Welcome Guide – Secure Mental Health and Personality Disorder Services Medium and Low Secure

This Welcome Guide provides information about your ward, the staff, and the treatments and therapies that will be available to you. It contains a lot of information, so it may be helpful to read a bit at a time.

Your nurse will discuss the Welcome Guide with you when you are first admitted and answer any questions about its contents throughout your stay.

The Welcome Guide will be used with you throughout your stay to ensure you have the information you need to support your recovery. Please keep this guide and all of your personal information in a safe place and do not share your information with other patients.

The welcome guide is for the following Secure Inpatients services:

• Berwick – 14 bed mental health rehabilitation ward.
• Elsdon – 12 bed mental health recovery and rehabilitation ward, including two enhanced care areas.
• Harthope – 10 bed mental health admission, assessment and treatment ward.
• Linhope – 12 bed complex personality disorder.
• Rothbury – 12 bed offender personality disorder ward.
• Tyne mental health – 12 bed low secure mental health service.

You can watch a video about Sycamore www.youtube.com/watch?v=3onvmbsXoA0 

This guide belongs to:

Your nurse is:

Your Responsible Clinician is:

The Ward manager is:

Services at Northgate Park, Morpeth provide assessment and treatment for men who have a mental illness or personality disorder and who may have come into conflict with the law and/or are thought to be a risk to others or themselves. We generally take patients who are from the North of England, usually from prisons or other mental health wards or as a step down from the High Secure Hospitals.

NHS-Led Provider Collaboratives will include providers from a range of backgrounds, including the voluntary sector, other NHS trusts and independent sector providers. Provider Collaboratives will work closely with established partnerships called Integrated Care systems, which include NHS organisations, local councils and others, to support improved commissioning of services for people within the same population footprint. They will also work alongside patients, carers and families.

We work in collaboration with Tees, Esk and Wear Valley NHS Foundation Trust and form the North East and North Cumbria Mental Health, Learning Disability and Autism Partnership.

There are key principles which underpin the Provider Collaborative model:

• Collaboration between providers and across local systems
• Experts by experience and clinicians leading improvements in care pathways
• Managing resources across the collaborative to invest in community alternatives and reduce inappropriate admissions/care away from home
• Working with local stakeholders
• Improvements in quality, patient experience and outcomes driving change
• Advancing equality for the local population

Coming into hospital can be a distressing experience for you and your family. Whether this is the first time that you have been admitted, or if you have been here before, we recognise that this is a difficult time. We will support you as much as possible during your stay.

Why have I come to hospital?
You have been admitted to the ward so that your needs can be fully assessed. The ward provides a place of safety where specialist team members can offer the care that best meets your needs.

The aim of admission is to aid your recovery, helping you to return to your everyday life by finding the treatment that is right for you.

Wherever possible, staff will try to involve you in decisions about your care.

What will happen when I arrive?
All admissions to Sycamore will be brought into the unit through an admission area at the rear of the building.  Patients arriving to Tyne will come through the main doors.  You will be welcomed by a member of the team.

On arrival you will be searched in line with Trust Policy to ensure no prohibited items are brought into the Unit.

You will then be shown to your ward.

You will be asked lots of questions, and this information will help your team plan care for you.

You will be asked to change your clothes in order for them to be checked for restricted items.   All your belongings will be checked before you can put them in your room. The staff will make a list of everything you brought with you.

On Harthope at least one member of nursing staff will stay with you. They will tell you about the unit and answer any questions you might have. On Berwick and Rothbury you will be introduced to your “Ward Buddy” – this is another patient who is familiar with the ward.

Staff or your “Buddy” will show you around the unit. They will introduce you to other patients if you wish.

• Bedroom – you will be shown your room.  We will try and keep your bedroom the same one throughout your stay, however there may be circumstances when we have to ask you to move rooms but only if there is a clinical need on the ward.
• Personal belongings – a member of staff will also show you where you can leave your belongings.  There is only a small amount of space available, so please only bring essentials.  Your Care Manager will make sure you are aware of what you can and cannot bring with you.
• Telephone – each ward had a hand-held telephone which you can use.  Your loved ones can contact you on the ward telephone.
• Mobile phones – can be accessed on some wards, this is risk accessed, Rothbury cannot access mobiles.

Bed linen and towels are supplied and will be replaced regularly during your stay. You will be responsible for changing these at least once per week.

The ward will supply some emergency toiletries for people admitted without personal belongings but in the longer term you will need your own clothes and toiletries.

Where can I store my things?
You may have access to a small locker in your room where you can keep your personal belongings (this does not include restricted items). Your bedroom can be locked by either staff or yourself (depending upon your care plan). The Patients Finance Office will store any money or valuables for safekeeping and provide you with a receipt for your items. There will be an agreed amount of money that you will be able to hold on your person – this will be discussed with you on admission.

• Toiletries with alcohol
• Areosol spray
• Aftershave or perfume
• Dental floss
• Safety razors
• Knitting needles
• Garden tools
• Scissors
• Craft Knifes
• Tin cans
• Cutlery and utensils
• Tin foil
• Wheel chairs or therapy equipment
• Glue
• Solvents
• Velcro tape
• Rope, string, cord
• Spiral notebooks
• Pornography
• Open bottles
• Glass bottles
• Binoculars
• CD’s and DVDs
• Memory stick
• Mobile phones
• Dictaphones
• Ecigarettes
• Laptops or tablets
• Cameras

Televisions are provided in all bedrooms.

