Welcome Guide – Richardson Eating Disorders Service (REDS)

This Welcome Guide provides information about your stay on the ward. There is a lot of information in this guide so it may be helpful to read it a bit at a time.

The guide tells you about the ward, the staff and the treatments and therapies that will be available to you. It also tells you what it will be like to be in hospital and gives information about understanding your rights.

In developing this guide patients who have used this service have provided some quotes about their experience of the service that we hope you will find useful.

On 31a, I felt safe enough to find the me that I’d lost and rediscover how beautiful life is.

A member of the ward team will go through the Welcome Guide with you when you first arrive on the ward. They will answer any questions you may have about 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.

Richardson Eating Disorder Service (REDS)
Ward 31A
Richardson Unit
Leazes Wing
Royal Victoria Infirmary
Richardson Road
Newcastle
NE1 4LP

Admin office telephone: 0191 282 5259 – Monday to Friday, 9am to 5pm
Nursing office telephone: 0191 282 5753

The Richardson Eating Disorder Service is a specialist service based at the Royal Victoria Infirmary in Newcastle which provides comprehensive assessment and treatment for eating disorders and is part of Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust.

The service is for men and women aged 18 and over living in the northern part of the North East.

The length of stay depends upon your personal needs. The care team will involve you fully in discussion about this.

As you progress, periods of leave off the ward will be agreed and planned with you. Leave helps create patterns of eating and purposeful activity to aid your recovery. It usually starts with short periods of time off the ward with staff. A wheelchair is available for those at very low body weight. Leave builds to spend up to four nights at home per week before discharge.

The team will look at your progress before increasing your leave. They will look at your meal plan and weight restoration. They will also look at how you manage independently and any medical or psychological risks.

To get the most out of your leave, we recommend that you work with the team to plan. You can agree leave targets on a weekly basis, or at admission, so you know where you are in the plan.

Arriving at the Richardson Eating Disorder Service
When you arrive you will be welcomed by a member of the care team. They will explain what will happen during your stay and give you information and a copy of this Welcome Guide.

On your admission you will be allocated a Named Nurse and an Associate Nurse. You will meet weekly with each, to plan your care and help you explore some of the difficulties that might be helping to maintain your eating disorder.

You will also spend time each day with a member of the nursing staff to explore any difficulties you might be experiencing. We call this time ‘Team Approach’. A member of the nursing staff will accompany you to certain meetings (e.g. care review meetings, family meetings) to help support you, and to ensure that your thoughts and feelings are heard.

Arriving at the Richardson Eating Disorder Service
When you arrive you will be welcomed by a member of the care team. They will explain what will happen during your stay and give you information and a copy of this Welcome Guide.

On your admission you will be allocated a Named Nurse and an Associate Nurse. You will meet weekly with each, to plan your care and help you explore some of the difficulties that might be helping to maintain your eating disorder.

You will also spend time each day with a member of the nursing staff to explore any difficulties you might be experiencing. We call this time ‘Team Approach’. A member of the nursing staff will accompany you to certain meetings (e.g. care review meetings, family meetings) to help support you, and to ensure that your thoughts and feelings are heard.

Arriving at the Richardson Eating Disorder Service
When you arrive you will be welcomed by a member of the care team. They will explain what will happen during your stay and give you information and a copy of this Welcome Guide.

On your admission you will be allocated a Named Nurse and an Associate Nurse. You will meet weekly with each, to plan your care and help you explore some of the difficulties that might be helping to maintain your eating disorder.

You will also spend time each day with a member of the nursing staff to explore any difficulties you might be experiencing. We call this time ‘Team Approach’. A member of the nursing staff will accompany you to certain meetings (e.g. care review meetings, family meetings) to help support you, and to ensure that your thoughts and feelings are heard.

Arriving at the Richardson Eating Disorder Service
When you arrive you will be welcomed by a member of the care team. They will explain what will happen during your stay and give you information and a copy of this Welcome Guide.

On your admission you will be allocated a Named Nurse and an Associate Nurse. You will meet weekly with each, to plan your care and help you explore some of the difficulties that might be helping to maintain your eating disorder.

