ELIZABETH’S TRANSFER TO CYGNET APPLETREE, MEADOWFIELD DURHAM A PICU UNIT

Without any warning or communication from staff at Ash Villa Elizabeth has tonight been transferred three hour’s journey away to Durham but that will not put me off visiting. In fact I am looking forward to visiting Durham. Looks a nice area and very interesting too. Because I will be a frequent visitor I am interested to hear of anyone who can recommend places to stay and we live in a beautiful place too. If anyone knows people living in Durham I will be interested to hear from them. The only thing that has spoilt things has been our experience under Lincolnshire Partnership Trust and Lincolnshire Council who have seen fit to leave my daughter on an acute MH ward after 20 months to go downhill. I am even thinking of the possibility of working there in Durham as well as well as another area also to bring me closer to my relatives.

https://www.bbc.co.uk/news/uk-england-tyne-58323174

I do not know much about this hospital even though the above article concerns me as Elizabeth is of high risk of mortality and I hope that Durham PICU Unit at Cygnet Meadowfield will treat Elizabeth better than Ash Villa have rated “good” by CQC. I cannot comment yet it is too early but I have to say Cygnet has not been the very worst. The very worst has been NHS care who fail to provide proper facilities such as Ash Villa. For instance to gain accreditation you need to have ensuites. Also there was no psychologist. Also Ash Villa is in breach of serious health and safety failings with needle coverings left on Elizabeth’s table and a faulty bed. Elizabeth has given consent to the CQC to investigate and I intend to pass this on to the CQC as it was Elizabeth’s sister the nearest relative who has complained this time about the shocking facilities. Now under huge investigation Ash Villa have decided to transfer Elizabeth hours away but nothing is going to put me off visiting my daughter. I have to say that Cygnet have respected the fact that Elizabeth is a poor and non metaboliser of psychiatric medication in the past.

I would also point out to Cygnet Meadowfield that I had a private scan done when refused by Ash Villa and found there was inflammation of the brain. Therefore Elizabeth needs to be on minimal amounts of medication. There is also the P450 liver enzyme tests to consider as well as the genetic tests I had done and endocrinology that needs to be further investigated.

Elizabeth was being picked on by certain members of staff at Ash Villa befitting of Panorama. Having food and water snatched away for one, breaches of health and safety for which I have photos, rapid tranquilisation given frequently and seclusion in the absence of any physical healthcare, being left without dentist appointment though I believe this has just been done, being told that chiropody is not provided under NHS care which is a load of rubbish. Being misled in terms of the fact of whom is paying for the so called S117 aftercare which is the department run by Lucy Omezi of Enfield Community Rehab and waiting still for the care act assessment by AMHP Hannah kAJUE. What kind of system is this! There needs to be something urgently done. Until the system is changed nothing is any better. Abuse is rife and so is bullying and we have had our fair share.

I would like my daughter transferred back to Lincolnshire where we live now and would prefer her to be transferred to a very nice unit I visited that she liked so very much. I am going to put this to Sarah Connery and have just written to her. In the meantime my complaint has escalated to every single ombudsman including legal ombudsman and social work england. The PHSO have tried to say they did not receive consent to get out of investigating and that this would mean timing was not within the limits. However I managed to find in my records the consent authorisations that Elizabeth wants this to go forward which is well within the timings and so I do not accept their excuses. I would like a full investigation into my daughter’s horrific treatment and prolonged ordeal at Ash Villa, an acute ward with most unsuitable facilities and also into Enfield who failed to do a care act assessment and give S117 aftercare which was the reason why we moved. I have today written to the Commissioners to ask what arrangements are in place for me to be able to visit like I was doing before eventually. Bearing in mind at first Cygnet will not allow six hours unescorted until they get to know me so therefore the least LPFT not NCLICBENFIELD as previously thought who have money to burn can provide the necessary overnight accommodation as well as travel expenses as it is double the amount of journey I would be doing in Lincolnshire. It is on the borders of Scotland so I see but I am not put off by this journey. There has also been two unlawful sections under the MHA under Enfield for which I won £1 compensation but I am still waiting for compensation for the second unlawful detention which I have calculated is more. Dr Ilyas Mirza was the RC in the community in Enfield and he has actually recommended in one of his reports a Judicial Review. I will share that with you another time as I had solicitors appointed for this against Enfield and then this is why she was hauled in and unlawfully sectioned.

