrum disorder
 brain injuries
 dementia and Huntington’s disease.
We have hospitals in
 Northampton
 Birmingham
 Essex and
 Mansfield, Nottinghamshire.
We ask patients if they would like us to include carers
in their treatment and care. We check this with the
patient from time to time while the patient is with us, to
make sure we are doing what they want.
4
Becoming a patient (the “Admission process”)
People come to us as patients when a healthcare
professional sends us a special request (a “referral”).
The person making the referral is usually a doctor or
commissioner.
How soon a person can become a patient with us
depends on things like:
 how urgently the person needs help from us
 the commissioner agreeing to pay for the
treatment and care; and
 any legal decisions that might need to be
made, for example by a judge in a court.
When we get a referral, our staff assess the person to
decide if we can provide care and treatment for them.
If we can help a person, the “MDT” decide which is
the best ward to welcome the person as a patient.
The MDT is the “multi-disciplinary team”, This is a
group of healthcare professionals such as doctors,
nurses and therapists who all care for a patient.
We plan for when the patient will arrive with us (“the
admission”) with the person’s current mental health
team, if they have one.
5
The patient’s first day at St Andrew’s
Patients go to their ward when they arrive. Staff from
their MDT team welcome them to the ward. When the
patient is ready, they have a look around where they
will be staying.
Staff give the patient information to help them with
living on the ward. This information includes who the
patient’s care co-ordinator is and the times of meals.
We will keep patient’s property safe, if it cannot be
with the patient on their ward.
Anyone who comes into a secure unit may be
searched for prohibited items, which are not allowed
on the wards. This is for the safety of everyone.
Treatment
Each patient has an individual plan for their treatment
and care. This based on the “Care Programme
Approach” (CPA).
We involve patients in deciding what this includes.
We ask what worked well and what didn’t in the past.
We use a range of professional assessment tools to
decide what treatment is best for the patient. This
takes up to 12 weeks.
6
Reviewing the patient’s care
We meet to look at the progress patients are making.
The patient can attend these meetings. They can be
involved in deciding what should be in their care plan.
Every week: the patient can meet with their Care Coordinator.
Every 1-3 weeks: the patient can attend the Care
Plan Update meeting (or Ward Round) with the MDT.
Every 6 months: the patient can attend the CPA
meeting with St Andrew’s MDT, clinicians from the
home area and carers or family, if invited by the
patient.
7
Preparing to move on
The CPA review meeting will identify when a patient
is ready to move to a different type of care, or into the
community.
Depending on the type of move, this may take some
time to arrange. This is because there are lots of
people outside of St Andrew’s involved, including:
 the Commissioners
 Community Health Professionals
 The Ministry of Justice.
The patient may need help to identify a place to live.
It can take a while to find the right place for them.
The ward team will do their best to progress the move
as quickly as possible.
8
The multi-disciplinary team
A lot of people help provide care for patients.
Depending on what an individual patient needs, these
people may include:
Chefs
Our qualified chefs make sure meals are freshly
made using local ingredients. Patients discuss menu
options with chefs. Menus include meals to meet a
wide range of cultural, religious and individual needs.
Dietitians
Help patients to be healthy and manage weight and
allergies. They may also develop individual plans.
Nurses and Healthcare Assistants
Support patients with doing things on the ward. This
may be things like having meetings or taking part in
therapy sessions.
Occupational Therapists
Help the patient to do as much as they can for
themselves. This can be things like getting dressed,
having a shower, cooking or taking part in activities.
Physical Healthcare team
Develops individual care plans that help patients be
active, fit and healthy. They use equipment on wards,
in our sports halls or at local leisure centres, with
agreement of the MDT.
Physiotherapists
Help patients improve their mobility, general health
and prevent injuries.
9
Psychologists
Deal with the way the mind works. They focus on
behaviour and the thoughts, feelings and motivation
underlying it. They aim to reduce distress and
enhance psychological well-being by delivering a
range of one-to-one and group therapeutic
interventions.
Psychiatrists
Are the responsible clinicians (“RC”) in overall charge
of a patient’s care. Only Psychiatrists can prescribe
medication and will monitor how successful it is.
Social Workers
They help make sure the patient’s social needs are
met. They help with arranging visits. They help
patients keep in contact with their families, if they
want to. They make sure everything is organised for
the people to leave St Andrew’s when they are ready
to move on.
Speech and Language Therapists
Support patients who have difficulty with
communication, eating and drinking. This may, for
example, help patients with voice problems or hearing
loss, and to find the right words to say.
10
Education and learning
We can help patients learn in ways that meet
their individual needs, even if they have had
poor experiences of learning in the past. We
look at this as part of care planning with
patients.
