Cefn Coed Hospital Swansea

Address Cockett, Sketty, Swansea  SA2 0GH cefn coed

The first Welsh asylum for the mentally ill was opened in Swansea at May Hill in 1815, followed in 1844 by Vernon House in Briton Ferry. The Glamorgan County Asylum in Bridgend opened twenty years later to serve the whole of the county of Glamorgan. But with the 1891 Public Health Act required each County Borough to build its own asylum . This took a long time to implement, for initially Townhill was thought to be the place to build an asylum, until in 1908 the Cefn Coed site was considered. Nearly 250 mentally ill persons from the Swansea area were being treated elsewhere. Eventually land was purchased, and the foundations were nearly complete when during the First World War shortage of labour and materials caused a halt. Building work began in 1928, utilising Unemployment Relief schemes, as with the erection of the Guildhall and Tir John Power Station. The Swansea Mental Hospital was opened in December 1932 by the then Princess Royal.

Work started in 2009 to build modern replacement mental health accommodation and facilities, including Ysbryd y Coed in the grounds of Cefn Coed, which is purpose-built for patients with dementia. Other new builds in the Cefn Coed grounds are the 18-bed Gwelfor Rehabilitation Unit, a pub featuring non-alcoholic beer called “The Derwen Arms” and two supported houses for recovering patients preparing to move back home.

In March 2015 the health board’s new low-secure mental health unit, Taith Newydd, opened in Bridgend, replacing some of the old wards at Cefn Coed. Other new mental health builds include the ARC Centre and Angelton Clinic in Bridgend, and Ty Einon in Swansea. In 2015 the NHS announced that the phased closure of Cefn Coed Hospital would continue for the next three to five years, with several decommissioned wards planned for demolition that year.

The Tawe Clinic provides assessment, therapeutic interventions and support for individuals experiencing an acute mental health episode where inpatient care is necessary. There are two wards, Fendrod providing care for men and Clyne providing care for women.

Two new facilities have been built at Cefn Coed Hospital.

  1. Gwelfor: Adult Mental Health Services

The 18-bed slow stream rehabilitation and two, four-bedroom step down houses at Cefn Coed Hospital are phase 1 of the reshaping mental health Services in Swansea project.

2. Ysbryd y Coed: Older People Mental Health Services

This 60 bed unit across three wards provides care for older people with dementia in purpose-built, modern surroundings which support our dedicated staff in providing effective care.

 

 

 

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mental health awareness week 18-24 May 2020.

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Mental Health Awareness Week takes place from 18-24 May 2020. The theme is kindness. Overall, kindness, to ourselves and others, has important benefits for our mental health and well-being, but kindness goes beyond individual action. It is important for our communities, organisations, and political institutions. Kindness has a critical role to play in policy, and policies rooted in the values of kindness, empathy, dignity, and respect have great potential to reduce inequality and discrimination, and strengthen relationships and trust between governments, citizens, and society. As part of this week, the Mental Health Foundation is calling on central and local governments across the UK to take preventative action rooted in justice and kindness to protect people’s mental health. 

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COVID-19 SECURE UNIT GUIDANCE

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Every secure hospital setting should have a simple social distancing policy in place which is compliant with public health guidance and preferably drafted with the knowledge and acceptance of the patients and preferably co produced.

In secure forensic hospital settings the responsible clinician (or deputy) should ensure that there is a review of each patient’s pre-existing physical health vulnerability and consider any particular vulnerabilities for the circumstances as a result of their mental disorder. This will help to make patient level decisions when required. An example of the risk assessment is as follows:

  • Does the patient have an underlying physical illness or anything causing them to be immunocompromised? If so, there should be a clear plan in place to provide extra protections and contingencies for that patient as far as possible.
  • If the patient’s discharge were pending, is it still safe to send them home, taking account of the risks of covid-19 being in the secure hospital setting and risks of transmitting this at home/next placement and the potential risks of the next placement to the patient. If there is to be any deferral of discharge, this will have to be discussed sensitively with the patient and their family or significant others.
  • If a patient’s discharge were not pending, is there any case for bringing this forward? This is unlikely, but should be formally considered in the interests of everyone’s physical health safety
  • Should the patient require isolating, to what extent will s/he be able to cooperate voluntarily? What measures are in place to ensure cooperation for the few cases where there are difficulties in this respect?
  • Is the patient on clozapine? What is the frequency of blood tests? When is the next one due? Which service can do clozapine blood tests in house?
  • Can the patient have visits with family by Skype or by other interactive media? Can patients make free (or cheap) phone calls to family and friends? Where such communication possibilities do not exist, units must prioritise setting up facilities for such communication as soon as basic safety precautions have been implemented.
  • It is really important that patients continue to have activities to occupy and divert them, and to stay fit or improve their physical fitness. It is unlikely that off-ward activities like OT can continue, but, as far as possible, occupational therapists should ensure an on-ward activity plan is available for each patient, which includes minimisation of any interpersonal interactions. Access to secure gardens must be planned to be compliant with public health guidance.
  • All leave outside the secure perimeter must be reviewed with each patient who already has permissions for this in place, and a new plan formulated to ensure patient and unit safety. Any decisions about leave will need to be taken based on latest government advice at the time and analysis of benefits and risks for that individual patient’s recover.

