Children and Young Peoples' Mental Health Service (CYPMHS) inpatient unit for West Yorkshire

So that we can understand the difficulties you are experiencing and provide you with the best support, there will be a period of assessment and treatment so we can get to know you better.  We also like to involve your family or carers in this as much as possible.

We will work with you to plan your care and your care team will write a care plan which explains what we are trying to achieve.  You may be offered medication as part of your treatment and this will be discussed with you.

Therapy sessions and/or group sessions will make up part of your treatment and you will be provided with a timetable which maps out what a typical week will look like for you.

If you are still in school and are well enough to carry on with your school work, our  teaching team will work with teachers from your own school so that you can continue to  receive appropriate schoolwork.

Review meetings will take place every where you and your family or carers can discuss with us your thoughts and feelings about how things are progressing and help us make decisions about your ongoing care and treatment.

Care Planning Meetings (CPAs) are held around once a month.  You and your family or carers will be invited to attend these along with any other professionals involved in your care outside of the unit.  These meetings are for you and your parents to put your thoughts and feelings to the team regarding your care.

You may be offered an individual worker who will spend one-to-one time with you working through your thoughts and feelings.  Your care team will also offer you individual time on a weekly basis and offer you any other information you may need.

Days start at 7.30am each morning.  This gives you half an hour before breakfast to get-up, clean up and get dressed before breakfast is served at 8am.

We’re more flexible on morning times during weekends or holidays depending on your care plan.

Community meeting

Every day we hold a ‘community meeting’. This is an opportunity for young people and staff to chat about any issues that might happen during your stay. This can include any compliments or complaints, sharing important information, and making decisions about the day.  We often ask that another young person in our care hosts this meeting.

School

Our schoolroom is staffed by qualified teachers and holds up to 5 sessions a day, Monday to Friday at the following times:

• Session 1:  9am – 9:50am
• Session 2:  9:50am – 10:50am
• Break:  10:50am – 11:10am
• Session 3:  11:10am – 12:10pm
• Lunch:  12:10pm – 1pm
• Session 4:  1pm – 2pm
• Session 5:  2pm – 3pm

Meal times and snacks

Meals and breaks are taken in the dining room and we encourage you to attend on time. Food is usually served by staff and second helpings are often available so do ask!

If you have any eating difficulties, you will have a specific care plan around meal times and eating.

• Breakfast:  8am
• Morning Break:  10:50am
• Lunch:  12.15pm
• Afternoon Break:  3pm
• Tea / Evening meal:  5pm
• Supper / Late evening snack:  8:30pm

We have a 20 minute snack time every day at 10:50am, 3pm and at 8.30pm in the dining room.  Food is provided, however you can bring your own food, unless this is restricted as part of your care plan.

We also do supermarket shops to get additional items such as chocolate and biscuits, and we are happy to get requests for things that you might specifically like.

Bedtimes

We do encourage routine and regular sleeping patterns, however we understand that everyone is different.  Bedtimes are individually care planned with you and your family or carers during admission so that this reflects your usual routine at home.

This can be reviewed at any time, and during weekends and school holidays bedtimes are usually extended by 30 minutes if parents/carers are in agreement with this.

To make sure you don’t feel left behind with your school work while you are here, we have a dedicated schoolroom and teaching staff which means you can carry on with your studies.

We will work together with your own school so that you can get into a routine of schoolroom attendance, carry on with a range of school subjects including English, mathematics and science and help you to maintain your achievement in core subjects.

If you are studying towards your GCSEs or other qualifications, you will still be able to complete coursework and sit your exams.  We will work with your School Examinations Officer to make sure that you can access the appropriate venues, resources and support that meets your needs.

If you are not a school pupil your care team will work with you to put together an individual timetable with therapeutic and occupational activities.  The teaching staff may also meet with you to discuss what education options are available to you.

During your stay you will have a care plan and timetable which will be regularly reviewed and updated.

In the early part of your admission you and your family or carers will meet with your care team to discuss your time on the ward, your care and how you are progressing.  You will also meet with members of the therapy team who will work with you and discuss your needs during your admission, including individual and group therapies.

The therapy team run a number of groups which aim to help you learn new skills together with your peers. These group sessions may include creative therapies, coping skills, mind and body activation, and life skills.  Joining a group can feel difficult but attending the groups is an important part of your treatment and recovery.  If you are worried about being in a group, please talk to us – we will do our very best to support you to attend.

We have a weekly timetable which details which groups are running each day.  These change periodically but can include; baking, meal preparation, arts and crafts, discussions and games. Other more therapeutic groups are designed to educate you and help you to develop skills to manage the stresses of life a little better.

Dietitian

Our dietitian provides support and practical information about food and nutrition. They will  carry out an assessment with all young people at Red Kite View to consider any individual dietary needs.   You can also work with the dietitian to explore the role of nutrition in your physical and mental health, consider how to achieve a balanced diet and make healthy lifestyle and food choices.

