Secure Mental Health Service
The Secure Mental Health Business Unit (SMHBU) based at Guild Lodge, in collaboration with the Health and Justice Business Unit (HJBU) and the Community Business Unit (CBU), forms the Specialist Services Network of Lancashire and South Cumbria NHS Foundation Trust (LSCFT).
Guild Lodge, Guild Park, Whittingham Lane, Preston, PR3 2JH
Originally, the SMHBU, known as Guild Lodge, opened as a Secure Mental Health inpatient facility in July 1999, comprising of three medium secure wards and one low secure ward able to facilitate inpatient care for up to 54 male and female Service Users and had a Forensic Community Nursing team. Since this time, a comprehensive network of 164 medium secure, low secure and step-down beds and specialist forensic community services has evolved in response to the needs of Service Users across Lancashire and South Cumbria, and those with Acquired Brain Injury (ABI) across the North West region as a whole.
The overall purpose of the SMHBU is to provide high standards of assessment and formulation; care and treatment interventions; rehabilitation and recovery; and risk assessment and risk management for individuals with complex mental health care needs, and to respond to these needs whilst safeguarding Service Users, staff, and the general public. Service Users are given the opportunity to be involved, as far as is practicable in their circumstances, in planning, developing and reviewing their own treatment and care to help ensure that it is delivered in a way that is as appropriate and effective for them as possible underpinned by My Shared Pathway and recovery principles.
The specific functions of the SMHBU are to:
- Assist Service Users to achieve health gains, to effectively treat or ameliorate mental disorder and psychological distress, and to minimise the disadvantages of psychosocial difficulties;
- Encourage individuals to explore the psychopathology, and contextual aspects, of offending and risky behaviour, and issues associated with individual vulnerability;
- Undertake comprehensive multi-disciplinary assessment, advice and consultation for patients, or services, who require the expertise of Specialist Forensic Mental Health services to manage identified risk;
- Provide an in-patient environment and in collaboration with the CBU community-based teams that undertake assessment, treatment and rehabilitation, across medium, low and step down physical, procedural and relational security needs, across the range of dependency needs, and in community settings and prisons;
- Meet needs, promote health and well-being, enhance quality of life and provide appropriate rehabilitation opportunities for Service Users;
- Maximise opportunities for recovery and reintegration, and in particular to prepare and facilitate individuals for transfer or discharge to the most appropriate health or social care setting to meet their needs, in collaboration with local services and referring agencies;
- Provide assertive community follow-up, community support, supervision and crisis response for identified high risk Service Users, and out-patient support where appropriate
- Promote the development of facilities and services in the community for mentally disordered offenders, vulnerable Service Users and those with similar needs who no longer require security;
- Manage risk and underlying psychological and other care needs, and to minimise opportunities for re-offending, while assisting the individual to develop alternative socially positive coping strategies
- Undertake liaison and co-ordination with other agencies and services, and act in advisory and supportive capacities
- Promote individual rights and the use of advocacy and self-advocacy in order to achieve this;
- Provide a dedicated Secure Pathway service for women Service Users, reflecting individual needs and a safe environment
- Provide a regional ABI Secure inpatient pathway with medium secure, low secure and step-down provision for the North West Region as a whole.
The SMHBU is comprised of three distinct multi-disciplinary Primary Service Lines (PSLs) which enable the co-ordinated delivery of the range of services provided. The PSLs function as semi-autonomous business units, with their own income, expenditure and performance framework.
The three PSLs are as follows:
- Male Secure Mental Health Services
- Women’s Secure Mental Health Services
- Male Secure Acquired Brain Injury (ABI) Service
The three PSLs are further divided into a number of individual clinical areas. Each individual clinical area has its own model and philosophy of care/operational policy describing its role and function.
Due to the diversity of Service Users being admitted to and discharged from the SMHBU, it is unfeasible to describe a single pathway from admission to discharge through the SMHBU. It is much more realistic to highlight that the diversity and longitudinal course of the Service User’s needs will determine the clinical areas s/he will pass through on their pathway through the SMHBU from admission to discharge.