Controlled items may be permitted within the secure perimeter of Northgate Park but will be subject to clinical and individual risk assessment.

• Alcohol
• Drugs
• Legal highs
• Weapons
• Matches
• Lighters
• Tobacco
• Cigarettes
• Blu tack
• Chewing gum
• Illegal sexual material
• Illegal copies
• Open packets
• Coar hangers
• Disposable razors
• Sellotape
• Open toiletries
• Plastic bags

All toiletries brought onto the wards must be brand new and not used.

Plastic bags are not allowed in patients bedrooms.

Alcohol and illicit drugs – Alcohol and illicit substances must not be brought into Northgate Park. The Trust operates a ‘zero tolerance’ approach to the possession, use of, or dealing of illicit substances on Trust premises.

Any person thought to be attempting to supply illicit substances will be reported to the police.

Soon after arriving on the ward a series of assessments will take place which look in detail at your needs.  Your carer, family and friends, with your permission, can also be involved in discussions. The assessments will be recorded in your care plan.

These include:

An assessment of your state of mental health – this involves staff talking with you and monitoring your activity. In some cases a member of staff may need to be with you at all times.

An assessment of your social situation and needs – this looks at your housing, employment, leisure and family welfare issues.

A risk assessment – this helps maintain your safety and the safety of others.

A physical healthcare assessment – this involves being examined by a doctor and various tests such as blood pressure, blood tests and urine sample testing. Some medications require these tests to be repeated regularly. We will also offer you a dental and optician appointment.

During the first 3-6 months the team will carry out a detailed assessment of your needs.  Care plans will be completed which set out the care and treatment you require during your stay. You are entitled to be involved in decisions about your care plan and will be offered copies to keep.  If you agree we will also share this information with your carer.

Engagement and observations 
When you arrive on the unit you will be nursed on one of four levels of observation. This depends on your presentation and history:

• General Observation
• Intermittent Observation
• Within Eyesight Observation
• Within Arm’s Length Observation

The team will explain this to you and give you a leaflet on observations.

Recovery Star Secure
Secure services provide safety and real change for a better life.

Secure services provide treatment for people with complex mental disorders linked to offending or seriously harmful behaviour. Some will be involved with the Criminal Justice System (CJS), courts and prison. Secure services help people gain a deep understanding of themselves and their history.

We will help patients gain new skills, understanding and ways of responding to things they find difficult. This will help people move on from secure settings and have more freedom, choice, and control in their lives. We will do this by focusing on:

• mental health;
• dealing with strong feelings;
• addictive behaviours;
• risk to others;
• physical health;
• social skills;
• relationships;
• meaningful activities; and
• trust and hope.

Model of Care
Our model of care forms the basis of consistent care that can be expected across medium and low secure services. The main goal is to strengthen professional practice and plan how we support, motivate, and develop staff to deliver the best care possible. The model of care has been created to develop a clear vision for how we deliver care to our patients and how we will care and support our staff within secure care services.

The model of care details how teams will continue to deliver a positive experience for patients, carers and families and it outlines the actions staff need to take to ensure that everyone’s experience of the service is encouraging and positive.

Our model of care identifies how we work collaboratively with the person to promote recovery. Our model of care highlights that recovery is an ongoing process and wherever the person is within their pathway their skills will be assessed, developed, and applied within different contexts supported by a multi-disciplinary team which focuses on the needs of the person.

Our model of care focuses on patients, families and their carers whilst utilising the Recovery Star Secure as the focus which will result in ‘Our Recovery Journey’. Throughout this process, the model will incorporate the following:

• Respect
• Empowerment
• Dedication
• Collaboration
• Opportunity
• Hope and optimism.
• Identity

The support given to staff will enhance confidence and competence of working within the complex environment of secure services, inspiring best practice and providing a place to work which they feel proud of.

Structured Clinical Management
Structured Clinical Management (SCM), is a generalist treatment for people who have personality and relational difficulties. This may include problems with

• managing emotions
• moods
• triggers of distress
• urge to deal with feelings and thoughts quickly

and interpersonal situations that make you feel vulnerable or sensitive, such as feeling rejected being alone.

Clinical/recovery meetings
There is a framework used to assess, plan, implement, review and coordinate care, treatment and support. This approach aims to provide safe, effective, person centred and recovery focussed care to patients. All patients within Northgate Park follow this framework and will meet regularity with the MDT to discuss their care and treatment. Regular meetings are held to monitor the progress of each care for each patient. For more information regarding the process, please speak with a member of the ward staff.

Understanding what influences your mental health and wellbeing (5Ps)
We use 5 P’s + plan formulations as a way of helping patients understand current difficulties, so that they can set goals and have plans to work on.  You can view/download a copy of this booklet at www.cntw.nhs.uk/resource-library/understanding-influences-mental-health-wellbeing/

Personalised Care Planning
Together we will made sure your loved ones care plan is focused on them, we will support your involvement throughout your loved ones stay.

Care (Education) and Treatment Review (C(E)TR)
Care and Treatment Reviews (C(E)TR) are part of NHS England’s commitment to transforming services for people with learning disabilities, autism or both. C(E)TR’s are for people whose behaviour is seen as challenging and/or for people with a mental health condition. They are used by commissioners or people living in the community and in learning disabilities and mental health hospitals.