You will also spend time each day with a member of the nursing staff to explore any difficulties you might be experiencing. We call this time ‘Team Approach’. A member of the nursing staff will accompany you to certain meetings (e.g. care review meetings, family meetings) to help support you, and to ensure that your thoughts and feelings are heard.

Bed linen and towels are supplied and will be replaced regularly during your stay. You will need your own clothes and toiletries, the ward supply some emergency toiletries.

Where can I store my things?
You will have storage in your room where you can keep your clothes and personal belongings. There is also a safe, but if you have any valuables please discuss with staff the best option for their safekeeping. Please don’t bring anything that is valuable or can get broken or lost.

There is a hospital banking system but it does not have a cash point. You can deposit money and make withdrawals Monday – Friday, office hours only.

What should I bring with me?
There is limited storage but you will need things that you require on a day to day basis:

• Nightwear, dressing gown and slippers
• Inside and outside day clothing (laundry facilities are available)
• Outdoor clothing appropriate to the season (hat, gloves, scarf, warm coat in the winter)
• Toiletries
• Any medicines that you use regularly – please give these to the nurse in charge
• Watch/alarm clock
• Telephone numbers, address book, writing materials
• Books, magazines, reading glasses
• Personal music player
• Hairdryer

All electrical equipment needs to be tested for safety before use on the ward. Please give equipment to your named nurse/associate nurse who will arrange for it to be checked.

Is there anything that I cannot bring onto the ward?
The following items must not be brought into hospital:

• Anything that is special
• Anything that is valuable
• Pets
• Lighter fuels
• Glass bottles
• Alcohol and any non-prescribed or illicit drugs, legal highs and any noxious substances. (If illegal drugs, legal highs or noxious substances are found the police will be contacted)
• Scissors
• Knifes
• Cameras
• Weapons of any kind
• Offensive media materials

This is not a full list and staff will inform you of any other items that are not allowed on your ward.

The staff caring for you include a team of:

• doctors
• nurses
• dietitians
• psychiatrist
• nurse therapists
• psychologists
• occupational therapists

The Team will help you to identify your needs and plan with you the most effective treatment to help you to restore your health and return to your home environment.

The members of staff involved in your care will introduce themselves and make time to talk about how they will work with you. Members of the nursing staff will introduce you to the daily routines and activities of the ward.

These are the qualified staff who will work most closely with you throughout your admission. You will be allocated to a designated member of staff on admission, who will be identified as your Named Nurse.

Your Named Nurse is responsible for ensuring your treatment plans are up to date, spending time with you discussing any issues you may have regarding illness and recovery, or anything else that may be worrying you, offering one to one support with weekly nursing sessions.

Associate nurses are support staff that will work alongside you and your named nurse offering support throughout your journey.

Care Plan
We will work with you to agree the goals of your stay and how best to work towards them. We will also discuss the treatments which are known to have the best effects in supporting your recovery. From this we will develop your personal care plan which will detail what needs to happen and who will do what.

Personal Care Plan
Your care plan will be discussed with you towards the start of admission and will be regularly reviewed as your nutrition, health and level of independence increases.

At each patient agenda meeting your progress over the past week will be reviewed, any requests you might have will be discussed, and your care plan for the next week will be agreed. Once your weekly care plan has been agreed no changes will be made until the following meeting a week later.

The Patient agenda meeting gives you the opportunity to ask questions about your care plan and allows the Team to give you information about your progress. At all stages of your care you will be included in discussions about your treatment, and you and your family will have the opportunity to be involved in the planning and evaluation of your treatment.

If you are not making progress with treatment your care plan will be reviewed. We will look to see if any changes are required to your meal plan and leave, or if you require more intensive support.

Weighing
At the start of admission you will be weighed twice per week, on a Tuesday and a Friday. To get a “dry weight” you will be weighed first thing in the morning, after you have been to the toilet and before you have eaten or drunk anything. This gives accurate information for the dietitian to use in advising you on your meal plan. Sometimes it is not possible to obtain a dry weight, for example if you are on overnight Naso-gastric feeds.

As admission progresses, weighing will usually be reduced to once per week (Tuesday). On the day of discharge, you will also be weighed later in the morning to get a “wet weight” – which is how your weight will be measured in the community.

Physical activity
Throughout your admission, you will be given advice as to the level of physical activity which is appropriate and safe at your stage of recovery.

