Involving Service Users to Define a New Standard of Care

Synopsis

Background
East London Mental Health Foundation Trust (ELFT) is reconfiguring its existing inpatient mental services to provide care closer to the population it serves. A new inpatient facility is proposed in Bedford that relocates several services in Luton. With affordability challenges, the schedule of accommodation required careful development, to optimize every square metre. ELFT has involved former service users throughout the design process, from the selection of the design team, to building the brief and assessing design proposals.

Research
A joint team of Staff, former Service Users and the architect visited existing facilities and exemplar buildings. We interviewed staff, reviewed the spaces and layout, and evaluated together what worked well, what did not, and how to improve.

Findings
From this, we have developed a set of guidelines which inform our Brief for the new service, these include:
• Understanding the staffing model to identify the optimum location for activity and therapy spaces, thereby avoiding underutilized activity space on ward that rely on staff supervision, and underutilized shared activity spaces that rely on staff escorting service users.
• How to address common issues with the ward’s Staff Base. How to address mounting tension between ward staff’s administration and active engagement with service users to avoid conflict.
• The concept of choice. Multiple smaller spaces that enable services users to quiet space, recreation space, spiritual space, even what to watch on TV while avoiding conflict with others.
• Creating opportunities for joined-up care, so a wider range of staff are kept informed of how a service user is doing on any particular day.

The issues identified are by no means unique to this Trust, and the resulting guidelines begin to define a new standard for mental health inpatient care in the UK.