Anyway I have nothing to say as yet about Cygnet Appletree, Meadowfield Durham only time will tell.

Elizabeth knows about this blog and I have often asked for her comments.

So far I have heard positive reports from Elizabeth about her treatment at Meadowfield apart from one instance.

She was bought a MacDonalds and the food is nice. She has her phone and can keep in touch with her family. She has a nice room with ensuite shower. There is a wardrobe and shelves to put things away and keep the room tidy. I heard at Ash Villa there was no wardrobe and no ensuite.

After the long journey on arrival Elizabeth had one of her ‘episodes’ and unfortunately five members of staff pinned her down and injected her. I hope that frequent tranquilisations will not be given to Elizabeth as they were at Ash Villa (about 8 in a short space of time) on top of her regular depot. If she had been at home she would have settled without such intervention so this is the first injection given at Cygnet Meadowfield when she had one of her ‘inconsolable’ moments and this is something I see they have been criticised for in previous reports.

God knows how much this facility costs. I am very interested to know why nothing can be provided in the local vicinity. However having written to this department I now find out this facility is being funded elsewhere and I intend to find out exactly who is responsible for paying. It would seem that LPFT are responsible for paying then this is even more interesting as there is absolutely nothing provided in terms of care and services in East Lindsay which is not good. This is of public interest for me to find out especially when the cost of adaptions to the annex I have provided would be nothing in comparison.

Latest inspection summary

On this page

• Background to this inspection
• Overall inspection
• Acute wards for adults of working age and psychiatric intensive care units

Background to this inspection

Updated 20 January 2023

Cygnet Appletree is an independent mental health hospital based in Durham. The hospital is split over two floors and has two wards. Bramley ward (15 bed acute ward), and Pippin ward (10 bed psychiatric intensive care unit) for females of 18 years and over. The service was last inspected in April and May 2021 and ratings for the service were suspended. Enforcement action was taken which prevented admissions. These had been removed at the time of the inspection and we found that the hospital had made significant progress.

The hospital had a registered manager and a controlled drugs accountable officer. Controlled drugs accountable officers are responsible for all aspects of controlled drugs management within their organisation. Cygnet Appletree has been registered with the CQC since 26 September 2012 and has been managed by two other providers during this time. In March 2018, the provider of Appletree became Cygnet Behavioural Health Limited.

Cygnet Appletree is registered to carry out the following regulated activities.

• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder, or injury

 Download full inspection report for Cygnet Appletree – PDF – (opens in new window)

Published 20 January 2023

Overall inspection

Good

Updated 20 January 2023

Our rating of this service improved. We rated it as good because:

• The service provided safe care and the ward environments were clean and well maintained. The wards usually had enough staff who assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Staff developed care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
• The service managed beds well so that a bed was always available to a person who would benefit from admission and patients were discharged promptly once their condition warranted this.
• The service was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

• The design and layout of Pippin ward meant that there were areas accessible to patients that were out of sight of the nurse’s station.
• The hospital had some nurse vacancies which meant that not all shifts on Pippin had the required 2 qualified nurses.
• Care plans were repetitive and sometimes difficult to follow due to the amount of information in them.
• One patient did not have clear care plans outlining the use of pro-re-nata (PRN) medication and use of intra-muscular administration of medications or rapid tranquilisation. PRN medications are medicines that are used when needed.

 Download full inspection report for Cygnet Appletree – PDF – (opens in new window)

Published 20 January 2023

On the whole I have had positive response to this facility but it is early days of course.

Elizabeth had just arrived and had not ventured out anywhere yet but no pressure was put on her by staff to explore her surroundings.

I shall be featuring in contrast treatment under the NHS and comparisons to private institutions in due course.

Still not had the care act assessment from Enfield. What on earth is going on about this. I need to chase this up.

I wonder what happened to the idea of Elizabeth pointing to a map to choose where she wanted to live.