Very occasionally, patients may be advised to remain on bed rest. This will be if you are at a dangerously low body weight with immediate risk to your health and safety, or high risk of falls.

Usually, patients are initially able to walk around the ward but would be required to first use a wheelchair to take leave off the ward. Leave can then gradually be increased (see the section above called “How long will I be in hospital for?”).

Meal Planning
Shortly after admission to Ward 31A you will meet with the dietitian to discuss your eating and drinking habits. This allows an individual food and fluid plan to be devised on how to restore your weight and health.

The dietitian will ensure that you are offered an appropriate nutritional balance for your individual needs, which will be reviewed as your requirements change. There is a two week menu cycle. A week’s menus will be given to you on a Tuesday when you meet with the dietician.

Supervised bathroom
Initially, most patients are placed on supervised toilet and shower and washes, due to poor physical health or to help manage unhelpful behaviours. This supervision is reviewed later in each patient’s care plan.

Psychological Therapy
Recovery from an eating disorder requires a great deal more than gaining weight and restoring physical health. Psychological therapy is considered essential for making a full and lasting recovery from an eating disorder.

REDS has a team of highly skilled therapists who specialise in recovery from eating disorders. Between us we provide all the main therapeutic models recommended in the treatment of eating disorders. All patients admitted to Ward 31A will be offered psychological therapy during their admission.

One to one sessions
You will meet with your primary nurse at least once a week. You may discuss a range of things such as your progress, concerns, making plans for the future or developing a Wellness Recovery Action Plan (WRAP).

All this will be agreed with you and written down in your care plan so everyone including yourself knows what the aims of these sessions are.

Making sure we are helping you make progress
We do this by holding regular reviews with you, your family and the care team working with you.

Care plan reviews
Usually yourself and your named nurse meet to look at how things are going with your recovery and the plans to make that happen. You may focus on just one or two plans or all of the plans with the aim of being clear what actions everyone needs to take. These will be at least monthly and may be more often.

Care co-ordination review
These happen around every 6 weeks and involve you, your family, your care coordinator and members of the ward team (nurse, psychiatrist, dietitian, therapist, occupational therapist).

The point of the meeting is to look at the bigger picture, checking you are making progress and planning the bits of work which need to happen in the next couple of months including planning your discharge. You can also request a care co-ordination review at any time.

Meeting your psychiatrist
You will meet with your consultant psychiatrist regularly through your stay.

Measures and questionnaires
You will be asked to complete questionnaires at the start and end of admission so we can see how your physical and mental health has improved, and how satisfied you are with the treatment you have received.

You may sometimes be asked to complete extra questionnaires during the admission, if there is a need to monitor specific aspects of your health more closely.

Multi-disciplinary team meeting (MDT)
There is a weekly multi-disciplinary team meeting held on a Tuesday morning and attended by the ward team. This meeting is used to discuss how your admission is progressing, identify any difficulties and make recommendations for changes to your treatment.

You will be invited to attend the second part of this meeting, known as the patient agenda meeting. This gives you the opportunity to feedback on your challenges and achievements over the past week, let us know your goals for the week ahead and agree changes to your care plan.

To help you to prepare for this meeting, you will be given a form the day before with prompts and questions to help you think about what you want to talk about.

Your family and carers play a very important role in your recovery. We will work with them to provide the information and support they need to support you. At the first opportunity a member of staff will meet with your main family/carers to get to know them. Staff will provide them with information about their caring role, and what needs they may have to carry out this role.

We will inform carers of local services, so that carers can receive their own support and advice.

There may be things that you do not want to share. You should discuss these first with your care team so that you can understand the impact this might have on your relationship with your family/carers. Usually we would recommend that your family/carers are fully involved and informed in your care.

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 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 on 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 decision will only be taken if your refusal would have a severe impact on your treatment.

Do you know you can meet with a mental health pharmacist to discuss your medication? Ask your named nurse/key worker for an appointment.

If you would like information leaflets about your medicines ask your named nurse. You will meet with the pharmacist on admission to discuss your medication.

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 5pm, Mon-Fri. The helpline number is 0191 245 6604.

The Trust produces a booklet about how patients can request a change of consultant or second opinion. This leaflet is available from staff or the Patient Information Centre on telephone 0191 246 7288.

