BEECHWOOD HOUSE

QUESTIONS AND ANSWERS FROM BARRY CROSBIE




Q1
Has Partnerships in Care advised Monmouthshire County Council of their intentions re. change of use?

ANSWER :We do not need to advise Monmouthshire County Council of our plans.

Q2
Has Partnerships in Care a duty to inform the Home Office of the change they wish to make to the current use?

ANSWER:We are in contact with the Home Office.

Q3
Has Partnerships in Care sought approval from the Local Health Authority?

ANSWER: We do not need approval from Monmouthshire Local Health Board.

Q4
Please can you briefly outline the proposals you have to change the use of Beechwood House and the reasons why such patients cannot continue their care at Llanarth Court?

ANSWER: Our proposal is to provide a step-down service for male patients with a mental disorder such as an enduring mental illness. The patients for the proposed service at Beechwood House will be at a very advanced stage of their rehabilitation and will no longer need care and treatment in medium-secure or even low-secure accommodation provided at units such as Llanarth Court. We have a duty to ensure that patients are not treated in a condition of security greater than they need.

Q5
Have you advised any official body who would have concerns with regard to the community safety aspects? If so, which body?

ANSWER: We have advised Gwent Police and are arranging meetings with them to agree whatever protocols will be necessary. We have also met with the Head Teacher and other Governors of Goytre Fawr Primary School.

Q6
What has Partnerships in Care done with regard to community safety aspects with regard to any proposed changes?

ANSWER: We have advised those people mentioned in A5. We will also ensure, following our normal procedures, that no patient is admitted to Beechwood House without a comprehensive assessment, including a thorough risk assessment, by our experienced clinical staff. No patient will be admitted if we do not think he is appropriate for the service. We have also consulted with Healthcare Inspectorate Wales and colleagues in the local NHS Trust.


Q7
Has a change of use to Beechwood House been registered as yet with Healthcare Inspectorate Wales?

ANSWER: We have been in discussion with HIW since our initial decision to change the service at Beechwood House. HIW inspectors have already visited the unit.

Q8
What additional security measures will be put in place at Beechwood House and within the community with regard to this proposal for change of use?

ANSWER: We will agree a protocol with the police to advise local people should any patient abscond.

Q9
What measures are taken in the event of an incident in the village ie. a patient with HIV who decides to play-up?

ANSWER: As stated earlier, patients who are likely to be placed at Beechwood House will be at a very advanced stage of their treatment. Patients at this stage of their care are very keen to complete their treatment and return to their home areas so it is rare for such patients not to follow the rules of such a service. Should a patient go into the village without an escort, and without our prior approval, then we will follow an agreed procedure (see A8/A10) and will consider returning him to Llanarth Court or another more secure service.

Q10
What action takes place in the event of a patient leaving the grounds, ie. without permission/supervision?

ANSWER: If a patient absconds we will notify the police and a number of other people (yet to be determined) in the vicinity. The police’s usual practice would be to notify the Neighbourhood Watch Scheme. We will also contact the village school.

Q11
If Beechwood House in the future wished to care for paedophiles which public bodies would they need to officially notify?

ANSWER: We will not be admitting convicted child sex offenders to Beechwood House.

Q12
Can you assure residents in writing through our Council that you have no intention now or in the future of housing child sex offenders at Beechwood House?

ANSWER: See A11 above.

Q13
Will Beechwood House residents have unsupervised access to the village now or in the future?

ANSWER: We do not envisage patients at Beechwood House having unescorted access to the village.

Q14
Will Beechwood House residents have unsupervised access to the grounds now or in the future?

ANSWER: The patients will have unescorted access to the grounds if:
(i) this is clinically appropriate and
(ii) a comprehensive risk assessment indicates that it is justified.

Q15
What will the staff/patient ratio be on days?

ANSWER: When the unit is fully occupied with 17 patients, the normal day shift Mondays to Fridays will consist of 4 qualified and 3 non-qualified nursing staff. There will also be a Patients’ Activities Coordinator, qualified and non-qualified Occupational Therapy staff, and other clinical and support staff. At weekends the day shift will be a minimum of 2 qualified and 3 non-qualified nursing staff.

Q16
What staff/patient ratio will there be on nights?

ANSWER: At night there will be 2 qualified and 2 non-qualified nursing staff on duty.

Q17
In the event of staff shortages what measures will be taken to ensure proper cover?

ANSWER: In the event of an unexpected shortage of staff we will follow our normal practice of bringing in covering staff from within our own Nursing Department at Llanarth Court or our Nursing Bank or, if there is no alternative, a Nursing Agency.

Q18
Under your proposals for an open unit are you obliged to follow a staff/ patient ratio? If so, what is the ratio?

ANSWER: We have discussed our staff/patient ratio with HIW.

Q19
What additional staff training will be provided to staff not suitably qualified and will all training be completed by the time patients move in?

ANSWER: Before the new service begins, staff at Beechwood House who are not
needed to care for the reducing number of brain-injured residents will work at Llanarth Court. The exact staffing arrangement is still to be confirmed but it is also our intention that, once the service opens, half the nursing staff at Beechwood House will spend up to six months being fully trained at Llanarth Court. These staff will be replaced by experienced staff from Llanarth Court. At the end of this period, the second half of the Beechwood House nursing staff will go to Llanarth Court. All nursing staff at Beechwood House will receive a clinical induction programme prior to the unit reaching full capacity.

Q20
Will you agree to a consultation with the village should a further change to patient category be deemed necessary?

ANSWER: We would very much like to work with the local community to discuss matters of mutual interest. At other sites, such as Llanarth Court, we have positive experiences of working with Local Liaison Committees, established by local residents, who meet regularly with the unit’s management. We would be very interested to work with such a committee in Goytre.

Q21
What is the maximum limit of patients to be housed at Beechwood House.

ANSWER: The maximum occupancy will be 17 patients.

Q22
Have you given consideration to other uses for these premises? If so, what?

ANSWER: This question has also been put to our Company by the Head Teacher of Goytre Fawr Primary School and our Chief Executive Officer is replying to him. However, in short, yes we obviously looked at the range of services we offer as an alternative to a brain injury service. Through our experience we believe that Beechwood House offers a suitable environment to provide a step-down service for patients near the end of their rehabilitation.

Q23
Are you aware of any other similar facility placed as close to a school/ pre-school, after school, park and OA housing?

ANSWER: Patients with mental disorders are rehabilitated in many communities, usually without local residents knowing it, eg. Whitchurch Hospital in Cardiff has a mental health unit in the middle of Whitchurch Village.

Q24
How many have absconded from Llanarth Court during the last year and what action took place in each event?

ANSWER: In the last 12 months, five patients have absconded from Llanarth Court. Four of these were on unescorted grounds pass and one was on unescorted leave to a local town. All were returned to the hospital within an hour or two. No adverse incidents occurred.

Q25
Will you only be relying on “patient contracts” and “trust” as measures to combat absconsion?

ANSWER: Patients will be put on trust not to leave the grounds unescorted. Our staff will be vigilant to try to ensure that this does not happen. Thorough risk protocols will be used to ensure that we admit only those patients who are appropriate.