More thoughts on working at Uplands Independent Mental Hospital

Working with people with enduring and severe mental illness is challenging and can be difficult, but can also be extremely rewarding.  The staff at Uplands work hard and are committed to making the lives of the residents as fulfilling and happy as possible.  Not an easy task.

Last week I attended a Positive Risk Assessment training day which was facilitated by Peter Kaye, an experienced RMN and a talented trainer.  Below are his thoughts on the difficulties and challenges faced by those of us who work with people in this client group and the care provided at Uplands Independent Mental Hospital.

"I've been providing the occasional training course for Uplands Independent Hospital for about two years, on mental health issues, risk management and staff management skills. I work throughout the country with care homes, hospitals, housing services, charities, social services departments etc and sometimes I go into care services which look very "posh" but when I scrape below the surface I find that the care is not as good as one might imagine it would be, and that, once you get beyond the chandeliers, care is negligent or, and this I often find in these "posh" services, the area set aside for the staff (rest rooms, training rooms etc) is downright grim. If staff are treated badly by their managers, you can guarantee that this will be reflected in the care given. 

"Uplands provides care for some of the most mentally ill people in our society, and, whilst we must always strive to help people to mesh effectively with the expectations of the wider society, it is unrealistic to expect that such unwell people will always be able to maintain the standards that our society may expect regarding personal conduct, dress or cleanliness of oneself or one's personal space. 

"From the perspective of service users such as those at Uplands, many of whom are likely to have experienced terrible traumas in their lives and who may well be tormented by horrific delusions or hallucinations, keeping oneself smartly attired or keeping one's room immaculately tidy may be low in the list of priorities. What may be far more important is to feel safe and respected in what we might think of as a refuge from a wider world which can seem overwhelmingly frightening. One of the great skills needed in working with such traumatised people is to build up their trust by being sensitive, gentle and supportive. If staff were very directive about tidiness or grooming of the service users they would alienate them. Indeed, such over-prescriptive care would be abuse in itself. The dilemma in mental health work is always how much do we allow people to be self-managing - even if that means the client may not conform to wider social norms - and how much do we intervene and "manage" (or over-manage) the client. 

"I believe that the management and staff at Uplands understand this dilemma and generally get the balance right. Why do I believe this? It's obvious: when I visit, I watch the clients: they have easy-going relationships with the staff, they do not look afraid, they come to the staff with their difficulties. These are signs of well-being despite the ravages of chronic mental illness. Yes, Uplands may not have the smartest of decor, but that's not important. It's the spirit of the place which counts, and on that crucial matter, I believe Uplands is very healthy. 

"When visiting any care service, I watch the way that staff interact with each other and with the residents. I have learnt over my 35 years in this business that anxious, withdrawn staff are a marker of an abusive care environment. But at Uplands, there is an easy-going, relaxed atmosphere. Staff do not look frightened, controlled or inhibited. One specific example: sometimes clients come into the training session to see what is happening. In many care services when such things happen, clients are ushered out by the staff in a fairly brusque way. At Uplands when this happens, staff talk to the residents politely and genuinely take time to explain to them that the room is in use for staff training. A little thing maybe, but it says a lot. Uplands provides a high standard of care to very unwell people and I am always pleased to work with the hospital in developing the staff's skills even more.

Best wishes

Peter Kaye
BSc(Soc) RMN RGN DPS-CPN AIfL

The Kaye Partnership
www.kaye.org.uk

Portsmouth Fairy Tales for Grown-Ups

After months of hard work by Life is Amazing (the incredible Matt Wingett) and the awesome Tessa Ditner, we are pleased to announce the launch of Portsmouth Fairy Tales for Grown-Ups in paperback version.

About a year ago I received a tweet from a certain Tessa Ditner, a woman I had never heard of, asking me if I wanted to be involved in a writing project in Portsmouth.  I was instantly suspicious.  Why would anyone want me to be involved?  Who was this woman?  I knew a lot of the writers around Portsmouth and had never come across this one before?  I ignored the tweet.

Several tweets later, I replied, asking who else was involved and that's when I realised that she already had on board several very talented writers, people I'd worked with before and had the utmost respect for.  So I was in.

A year on, I can honestly say that this has been a great experience in many ways.  I have been given the much needed kick up the arse to get on and write again.  Three of my short stories are now published in the ebook version of Portsmouth Fairy Tales for Grown-Ups, I have been involved in The Portsmouth Festivities, presenting one of my stories to an enthusiastic audience.  I then performed in a promenade event at the locations of the stories in this collection.  This evening I will be reading a story at the official launch of both the Portsmouth BookFest and the launch of this brand new paperback version of Portsmouth Fairy Tales for Grown-Ups in the Lord Mayor's Room at Portsmouth Guildhall.