Workbridge offers a range of opportunities to
learn new social, technical and life skills in:
 Catering
 Ceramics
 Horticulture
 Office skills.
St Andrew’s college offers a broad range of
education programmes including English,
Mathematics and Science, to meet our
adolescent’s needs.
11
Keeping in touch
Contact with carers, families and friends can
help people to be happy and well. There are
lots of ways people choose to do this.
Telephone
Please make telephone calls at times when
patients are not doing therapy activities. The
Social Work team can advise you of the best
time to call.
Letters
Patients can choose to write letters. They can
buy stamps at St Andrew’s, if they want. They
may be asked not to write letters to someone if
their letter is likely to upset that person.
Patients can receive letters.
Webcam/Video call
We can arrange a secure video call using our
system call Radvision (similar to Skype).
There are special times when people can
make these calls. The calls need to be booked
in advance. Please ask staff if you would like
to do this.
Visits to St Andrew’s
Before you visit a patient at St Andrew’s you
will need to ensure you are on the Approved
Visitor List. We ask that visits are at weekends
and evenings if possible. Your Social Worker
can help you with this.
Home Visits
If the patient is well enough, a home visit can
be arranged with the Social Worker.
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Visiting
Visits usually last between 1-2 hours and take
place in dedicated visiting rooms, some with
CCTV. Depending on individual circumstances
visits may take place in other locations.
Anyone under 18 must be accompanied by an
adult. A member of the Social Work team will
supervise the first visit. A risk assessment will
be completed before a visit.
Costs of visiting
St Andrew’s may be able to help towards the
costs of visits. Please talk to staff about this
before you plan your visit.
Can I park on-site?
Please reserve a parking space in advance.
Please tell us if you need a disabled access
space. Please bring your blue badge with you.
Is it possible to stay overnight?
There is some family accommodation in
Northampton. St Andrew’s staff can help you
find a place to stay near any of our hospitals.
What do I do when I arrive?
Please go to the main reception. Staff will take
your photograph and issue you with a visitor’s
badge.
What do I need to bring with me?
Please display your parking permit (if you have
one). Please bring photographic ID for
reception.
13
What can’t I bring with me?
Each area will have its own list of things you
can’t take onto the ward. The Social Work
team will be able to tell you about the area you
are visiting.
Will I be searched?
People entering secure areas may be
searched. This includes carers, families and
friends.
Can I bring food with me?
Home-made food can only be brought with the
agreement of the Lead Nurse. Food cannot be
stored on site and can usually only be taken
into the visiting rooms.
Can I bring gifts for the patient?
You can bring gifts for the patient. Please
check first that the patient is allowed to have
them at St Andrew’s or on the ward. Your
Social Worker can tell you about this.
Can a visit be refused or cancelled?
From time-to-time it may not be possible for a
visit to go ahead, for example, if the patient is
unwell or if there is an infection or outbreak of
illness (such as flu). We try to minimise the
number of visits which are cancelled.
14
Keeping people safe
It is important to us that everyone feels safe and
free from abuse and bullying when they are at St
Andrew’s.
The law says that everyone should be treated with
dignity and respect.
The law says that everyone should enjoy equality
and human rights, even when detained under the
Mental Health Act.
So we always try to work in ways that help us to
respect everyone’s rights. We hope you never feel
unsafe, or that a patient is unsafe.
If you do have any concerns, please tell us as soon
as possible. This will help sort things out quickly.
You can tell staff at St Andrew’s such as:
- the MDT
- Complaints Department tel: 01604 616 829
- Patient Experience Team
- Safeguarding Lead tel: 01604 616 701.
Or, you can tell an independent organisation such
as:
- VoiceAbility
- local Safeguarding Team
- Healthwatch
- The Care Quality Commission (CQC).
If you use the internet, you can find more
information about rights and organisations at:
http://www.standrewshealthcare.co.uk/safeguarding
15
Listening to Patients
There are lots of ways people can tell us about
their experience and wishes at St Andrew’s.
All of our wards provide access to advocacy or
solicitor services.
Advocacy
VoiceAbility provides independent, free,
confidential advocacy to all St Andrew’s
patients.
Advocates visit the wards at St Andrew’s
regularly to provide patients with the
opportunity to find out more about their rights
or to discuss their care and treatment.
Befriending
A volunteer befriender may be assigned to
offer additional support if the patient would like
one.
Befrienders attend specialist training and have
enhanced checks before we match them with
a patient.
Solicitors
We use the Law Society’s database of
solicitors, which offers a full range of services.
