Tatton Unit

18 - 65

3 - 5

Tatton Unit at a glance: 16 - bed Low Secure Unit

For men aged between 18 and 65 years - admissions can be accepted for those older than 65 years, where appropriate

Provides care and support for people who have a severe and enduring mental health condition, such as paranoid schizophrenia, which is complicated with other mental health issues

Three to five year care pathway Staffed by a skilled multi-disciplinary team, including a Consultant Psychiatrist, Psychologists, Doctors, Nurses and Occupational Therapists

Newly opened in 2013 providing a longer pathway for people who require low secure care

Since opening, 100 per cent of service users have been discharged to placements of lesser security

Of these discharges, 100 per cent achieved an early discharge from their prescribed care pathway

“Staff are helpful, you can talk to them

anytime.”

100%

The unit offers a range of interventions including:

• Pharmacological treatment (medication)

• Psychological therapies including:

• Psycho education

• Cognitive Behaviour Therapy

• Cognitive Analytic Therapy

• Dialectical Behaviour Therapy (one-to-one or group sessions)

• Mindfulness

• Brief Family Therapy

• Drug and alcohol work

• Neuropsychological screening

• Interventions to improve day-to-day living skills including:

• Budgeting

• Shopping

• Cooking

• Self-care

• Washing and ironing

• Group and social activities:

• Social skills and inclusion

• Substance misuse awareness

• Baking

• Music

• Arts and crafts

• Wellbeing

• Sports

As part of their rehabilitation, service users are encouraged to get involved in community-based activities. These may be undertaken independently or escorted, depending on their needs and requirements and could include:

• Leisure activities

• Library or college courses

• Voluntary work placements

• Support groups

Service users are encouraged and supported to pursue individual hobbies, such as painting or model building. They also have plenty of free time, in which they can simply relax.

About Tatton UnitTatton Unit is a 16-bed Low Secure Unit that opened in 2013 and is located on the site of Tameside General Hospital in Ashton-under-Lyne.

It provides care and treatment for men aged 18 to 65 years, although admissions are accepted for men older than 65 years, where appropriate. It provides care and support for people who have a serious enduring mental health problem, for example paranoid schizophrenia, which is complicated with other mental health issues, for example anxiety, drug and alcohol misuse and a range of index offences.

The unit was established to provide step-down care for men who no longer require a medium secure unit, but who require a longer period of recovery before being discharged.

The unit offers a three to five year pathway, compared to the standard two year pathway offered by other low secure units. Some service users can stay longer than five years if needed and, equally, others have moved through the pathway more quickly than this.

Throughout a service user’s time on the Tatton Unit, they are regularly reviewed by the multidisciplinary team. Consideration is given to eventual discharge and continued support during the next stage of their recovery and rehabilitation plan.

At the end of their pathway of recovery, service users may be discharged to a range of places including an adult or older people step-down unit, into supported accommodation, back home to their family, or their own flat. However, this decision is made in partnership with the service user, their care co-ordinator and their family to ensure it best meets their needs.

In 2014, after opening only seven months earlier, the unit not only met all statutory Care Quality Commission requirements but achieved commended practice in some areas.

Supporting recoveryStaff support service users to function at their very best, ensure they have an awareness of what keeps them well and how to manage when they don’t feel well. This will ultimately enable the majority of service users to be discharged from secure services.

The focus of Tatton Unit is on recovery and rehabilitation. The whole team works with the service user to identify personal goals. The service user is encouraged to be involved in any decisions about their care, including attending meetings and providing their own reports for these.

Every service user has a named nurse, who will provide them with one-to-one discussions about their progress, support them to resolve any issues and work with them on goal-specific work. This one-to-one relationship provides continuity of care and enables a good rapport to be established.

A personal activity planner is produced for each service user, which sets activities for the week ahead, based on their individual needs and goals.

Family and friend involvement and support:

Family and friends play a valuable role in service users’ recovery and are welcome on the unit. In between visits, service users can keep in regular contact via Skype and phone.

Family and friends can often provide valuable insight into the best ways to support recovery and may be invited to attend meetings and/or appointments with team members.

These meetings are also a good opportunity to hear about the support family and friends themselves may need, which can be provided by the team. For example, family interventions can be provided by the team psychologist, which can facilitate difficult conversations and help to overcome relationship difficulties.

A piece of work has been undertaken to improve carers’ involvement in service users’ experiences.

The environmentEach service user has their own en-suite bathroom and bedroom, which is equipped with fully fitted furniture and facilities for personal items such as a TV and stereo.

Service users are encouraged to bring along personal items to help them to feel at home, for example, photos, books etc. Some items are not permitted on the unit to ensure service users’ health and safety and staff can advise about this prior to admission.

A range of communal areas are provided on the unit including a lounge, a dining area, kitchen, courtyards and an activity room which provide opportunities for social interaction and peer support.

Having undergone a complete refurbishment prior to opening in 2013, it has been specifically designed to be as ‘user friendly’ as possible. The team works hard to provide a homely environment for service users and all areas of the unit are kept clean, tidy, safe and comfortable. Feedback is always welcome.

