Joint Hospital, Dumbarton
At present the hospital provides Mental Health Services and Addiction Services to a population of approximately 80,000 people and covers the wide geographical areas of Alexandria, Patient Information Leaflet Dumbarton and Helensburgh.
Developments within the hospital have seen the introduction of many services including drug and alcohol, mental health crisis team, out of hours services, dementia day hospital, community and in-patient dementia services to name but a few. The adult CMHT provide services from Riverview Resource Centre.
Riverview Resource Centre Community Mental Health Team (Adult) for Dumbarton & Alexandria areas
Riverview Resourc Centre
Victoria Infirmary Community Mental Health Team (Adult) for the Helensburgh & Lochside areas.
CMHT (Adult) Service Aims The aim is to provide a locally based responsive service which delivers high quality community care to adults and their families in their own homes who are experiencing Mental Health problems. They can offer a specialised mental health assessment and various different treatment approaches according to identified need. Treatments available include psychosocial interventions aimed at reducing symptoms and increasing coping skills.
The local teams work with a range of local services including: Local Authority, Voluntary Services and Primary Health Care Teams.
The Team consists of: Medical Staff Nursing staff . Admin & Clerical Social Workers MHOs SW Assistant Clinical Psychology Occupational Therapist
Operational Aspects Flexible referral system Monday to Friday 9.00am-6.00pm Keyworker system/care management MDT assessment/reviews/care planning Discharge Planning/CPA Risk Assessment/management
Services Provided Assessment clinics Operate a duty system/crisis services Diagnostics/Care Planning Supportive counselling Brief therapies Cognitive Behavioural Techniques Social Skills training Problem solving techniques Assertiveness/confidence building Independent living skills Anxiety Management Referral to other appropriate services i.e. voluntary agencies
Assessment Clinic The local teams run weekly assessment clinics. These are facilitated by nurses, OTs, medical and social work staff.
Emergency assessments can still take place outside of these times and will be seen by the duty worker and maybe referred onto the crisis service.
Duty System
Duty System The system operates from Riverview Resource Centre, Joint Hospital, Dumbarton, presently Mon to Fri, 9am to 6pm.
Crisis Service
The Crisis Service Take over the duty system when the CMHT stops at 6pm. During CMHT hours of operation the crisis service is accessed by calling the duty system. After 6pm it can be accessed directly by telephone until 8pm and 9am to 5pm at weekends.
The Duty and Crisis Service provide same day assessment services to people considered to be at risk due to mental health issues/problems.
Out of Hours (West Dumbarton Only) At 8pm to 8am the Out of Hours services operate and can be contacted through NHS24 or your GP. (West Dumbarton Only)
Clozapine Clinic The CMHT provides clozapine monitoring / administration services for clients living in the area.
Depot Clinics Operate in West Dunbartonshire only and encourage clients to engage with services locally and offer lifestyle advice/support. People who receive deopt medication in the Helensburgh and surrounding peninsula will have a named keyworker who administers their depot either at home or in the clinic.
Group Work The CMHT provides a programme of groups, from Riverview Resource Centre, these groups also extend to the Helensburgh area whenever there is a locally identified need.
Men’s Groups: have been established in Dumbarton & Helensburgh. The main objective of this group is to provide a social setting and network for men experiencing mental health problems.
There is a Hearing Voices Group that takes place in Helensburgh once every two weeks. This is a user lead group however input is provided from a CPN from the CMHT.
St. Kessog’s Drop In: operates on a Tuesday morning in Alexandria. It is jointly provided with the CMHT, SAMH and Social Work staff.
Ante Natal Education Programme: Members of the CMHT provide input to this Group ran by the midwifery team at the Vale of Leven Hospital and also at the Jeanie deans Unit in Helensburgh. They provide information and education on postnatal depression.
RESST group: (Relaxation Exercise Stress management Therapy Tea) The CMHT provide input to this group ran by health visitors in conjunction with the Healthy Living initiative. This group offers support to women living in West Dunbartonshire and suffering from postnatal depression.
Primary Care Link Nurse GP surgeries may wish to have a named Primary Care Link Nurse attached to their practice. Their role is to provide the local GPs and the PHCT with a named person who can be contacted to discuss referrals or provide up to date information regarding local mental health services.