St Andrew’s do not recommend any solicitors.
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Complaints and feedback
We welcome feedback to help us improve. If
possible, please discuss any concerns you have
with the multi-disciplinary team first. This helps to
sort thing out quickly. If you would prefer, you can
contact the Complaints Department directly.
Telephone
01604 616 829
(text relay calls welcome)
Email
Complaints@standrew.co.uk
Post
Complaints Department
Patient Experience Team
St Andrew’s Healthcare
Cliftonville Road
Northampton
NN1 5DG.
Internet
If you use the internet, you can download a form to
give us feedback or make a complaint. This is the
link: www.standrewshealthcare.co.uk/complaints
17
Other useful information and groups for carers
There is a range of additional support available to you.
The MDT looking after the patient can provide you with
information about local groups.
Our Chaplaincy and Spiritual Care team can offer
support, call 01604 616 613 (text relay calls welcome).
Organisations that can provide support include:
NHS Carers Direct
Tel: 0808 8020 202
www.nhs.uk/conditions/social-care-and-support-guide
Rethink
Tel: 0300 5000 927
www.rethink.org/carers-family-friends
Mental Health Foundation
www.mentalhealth.org.uk/
Who looks after you?
Tel: 01933 677 907
www.wholooksafteryou.co.uk/
Royal College of Psychiatrists
www.rcpsych.ac.uk/healthadvice/parentsandyouthinfo.a
spx
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Young Minds (Adolescent)
Tel: 0808 8025 544
www.youngminds.org.uk
Dementia Friends
www.dementiafriends.org.uk/
Headway (Brain Injury)
Tel: 0808 8002 244
www.headway.org.uk/caring.aspx
Foundation for people with learning disabilities
www.learningdisabilities.org.uk/
Mencap
Tel: 0808 8081 111
www.mencap.org.uk/about-learning-disability/aboutlearning-disability
National Autistic Society
Tel: 0808 8004 104
www.autism.org.uk/living-with-autism/parents-relativesand-carers
Action on Hearing Loss
Telephone 0808 8080 123 Textphone 0808 8089 000
SMS 0780 0000 360
www.actiononhearingloss.org.uk/supportingyou/factsheets-and-leaflets.aspx
Royal Association for Deaf People
http://deafcarers.royaldeaf.org.uk/
Forums to join for carers at St Andrew’s
You may be able to join a carers’ forum. Please ask
your Social Worker or ward team to find out more. The
Carers, Families and Friends Strategy Monitoring Group
is open to all and meets regularly in Northampton.
19
St Andrew’s Locations
Northampton
We care for over 500 young people, men,
women and older adults in Northampton.
These services are medium and low secure,
locked and open, so people may be with us when
they are very unwell and when they are
preparing to live in the community.
We have a range of facilities to help patients on
their recovery journey including:
 En-suite bedrooms
 Arts and crafts workshops
 Music studios
 Gym
 Café
There are lots of buildings at St Andrew’s in
Northampton. Some have their own reception.
When you plan your journey, please check which
reception you will need to go to when you arrive.
Your Social Worker will be able to tell you.
There are lots of things for patients to do.
Patients are risk assessed to decide what they
can do. Activities include:
 Art therapy
 Music
 Drama
 Sport and exercise
 Health and well-being sessions
 Work skills
 Adult education
 Vocational therapy at Workbridge.
Northampton is in the middle of England. It has
good road, train, coach and bus services.
If you use the internet, you can find more
information at:
www.standrewshealthcare.co.uk/northampton
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There are cafés you can use at Workbridge on
Cliftonville Road and at the Tompkins Centre
(towards the Billing Road end of the site).
Birmingham
We care for care for over 120 men and women
in Birmingham.
They have conditions such mental illness – for
example psychosis and schizophrenia – and
autistic spectrum disorder.
These services are medium and low secure, so
people may be with us when they are very
unwell and when they are preparing to live in
the community.
There are lots of things for patients to do.
Patients are risk assessed to decide what they
can do. Activities include:
- Art therapy
- Music
- Drama
- Computer sessions
- Sport and exercise
- Health and well-being sessions
- Spiritual and cultural time
- Work skills
- Adult education
- Community outreach.
There are lots of places to visit in the city. They
include:
- West Midland safari park
- National Sea Life Centre,
- Cadbury World,
- museums and galleries.
21
Birmingham is in the middle of England. It has
good road, train, coach and bus services. If you
use the internet, you can find more information
at:
www.standrewshealthcare.co.uk/birmingham
Essex
We care for over 80 men and women in Essex.
They have conditions such as complex mental
health and personality disorders.