The teamThe unit is staffed by an experienced, knowledgeable and skilled multi-disciplinary clinical team and a range of support staff, who provide round-the clock care. The team includes:

• A Consultant Psychiatrist

• A Staff Grade Doctor

• Psychologists

• Mental Health Nurses

• Nursing Assistants

• An Occupational Therapist

• A Technical Instructor

• A Medical Secretary

• A dedicated Unit Manager

• Unit Administrators

To support service users’ wider health and wellbeing needs, the team works with a range of partners including GPs, community health professionals, the police and local voluntary organisations, such as the Mind advocacy service.

Staff training and education:All staff are required to undertake a package of mandatory training before starting employment. Topics include adult safeguarding, conflict resolution, managing challenging behaviour, violence and aggression, movement and handling, equality and diversity and infection prevention and control. There is a requirement that all topics are refreshed at regular intervals.

In addition to mandatory training, all members of staff are actively encouraged undertake further training that will be helpful to their role. This includes training around relational security, wound care, physical health care, mentorship, the Mental Health Act and specific disorders.

The unit’s multi-disciplinary team and psychologist work closely on the ward to provide training and co-facilitate groups for both service users and staff.

Each member of the team receives clinical supervision and line management support. These provide opportunities to review and discuss strengths, concerns and areas for development and allow team members to be kept up to date with service developments and best practice guidelines. This ensures they can deliver the best possible care to service users.

Referral informationReferrals are accepted for service users who live in the North West.

They must have a primary diagnosis of a serious enduring mental health problem, for example paranoid schizophrenia, which may be complicated with other mental health issues, for example anxiety, drug and alcohol misuse and a range of index offences. They must be currently placed in medium secure care, with a view that a step-down to low secure would be suitable.

To discuss a referral please contact the Clinical Pathway Team on 0161 716 4364.

Outcomes and feedbackSince opening in 2013, 100 per cent of service users have been discharged to placements of lesser security. Of these discharges, 100 per cent achieved an early discharge from their prescribed care pathway.

Data collected in the first year following the service users’ discharge highlighted that none needed to be re-admitted to acute services.

The average length of stay is 363 days out of a total pathway of 1825 days.

The feedback from service users is very positive and comments include:

• “It’s a caring atmosphere.”

• “The staff and environment is friendly.”

• “[The staff] don’t give up ‘till you get better.”

• “Staff are helpful, you can talk to them anytime.”

• “This is the most relaxed place I’ve been in.”

• “I value the time I spend with my named nurse.”

Service users were asked to share feedback as part of the unit’s first birthday celebration. One service user said: “Describing the Tatton Unit is one of the best things I’ve done as it lets me say thank you to all the staff for caring for me. We have problems, but they are always worked out.

“Apart from that, the staff are great and always pleasant. The manager is nice and always sorts your problems out.

“Above all, the Tatton Unit is a great place to be if you’re feeling unwell as the staff are caring and understanding.”

The feedback from staff is also positive and comments included:

• “There is a culture among the team of respect for service users.”

• “It’s a really a calm and friendly environment. All the staff treat the service users with respect and it shows. The staff work really hard to create a positive and caring environment and strive to constantly improve on the quality of care we give.”

In my own words… a service user’s journey“When I was 15 I remember thinking I could magically answer questions in a test and that they would be correct.

“I was 23 when my problems really started with substance misuse. After being diagnosed with manic depression, I was put on medication. “I got into some criminal activities at university. I realised how easy it was to get into a small amount of drug dealing – however, had I been caught, I would have been devastated. I experienced feelings of madness - extreme highs or lows and anxiety.

“It ruined my life for 27 years. My mum and dad were really worried and I felt really paranoid.

“I was eventually persuaded by my parents to go to a psychiatric intensive care unit. I was given an injection, but I didn’t really mind as it calmed my mind.

“I have now been at the Tatton Unit for a while, as I really needed more help with coping with feeling bad about myself and anxiety.

“I have done an analysis with the psychologist and have also become more empathetic towards myself. Medication is also a huge help. “I have joined a walking group and I value my leave with family and friends. We also go on group trips which are excellent.

“My named nurse and other staff are really professional.

“The care and support offered on the unit has really benefitted me. I no longer have the highs and lows of bi-polar. If my stress levels remain low, my schizoaffective tendencies don’t occur.

“I read a lot and learn a lot which has helped me enormously. Compared to 10 years ago I enjoy things much more.

“The fact that the unit is new, clean and tidy makes a big difference. The consultants are compassionate and the unit is excellent and has great facilities.

“My previous admission wasn’t great for me as the building was a bit dated. There were also quite a lot of younger men who ‘bounced around’ a lot which was quite tiring.

“There is lovely countryside nearby and Manchester seems to be a ‘happening’ city.”

“The care and support offered on the unit has really benefitted me. I no longer

have the highs and lows of bi-polar.”

Contact usFor further information about Tatton Unit, please phone 0161 716 3797.

Lower Buckton Building, Tameside General Hospital, Fountain Street, Ashton-under-Lyne, OL6 9RW.

Date of publication: September 2015 | Reference: 4006/Tatton Unit Brochure | © Pennine Care NHS Foundation Trust