Please check within your own settings with regard to this guidance which is taken directly from https://www.rcpsych.ac.uk/about-us/responding-to-covid-19/responding-to-covid-19-guidance-for-clinicians/community-and-inpatient-services/secure-hospital-and-criminal-justice-settings

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Deaths of detained mental health patients double due to “covid 19”

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  • Deaths of patients detained under the Mental Health Act have doubled in 2020 compared to last year
  •  To date 122 people have died whilst under section, of these 56 patients died from either confirmed or suspected covid-19
  • The CQC has written to providers highlighting its concern over the deaths

Deaths of patients detained under the Mental Health Act are running at twice the rate of 2019, with half of the fatalities down to covid-19, new data has revealed.

The Care Quality Commission have said 112 patients detained under the Mental Health Act had died between 1 March and 1 May. This compares to a total of 56 deaths during the same period of 2019, 61 deaths in 2018, and 70 deaths in 2017.

These figures include both people who are detained in hospital and people subject to the Mental Health Act, but who are still in the community.

Since 1 March, 56 detained patients have died from either suspected or confirmed covid-19 said the CQC. 54 of these were under the care of a mental health provider, and two of a non-mental health providers.

However, it is likely that the number of detained patients who have died with coronavirus is higher.

According to NHS England’s latest data there have been 65 such deaths recorded within stand alone mental health providers. What is more, NHS England’s data also does not capture the number of patients transferred from mental health trusts to acute trusts for treatment who may have subsequently died. HSJ has previously asked the national commissioner if it is able to share any data regarding this, but it did not respond.

The Office for National Statistics also confirmed to HSJ it could not supply a breakdown of its data on deaths within care homes by those with a psychiatric condition.

Last week the CQC wrote to providers asking them to continue reporting the deaths of patients under the Mental Health Act regardless of whether they are transferred to an acute trust for treatment. HSJ understands some providers had taken patients off their section when transferring them. 

Dr Kevin Cleary, deputy chief inspector of hospitals and lead for mental health said: “This increase of death notifications is due to coronavirus related deaths and while this mirrors a rise in notifications from other sectors and includes deaths from confirmed or suspected coronavirus cases, it is obviously of concern.

“That a number of people detained under the Mental Health Act have died from suspected or confirmed coronavirus is a particular worry as these are some of the most vulnerable people in society.”

He added mental health providers should continue to notify the CQC of the deaths of people subject to the Mental Health Act in a “timely way”.

“We want to be clear what we expect from providers in term of their management of coronavirus and we will be asking some providers to urgently confirm the action they are taking to manage coronavirus outbreaks.”

Deborah Coles director of charity Inquest said: ”There has been considerable delay in getting any scrutiny of the impact of this pandemic on mental health and learning disability settings. Finally some data has been disclosed but it is incomplete. People in detention are reliant on others for their care and there have been well documented concerns about ill treatment and abuse.

”At a time when there is no external scrutiny and family visits are suspended openness and transparency is essential to ensure the human rights of detained people are protected. This should not have to be fought for. We need to know how this pandemic is impacting on therapeutic services, staffing levels and the use of seclusion, restraint and medication.”

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Earth Day April 22nd 2020

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pic c/o THE GUARDIAN

Earth Day was a unified response to an environment in crisis — oil spills, smog, rivers so polluted they literally caught fire.
On April 22, 1970, 20 million Americans — 10% of the U.S. population at the time — took to the streets, college campuses and hundreds of cities to protest environmental ignorance and demand a new way forward for our planet.The first Earth Day is credited with launching the modern environmental movement, and is now recognised as the planet’s largest civic event. Over the 24 hours of Earth Day, the 50th anniversary of Earth Day will fill the digital landscape with global conversations, calls to action, performances, video teach-ins and more.