Mental Health Act 1983
Some people receiving treatment in psychiatric wards are in hospital on an informal basis and have usually agreed to come into hospital – this is known as an informal or voluntary admission.

If you are in hospital as a formal patient you will not be free to leave and will lose some other important rights that are available to informal patients. This is because you have been ‘sectioned’ (or detained) under the Mental Health Act 1983. This could mean you can be given medicine or feed without your consent if this is necessary for your health and safety. However, information about your medication will be provided – the doctor, nurse or pharmacist will help you understand about any side effects.

You will be informed about your rights and fact sheets are available on the ward and from the Trust website www.cntw.nhs.uk We will always include you in decision making about your care and treatment.

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.

Locked doors
Please be aware that it is normal for most of the exit doors in our inpatient areas to be locked. This is for patient’s security and safety. Staff will make you aware how and if you can leave the ward as peoples individual circumstances can differ greatly.

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 more than 7,000 people working for us and a budget of over £380 million.

The services we provide are divided into four sections, which are organised geographically into “locality care groups”. These are known as North, Central, South and Cumbria.

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

There are likely to be many practical things to consider during your stay. Your named nurse/key worker 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

If you are employed or on benefits we will, with your permission, send a medical certificate to your employer or DWP on admission.

A medical certificate will then be sent as required and upon discharge.

Any pensions or benefits you receive will continue while you are in hospital, however some adjustments may need to be made. Informing DWP as soon as you come into hospital can reduce the need to repay any overpayments that accrue during your stay.

Advice regarding benefits and finance can be obtained via the unit’s occupational therapist.

While you are recovering we want to enable you to carry on your life as normally as possible and keep up personal interests. Please tell us if there is anything we can do to help you do this. Perhaps your family or friends could bring a few things from home or you might like to try out a new activity.

Some activities available are:

• Arts and crafts, movie nights, recovery focused groups, relaxation
• Medicinema available twice a week as per your care plan
• Occupational therapy, either open or structured sessions
• Social events which are organised by the activities co-ordinator
• Unit-based activities such as cooking, board games, social out and about events
• Open art groups

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

Weekly timetable
A balance of rest and recovery is essential to your recovery. Sometimes you may feel like staying in bed or spending all your time in your room, but this may lead to you missing helpful opportunities and to your mood becoming lower.

We would encourage everyone to create a weekly planner which gives you a balance of time alone, time with others, restful activities and time off the ward. Your key nurse and occupational therapist will be able to work with you on this.

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

Domestic services
A housekeeping service is provided to keep the ward clean and tidy. We encourage you to take responsibility for keeping your room clean, as well as helping keep the ward tidy (with help if needed) to prepare you for discharge. Ben linen will be laundered for you. The ward has a washing machine and tumble dryer.

Bedrooms
Each patient has his/her own bedroom, with a hand basin. You may bring some items from home to make your room feel homely. However, for health and safety reasons patients may not bring furniture or soft furnishings. Each bedroom has its own TV with DVDs. The lounge area has a TV, DVD player, and a hi-fi system. Patients are not allowed into each others’ rooms.

Patients are likely to be asked to move bedrooms during their admission. During the early part of an admission patients are usually given bedrooms that allow a high level of observation.

Meal planning
Shortly after admission to Ward 31A you will meet with the dietitian to discuss your eating and drinking habits. This allows an individual food and fluid plan to be devised on how to restore your weight and health.

The dietitian will ensure that you are offered an appropriate nutritional balance for your individual needs, which will be reviewed as your requirements change. There is a two week menu cycle. A week’s menus will be given to you on a Tuesday when you meet with the dietitian. We meet all spiritual and vegetarian needs.

Meals
There is a separate leaflet about meals – ‘Catering guidelines and dietetics’. A member of staff will give you a copy of this leaflet and discuss any questions that you may have.

Protected meal times
Where there are ward mealtimes, arrangements are in place so you can enjoy your meal without any interruptions. Visitors and staff should not be in the dining room at lunch or evening meal time.

Visitors
Your friends and family are very welcome to visit. Usual visiting times are 3pm to 5pm and 6pm to 8pm. Please speak to the nurse in charge about arranging visits at other times. It is best for visitors to phone before they come to check you are in. Please ask your visitors not to ring at mealtimes, during snack times or when therapy is being carried out.