C(E)TRs help to improve the quality of care people receive in hospital by asking key questions and making recommendations that lead to improvement in safety, care and treatment. They help to improve current and future care planning, including plans for leaving hospital. C(E)TRs are carried out by an independent panel. This includes an expert by experience, who is a person or family carer with lived experience of services. The panel also includes a clinical expert who is qualified to work in health care and the commissioner who pays for the person’s care. A C(E)TR will take place within 4 weeks of the patient’s admission to hospital, and then at least every 12 months. They may be held at the same time as a CPA meeting. For more information about C(E)TR’s please visit www.england.nhs.uk/learning-disabilities/ctr. 

The Quality Commission (CQC)
The Care Quality Commission is the independent health and adult social care regulator. Their job is to ensure health and social care service are providing effective, safe, compassionate, high quality care and encourage them to make improvement wherever necessary. This is done by inspecting, monitoring and regulating services to make sure they meet fundamental standards of quality and safety. Their finding are published and made publicly available to help people choose care.

Throughout your stay there will be opportunities for you to be involved in discussions about your care. Your wishes will be carefully listened to and treatment decisions should have your agreement.

Our initiatives
The Trust has a range of initiatives that are used to support patient care.

Talk 1st
Talk1st is CNTW’s Trust-wide patient safety initiative, working to reduce violence, aggression and restrictive interventions.

Hope(s) 
Hope(s) is an approach to support reducing the use of Long Term Segregation as a practice. It is underpinned by Human Rights and Trauma informed practice. Based on research and significant work around factors that prevent the need to use Long Term Segregation and help address barriers to change once the individual is in Long Term Segregation.

Delivering safer care designed to empower each individual patient to be stronger and more confident; especially in controlling their life and asserting their rights”.

Star Wards
Star Wards provided practical ideas and inspiring examples from and for mental health ward staff.  All of our wards have achieved the full monty, star wards, we work tirelessly to ensure we continue to improve everyones experiences and outcomes, this includes our patients, carers, friend and families and all staff. https://www.starwards.org.uk/

Sleep Well
Sleep is so important to us all, having a restful night’s sleep and good sleeping habits contribute to maintaining mental and physical health. Within Secure Care, we have embraced the Sleep Well Project at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust.  This is a multi-disciplinary approach to supporting patients to be assessed and if appropriate to have individual sleep care plans.  These plans ensure appropriate monitoring and support measure are in place through the night or any time they are sleeping, ensuring they can have a really good night’s sleep, but also safe and secure within our wards.

Involvement
Involving patients, carers and their families in making decisions about their care can lead to better outcomes and a better overall experience. We are looking at ways to involve patients in shaping future healthcare services.

We recognise and value the contribution of patients and carers. It is the role of the Patient and Carer Involvement Team to co-ordinate and facilitate involvement, as well as ensure that appropriate training and support of those involved is provided in order to maintain their own wellbeing.

The Involvement Team support an Involvement Bank, this is a way for patients and carers who are not paid by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) to have their say and help shape our services.

For more information about how to get involved email [email protected]

Do you know you can meet with a mental health pharmacist to discuss your medication? Ask your primary nurse for an appointment. If you would like information leaflets about your medicines ask your primary nurse.

Pharmacy Medicines Information Helpline
The Trust has a helpline for confidential advice about medication. You and your carer can call the helpline between 9am and 4pm, Monday to Friday.

The helpline number is 0191 245 6604

Commitment to our families and carers (also known as our ‘Carer Promise’):

• Recognise, value and involve me;
• Work with me to ensure you’re aware of my needs as a carer;
• Listen to me, share information with me, and be honest with me when there is information you can’t share;
• Talk with me about where I can get further help and information, and about what I can expect from you.

We will work in partnership to involve you, not just because we have a statutory duty to do so, but because we want to and appreciate that your knowledge and experience, as a carer, can benefit and improve the care we give.

We understand that carers play a critical role and without your support, we would not be able to deliver the hope, treatment and care that we always aim to do.

We recognise that, on occasion, carers will also need support for themselves.

You will be:

• offered a Carer Card which will enable staff to recognise you in your role as a carer. A member of staff can provide further information.
• asked how you want to be involved in the care of the person you care for and what practical measures can be put in place to support this.
• given the opportunity to discuss any difficulties you are experiencing in your caring role, with staff.

Following your loved one’s admission, the ward will contact you and offer support as well as additional information about the ward. Our wards and services have a number of ‘Carers Champions’.  Their role is to ensure our carers, friends and families receive the right information and are encouraged and supported to be involved in their loved one pathway.

Advance decisions are about making choices about your healthcare while you are well. In mental health, this means that your wishes can be taken into account if you ever become mentally incapable of making informed choices during a crisis.

An advance decision can be spoken or written down and should be reviewed regularly. Only an advance decision to refuse treatment is legally binding; you cannot demand certain treatments but can state your preferred options.

The Trust produces an Advance Decisions and Statements booklet, copies are available from staff or the Patient Information Centre Tel 0191 246 7288

If you are detained under the Mental Health Act, there may be circumstances where you are given treatment that you have previously stated you do not want. This

The Trust has a policy about how patients can request a change of Consultant or second opinion. A patient information leaflet about this is available from staff or the Patient Information Centre 0191 246 7288

Mental Health Act 1983
You may be kept in hospital even if you want to go home, this is sometimes called ‘sectioned’ or ‘detained’. You will always be given an explanation and written information should this happen so you understand what your rights are. Sometimes this could mean we give you medication for mental disorder without your consent.   However, we will always include you in decision making about your care and treatment.