There are lots of things for patients to do
Patients are risk assessed to decide what they
can do. Activities include:
- Art therapy
- Music
- Drama
- Computer sessions
- Sport and exercise
- Health and well-being sessions
- Spiritual and cultural time
- Work skills
- Adult education
- Community outreach.
Our hospital is in Benfleet, not far from
London. It is easy to reach by car.
If you use the internet, you can find more
information at:
www.standrewshealthcare.co.uk/essex.
22
Nottinghamshire
We care for up to 64 men at our Mansfield site.
They have conditions such as autistic spectrum
disorder and learning disabilities.
There are lots of things for patients to do.
Patients are risk assessed to decide what they
can do. Activities include:
- Art therapy
- Music
- Drama
- Computer sessions
- Sport and exercise
- Health and well-being sessions
- Spiritual and cultural time
- Work skills
- Adult education
- Community outreach.
Nottinghamshire is centrally located. It is easy
to reach by car.
If you use the internet, you can find more
information at:
www.standrewshealthcare.co.uk/Nottinghamshire
23
Glossary
There may be a lot of new words to learn. This
word list explains some of the words used in
this leaflet and at St Andrew’s. We hope that
this list will be helpful to you.
Contraband
A word some people use for “restricted or
prohibited items”. Those are things that people
cannot have at St Andrew’s for safety reasons.
AWOL
“Absent Without Leave” is when a detained
patient does not have permission (“leave”) to
be in the grounds or community.
Best interests
Under the Mental Capacity Act anything done
for a person who cannot make decisions for
themselves must be in their “best interests”.
This means thinking about what is best for the
person and not about what anyone else wants.
The law has a checklist of things to think about
when deciding on someone’s best interests.
Capacity
In mental health, this term has a technical
meaning relating to the Mental Capacity Act.
Having “mental capacity” means being able to
make your own decision about something at a
particular time. “Lacking capacity” is when a
person is not able to make their own decision
about something.
Code of Practice
Both the Mental Health Act and the Mental
Capacity Act – have a “Code of Practice”.
The Code of Practice tells doctors and nurses,
in particular, how to make sure they are
following the law.
24
Detained
A person is detained if they are being kept in
hospital under a section of the Mental Health
Act and cannot leave.
Informal patient
This is when a person has chosen to be a
patient at St Andrew’s. They are not detained.
They have rights like other people not
detained under the Mental Health Act.
Leave
Leave is when a patient, who is detained at St
Andrew’s under the Mental Health Act, has
permission to go into the hospital grounds or
community.
There are different types of leave. The type of
leave a patient has describes where they have
permission to go and when they can go there.
For example “community leave” or “grounds
leave”.
Mental Capacity Act
This law helps people who cannot make their
own decisions because of their disability or
“mental disorder”. Staff must use this law to
help them decide whether a person is able, or
unable, to make a particular decision.
Mental disorder
When the Mental Health Act talks about
someone with mental health problems and
whether or not they should be sectioned, it
often uses the term “mental disorder”.
The Act defines says this is any disorder or
mental disability. It includes learning disability.
It includes disability that makes you act in way
which may seem dangerous to yourself of
other people ( “abnormally aggressive” or
25
“seriously irresponsible”).
Mental Health Act 1983 (“MHA”)
This is a law in England and Wales which
allows people to be detained in hospital
(“sectioned”) if they have a mental illness and
need treatment. A patient can only be kept in
hospital if certain conditions are met.
Nearest relative
This is a family member who has certain
responsibilities and powers if a person is
detained in hospital under the Mental Health
Act. These include the right to information and
to discharge in some situations. The law sets
out a list to decide who will be the nearest
relative. The nearest relative can sometimes
be changed.
Section (“on a section”)
This refers to the specific bit of law used to
keep (or “detain”) a patient at St Andrew’s
under the Mental Health Act. There are various
different sections.
People can be detained as patients for
different lengths of time. Patients have the
right to know why they have been detained
and how long for. The law states that the
professionals must review their detention
periodically to confirm whether it is still
necessary.
 Section 2 allows a person to be detained
for up to 28 days in order to be assessed
for their mental disorder. During this time
the doctor can ask for an assessment
under section 3 of the Act.
 Section 3 allows a person to be detained
initially for up to six months so they can
receive treatment in hospital. If
necessary, detention under Section 3
can be renewed for a further six months
and then yearly thereafter.
 Section 35 allows the Courts to remand
a person to hospital for a report on their
26
mental condition.
 Section 37 (without restrictions), section
37/41(with restrictions) allows the
Courts, on the advice of two doctors, to
remand a person in hospital rather than
prison.
27