Cairnmhor Resource Centre Community Mental Health Team – (Older Adults)
Cairnmhor Resource The Community Mental Health Team for Older Adults Centre is a service for adults (aged 65yrs +) diagnosed with a mental illness including Dementia, based at Dumbarton Joint Hospital and services are provided from Cairnmhor Resource Centre. The service covers the three main geographical areas of Dumbarton, Alexandria, Helensburgh and Lochside.
The CMHT operates Monday to Friday, 9am to 5pm and operates an open referral /keyworker system and is the main single point of access to the local mental health older adults services.
Most clinical contact is provided in the patient’s own home. Where appropriate any group work is carried out in local community premises. There have been well- received initiatives along the way and feedback from partners in care has always been very positive.
Services Aims To provide advice, support and education to patients, carers and others while providing assessment of care needs and co-ordinating plans of care to people within their own community.
Operational Aspects Open Referral system Keyworker system MDT reviews/multi professional assessment Risk assessment Discharge Planning
Services Provided Comprehensive person centred approach to assessment Assessment of carers needs Liaison role to co-ordinate plans of care Advice, education and support to other professionals/agencies Provide emotional support to clients and carers Provide practical advice to clients and carers on day to day aspects of daily living (e.g. reality orientation, behavioural interventions, occupational activities, validation therapy, reminiscence, environmental modification (as per SIGN Guidelines). Duty System The system operates from Cairnmhor Resource Centre, Joint Hospital, Dumbarton, presently Mon to Fri, 9am to 5pm. The Crisis Service Take over the duty system when the CMHT stops at 5pm. During CMHT hours of operation the crisis service is accessed by calling the duty system. After 6pm it can be accessed directly by telephone until 8pm and 9am to 5pm at weekends.
The Duty and Crisis Service provide same day assessment services to people considered to be at risk due to mental health issues/problems.
Out of Hours (West Dumbarton Only) At 8pm to 8am the Out of Hours services operate and can be contacted through NHS24 or your GP. (West Dumbarton Only)
Community Staff (Link) Nurse The Link Nurse, provides an input into Local Care Homes, they provide awareness/advice support for staff working in the Vale Of Leven Hospital wards for care of the older person.
A Link Nurse provides specific input to the Helensburgh area combining Liaison work with Care Homes as well as seeing client’s in their own home.
Staff regularly carry out joint visits and assessments with Social Work, often being initiated by the Single Shared Assessment for accessing social/community support services.
Early Onset Focus Group for People with Dementia. The nursing/OT staff along with Alzheimers Scotland and the local clinical audit/effectiveness personnel set up a pilot Early Onset Dementia Support Group.
The pilot was able to determine that this was something that would be better maintained and sustained in the future through a multidi-agency approach. The focus groups should have a dual function to serve as a forum for patients and their carers to provide feedback about their services/care and for this feedback to be used to improve local services.
Carer Education/Local Alzheimers Scotland Action on Dementia Project. Team members provide information for the Alzheimers Scotland Carers Education Programme information on the service and what it is able to provide.
Dementia Care Mapping The Local authority have trained three Local Authority Staff and the team are planning to send the OT for training. Across both health and local Authority there should then be a large enough pool of staff to allow for more regular mapping. This will have a particular benefit for local authority care settings in providing evidence of Quality of Care and for the Care Commission. There is now a pool of 9-10 mappers across health and local authority in WDC. To date this has allowed three sessions of mapping in local authority day care and residential establishments. The primary purpose of the joint mapping was to look at training issues that may be determinded through DCM and the underpinning principles of person centered care.
Helensburgh Carers Drop In Initiative Along with Alzheimers Scotland Carers Support Worker and members in the CMHTD, this Drop-In Initiative was established in the Helensburgh Area.