Factsheets on each section of the Mental Health Act are available on the wards – please ask a member of staff for a copy relevant to your circumstances.  Copies are also available from the Mental Health Act Office and Trust www.cntw.nhs.uk

Mental Capacity Act 2005
Sometimes people are so unwell that they are unable to make some decisions for themselves; this is called ‘lacking capacity’. We will always assume you have the mental capacity to make decisions unless an assessment has been carried out to establish that you have not got capacity. Where people ‘lack capacity’ we will always act in their best interests.

The Trust works from more than 70 sites across Cumbria, Northumberland, Newcastle, North Tyneside, Gateshead, South Tyneside and Sunderland. We also run a number of regional and national specialist services. Along with partners, we deliver support to people in their own homes, and from community and hospital-based premises.

We have around 9,000 people working for us and a budget of over £537 million.

The services we provide are divided into three care groups, these are known as inpatient, Community and Specialist.

Can you tell me about my ward?
Staff will provide you with a patient information leaflet about your specific ward.

Northgate Park
Northgate Park is located off the A1 in Morpeth. Most patients will access leave during their stay at Northgate Park, this will be agreed, carer and MDT team with a very clear plan in place. They may use this to visit local shops, gyms and cinemas, and may also be able to visit local countryside and beaches.

The hospital can easily be accessed via the A1. There is a bus stop located within the hospital.

For more information about bus timetables, please speak to a member of staff.

There are likely to be many practical things to consider while you are in hospital. Your nurse and other ward staff can help you.

For example, you may need to:

• Make arrangements for the care of your children or others
• Get somebody to take care of your pets
• Get a change of clothing
• Pay urgent or outstanding bills
• Cancel/rearrange appointments
• Contact employers
• Disconnect gas and electricity
• Notify the benefits office

Staff on the ward can help you with any financial concerns while you are in hospital. For example, they can complete an inpatient medical certificate to verify your inability to work,  or write letters on your behalf to resolve financial issues. Staff will also help you to understand your benefit entitlements.

A few frequently asked questions are answered below:

Will being in hospital affect my benefits?
This depends upon what type of benefits you were receiving before your admission.  If you were claiming benefits prior to your admission your benefits may change slightly.  Some
benefits can be affected by a hospital admission so it is important that the Department for Work and Pensions (DWP) is informed, staff on the ward can help you to contact them. If you were transferred from prison, staff will assist you to claim for any new benefits that you might be entitled to.

Where can I get help to sort out my benefits?
Staff will refer you to Patients Finance if you need any advice or support on benefits.  You can also get advice from the Citizens Advice Bureau. Please go to www.citizensadvice.org.uk and enter your postcode to find your local bureau.

What happens when I leave hospital?
This depends on your individual circumstances. In most cases if your money was reduced while you were in hospital it should revert to the full amount when you are discharged. The DWP need to be informed of your discharge to make these calculations.

If you are granted overnight or hostel leave you are eligible to full entitlement for those dates.

The Trust produces a booklet about Patients Finance. This leaflet is available from staff or the Patient Information Centre 0191 246 7288.

The following information will tell you a little about life on the ward.

Ward Rounds
Ward Rounds happen weekly/fortnightly. This is where your clinical team will meet to discuss your current progress and identify goals for your treatment and care. You will be invited to these meetings.

Case Conference Reviews (CCRs)
These meetings take place every 6 months. You care pathway will be discussed in these meetings. You and your carer/relative will be invited to these – along with any professionals involved in your care.

Community meetings 
Take place on a regular basis. They give you an opportunity to meet with staff and other patients to discuss and resolve issues on the ward.

Housekeeping
It is the expectation of all staff and patients to ensure that the ward is kept tidy. Domestic staff will regularly clean all areas. There is a washing machine for you to do your own laundry.

Meals
Your meals will be provided on the ward. You will be offered a menu and you choose your meals in advance. Drinks are available 24 hours a day. On some wards you will be encouraged to prepare your own meals.  If you have special dietary needs or cultural needs please discuss these with your primary nurse.

Protected meal times
Arrangements are in place so you can enjoy your meal without any interruptions.

Toilets and bathrooms
All rooms have en-suite toilet and shower facilities. There is also a bath for you to use as you need.

Courtyard
All wards have access to a courtyard, which you will be able to use throughout the day.

Visitors
Your family, friends and carers are welcome to visit you. There is a room on each ward where you can spend time with your visitors. Some visits will be supervised, and new visitors will be discussed during the Ward Round. There is a Family Room for visitors under 18. Visitors can visit freely, however we ask that visits are not during protected meal times and planned sessions. Visitors will be required to book the visit in with ward staff at least one day before. There is overnight accommodation available at Cambo, a leaflet is available about what is provided, please ask ward staff for more details.

Multi-disciplinary Team
Each patient in the hospital has a team of professionals working with them to provide the best care for their needs. This is called a multi-disciplinary team (MDT). The MDT will meet together with the patients every week or two weeks to review their ongoing care and treatment, to ensure it continues to meet their needs.

Each member of the MDT will work with the patients to help them achieve their short and long-term recovery goals. Patients can use their MDT meetings to discuss their progress and request changes in their care.  Decisions about this will be made collaboratively by the team and patient.

The MDT will include: 

Approved Clinician (AC)
An Approved Clinician (AC) is “a person approved by the appropriate national authority to act as an approved clinician for the purposes of the Mental Health Act 1983”.  The  Responsible Clinician is the “AC who has been given overall responsibility for a patient’s case”.

