Call for changes to ‘clinical and bare’ psychiatric wards

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A visit to two Larbert psychiatric assessment wards disclosed cheerless surroundings and a “garden” covered in stone chips.

Meanwhile care plans for patients still lacked detail - “particularly where there were high levels of stress and distress”.

The findings follow a visit to Forth Valley Royal Hospital by the Mental Welfare Commission for Scotland earlier this month.

Positive points included detailed nursing notes which provided a good record of the patient’s presentation, day by day, although “fragmented” recording generally was said to mean important information could not be easily accessed - and might be missed.

Consultant psychiatric cover was partly provided by a locum, which in one case was said to have had a significant impact on patient care.

But in what seemed a positive response to this the service is now ensuring patients with complex needs are being managed by permanent consultants, regardless of catchment areas.

Meanwhile the Commission said evidence of “back to back” short term detention certificates is concerning, because this can extend the total period of detention to well over 28 days before a tribunal hearing can properly test the reasons for it.

The Commission’s report notes: “We will write to the service to seek a review of the circumstances which resulted in this error, and ensure that the patient is advised of their rights in this instance”.

The wards are locked and, the report says, although there are plans to develop the garden area its stone chip surface needs to be replaced with something more suitable.

The Commission notes: “Given the high levels of distress we witnessed during this visit we would suggest that this development should be progressed as soon as possible, offering patients this option of outside space to reduce distress”.

The claimed lack of structured activity was also said by one carer to be contributing to his relative’s distress.

The Commission did conclude some action had been taken to improve the wards with some colour and artwork, but added: “The environment remains clinical and bare, and could be improved by the involvement of patients, where possible, and carers”.

The Mental Welfare Commission’s key role is to protect and promote the human rights of people with

mental illness, learning disabilities, dementia and related conditions.