Group Work The CMHT provides Community based groups in conjunction with OT and nursing Staff as well as other agencies. The service aims to identify areas of unmet need and provide evidence based Person centred interventions. A Relaxation Group is held in the community centre in Bonhill. It is targeted at females who are at an earlier stage of the illness. A Well-being Group is run once a week in Helensburgh which primarily looks at mobility and exercise whilst providing a relaxed social experinece for those who attend. A new development is the Horticulture/Gardening Group, to provide people with outdoor activity. Another new proposal is a joint initiative between AHP, Day Hospital support workers and voluntary staff from Alzheimer Scotland in having a full day which as well as incorporating the existing relaxation and well-being groups, would allow for other activities to be explored. Due to the potential of sustainability under existing staff resources and very little extra costs the prospect of a “day” as opposed to 2-3 hours over two days is more appealing in the longer term and other ideas may mushroom.
Glenarn Ward
Glenarn Ward is based within the Joint Hospital, Dumbarton. The Ward which first opened in 2001 is the only in-patient ward in the hospital, and the only ward of it's kind in the existing health board to provide 24 hour care for 12 patients presenting with complex care needs in dementia. The ward is ground level with a garden to the rear. The internal environment is calm, homely, open, friendly and welcoming.
The patients admitted to Glenarn Ward are assessed in Fruin Ward at the Vale of Leven Hospital, and transferred to Glenarn, if complex care is required.
Service Aims . To provide local mental health in-patient services for those patients presenting with complex care needs in dementia . To develop a person centred approach to delivering high quality nursing care which promotes/maintains the persons abilities, while providing education and support to carers and families. . To provide the highest standard of individualised care and services, involving patient's, relatives, friends and carers in the assessment process. . To work in partnership with other agencies/disciplines to ensure an integrated approach to care. . To continually assess the care needs of client group and arrange for discharge to appropriate care setting when deemed suitable for discharge. . To ensure the development and retention of skilled staff, committed to patient, colleagues, the organisation and others involved in patient care.
Operational Aspects . Referrals are received via Fruin Ward assessment facility . Client centred approach utilising Kitwood, Maslow's Hierarchy of Needs and Roper, Logan and Tierney's Activities of Daily Living . Named Nurse system which includes, named nurse, associate nurses, and a team of nursing assistants. . Multidisciplinary review meetings held weekly by the General Practitioner and monthly by the consultant attended by nursing staff/patient/relatives. .Discharge planning
Services Provided . Therapeutic interventions . Support, Counselling for Patients and Carers . Education, Advice readily available for relatives and carers . Information leaflets and resources available (various languages) . An advocacy service is available for patients carers and relatives on request. Information leaflets available on entrance to the ward . End of life care Ardmore Day Hospital:
Ardmore Day Hospital aims to provide a service for older people with mental health problems living in Alexandria, Dumbarton and Helensburgh. The service moved to it’s present location at the Joint Hospital in Dumbarton early in 1999.
Service Aims To provide locally based community day hospital services for people with mental health problems including dementia. These services will be provided by community and day hospital based multi- disciplinary personnel. To promote a seamless/integrated approach to provide an enhanced and comprehensive range of services for the benefit of the local community. To provide the highest standard of individualised care to older people with mental health problems and actively involve relatives and carers in the provision and assessment of all care in an open and friendly environment. To develop and retain staff who are skilled, valued and committed and who can help fulfil the aims of the organisation.
Operational Aspects 6 Day service, 9.00am to 5.00pm for 14 people daily. Transport is provided by Scottish Ambulance Services. Referrals are received via the Community Mental Health Team (Older Adults) he Named Nurses are supported by Associate Nurses and Support workers. Multi-disciplinary review meetings held weekly and attended by all disciplines. Discharge planning. Staff work very closely with CMHT (older adult) and attend the CMHT’s weekly allocation MDT meeting.
Services Provided Assessment & diagnostic service. Behaviour management Therapeutic multi-disciplinary interventions Cognitive behavioural interventions Support and advice available for patients, relatives and carers Education and advice available for relatives and carers Information leaflets and resources available
Mental Health Services Vale of Leven Hospital
Christie Ward – Adult Acute Admission Ward 18 bedded mixed sex unit. 8 single en-suite bedrooms 3 x 4 bedded dormitories with en-suite shower/ toilet.
The ward opened on 4th April 1997. It is the first adult acute in-patient facility in the Local area for people experiencing acute mental health crisis.