The Mental Health Act 2007 identifies the following as eligible to act as approved clinicians in England:

• practitioner psychologists listed on the register maintained by the Health and Care Professions Council (HCPC)
• first level nurses with a field of practice in mental health or learning disability
• occupational therapists registered by the HCPC
• social workers registered by Social Work England.

Responsible Clinician (RC)
This is a consultant psychiatrist who will oversee the patient’s care, and play a key part in any decisions made. They are known as the Responsible Clinician, as they have overall responsibility for the care and treatment of the patient while they are detained under the Mental Health Act. While important decisions will always be made in collaboration with service users and the rest of the MDT, the RC will have the overall responsibility for decisions made.

Art and Music Psychotherapist
Art and music psychotherapists help people think about and express their feelings by using different kinds of art and music.

Case Manager
All patients within secure care services will have a Case Manager allocated to oversee and support service users to ensure care and treatment is appropriate. This person will work with the patient for the duration of their stay.

Dentist 
Dental treatment is available on site, patients are given an annual dental check as well as the service providing emergency treatment.

Dietician
A Dietician will work with patients individually to support them with a healthy diet and lifestyle within the hospital.

General Practitioner
Our GP works in partnership with the Physical Health Team, and wider MDT, to support patients. Having a GP on site reduces health inequalities and provides patients with direct access to support and care. The GP and Physical Health Team can support and work with patients that have long term health conditions and increase life expectancy.

Nurse Consultants
Nurse Consultants provide clinical leadership to ensure that our care and treatment is safe, effective, holistic and patient-led, where appropriate, they act as responsible clinicians for patients within our service.

Nursing Team
Each ward has a team of qualified Nurses, Associate Practitioners and Health Care Assistants. A qualified Nurse will be allocated to each patient, as well as Associate Nurses and Nursing Assistants, meaning each patient has a dedicated team who will work with them. The wider Nursing Team are on site 24 hours a day 7 days a week to support all patients on the ward.

Occupational Therapist (OT)
Each ward MDT has an Occupational Therapist, who will work with the patient on an individual basis and also run group sessions to develop and maintain life skills.

Peer supporters 
Peer supporters are experts by experience and have been employed by the Trust to support patients in recovery spending time with patients and helping patients to work out how to best manage patient recovery. They are particularly good at helping patients develop a Wellness Recovery Action Plan (WRAP) or staying well plan.

Pharmacist
A pharmacist will work with the MDT to make sure that each patient is on the right medication and to help patients manage any side effects of medication.

Physical Health Nurses
Physical Health Nurses are general (adult) trained nurses who provide physical health care to patients on site, as well as support ward and medical staff. The team run several clinics that include Weight Management Clinic, Clozapine Clinic, Diabetic Clinic, Annual Health Check Clinic, Chest Clinic and more. The team work with patients and ward staff to make recovery goals and health actions plans to promote a healthier lifestyle, that they can continue once discharged.

Physiotherapists 
Physiotherapists work with patients to help restore movement. They provide physiotherapy assessment and treatment.

Psychologist
A Psychologist will work with the patients on an individual or group basis to help them towards their recovery. This could be through therapy, addressing underlying issues and developing coping strategies, or working to build confidence and self-esteem.

Recovery and engagement facilitators
There are a range of activity specialists on site who provide activities on wards and in the Recovery College in Northgate Park to support your loved one to build skills, increase confidence and make connections with others.

Social Worker
A Social Worker will help patients with things such as benefits, plans for discharge and maintaining good relationships.

Specialist Nurse 
A Specialist Nurse provides professional leadership, advice and role modelling to the clinical nurse team. They provide education training to staff and review standards of practice and care delivered to patients.

Speech and Language Therapist (SALT)
Patients may have support from a Speech and Language Therapist if they have difficulty with communication, eating, drinking or swallowing.

You might hear the following words and phrases when you are in hospital.

Coordinating your care – this is a way of helping and supporting people with mental health problems. It starts as soon as you come into contact with mental health services. It is the system that ensures that you receive help and support from the health service, social or voluntary sector.

Care Plan – this is a way of recording the help and support you need and explains how this will be done.

Multidisciplinary Team Meeting (MDT), CCR or Ward Round – this is when all of the professionals involved in your care meet to discuss your progress with you, and your carers if appropriate. This meeting takes place on the ward.

Observation – this is an important tool nurses use which helps us to get to know you and to
help us maintain your safety whilst you are in hospital. You will always be fully informed if you are being observed and given the reasons why.

PALS (Patient Advice and Liaison Service) – This service provides help, advice and guidance to users of the NHS and their families.
Tel: 0800 032 02 02, Monday to Friday 9am-4.30pm

Independent Mental Health Advocate (IMHA) – This service supports those people detained under the Mental Health Act. Please ask staff for their details.

Person Centred Care – Staff are committed to person centred care which ensures that you are the focus of all activity concerning you and you are fully involved in all aspects of your care.

RiO – This is the system that the Trust uses to securely store electronic patient records.  For further information see ‘Information the Trust keeps about you’.

Staff can arrange an interpreter if you need one.

Our Trust is smokefree
All of our Trust sites are now completely smokefree which means that you and your visitors are not allowed to smoke anywhere on our sites. This means both indoors and on our Trust grounds.  This is part of our approach to support service users and staff to achieve a healthy lifestyle and reduce the harmful effects of smoking.