Earth Day will educate and mobilise more than one billion people to grow and support the next generation of environmental activists. It’s time to re=imagine what we can collectively do for our global environment with activities and events. Remember that the benefits to our own mental health is immense. The more we care for the Earth the more we take care of ourselves.

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Mindfulness

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Buddhist meditation has encouraged the practice of mindfulness for more than 2000 years. However, its mental and physical health benefits were not clinically tested and proven until the 1990’s. The medical benefits of meditation attracted the interest of American biologist and psychologist Jon Kabat-Zinn who went on to pioneer an approach known as Mindfulness Based Stress Reduction (MBSR).  In this form of meditation the object is to observe thoughts and mental processes in a detached, de-centred and non judgemental way. In mindfulness meditation the objective is to learn to observe thought processes calmly ,without identifying with them, and realise that our minds have a life of their own. A thought of failure, for instance, is seen as simply an event in the mind, not as a springboard to the conclusion “I am a failure”.

1960’s – Vietnamese Buddhist monk Thich Nhat Hanh popularised mindful meditation in the USA. Mindfulness Based Cognitive Therapy was developed  by Zindel Segal, Mark Williams and John D Teasdale in the 1990’s for the treatment of depression, and is based on Kabat-Zinn’s work. Dialectical Behaviour Therapy uses mindfulness without meditation for people too disturbed to achieve the necessary state of mind. MBCT

The Mindful Nation UK Report by the Mindfulness All-Party
Parliamentary Group (MAPPG) October 2015 concluded that Mindfulness-Based Cognitive Therapy should be commissioned in the NHS in line with NICE guidelines so that it is available to the 580,000 adults each year who will be at risk of recurrent depression. As a first step, MBCT should be available to 15% of this group by 2020, a total of 87,000 each year. This should be conditional on standard outcome monitoring of the
progress of those receiving help.

Mindfulness is about more than just sitting down to meditate. The wonderful thing about mindfulness is that it can be used to enrich all aspects of life, including our hobbies and creative pursuits such as photography. By adding some mindfulness into the process we can start to see the world around in fresher ways.  Mindfulness in photography isn’t about being good at it or not, it’s all about the process of seeing, exploring and experimenting.You don’t have to meditate to develop mindfulness. You can cultivate this state of awareness during almost any activity. When you’re eating, walking, driving, showering, washing dishes, whatever – simply be aware of your surroundings. Seemingly boring, mundane things can appear new and fascinating. Notice the light, shadows, colours, textures, and patterns

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A non-executive director (NED) in the NHS

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Essentially the non-executive director’s (NED) role is to provide a creative contribution to the board by providing independent oversight and constructive challenge to the executive directors.

The 1992 Cadbury Report initiated a debate about the main functions and responsibilities of non-executive directors. Today, it is widely accepted that non-executive directors have an important contribution to make to the proper running of companies and, therefore, more widely to the economy at large. As the Cadbury Report said, they “should bring an independent judgement to bear on issues of strategy, performance and resources including key appointments and standards of conduct”. The NonExecutive Directors ensure the Board acts in the best interests of patients and the public. Acting as critical friends, they hold the Board to account by challenging its decisions and outcomes. They also help the Board to formulate strategies, by bringing independent, external perspectives.

TheNHS Improvement’s Non-executive Appointments Team offers a range of support in finding and developing the very best chairs and non-executive directors for NHS provider boards.  They appoint and support NHS trust chairs and non-executives.  The power to make, suspend and terminate these ministerial appointments is delegated by the Secretary of State for Health. Their recruitment processes are conducted in accordance with the Cabinet Office’s Governance Code on Public Appointments. Appointments are made on merit generally after a fair and open process so that the best people, from the widest possible pool of candidates are appointed.

The Non-executive Appointments Team provide chairs and non-executive directors (NEDs) of NHS providers with confidential advice and support on a range of issues including recruiting and appointing, performance management and appraisals, induction and development and any associated governance issues.

Non-Executive Directors have a duty to:
• scrutinise the performance of the Executive management in meeting agreed goals and objectives;
• satisfy themselves as to the integrity of financial, clinical and other information;
• satisfy themselves that financial and clinical quality controls and systems of risk management and governance are sound and that they are used;
• commission and use external advice as necessary

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