Lapwing – Psychiatric Intensive Care Unit

What is Red Kite View?

Red Kite View is a new unit where we work with young people experiencing a variety of mental health issues.

These include difficulties with eating, with unusual experiences, or with managing strong emotions.

We provide support for young people between 13 and 18 years old. Some young people may also have a diagnosis of Autism or Intellectual Disability.

We aim to support young people along their recovery journey. We will make sure that you’re safe and that your time with us is as comfortable as possible. You may feel nervous about your admission to Red Kite View, and we aim to make the admission process as smooth as possible.

What is Lapwing ward?

Lapwing is our 6-bedded psychiatric intensive care unit (PICU) for 13 to 18-year-olds who need assessment and treatment for a range of mental health difficulties.

The ward provides a safe, therapeutic, supportive, and structured environment for young people who cannot safely be cared for within the community, which ensures that you are at the centre of your care, treatment and recovery.

Lapwing uses Positive Behaviour Support (PBS), a collaborative approach to working with young people and their families. PBS allows the team of professionals working with you to better understand your experience and tailor support to you. During your admission, the team will support you to engage with the production of your PBS plan.

Additionally, the team use an approach called AMBIT (Adaptive Mentalisation Based Integrative Treatment). AMBIT helps us to better understand the experiences of young people and their families, through increasing our awareness of how young people may be thinking and feeling (‘mentalising’), to support young people in understanding their own thoughts and feelings, and how others might be thinking and feeling too. AMBIT helps us to build trusting relationships with young people so they feel safe to engage with the help and treatment available.

Admission

When you get here, a member of the team will greet you. You will be able to discuss your admission and ask any questions you may have; you will also be asked to fill out some consent forms. Usually, a doctor will ask your consent to carry out a basic physical examination. This will be explained to you and isn’t anything to worry about (it may include listening to your heart with a stethoscope, an ECG, blood test, questions about allergies etc). An ECG (also called heart tracing) involves some stickers being placed on your chest and linked to a machine that measures the electrical activity of your heart – this doesn’t hurt and doesn’t take long. Each aspect of this will only be completed with your consent and you can request a same-gender doctor if you’d prefer this. To keep you and our other young people safe, we will ask you to consent to a search of your person and a search of your belongings. The mutual expectations of the ward will also be shared with you during admission – these are a set of standards and values that both staff and young people have developed and agree on in order to maintain a positive and safe environment.

You will then be shown to your bedroom and given a tour of the unit. You’ll also be introduced to members of staff and other young people staying at the unit.

What is a typical day like?

Getting up and breakfast

Breakfast is served at 8am on weekdays and 8:30 on weekends and holidays. You’ll be woken up at 7.30am on weekdays and 8am on weekends and holidays. This gives you half an hour before breakfast to get-up, clean up and get dressed.

9.45 Sunrise Meeting

After breakfast we have a morning community meeting called ‘Sunrise’. This meeting aims to bring a community feel to the environment and create a safe space for young people and staff to make the ward a welcoming place for the day. The group follows this structure:

• Mindfulness exercise
• Round up of news (e.g. any updates, groups for the day)
• Suggestions for how to make the ward a safer or more comfortable space today
• Offers and requests of help or support
• One thing we are each grateful for in the past 24 hours and one thing each of us is going to do today.

Education

To ensure you can continue with your education, we have our own school called the Starling Education Suite, which everyone is referred to. If you feel well enough, one of the teachers will discuss school or college with you to find out what subjects you are studying, any learning needs you might have and how you feel about school or college.

Our education team:

• Help you get into a routine of schoolroom attendance.
• Help you carry on with a range of school subjects including English, mathematics, and science.
• Support you in accessing your school in the community.
• Meet you to discuss other education options.

The education team will work with you to develop an individual timetable that you feel able to manage and suits your personal education needs.

If you are studying for your GCSEs or other qualifications, you will still be able to complete coursework and sit your exams. The Red Kite View school team will work with your school’s examinations officer so that you can use the venues, resources, and support you need. RKV also provides post 16 education support.

Mealtimes

On Lapwing your meals and breaks will be taken in the dining area within the day space.

For breakfast we have a selection of cereals and toast available. For lunch you can choose from a range of sandwiches, jacket potatoes and cold desserts. For the evening meal we have a selection of hot meals prepared fresh on site. Favourites include Fish and Chips, Sausage and Mash, Singapore Chicken Noodles and Spaghetti Bolognese.

In addition to our home cooked dishes, we also have a selection of favourite foods that are available every day. Our menu was designed with the input of young people and ward staff to ensure that we are offering the foods that young people prefer. We welcome feedback, which you can give by speaking to any staff member or raising in Thursday Group (our weekly community meeting).

Nutrition

We also offer a range of food options including kosher, halal, vegan, vegetarian and gluten-free meals. The food is freshly cooked daily, and you can always discuss it with the dietetics and catering team.

Bedtimes

Routine and regular sleeping patterns are encouraged, but everybody is different, so your bedtime is discussed as part of your care plan. During weekends and school holidays, bedtimes are usually extended by 30 minutes if parents/carers are in agreement with this.