Smoking materials are prohibited items
Smoking materials are prohibited items on Trust sites. If you come into hospital with tobacco products, cigarettes, lighters or matches, they will need to be given to staff. Cigarettes and tobacco products will be returned to you on discharge from the ward on request, lighters and matches will be destroyed.

Alternatively they can be given to a family member or carer to take home with them.  Tobacco products, cigarettes, lighters or matches will not be given back to you for any periods of leave from the ward.

Visitors are asked not to bring any cigarettes or tobacco products (including lighters) on to the ward.

Smoking on Trust sites
Smoking anywhere on Trust sites is not permitted and is a breach of the law (the Smoke Free Regulations) to smoke inside any building which may result in a fine of up to £200.
Helping us to maintain this policy protects other service users, staff and the care environment.

Support to stay smokefree during your admission
On admission if you smoke you will be seen by a member of the Tobacco Dependency Treatment service who will talk to you and offer you support to be smokefree while you are in hospital. You will be offered nicotine replacement products such as patches, inhalators and lozenges on admission to keep you comfortable and help with nicotine withdrawal and cravings to smoke. You may also be offered an E-cigarette (vape).

Your advisor will discuss with you a variety of options that they are able to support you with to be smokefree, they will listen to you and offer advice on the best option for you. They may be able to offer you alternative nicotine replacement therapy or medication and recommend the best treatment option for you.  This will also be discussed with your doctor as the dose of some of your medications may need to change (this may result in taking less medication).

Vaping/E-cigarettes
Provided you are 18 years old or over:
‘Vaping’ (use of an electronic cigarette/e-cig) is permitted by service users on Trust sites in outdoor areas, including ward gardens/courtyards (if available).

An e-cigarette can be supplied on admission if you wish to use one as an alternative to cigarettes. Some of the cafes and shops on Trust sites sell replacement cartridges.  You may also use your own e-cigarette, however staff will need to do a brief check of your device and charger to make sure they are safe.

Some services may have restrictions on e-cigarettes for safety reasons.

The Trust needs to keep information about you, your health and treatment so that we can provide the best possible care for you.

We may also use your information for a number of different purposes including:

• Administration and management of healthcare services (such as maintaining records, receiving professional advice)
• Service improvement, evaluation and audit (in order to improve the healthcare services that the Trust and others provide, and to protect and improve the health of the public)
• Communicating with you and resolving any queries or complaints that you might have
• Communicating with any other individual that you ask us to update about your care
• Complying with our legal and regulatory requirements
• Clinical research and development
• Safeguarding purposes (for example, in order to ensure the health and safety of an individual).

Is the information kept confidential?
Everyone who works in the Trust and within the wider NHS must keep information about you confidential. All Trust staff, have agreed to a confidentiality statement within their contract of employment which enforces the need to protect and only access the information which is required for the purpose of their role.

We do share information within the team that is caring for you, and sometimes with other professionals in other organisations that are providing care for you, like Social Services.

From time to time, we may share your personal information with others. We will keep your personal information confidential and only share it for the purposes above.
If we do share information with other organisations, we would normally talk to you about it first and ask for your permission.  On very rare occasions we may also share information with other organisations because we feel that there would be a serious risk to you or to other people if we did not do so, or because there is a legal obligation, such as a court order, that means we have to disclose information.

What sort of information do you keep?
We keep information both on paper and electronically. The kinds of details that we keep include:

• Basic information about you, such as your name, date of birth, address, next of kin
• Records of your contacts with professionals, such as clinic visits
• Notes and reports on your health and any treatment or care that you need
• Records of any tests or assessments that we carry out
• Records of the treatment and care that we provide for you
• Relevant information from other health professionals, members of your family or friends who care for you and know you well

Can I see what information you have about me?
You have the right, under the Data Protection Act 1998, to obtain a copy of the information we hold about you. If you want to do this, you should write to:

Disclosure Team
Information Governance Department
St Nicholas Hospital
Jubilee Road
Gosforth
Newcastle upon Tyne
NE3 3XT

Email: [email protected] 

How can I find more about the information the Trust keeps about me? 
You can find further details about the information the Trust keeps about you and the  processing purposes in the Trust’s Privacy Notice available via the Trust website www.cntw.nhs.uk/foi/data-protection/ 

If you have any concerns about the way the Trust is using or sharing your information, you can speak to your clinical team or the Data Protection Officer in the first instance.

Fire safety – All Trust hospital premises are provided with automatic fire and smoke detectors and they are installed for your safety.

If you hear the fire alarm, ward staff will direct you to a safe location away from the fire and away from danger.  Please follow staff instructions and please try to stay calm.

The staff will silence the fire alarm when it is safe to do so.

Infection control – please speak to a member of staff or the infection control nurse if you have any concerns about the cleanliness of the hospital.

Personal safety – we have personal wrist alarms for patients. If you feel you would like one of these you can speak with any member of staff and they will support you.

Narcotics Search Dog – the Trust has a narcotics search dog and handler who make both planned and unannounced visits to wards and departments.  The search dog is trained to locate illegal substances such as cannabis, cocaine, amphetamine, ecstasy and heroin.

We also have a community police officer who visits and supports the service; he is there for advice and guidance.

Oxevision – Oxevision is a medical device that uses an infrared-sensitive camera to measure your pulse and breathing rate. The system has been installed in bedrooms to improve patient safety and patient experience. If you would like further information, please ask staff for a copy of the Oxevision patient information leaflet.