Family therapy

Family therapy is offered to most young people and their families at some point during their stay.

Family therapy can help families express and explore difficult emotions safely, understand each other’s experiences and views, appreciate each other’s needs, build on family strengths, and make the changes in their relationships and lives they want to make.

Therapy on the unit is offered by a small team of practitioners, led by a qualified family therapist. One member of the team will talk face-to-face with the family, while the others listen carefully. At different points in the session the team will share their thoughts with the family and offer a range of ideas and views on the difficulties they are experiencing.

Occupational therapy

Occupational therapy provides support to people who have any health problems which stop them from doing the activities that matter to them. Our occupational therapists work with each young person to find out what support is needed.  This could include treatment targeting a specific area, or it could be taking part in weekly therapeutic groups to develop useful coping skills so that you can carry out your everyday tasks with more confidence and independence.

Psychological therapies

We have a number of therapists at Red Kite View who offer a range of individual psychological therapies.  These include talking therapies and creative therapies and usually take place weekly for about an hour.

Some psychological therapies aim to explore what has led you to the difficulties you are experiencing now in order to help you to move forwards in your recovery.  Other therapies focus more on the here-and-now, helping you to understand your thoughts, feelings and behaviours and learn new ways to cope with or manage your emotions.

We know that not everyone will be ready to take part in therapy while they are on the unit and it may be better for you to continue with therapy from your community team or wait until after discharge. We will always consider what will be the best approach for you.

What is Formulation?

Formulation is a way of describing problems and ways out of them. Formulations start with the idea that a young person has good reasons for having difficulties, being distressed or feeling stuck, even if these may be difficult to understand or accept.

These good reasons may include:

• past difficulties and experiences
• changes in relationships with family and friends
• people having left, become ill or died
• conflict at home, at school or with friends
• difficult changes in life (e.g. starting a new school).

Working out how different aspects of life fit together can help the young person begin to make sense of and understand why they are having difficulties.

A good formulation also recognises positive things, such as the young person’s own strengths and resources and they people they can call on for help, and it points the way forward to positive change.

How formulations are developed at Red Kite View

Developing a formulation is like doing a jigsaw – you work together to find different pieces of the puzzle and put it together in a way you both think fits.  A formulation is developed together between the young person and the inpatient team, along with family members, carers or other care professionals.  This is usually led by a Psychologist or Psychological Therapist.

The pieces of the ‘jigsaw’ are pieces of information, like:

• how you feel at the moment
• what’s going on in your life now
• what’s going on with family, friends and school
• when did the difficulties or distress start
• key experiences and relationships in your life
• what these experiences and relationships mean to you

When doing a formulation, we understand that the most likely explanation is that a young person is trying to cope with a current situation, past events or some really difficult experiences in the only way they know how.  Even if this is inadvertently keeping them trapped in distress and difficulty.

This is why we work to understand not only why someone is in difficulty, but also what has kept them there, and what might help them move forwards.

Like with a jigsaw, the time it takes to complete a formulation depends on how many pieces there are and how complicated the ‘picture’ is. Once the pieces are put together, the formulation can be used to explore the best way forward.

Formulation meetings

When a young person is admitted to Red Kite View, we aim to arrange a formulation meeting within 21 days of admission.

The formulation meeting will bring together all the professionals who are involved in the young person’s care and treatment, both from inpatient and community services, to develop a shared understanding of the young person’s difficulties.

The young person and their family or carers are not invited to attend the formulation meeting as this is a chance for the team and other professionals to develop more positive understandings of the young persons’s difficulties and to exclude inaccurate or inappropriate ideas.

It is not considered helpful to have a young person or their family or carers, listening to “guesses” about their history that might be inaccurate. However, the views of the young person and their family about their experiences from discussions, reports and observations made prior to the formulation meeting will be included.

What happens next?

The ideas generated at the formulation meeting will be discussed with the young person and their family.  These discussions may lead to further changes or additions so that we have a shared and an agreed written formulation.

We will agree with the young person on who it would be useful to share the formulation  with, in addition to the inpatient team and the community team(s) who will be supporting them following discharge from Red Kite View, and how it will be shared.

Reformulation

A formulation is not a solution, instead it provides a hypotheses or theory which can be tested out over time. A young person’s difficulties and needs may change significantly while they are at Red Kite View, so formulations will be reviewed regularly at MDT discussions, CPA meetings and reformulation meetings.

The formulation will guide the intervention and treatments that are offered to the young person and their family while they are at Red Kite View, and it will also inform post-discharge intervention and treatment planning.

Outcome measures are a set of questionnaires you will be asked to complete while you are here. The results of these questionnaires help us to get an idea of things you may be struggling with and they can help us identify areas you can work on with your Care Team and the wider Multi-Disciplinary Team.