Bedtimes can be reviewed at any time and, if needed, we can support you to develop a sleep hygiene plan.

Therapy, treatment and care

A Consultant Psychiatrist will be your Responsible Clinician and will have overall responsibility for your care during your admission, as well as being involved in prescribing/reviewing medication and Mental Health Act assessments. You may also be seen by other members of the medical team.

On a day-to-day basis you will be supported by the nursing team, through administering medication (if appropriate), work with you developing and updating care plans that outline your treatment at Red Kite View, offering 1-1 time, supporting with activities and leave.

You and your parent/carers have a multidisciplinary team review (MDT) every fortnight in which you will meet with your Consultant Psychiatrist, a member of the nursing team and any other professional that you wish you attend. In this meeting, you will be provided feedback by the team, your treatment will be reviewed, and you and your parents/carers can raise any issues or requests.

You also will have a Care Programme Approach (CPA) meeting at the beginning of your admission. This is called an Initial Planning Meeting, where the focus and plans for your admission will be discussed. You will then have a CPA meeting every 2-4 weeks during your admission in which in your needs and progress will be discussed, and on-going treatment will be planned. Finally, you will have a Discharge CPA at the end of your admission to plan your support in the community. You, your parents/carers and inpatient, community and education professionals involved in your care will be invited to attend these meetings.

Therapeutic Timetable and Spaces

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. You will have an individualised timetable which will regularly reviewed and updated.

Therapeutic Groups

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 and therapeutic recreational groups which support the development of life skills, including:

• Gardening
• Journaling
• Art and Crafts
• Baking
• DJ-ing
• Dungeons and Dragons
• Therapy dogs
• Bingo
• Quiz

We have a weekly timetable which details which groups are running each day and these change periodically depending on the time of year and requests from young people. Groups will be prescribed based on your interests and needs.

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 variety of therapeutic spaces that you can access during your admission:

Activity room: The activity room offers both space and resources to explore your interests through individual and groups sessions.

Activities of Daily Living (ADL) Kitchen: During your time at Red Kite View, an Occupational Therapist may support you to access the ADL kitchen to cook and bake as part of a therapeutic group or individual session.

Sensory room: Our sensory room offers a space where we can explore your sensory preferences and needs using different lighting, sounds, smells and textures. You may choose to spend time in the sensory room to “chill out” or regulate throughout the day.

Our Team/ People who may be involved in your care

Occupational Therapy

Occupational Therapy provides support to young people at Red Kite View, with any difficulties that affect their ability to do the things they need and want to do. This may include work within our Therapeutic group program or more targeted one to one work.

Speech and Language Therapy

Speech and Language Therapists may work with you and other people, such as ward staff, education staff and home to support your speech, language and communication needs. A Speech and Language Therapist may also give advice about your eating, drinking and swallowing needs.

Psychological therapies

We have a number of psychological therapists at Red Kite View who may be involved in your care in different ways:

Psychology

The psychology team is involved with thinking about and supporting your emotional needs. Clinical Psychologists on the unit will work with you, your family/carers and staff to complete a psychological assessment and formulation (a shared understanding of your difficulties) to develop a greater understanding of what you are currently finding challenging and why, and to think about the best way to support you and your emotional needs moving forwards.

Clinical Psychologists may be involved in working directly with you, typically in a group, but will sometimes provide one-to-one sessions if appropriate. You may already have therapists in your community team and, where possible, we try to support these therapeutic relationships during your admission so you can continue with the same worker through your admission and once you are discharged home.

Assistant Psychologists work alongside Clinical Psychologists. Assistant Psychologists may offer you 1:1 sessions around psychological wellbeing, support you to complete outcome measures and help facilitate therapeutic groups on the ward.

Family therapy

Family therapy at Red Kite View helps family members to further understand and support each other. Our Family Therapist helps family members to feel safe so they can talk about their difficult thoughts and feelings, understand each other’s experiences and views, appreciate each other’s needs, build on family strengths, and work together to make useful changes in their relationships.

Art Therapy

Art therapy, or art psychotherapy, is a form of therapy that uses art materials to help people explore their thoughts, feelings and life experiences without having to talk. You might use paint, pencils, clay, sand, chalks or other objects in the art room. Most importantly, you do not have to be ‘good’ at art to use this therapy.

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.

Dietetics

Dietitians help service users to eat well and develop a positive relationship with food, providing support and practical information. At Red Kite View, we have a specialist eating disorders dietitian who uses evidence-based therapeutic models to support young people and their families.

Social Worker

Social Workers at Red Kite View will meet with you and your carers both at the hospital and at home. We will support with your admission and discharge planning which will include speaking with professionals who work with you in the community and with your family. We will also come and visit you at home when you are discharged. If you and your family are facing difficulties with how you’re feeling, relationships, change or feeling safe you can come and talk to us to see if we can help.

You may not meet with all the different professionals listed above. The people you work with will depend on your individual needs and circumstances.