Body worn cameras – all staff working within secure care wear body worn cameras.  Body worn cameras will only be activated in a crisis and staff will inform you if they are switched on.

Close-circuit television (CCTV) – is live in all clinical areas within secure services, except bedrooms, bathrooms and toilets.  Signage displayed where CCTV is in operation.

Security equipment – all staff within secure care services carry personal alarms, handheld radios and pagers to maintain a safe environment for everyone.

Scanning – all patients and visitors must be scanned prior to entering the unit, we use a metal detector within the first airlock as you enter the unit.  There is a small search room for privacy, if  the metal detector is activated, an additional search is required.  It will always be someone of the same sex who carries out the security scan.  Staff will explain the process to you.

Patient Advice and Liaison Service (PALS)
Provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care. Ask a member of staff for your local PALS telephone number or find details online at www.cntw.nhs.uk/contact/patient-advice-service/

Independent advocacy
You are entitled to the support of an independent advocacy service to help you understand and speak up for your rights while you are in hospital.  Advocates provide an unbiased service and will work with you to understand your rights, your medication and treatment options and discharge plans.  They can also support you to take part in meetings, tribunals and appeals.

If you have been admitted to hospital under a section of the Mental Health Act, you can ask for an Independent Mental Health Advocate (IMHA) by contacting the service that covers the area where you live. This right extends to you if you are subject to a Community Treatment Order (CTO) or guardianship.

Even if you are in hospital as an informal or voluntary patient, you might still be entitled to advocate support. Feel free to approach hospital staff members to learn more about the advocacy services available in your area, including advocacy under the Care Act.

Hospital staff can also give you the contact information to connect to the right advocacy service or help you with a referral.  You can also find information online at
www.cntw.nhs.uk/resource-library/do-you-need-an-independent-mental-health-advocate/

The Trust produces a booklet ‘Independent Mental Health Advocacy. Copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

Care Quality Commission (CQC)
The CQC is the independent regulator of all health and social care services in England.  It checks all hospitals in England to ensure they are meeting government standards of quality and safety. www.cqc.org.uk/public

If you want to make a comment, suggestion, compliment or complaint you can:

• talk to the people directly involved in your care
• ask a member of staff for a feedback form, or complete a form on the Trust  website www.cntw.nhs.uk/contact/complaints/
• telephone the Complaints Department Tel: 0191 245 6672
• email [email protected] 

We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention.

You can provide feedback in the following ways:
– the quickest way for you to do this is to complete our short online survey at www.cntw.nhs.uk/yourvoice
– complete a Your Voice survey, available on wards, reception areas or from staff
– other options for sharing your feedback and experience www.cntw.nhs.uk/yourfeedback

Patient Advice and Liaison Service (PALS)
PALS provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care.

We act independently when handling patient and family concerns, liaising with staff, managers and, where appropriate, relevant organisations, to negotiate prompt solutions. If necessary, we can also refer patients and families to specific local or national-based support agencies.

PALS
Tel: 0800 032 0202
Email: [email protected]
Post: FREEPOST PALS

South of Tyne
Tel: 0800 328 4397
Text: 07825 061 035
Email: [email protected]
Post: Patient Advice and Liaison Service, Garden Lodge, Hopewood Park, Ryhope, Sunderland, SR2 0NB

9.00 am – 4.30 pm, Monday to Friday
An answerphone is available at all times for you to leave a message. A member of the PALS team will aim to return your call as soon as possible.

Leaving hospital can be an important life event so it is essential that you receive good quality discharge care. Plans around your discharge should commence soon after admission and be part of all care planning processes. You will be involved in this process. Carers will also be invited to be a part of planning any discharge.

There may be times when transfers between wards may occur. You clinical team will explain why this may be the case – generally this will be because of your care pathway and recovery needs.

Staff on the ward will be able to assist you with concerns you might have about these or any other issues and provide you with contact details of the crisis team.

Care Programme Approach (CPA) is a way of planning and co-ordinating your care after you leave hospital.  It helps make sure that you are supported in a way that fits your individual health and care needs. CPA includes:

Assessing your needs with you
Developing a plan in response to the needs identified and agreed
Sharing responsibility with you (and others as needed) to put the plan into action
Reviewing the plan with you to check that it is meeting your needs and to agree any changes

What is meant by Care Co-ordination?
Care Co-ordination describes the process of how mental health services assess your needs, plan ways to meet them and check that they are being met. You should always feel able to ask mental health workers to explain this process clearly to you.

Who will be my Care Co-ordinator?
Your care co-ordinator during your stay will be your Primary Nurse. You should always be informed of the name and contact details of your Care Co-ordinator. You may have another lead professional involved in your care prior to admission, they will continue to be updated and involved during your stay.

What does a Care Plan look like?
A care plan is usually a detailed form which states your needs, the range of services required and who will provide these services. It might include things like your medication, your support at home and finance or other personal needs. The process of CPA is also about recognising what you are able to do and what you want to do (your strengths). A copy of the care plan will be given to you to keep.

What does a CPA review look like?
A CPA review is not all about complicated forms and meetings; it is about discussing and writing down your needs and checking they are being met. Reviews should recognise any progress that has been made and involve discussion of all elements of your care plan. During your stay here, you may hear this referred to as a “CCR”.

How do I call a review?
You (or your carer) and anyone providing services can call a review. If you feel that a review is needed, you should contact your care co-ordinator who will assist you with making the arrangements. A review should be flexible about where and when it happens and who attends – you might like to invite a family member or friend who supports you.