If children would like to visit please check with the nursing staff first. Children visiting are the responsibility of the adult who accompanies them to the unit and must always be supervised. The conservatory is the area that is used when children are visiting.

There is a pay phone on the unit where you can receive and make calls; you can use your mobile, being mindful of other ward occupants.

You may be able to leave the unit with your visitors. You will need to talk to your named nurse about this as per your care plan.

Using the phone
The ward has a portable telephone, which you may use to receive calls from family and friends on 0191 261 6895. You may also use your mobile phone when on the ward, however we ask both patients and visitors to be mindful of others. Mobile phones are restricted from being used within protected therapeutic times. If family wish to speak to a member of staff, they may phone the Ward office on 0191 282 5753.

Access to computers and the internet
Some patients bring their own laptops. There is internet access via the RVI hospital.

Hairdressing Salon
A hairdressing salon is situated in Leazes Wing. Alternatively the hairdresser can visit you on the Ward, and this may be arranged through staff.

Car Parking
Please ask your visitors to use the main car parks when visiting; there is a charge Monday to Saturday. On Sunday there is free parking on Richardson Road.

The multi-disciplinary team approach we use means that there are many different people available to help you. Staff include:

Nursing

• Ward Manager – the ward manager is a nurse and provides both managerial and clinical leadership to all staff on the ward.
• Clinical Lead – this is a senior clinical nurse, providing clinical leadership on the ward.
• Nurse in charge – this is the nurse who is in charge of a shift and is responsible for ensuring the smooth running of the ward.
• Staff Nurse – a qualified nurse who is a Registered Mental Health Nurse. They deliver the nursing care and also psychosocial interventions to help you recover.
• Named Nurse – is responsible for co-ordinating your nursing care while you are on the ward. They will be introduced soon after your admission and will be your point of contact during your stay. All named nurses are staff nurses.
• Associate Nurse – will be allocated to you as well as your named nurse, they will support the named nurse in delivering your care. Associate nurses are usually support workers.
• Support Worker, Nursing Assistant, Health Care Assistant – supports the nursing staff in caring for you.

Medical

• Consultant Psychiatrists – are the most senior doctors with overall responsibility for your care. They lead on important decisions about your treatment and discharge. You will be introduced to your consultant when you transfer to the unit and continue to meet regularly.
• Ward doctors – are training to become psychiatrists or GPs. They will be available to you on a regular basis with regard to your physical and mental health and your care plan.
• Pharmacy staff – the pharmacy team ensures that you receive your medication in a safe and effective manner whilst you are on the ward. The team can offer advice on medicines and any side effects. If you would like to speak to a member of the pharmacy team whilst on the ward, ask one of the nursing staff who will let the team know.

Support and Occupational staff

• Clinical Psychologists – are trained to help people deal with emotional and behavioural difficulties, they are available to provide structured talking therapies.
• Occupational Therapists (OTs) – use activity to help to develop skills needed in recovery which include shopping, cooking, looking for work etc. This may be on a group or individual basis.
• Physiotherapists – work with you to help restore movement. They provide any necessary physiotherapy assessment and treatment.
• Peer support Workers – these are people who like you, are experts by experience and have been employed by the Trust to support you in your recovery spending time with you and helping you to work out how to best manage your recovery. They are particularly good at helping you develop a Wellness Recovery Action Plan (WRAP) or staying well plan.
• Dieticians – are experts in food and nutrition. They provide dietary advice on a wide variety of conditions using the most up to date information. They help promote healthy eating habits and well balanced diets based on individual needs.

Other staff

• Students – the Trust supports the teaching of students from various professions. From time to time you may be asked whether a student can be present or deliver part of your care. Your verbal consent will be sought and you have the right to refuse. All students are supervised by a qualified member of staff.
• Domestic staff – undertake housekeeping duties, keep the ward tidy and clean.
• Admin staff – provides administration support and assists in the smooth running of the ward.
• Hostess – cook and prepare meals.

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

Care Co-ordination – 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) or patient agenda meeting – this is when all 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.

Patient Advice and Liaison Service (PALS) – this service provides help, advice and guidance to users of the NHS and their families.

North of Tyne – 0800 032 02 02, Monday to Friday 9am-4.30pm.

