Enter and View - Magnolia Unit, St Michael's site

Healthwatch Enfield’s Enter and View Authorised Representatives have statutory powers to enter health and social care premises to observe and assess the nature and quality of services and to obtain the views of the people using those services. Magnolia unit visit was an announced Enter and View visit as part of Healthwatch Enfield’s planned strategy to look at a range of care settings within the London Borough of Enfield, to assess the quality of care provided. We wanted to ensure patients are receiving a good service from local health providers.

Whilst at the Magnolia Unit we heard from the manager, Mark Cubitt and his line manager Susan Jowett, the nursing team leader Dumsile Mabuza, 8 patients, 2 HCA, 1 nurse and the OT team. There were 24 patients at the unit on the day of the visit. We found that patients valued staff, found them friendly and understanding and all patients were focussed on going home.

Approximately 90% of patients are discharged to schedule. Staff will accompany patients to their home and will stay for a while until family/carer arrives.

During our visit we noted many examples of good practice:

• They have acknowledged the points raised in a recent CQC inspection and have taken a number of initiatives to address these
• There has been a Quality Improvement team established and action plan agreed and initial issues addressed
• The Management team appear approachable and visible
• Staff are required to do mandatory training
• Care planning documents are comprehensive and regularly reviewed. They are thorough and kept at the foot of the bed. The care plans we saw were signed by the patient and were multi-disciplinary allowing patient progress to be readily assessed
• The staff were highly complimented for being friendly, approachable, caring
• Staff make time to chat and interact with patients
• Meals and bed times are flexible and personalised to suit individual preferences. There were only 3 red tray patients during our visit – however, the staff were observed helping (other) patients with eating and drinking
• For the patient and carer survey questions include staffing, interaction, and discharge. The BEH Mental Health Trust is responsible for designing and formulating the questionnaire to ensure comparable outcomes. However, as this is a rehab unit and not a mental health provider the questions are not all suitable. The unit carries out its own survey, usually at weekends. The responses to this were all good and are kept in the resource room for staff to view

An area of concern was:

• The call bell response remains a concern, some patients report a delay

Since the last Healthwatch Enfield visit, it was noted that:

• The volunteers are no longer active which has affected the gardening activities and knitting group in particular
• The League of Friends from Chase Farm Hospital has been disbanded and this support has been withdrawn. Recently the Friends purchased TVs although these are not all operational yet. In addition to this, the League of Friends had supplied roving PCs, TV’s for the unit for entertainment, and these units have programmes that patients can use to improve their cognitive and coordination. The League of Friends have also supplied a number of items for the gym and an ECG machine
• The range of activities was commented on. It was noted during this visit that: the weekly pet therapy dog continues, as does the weekly memory group. The lack of newspaper provision continues.

As a result of our visit, we made 9 recommendations as to how the service provided could be improved.