The stories in this collection are all set in locations in Portsmouth.  Some are dark moral tales, some are complete fantasy, some are historical, some futuristic, our own collection of tales of mystery which spring from the imagination of eleven writers who have a fascination of this intriguing City.

I am now looking forward to, hopefully, more similar projects in the future.  Who knows....

Special thanks to Tessa, Matt, Jon Everitt (Cover art and design) and Nick Ingamells (Photography).

Thanks and Portsmouth BookFest events

Well that last post stirred up a lot of people.  Thanks for all the comments on facebook, mostly supportive but not all.  I just wanted to put an honest account of life at Uplands out there.  It's easy to take photos of a moment in time, instead of getting on and cleaning up the mess which is what we, in fact, do.

Today I am preparing for the up and coming events of the next couple of weeks.  On thursday I shall be at Portsmouth Guildhall, attending the launching of both the Portsmouth Bookfest and the paperback version of Portsmouth Fairy Tales.  I am looking forward to performing one of my short stories at this event and looking forward to working once again with some amazing local authors.

On the 31st October, I will be performing a brand new piece of writing - still being worked on - for the Day of The Dead: Hello Darkness event at the Square Tower in Old Portsmouth.

Both of these events are park of the Portsmouth BookFest and places can be booked online through their website.  Anyone interested in writing, please come along and meet the team.

I hope to see some of you there.

Working at Uplands Independent Hospital

Anyone who has ever worked in Mental Health will understand how challenging it can be sometimes to motivate those we care for.  We all have our own standards of personal hygiene and routines for when we get up in the morning, when we shower, bath or wash, how often we wash our hair or like to shave.  Our personal space is important to us as human beings and we each have the right to our own privacy.

If a person suffers from an enduring and severe Mental Illness such as Schizophrenia or other forms of regular Psychotic episodes, often this results in self-neglect, not just in their personal hygiene but also in the way they maintain their personal space.

When I started working in the Mental Health sector, way back in the 1970s, our patients were “well looked after”.  We had routines of when people had baths - we had the “bath book” which had columns for “hair washed”, “nails cut” and “shaved”, to make sure that every patient on the ward was kept clean and well-groomed.  Baths were done after breakfast and usually two at a time in a large bathroom with two baths and a row of basins.

Patients were turned out of their rooms first thing in the morning when the beds were stripped and made up with clean linen.  Usually after that, the doors were locked and the patients were able to sit in the Day Area unless they went off to Occupational Therapy or Industrial Therapy, two departments in another part of the hospital.   Anyone visiting the ward would see only clean rooms, tidy beds, and patients who were washed and dressed in clean, if ill-fitting clothes.

It’s not like that anymore, thank goodness.

For the past couple of years I have been working at Uplands, an Independent Mental Health Unit which caters for the rehabilitation of people with enduring Mental Health issues.

O.K., to an outsider perhaps, if you look into a resident’s room and see that it is untidy, with spilt coffee on the bedside table, the dregs of several roll-ups on the bed, the sheets awry and the mattress soiled, clothing and rubbish on the floor, you may think this is a sign of neglect.  But it is only one moment in time, any one moment during the day of that resident .  The task of the nurses and support workers is to assist and encourage the resident to have pride in their personal hygiene and their personal space.  Their rooms are the only space that they can go to get away from others that is theirs alone.  They have the key to their own door and they are not locked out of their rooms after cleaners have been in.  Many of our residents have their own tea and coffee facilities in their rooms so that they are able to make themselves a hot drink whenever they wish rather than having to rely on a trolley in the dining room or a ‘beverage point’.  Whilst this makes their lives more independent it needs to be monitored and often their rooms can be messy.  

The work is demanding and challenging but the team is committed to improving the way it delivers the care for which we are employed.  You may find yourself repeating the same tasks day after day, or even several times every day, with residents who need constant support and encouragement to be motivated in doing what to many of us, are simple daily living skills.  Our job is to ensure that our residents receive the best possible care and that their lives are the best that they can be with the limitations that they experience.