Male Secure Mental Health PSL – Fairsnape, Calder, Greenside, Marshaw, Mallowdale, Fairoak, Dutton and Fellside
The Male Secure PSL has the capacity to provide inpatient care for up to 96 male Service Users across a pathway of medium secure and low secure clinical areas. This is divided into seven clinical areas:
- Fairsnape has 8 beds and provides a medium secure admission and bespoke 12 week assessment function;
- Calder has 10 beds and provides a medium secure admission and assessment function;
- Greenside has 12 beds and provides an on-going medium secure care and treatment function;
- Marshaw has 10 beds and provides a Long Term Medium Secure (LTMS) function;
- Mallowdale has 8 beds and will be commissioned later in 2016 to provide an on-going medium secure and treatment function;
- Fairoak has 18 beds and provides low secure rehabilitation for stepping down from medium secure care. Fairoak also carries a community bed for male Service Users under the care of the Forensic Community Mental Health Team (FCMHT) to access in times of crisis;
- Dutton has 15 beds and provides low secure admission and assessment as well as on-going low secure care and treatment.
- Fellside West has 15 beds, 10 beds on an open clinical area and 5 self-contained flatlets. This facility is accessed by male Service Users stepping down from medium Secure and low secure care within the male Service PSL.
Women’s Secure Mental Health PSL – Elmridge, Fellside East and Forest Beck
The Women’s Service PSL has the capacity to provide inpatient care for up to 25 female Service Users across a pathway of medium secure, low secure and step down clinical areas. This is divided into three clinical areas:
- Elmridge has 9 beds and provides medium secure admission for assessment and treatment to Service Users;
- Fellside East has 8 beds and provides low secure packages of assessment and treatment to Service Users as well as on-going low secure care and treatment;
- Forest Beck has 8 beds and provides a step down service for Service Users stepping out of medium and low secure care on Mallowdale and Fellside East.
Male Secure Acquired Brain Injury PSL – Bleasdale, Whinfell, Langden and The Hermitage
The Male Acquired Brain Injury PSL has the capacity to provide inpatient care for up to 43 male Service Users with an Acquired Brain Injury (ABI) offering a pathway of medium secure, low secure and step down clinical areas. This is a regional service provided to the North West region as a whole. This is divided into three clinical areas:
- Bleasdale has 9 beds and provides a medium secure ABI admission; assessment and treatment function;
- Whinfell has 9 beds and provides a medium secure ABI admission; assessment and treatment function;
- Langden has 15 beds and provides a low secure admission, assessment; treatment and rehabilitation function;
- The Hermitage has 10 beds and provides a community house model for Service Users stepping out of medium and low secure care from within the Male Secure ABI medium and low secure service and the Male Secure
Multi-Disciplinary Team Working
Within the SMHBU, Service Users have access to a broad range of expertise with staff from a diverse pool of professional backgrounds. These include:
- Registered Mental Health Nurses and Health Care Support Workers
- Associate Practitioners
- Ward based Occupational Therapy Assistants
- Consultant forensic and rehabilitation Psychiatrists
- Trainee psychiatrists
- Clinical Nurse Specialists
- Patient Safety and Clinical Risk Manager
- Occupational Therapists and Technical Instructors (including Physical Activities Coordinator)
- Clinical Psychologists, Psychological Therapists and Psychology Assistants
- Social Workers and Approved Social Workers
- Forensic Community Mental Health Nurses
- Clinical Pharmacists
- Primary healthcare services including a General Practitioner and Practice Nurse, Dental Care, Podiatry, and Dietician, Speech and Language Therapy
- Hospital Chaplain and other ministers and spiritual leaders
Multi-Disciplinary Team working is at the heart of practice within the SMHBU. Good team work enables the provision of effective, comprehensive care. Responding effectively to Service User needs is the primary task of the team. All relevant professionals contribute to this process and to the creation of a safe and therapeutic care environment, whilst maintaining good inter-professional relationships.
We are based at Guild Lodge, Guild Park, Whittingham Lane, Preston, PR3 2JH. The telephone number for Reception at the hospital is 01772 773698.