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.

Wellness Recovery Action Plan (WRAP) – is a structured system for monitoring and managing your mental health through planned responses that work for you. It also informs services and carers on how to respond should you find it difficult to make decisions for yourself should you become unwell.

Your care in hospital will comprise of a number of different treatments. The main treatments on offer are outlined here.

Medication – Your doctor may prescribe medication to help treat your illness. A ward doctor can usually answer any questions you have about your medication or how it works.

Psychological – Therapies may include Cognitive Behavioural Therapy (CBT), Cognitive Analytic Therapy (CAT), Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), Specialist Supportive Clinical Management (SSCM), Dialectical Behavioural Therapy (DBT) or systemic therapy.

Family Intervention – Families play an important role in your recovery, we will provide them with information and support to carry out this role.

Physical Health – Your physical health is very important. We will regularly assess your physical health needs and work with your GP to provide you with appropriate advice and treatments. Some patients will need a bone scan to assess possible damage to bone density arising from anorexia nervosa. Many patients with eating disorders have dental damage and may be referred to the dental hospital for treatment. Gastro-intestinal and haematological (blood) problems are also common, and patients will be referred to appropriate medical services if required.

Occupational Therapy – The main aim of occupational therapy is to assist your recovery by encouraging you to take part in activities that have meaning and value for you.

During your stay in hospital, occupational therapists (OTs) will look at your strengths and needs. An individual treatment plan will be developed and reviewed with you, which may be a mixture of one-to-one sessions and group activities. These take place in the hospital setting, occupational therapy department or community venues.

The following list gives examples of some of the activities that are available:

• Daily living skills to develop or improve your skills in areas like cooking, shopping, budgeting and other day-to-day activities.
• Health promotion with advice on different areas such as healthy eating, exercise and stress management.
• Work, training and/or education to help you develop the skills and confidence to take part in paid or unpaid work, courses or training that you may be interested in.
• Leisure activities such as pursuing a hobby or sport that builds on your self esteem, social 
• Relating to yourself and others to improve your confidence and self esteem and help you to develop coping strategies.
• Activities that encourage you to be a part of your local community and help you build links with other people in the area.

Availability of these activities does vary slightly from area to area; the current programme for your ward will be displayed on the wall.

We understand the important role that spirituality and religion can play in people’s lives and recovery. This will be very individual to you so we will work with you to understand and support your specific needs. Chaplaincy is offered to people of all faiths and none.

You can talk to a chaplain if you would like to. We have a team of chaplains from a range of different faith communities who are available to visit you. You are also welcome to ask your own local faith leader to visit you whilst you are here.

Royal Victoria Infirmary
There is a Christian service in the Chapel on Sunday mornings at 9.45 am. The Chapel may also be used at any time. Prayer-mats are provided for Muslims. Please ask staff or call at the chapel for a most up-to-date leaflet concerning Spiritual Care at the Royal Victoria Infirmary.

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.

Smoking during your stay at REDS, Ward 31a, RVI
REDS is a CNTW service which is located on the premises of another Trust (Newcastle upon Tyne Hospitals Trust (NUTH)). NUTH is also a smokefree site and smoking is not permitted anywhere on hospital grounds.

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).

E-cigarettes/vaping during your stay at REDS, Ward 31a, RVI
The use of e-cigarettes/vaping is not permitted on Newcastle upon Tyne Hospital sites – this includes the RVI. If you wish to use an e-cigarette/vape you must leave the hospital site in order to do so.

Why does the Trust keep information about me?
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

www.disclosures@cntw.nhs.uk

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.

The following safety systems are in place for your safety and security.  If you have any questions please speak to a member of the healthcare team who will be able to provide you with more information.

Body worn video
A body worn camera is a small video-camera device that can be attached to a member of staffs clothing. When the camera is turned on by staff, it will provide audio and video recordings.

If you have any concerns about your safety you can ask staff to turn on the camera. You can ask the nurse in charge for access to any recordings made, to be shared with you about your care.

Closed Circuit television (CCTV)
CCTV operates in all public spaces of hospital sites and in-patient wards. There are signs that inform everyone which areas are covered by CCTV. Recordings are stored for 30 days.

You can ask the nurse in charge for access to any recordings made, in relation to your care.