The Trust produces a booklet ‘Care Co-ordination including Care Programme Approach (CPA) – A guide for people with mental health problems and their carers’. Copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

When you leave hospital, you will be supported by a team of professionals who are based in the community. As you near discharge, this team will become more involved in your care. This will help you transition out of hospital.

The Secure Outreach and Transition Team (SOTT) will support patients in the Forensic Learning Disability Service; for more information, please contact the team on Tel: 01670 394 611

The Forensic Community Service will support patients in the Forensic Mental Health Service; for more information, please contact the team on Tel: 0191 246 7273 

You can watch a video about The Forensic Community Service by – https://youtu.be/R5LDQX1vz6s

The Social Work Team ensures that their discharge plan is in their best interest, if they are unable to make that decision.

They also make sure that they are supported to be discharged to the right place, at the right time and with the right support that maximises their independence and leads to the best possible sustainable outcome.

For more information, please contact your loved ones social worker directly about discharge into the community.

The Quality Commission (CQC)
The Care Quality Commission is the independent health and adult social care regulator. Their job is to ensure health and social care service are providing effective, safe, compassionate, high quality care and encourage them to make improvement wherever necessary. This is done by inspecting, monitoring and regulating services to make sure they meet fundamental standards of quality and safety. Their finding are published and made publicly available to help people choose care.

Quality Network
The Quality Network for Forensic Mental Health Services (QNFMHS) is a quality improvement network for low and medium secure inpatient forensic mental health services in the UK. We have annual reviews where carers, patients and staff can provide essential information to support the ongoing improvement of our services.

Advocacy
Advocacy services help people, especially those who are vulnerable or in a vulnerable situation, to speak out, express their views and defend their rights. Northgate Park maintains close links with a number of advocacy services. Patients are encouraged to access these services and make their voice to be heard. Patients may keep their current advocate should they prefer.

Independent Mental Health Advocate (IMHA)
The Independent Mental Health Advocacy Service provides an additional safeguard for patients who are subject to The Mental Health Act (1983). IMHA are specialist advocates specifically trained to work within the framework of the Mental Health Act (1983) to meet the needs of the patient. You can find more information on the Trust website at www.cntw.nhs.uk/resource-library/do-you-need-an-independent-mental-health-advocate/

Independent Mental Capacity Advocate (IMCA)
The Independent Mental Capacity Advocacy service was introduced as part of the Mental Capacity Act 2005. IMCA’s safeguard the rights of people who are facing a decision about a long-term move or serious medical treatment, lack the capacity to make a decision at the time it needs to be made and have nobody who is willing and able to represent them, other than paid staff.

Recovery Colleges
A safe place where people can connect, gain knowledge and develop skills that support recovery from mental health problems.  Courses are open to anyone who would find them helpful in their recovery from mental illness, substance misuse, trauma or distress.  To find out more information visit www.cntw.nhs.uk/recovery

Mind Infoline
Tel: 0300 123 3393
Welfare benefits line Tel: 0300 222 5782
www.mind.org.uk
Email: [email protected]
2 Redman Place, London, E20 1JQ
Provides information on a range of topics including types of mental distress, where to get help, drug and alternative treatments and advocacy. Also provides details of help and support for people in their own area. Helpline available Mon-Fri, 9am-6pm.

Rethink
Helpline: 0808 801 0525
www.rethink.org
Rethink, PO BOX 18252, Solihull, B91 9BA
Provides information and a helpline for anyone affected by mental health problems.
Helpline available Mon-Fri, 10am-2pm

Samaritans
Tel: 116 123
www.samaritans.org
Email: [email protected]
Freepost SAMARITANS LETTERS
Provides confidential support for anyone in a crisis.

Patient Information Centre – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
Provides a range of health information covering conditions, treatments, medication and health promotion. Information is available in alternative formats and languages.  www.cntw.nhs.uk or Tel: 0191 246 7288

The NHS website
www.nhs.uk 
Information about conditions, treatments, local services and healthy lives.

There are a number of different ways for carers to get involved.

Service User and Carer Reference Group 
A service user and carer led forum working in partnership with staff to support continuous improvement of Trust services. Tel: 01670 501 816 Email: [email protected]

The Involvement Bank 
Provides opportunities for service users and carers with recent lived experience to be involved in a range of service development opportunities including recruitment and training of staff. Tel: 01670 501 816 Email: [email protected] 

Voluntary Services 
Volunteers participate in a wide range of non-clinical activities across the Trust, complementing the work of healthcare professionals to enhance the experience of our patients and carers. Tel: 0191 246 7287 Email: [email protected]

Trust Membership 
Members can receive regular information about the Trust with opportunities to give views and elect people to the Council of Governors. Tel: 0191 245 6827 Email: [email protected]

Lived Experience Advisory Group
With the support of the Provider Collaborative the services have a well-established lived experience advisory group, the purpose of this group is ensure all current and newly developed services are influenced by the voices of our services users, carers friend and families.

All carers interested in being involved are more than welcome to attend, we offer training to support you in this role as well as a recognition payment.

Recovery Council
We continue to involve patients and carers in service delivery and improvement through our recovery council.  We will always act on suggestions, issues raised and patient wishes.

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Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this leaflet please get in touch.

This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre Tel: 0191 246 7288

Published by the Patient Information Centre
2025 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Ref, PIC/949/0825 August 2025 V1

www.cntw.nhs.uk

Tel: 0191 246 7288

Review date 2028