Some of the questions seem odd or difficult to answer…?

Some of these questions may seem odd, but remember these questionnaires are not specifically about you, but are used to cover a wide range of other young people’s experiences.  If you are struggling to answer a question, don’t worry! Just put what you think would be closest to your ideal answer.  If you are unsure of what the question is asking you can always ask a member of staff for help.

I feel embarrassed answering these questions…

Try not to worry about this, you will not be judged by any of the answers you give.

Your answers are a useful way to identify any areas that you may be struggling with, and we are here to help you with this. It can also be useful for us to get a sense of how you are doing, especially if you find it difficult speaking to staff.

When do I complete Outcome Measures?

We ask that you complete an Outcome Measure Pack on admission and before your discharge.  You may also be asked to complete some questionnaires before your CPA meetings, which happen every four to six weeks during your admission. We do this to keep track of your progress and look for any changes in areas of difficulties.

Who will see my answers?

Only the people directly involved in scoring your questionnaires will see your answers to specific questions. Sometimes information may get passed onto your Care Team or MDT members if the person scoring your questionnaire thinks it will be helpful for your care and treatment.

With your consent, your answers will also be entered anonymously (without your name or personal details) into a national database called QNIC-ROM.  This database helps us to produce a report for you and your team which summarises your scores from the questionnaires.

Your scores are presented in graphs with a short explanation of what your scores mean.  The QNIC-ROM system also provides anonymous reports for the whole service, so we can see how we are doing as a service.

Of course you can!  We understand that this might be the first time you’ve ever been away from family and you may feel homesick, so the visiting times are flexible because of this.

We ask that you have no more than 4 visitors at any one time as we do not have the facilities to deal with large numbers of visitors.  We know that some young people have big families and we try to be flexible to accommodate this, especially around special occasions, but we ask that you be considerate of other young people on the unit.

Visitors can come and see you any time during the day, but we ask that visitors do not come during your school hours or when you’re in therapy sessions.

Can my friends visit me?

Yes they can, if they are under the age of 18 we ask that they are supervised by an adult, ideally a parent.  This also includes visits by your boyfriend or girlfriend.

How long will I be here for?

This all depends on what progress you make and what is agreed by your care team. Your discharge will be arranged by your care team and community team when they think you’re ready.

What can I bring to the unit?

You will need to bring clothes, nightwear and toiletries.  You may also want to bring in books, music and other belongings in with you.

We will provide you with towels and bed linen, but you can bring in your own duvet, pillow, duvet cover if you prefer.  We also have washing machines and tumble driers that you can use.

You can personalise your room but we ask that you do not use blue-tac on the bedroom walls as this pulls the paint off.

In order to maintain a safe environment for everyone, some personal items can only be used under supervision and any restricted items will be kept in a patient box in a locked room.

These items include;

• Things made of glass
• Mirrors, including in compact makeup kits
• Tweezers, scissors and other sharp objects
• Small electrical devices such as hairdryer’s
• Items that may be operated by battery
• Chemical agents such as nail polish remover or cream hair remover
• Chargers, headphones and airpod type earphones
• Some jewellery and accessories

There are some items we don’t allow on the unit at all, including:

• Alcohol and non-prescription drugs.
• Disposable Razors
• Wire Coats Hangers
• Spiral bound pads and books (we can explain if you’re not sure what this is)
• Any illegally copied or certificate 18 DVD’s, games etc.
• Cigarettes including e-cigarettes, vapes and lighters.

Can I use my mobile phone?

The use of mobile phones and other mobile devices will be individually care planned and if used inappropriately the device may be sent home. This will be discussed during your admission.

We also ask that visitors do not take any photographs on the unit of other young people or staff members.  This is to preserve other people’s right to confidentiality.

When can I leave the unit?

You can have time out in the grounds on a daily basis.  This may be restricted or supervised if we have concerns about your safety, but this will be discussed and planned with you and your family or carers.

During your admission you will be encouraged to have time off the unit if it is appropriate to do so, and we encourage you to take “home leave” for periods of time during the day, and overnight.  All leave away from the unit will be planned with you, your parents or carers and your care team, and this will be identified on your individual timetable and care plan.

Discharge from the unit will be also be planned with you, your family or carers and your community team.

What about my religious or cultural needs?

If you have any religious, cultural or spiritual needs or requests, please ask and we will do all we can to accommodate you.  For example, if you require a space to pray we can identify a place for you to use.

We also offer a range of food options including: Kosher, Halal, African Caribbean, vegan, vegetarian and gluten free meals.

Young people have been involved with the design and the name of the new inpatient unit.  The unit is has a multi-purpose activity room, educational facilities, a room for family visits and an enclosed garden. It  will support young people aged from 13 to 18 years of age who have a variety of mental health issues with an inpatient service in their journey to recovery.