Service Aims To provide a flexible, accessible inpatient, person centred, service to people in the local community experiencing acute mental health crisis. To promote a seamless, integrated approach to provide an enhanced and comprehensive range of services. To increase peoples awareness of health promotion and to provide a proactive approach to health education To develop and retain staff who are skilled, valued and committed and who strive to fulfil the aims of the service
Operational Aspects Referrals are received from the following areas:
Community Mental Health Team/Crisis/OOH General Practice Medical Assessment Unit/Minor Injuries Unit Police Vale of Leven Hospital In patient units A+E RAH
Services Provided The ward has adopted the Tidal/Recovery model. Assessment and diagnosis General Medical Health Screen Nursing assessment and intervention Psych-social Education Physiotherapy – assessment and intervention Occupational Therapy – assessment and intervention Domiciliary Functional Assessments Medication intervention and management Group work Off the ward activities Healthy Living – Nutritional advice and exercise Access to Podiatry/ Dentistry and Speech and Language Therapy Social Work Assistant Clinic – weekly Lomond and Argyll Advocacy Service
Katrine Ward : Due to open in April 2010, an acute admission ward specifically for people with acute mental health problems aged 65 years and over.
Fruin Ward:
Fruin Ward was established on the third floor of the Care of the Elderly Unit at the Vale of Leven Hospital on the 17th May 1986. It was the first in patient service in the Dumbarton District to provide facilities to meet the needs of the expanding population of the elderly with mental health problems who predominantly suffer from Dementia, of which Alzheimer’s disease is the most common.
The admission criteria dictates that people, irrespective of age, with a suspected diagnosis of dementia who has challenging behaviour and/or complex nursing needs will be admitted for assessment.
Fruin is a mixed sex ward and provides assessment for any type of dementia, some of the most common forms seen are: Alzheimer’s disease Multi Infarct dementia Lewy Body Disease Alcohol Related Dementias including Korsakoff’s disease Frontal Lobe Disease Each form of dementia has it’s own issues and presenting problems requiring assessment from a highly skilled multi-disciplinary team.
Service Aims To provide locally based mental health in-patient services for people with a suspected diagnosis of Dementia. These services to be provided by community and hospital based multi-disciplinary personnel. To promote a seamless/integrated approach to provide an enhanced and comprehensive range of services for the benefit of the local community. to provide the highest standard of individualised care to older people with mental health problems and actively involve relatives and carers in the provision and assessment of all care in an open and friendly environment. To develop and retain staff who are skilled, valued and committed and who can help fulfil the aims of the organisation.
Operational Aspects Referrals are received via the Community Mental Health Team (Older Adults). Patient centred approach to care utilising the Kitwood model of Person Centred Care in conjunction with the Roper, Logan & Tierney model and Maslow’s hierarchy of human needs. Named nursing – there are two Named Nurses within the ward each supported by Associate Nurses and Nursing Assistants. Multi-disciplinary review meetings held weekly and attended by all disciplines. Discharge planning.
Services Provided Therapeutic multi-disciplinary interventions Cognitive behavioural interventions Support and advice available for patients, relatives and carers Education and advice available for relatives and carers Education and support available for unqualified staff and student nurses Information leaflets and resources available Ongoing and continual support and liaison provided to Acute General and Elderly Wards Advocacy End of Life Care and support for patients and their families
Primary Care Mental Health Services – NEW SERVICE
This is a service across West Dunbartonshire and Helensburgh. The service is for people aged 16 and over who are experiencing mental, psychological or emotional problems which affect their normal functioning and who are likely to respond to time limited psychological interventions.
The Primary Care Mental Health Team has three main responsibilities for service delivery:
Community development & health promotion Community bridge building supports Provision of brief intervention therapies on self help, group & individual basis consistent with a matched model of intervention
The matched care model will be developed across West Dunbartonshire. This model will involve developing the following:
Population health - Awareness raising/community involvement/early intervention & prevention
Working with others - General practice networks/community organisations/local authority partners
Non face to face work - Education resources – healthy reading, self help approaches
Single contacts - Information sessions/advice
Groups - Groups will be developed dependent on need
Individual Therapy - Brief time limited psychological intervention provided Sessions by team members (Mental Health Practitioners & Clinical Psychologists)