Metal Detectors
Metal detectors are used as part of search processes. This is to improve the quality and safety of care across in-patient services and prevent restricted items from entering the ward.

The clinical team will let you and your carers know what is and isn’t allowed to be brought onto the ward.

If you have any questions about safety systems, please email Safetyteam@cntw.nhs.uk

Fire safety
All Trust hospital premises are provided with automatic fire and smoke detectors which 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.

Narcotics search dogs
The Trust has narcotics search dogs and handlers who make both planned and unannounced visits to wards and departments.  The search dogs are trained to locate illegal substances such as cannabis, cocaine, amphetamine, ecstasy and heroin.

Oxevision
Oxevision (also sometimes known as Oxehealth) is an assistive tool for staff.

It provides three main functions:

• Measuring vital signs (not constant monitoring)
• Alerts to activity in room
• Reports on risk factors
• Oxevision is an assistive tool and does not replace human interaction or personal care.

It is important to note that Oxevision only measures a patient’s vital signs when a member of staff interacts with the system and prompts it to take vital signs. Oxevision will not provide an automatic alert if a patient’s heart or breathing stops.

The system will measure vital signs when staff take an observation, but will not constantly monitor them.

The Trust produces an ‘Oxevision – patient information leaflet’. Copies are available from staff or the Patient Information Centre Tel: 0191 246 7288.

Safety and restraint
The most effective care is provided in a safe environment. If a person acts in a way that compromises safety on the ward, staff will take action to reduce the risk to all concerned.

In most situations staff will try to resolve such issues through discussion. They will work with the individual to deal with any problems and may suggest moving to a quieter area.

There may be occasions when a more urgent response is needed, which can involve staff using physical restraint skills.  However, these techniques are only used when there is an immediate danger of violence towards yourself or others.

Physical restraint is only ever carried out by staff who have received training in how to use these skills safely. It is intended to allow for safe management of harmful situations and to make the environment safe as quickly as possible. Dignity should be maintained throughout any restraint procedure.

If you see anything that you think could pose a risk to yourself or others, you should report this to a member of staff immediately.  Staff can help to reduce the risk and discuss any concerns you might have.

Patient Advice and Liaison Service (PALS)
PALS is a user-friendly service dedicated to listening to service users, their carers, family and friends and helping them to resolve their concerns. It offers confidential advice and supports people to navigate through NHS systems. PALS is not a complaints service but will offer advice on the Trust’s complaints process.

Telephone: North of Tyne 0800 032 02 02, Monday to Friday, 9am to 4.30pm.

Independent advocacy
As a mental health service user you are entitled to independent advocacy. Advocates can provide unbiased advice, attend ward meetings with you and make sure that your views are listened to. If you have been admitted to hospital under a section of the Mental Health Act then please contact the service that covers the area where you live. A member of staff can also help you and provide you with contact telephone numbers.

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 complaints@cntw.nhs.uk 

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: pals@nhct.nhs.uk
Post: FREEPOST PALS

South of Tyne
Tel: 0800 328 4397
Text: 07825 061 035
Email: pals@cntw.nhs.uk
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 is an important life event; it’s a sign that you are making progress with your recovery. It can be an exciting time and also for some people it may feel daunting. During this time it is essential that you receive good quality support and care. Planning around your move on will start soon after your arrival on the ward and will be part of all care planning processes. Carers will be involved in the planning of any move on from the ward.

Your move on will be a planned process involving you and the care team. Extra support will be available for you during this time to make your move on as successful as possible.

During home leave and upon discharge you will have the support of the community based staff involved in your care. You will be given a 14-day supply of prescribed medication. A summary of your admission, including current prescription, will be faxed to your GP to enable you to get a further supply from them.
You will be seen within 7 days by a community professional or psychiatrist for “7 day follow up” which is a Trust protocol, to ensure you are maintaining wellness.

No matter what happened and where I was in my recovery, the support, respect and encouragement of all staff on ward 31a they always said to me ‘we’re going to get through this together’ and we did.