I feel privileged to be working with the amazing team at Uplands, a group of hard-working, dedicated professionals who, in the face of adversity, have come together as a strong team.  Over the past year I have attended training on First Aid, De-fibulator, 2 sessions of training on restraint and de-esculation techniques, Safeguarding, Aspergers, Recovery Star, and Mental Health Act.  Over the next few weeks I am attending training on Fire extinguishers, Risk Management, Drug and Alcohol Awareness, Suicide Risk/Self Harm training.  I know there is always room for improvement but after so many years of working in this field, I can honestly say that Uplands is one of the best places I have worked.

Southwick D-Day 70 - Pirate talk - and Round and Round a Garden!

Things have really been hotting up here in Southwick over the past few weeks.  It's now 55 days to D-Day.  Well, the 70th anniversary of D-Day, and Southwick village played a very important part in this event in history.  For more information on the day, please log into our website at http://www.southwickdday70.co.uk  Of course, the lead up to the weekend has been fun and eventful - more about that later.

Today I have been practicing talking like a pirate for an event I am performing at tomorrow.  Aaaarrr!  The venue is The Groundlings Theatre in Old Portsmouth for which I have written a short piece entitled "Lady Mary's Downfall".  I won't paste the story on here until after the event - don't want to spoil it for the audience.  The rest of this lovely sunny morning I am off to sort out a costume for myself for this event.

On another note, I have been directing Round and Round the Garden which went into the performance run this week.  We have already had a review which is on The Southampton Echo Curtain Call page.  Not a bad review.  What I would call "nice".  Aside from the review, many of those who have come along to Titchfield Festival Theatre in St. Margaret's Lane to see the play have given good reports both on line and to me in person.  So thanks to all of those, and if you want to see the play you can check out the details on the website which is www.titchfieldfestivaltheatre.com . The show is on tonight and all next week, including Good Friday, so come along and have a laugh.  The set alone is worth a look at.  The acting is pretty good as well!  A great fun play by Alan Ayckbourn - one of the Norman Conquests which was a trilogy of plays he wrote over 10 days back in the early 1970s.

Just a reminder though, if you do come, wear warm clothes - the theatre heating's not that brilliant.
Hope to see you there....

Southwick Writer Woman News

Today has been an interesting and quite exciting day.  I spent a while at the theatre watching my brilliant set building team getting the set together for Round and Round the Garden, a play I am directing at Titchfield Festival Theatre.  It's great to see something fantastic growing out of a few bits of wood and some fake grass!  Still early days of course but by tomorrow evening we should be able to at least use the entrances and exits and have a feel for the acting space.

The play is to be performed from the 9th to the 19th April, so less than a couple of weeks rehearsal time left.  We have an amazing cast with Georgie Gulliford as Annie, Kay Fraser as Sarah, and Mandy Watmaugh as Ruth.  The men are played by Rick Barter as Reg, Laurence Lloyd as Tom and Randy Vince as Norman.  The play is the third in the trilogy The Norman Conquests, written by Alan Ayckbourn.  A masterpiece of theatre.  I just hope we can do it justice.  By that I mean me, as the director.  I have great faith in all the cast and still laugh out loud at rehearsals over and over again.  Not hysterical laughter either although there is a little of that!

For the past few days I have been promoting my novel Caught in the Web by giving it away free on Kindle.  Today is the last day, all those I've been pestering will be pleased to hear.  Just wanted to say that it has been a great success and has been downloaded all over the world by nearly 1,800 people so far.  Even though I haven't received any cash for this, it feels good knowing that I am reaching out to so many people in so many countries.  Wow!

Then, as if I didn't have enough to do, I'm involved in the D-Day 70 commemoration weekend in the village of Southwick and have to get off to a meeting in the local pub in about 20 minutes - so I guess I'd better get going.

Caught in the Web - Chapter forty-eight

Caught in the Web is free to download on Kindle until tomorrow - 25th March.  Here is the next chapter.........

Chapter Forty-eight

Another long night stretched ahead.

Karen tried not to sleep. She wasn’t sure what staying awake would achieve but felt too vulnerable to let herself relax into oblivion.

It was nearly dawn when she felt herself finally slipping into sleep. Her head was aching from all the thoughts which were fighting for her attention. Her body was sore from Peter forcing himself on her. She was frightened. Afraid to stay with Peter and afraid to leave him.

She could see no way through this.

In the early hours, she started to wonder if Peter was right and she was mentally ill. The darkness brought its own demons which fed on her tired brain and troubled emotions.

When Peter got out of bed at seven, Karen was immediately wide awake and on edge. She kept her eyes closed, feigning sleep, hoping that he would go to work and leave her to make her escape somehow.