The following suggestions are things you will need to consider when planning your move on from the ward:

• Having the right accommodation to meet your needs.
• Having your finances in place.
• Having a GP (family doctor).
• Having a good understanding of your medication, where and how you will receive it.
• Having the skills you need to look after yourself.
• Understanding the future support and care you will receive.
• Having a Wellness Recovery Action Plan (WRAP) or Staying Well Plan in place.
• Informing your family and friends so they know when you will be leaving hospital and where you are living.
• Knowing how you will spend your time i.e. interests, hobbies, activity and work
• Knowing how and where to get help when you need it.
• Any conditions attached to your discharge i.e. Community Treatment Order. A Community Treatment Order is a power given to your consultant under the Mental Health Act to place certain conditions on you which you must follow when you have left the hospital. It is meant to ensure that you receive the right treatment once you have left the hospital and it means you have to keep in touch regularly with your mental health team.

Staff on the ward will be able to help 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 will usually be a nurse, social worker or occupational therapist. Ideally they should be the person who knows you best and with whom you feel most comfortable to talk with. You should always be informed of the name and contact details of your care co-ordinator.

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.

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 on 0191 246 7288.

People can have setbacks. On leaving hospital you will have a Wellness Recovery Action Plan (WRAP) in place that was developed with you. This plan will identify any early signs that you are aware of that may mean you are becoming unwell and what you and your care team should do to prevent you becoming more unwell. You will also have a plan in place should you become unwell.

Self help organisations

Beat Eating Disorders
Unit 1 Chalk Hill House, 19 Rosary Road, Norwich, Norfolk, NR1 1SZ
Helpline: 0808 801 0677
Website: www.beateatingdisorders.org.uk
The leading UK charity for people with eating disorders and families.

Eating Distress North East
58 Leazes Park Road, Newcastle upon Tyne, NE1 4PG
Telephone: 0191 221 0233
Email: enquiries@edne.org.uk
Website: www.edne.org.uk
Offers counselling and psychotherapy, health and wellbeing groups, education and support to individuals, friends, families and carers, free of charge and by self-referral.

Patient Information Centre – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
Provides a range of health information covering conditions, treatments, medication and health promotion.
Website: www.cntw.nhs.uk
Telephone: 0191 246 7288

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

As a member of our NHS Foundation Trust you can be as active a member as you would like, from just receiving regular information about the Trust to getting involved in issues that you care about. The choice is yours!

To become a member, all you need to do is complete a membership application form or join online at www.cntw.nhs.uk/about/membership.

Membership is free and members can also benefit from discounts for many shops and services.

The Trust values the involvement of service users, their carers and their families in making decisions about your care, and recognises this can lead to better outcomes and a better overall experience.

Therefore, imagine the benefits and value that your contributions could make in the design, delivery and evaluation of our services.

The Involvement Service co-ordinate and facilitate service user and carer involvement, in specific short-term activities and projects, to ensure their needs are represented and reflected at the heart of everything we do. We have set up an Involvement Bank to help us do this work.

There are three levels to involvement which are:

Individual level – Ensuring you and the people who support you are at the centre of every aspect of care from assessment, through treatment to leaving a service. Increasing your control for recovery and wellbeing with a voice that is heard.

Ongoing development of services – Opportunities to be involved in forums, saying what’s working well and why, i.e. being part of ward and community meetings, sharing an understanding and awareness of what your personal experience has been and how this can help improve services.

In service change and service improvement – This is a more strategic level looking at service change such as transformation projects, commissioning of services, and service redesign.

Getting involved is easy, and how much you get involved is up to you. If you are interested in influencing how we work, the Guide to Involvement and the Involvement Bank registration form are available in hardcopy or online at: www.cntw.nhs.uk/LivedExperience

If you would like more information or support with registering, the Involvement Service would love to hear from you:
Telephone: 01670 501 816
Email: involvement@cntw.nhs.uk

You can use the following area to keep a record of your appointments and activities. Printed sheets are available from ward staff.

We would like to know what you think about the Welcome Guide, your views will help us to improve the guide.

We would be very grateful if you would take a couple of minutes to answer the following questions – thank you.

Richardson Eating Disorder Service

We would like to thank the patients within the Richardson Eating Disorders Service who have contributed to the development of this Welcome Guide.

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 (Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre by telephone on 0191 246 7288.

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

Ref: PIC/714/0225 February 2025 V4

Website: www.cntw.nhs.uk    

Telephone: 0191 246 7288

Review date 2028