But he was in no hurry to leave.

She could hear him moving around downstairs and fearfully heard him clanking up the stairs with a laden tray.

‘Wake up darling,’ he said. ‘I’ve made you some breakfast.’

Karen opened her eyes and watched as he fussed about with placing the tray on the bed. There was a single red rose in a vase on the tray. ‘Blood red,’ Karen thought.

Peter pulled open the curtains.

‘It’s a lovely day.’ He turned and smiled at her. ‘Now, I don’t want any nonsense from you today,’ he continued. ‘You will eat this all up and then I’m taking you out for a drive. You need a change of scenery I think.’

Karen panicked.

‘Where are you taking me?’ she asked. ‘What about Margaret? She said she’d come round this morning.’

‘I told her not to come, remember?’ he said.

‘But... what about your work?’ Karen clutched at a straw, already knowing the answer.

‘No work today. You’re my priority,’ he said. ‘Now, be a good girl and do as I ask for once.’ He pushed the tray towards her.

Karen looked at the tray.

‘I’m not hungry,’ Karen began, wondering what was hiding in the marmalade.

‘Don’t be like that,’ he snapped back. You’d better eat now, we could be out for a while.’ He sat and waited.

Karen ignored the tray, pushed the covers back and got out of bed. She gathered her clothes together. ‘I’m getting dressed in the bathroom,’ she said and left the room with a flourish of bravery that she did not feel inside.

‘Silly girl,’ she heard his loud whisper as the door closed.

She stayed in the bathroom for as long as she could, trying to work out what she would do next. Eventually, she had to come out.

Determined that he would not get the better of her, she went straight to the kitchen and made herself some toast and tea. Peter said nothing, just stood watching her from the doorway. He moved out of the way when she took her breakfast into the lounge and watched her as she ate each piece, carefully brushing the crumbs from her mouth when she’d finished.

‘Are you going to take your pills now?’ he asked, as she sipped her tea. He took the bottle from his pocket.

‘I don’t know why you think you have to look after those,’ she replied. ‘I am an adult you know. I can decide whether to take them or not without your help.’

‘We both know that’s not true,’ he sneered. ‘Now you make sure you take them properly or I’ll have to get the Doctor back again.’

‘I wish you would,’ Karen said.

He stood over her. ‘Take the bloody pills,’ he held them out to her. ‘Or do you want me to make you?’

Karen shuddered. ‘I’ll take them.’ She took the pills from him and dropped them into her mouth, quickly swallowing a mouthful of tea. She managed to conceal them in her cheek again without them going down.

Peter smiled.

‘That’s better,’ he said. ‘Now, get your coat on. We’re going out.’ He ran up the stairs to the bathroom. ‘I’ll be down in a minute,’ he called.

Karen slipped the pills from her mouth into her pocket. She could feel her strength returning now that she wasn’t drugged all the time. Maybe getting out of the house would be her chance to get away. It was with a certain hope that she got into the car a short while later.

The countryside flashed past the car window.

Karen gazed out at the fields and wondered what Peter hoped to achieve by all of this subterfuge, keeping her away from Margaret, Dr. Wright, and her work friends. He’d have to take his eyes off her eventually, she knew that. Sooner or later, people would see that it was Peter who was off his head, not her. She just needed to bide her time and keep calm.

Peter drove in silence. Karen was left with her thoughts, hoping that they’d stop somewhere in a town when she stood the best chance of giving him the slip. She was lost in her own thoughts sometime later as they pulled into the driveway of a secluded house. The nearest neighbour was just beyond some trees which surrounded the house.

‘Who lives here?’ Karen asked. ‘Where are we?’

Peter said nothing. He pulled the car up outside the house. The windows were dark and gloomy, giving the place an air of abandonment. He got out of the car and went round to the passenger side, opening the door.

‘Hop out,’ he said. ‘There’s someone I want you to meet.’ He reached in and took Karen’s arm.

‘Who?’ Karen tried to push down the feeling of panic. ‘Who lives here?’

‘Just come along and you’ll see,’ he said. ‘It’s a surprise. You like surprises.’

As Karen was pulled from the car she looked up at the house. A black crow sat on the roof, eyeing her. She shivered.

‘You’re cold,’ Peter said. ‘And such a nice day. You must be coming down with a chill.’

The keys jangled as he opened the door. He held onto Karen with one hand. She struggled in his grip but he had already ushered her in, the darkness in the hallway enveloping her.