When I asked how long Elizabeth would be at Cygnet I was told short term. I have directly asked Sarah Connery CEO in this respect. Durham looks a nice area and I have never visited there before but it is such a long way and this leads me to think it might be good if I were to get a job in this area and maybe a job in another area too where another relative is based. When I asked Cygnet how long the stay was they emphasised short term. The longer this stay goes on the more I will have to write about as it is obviously causing problems as I am carer to someone else too.

Today I spoke to Cygnet Appletree about visiting but I was told that it was unlikely to be granted so soon. I still have not got an email address to share information which might be helpful to them as nothing in the files seems to be very accurate and I have very accurate records.

It would seem I got it wrong about Enfield ICB paying for the facility of Cygnet Appletree so I am now assuming it is the ICB under LPFT of which John Turner is CEO. I will check on this and have written to them for confirmation. I am always interested to know how much such a facility costs per week. If only there was proper communication especially where carers are concerned when the person they care for is sent out of area there should be proper support in place and assistance in terms of travel expenses and you should just be able to resume your weekly visits as per before.

From: SEED, Daniel (NHS NORTH CENTRAL LONDON ICB – 93C)
Sent: 29 June 2023 15:09
To: susan bevis
Cc: MCKENZIE, Joy (NHS NORTH CENTRAL LONDON ICB – 93C); nclccg@nhs.net <nclccg@nhs.net>; ROBSON, Jon (NHS NORTH CENTRAL LONDON ICB – 93C); victoria@victoriaatkins.org.uk; Christopher Reid;
Subject: RE: Cygnet Appletree Durham

Good afternoon, Mrs Bevis,

Thank you for your email, and very sorry to hear that your daughter has been placed so far away from you.

I’m very sorry but we are not the commissioners of her current inpatient stay at Cygnet – I assume she has been transferred to Cygnet from her current inpatient stay in NHS Lincolnshire Foundation Trust.

I would advise it is best to speak to the NHS Trust in Lincolnshire to see if there is any way for you to reclaim costs – apologies I am unable to confirm if this would be possible though.

I have however located the below advise from NHS.uk which has further details on travel costs.

https://www.nhs.uk/nhs-services/help-with-health-costs/healthcare-travel-costs-scheme-htcs/

I hope this helps and, am hopeful that your daughter can be repatriated closer to home soon.

Kind regards

Daniel Seed

 
Head of Mental Health

Complex Individualised Commissioning

Chief Nursing Officer’s Directorate

NHS North Central London Integrated Care Board

Email: d.seed@nhs.net 

Team Email: nclccg.cicmh@nhs.net

Tel: MSTeams

Working hours: Monday – Friday 09:00 – 17:00

Web: nclhealthandcare.org.uk

From: susan bevis
Sent: Thursday, June 29, 2023 12:17 PM
To: SEED, Daniel (NHS NORTH CENTRAL LONDON ICB – 93C) <d.seed@nhs.net>
Cc: MCKENZIE, Joy (NHS NORTH CENTRAL LONDON ICB – 93C) <joy.mckenzie4@nhs.net>; nclccg@nhs.net <nclccg@nhs.net> <nclccg@nhs.net>; ROBSON, Jon (NHS NORTH CENTRAL LONDON ICB – 93C) <jon.robson1@nhs.net>; victoria@victoriaatkins.org.uk; Christopher Reid <Chris.Reid@parliament.uk>;
Subject: Cygnet Appletree Durham

This message originated from outside of NHSmail. Please do not click links or open attachments unless you recognise the sender and know the content is safe.

For the Attention of Daniel Seed and Joy McKenzie

Dear Mr Seed and Ms McKenzie

I have had a call from my daughter Elizabeth Bevis who is placed now at Cygnet Appletree in Durham.  As you can appreciate this is a 3.5 hour journey away for me to do and then another 3.5 hour journey back.  My daughter has asked me to visit her.  I have been visiting on a weekly basis so far.   I also have another relative in hospital 1.5 hours away from me but not sure if funding comes under Enfield or elsewhere.   Perhaps you can kindly confirm this.

In order that I can visit my daughter in Durham I would like to know the procedures for claiming back travel expenses and hotel accommodation in the case of Durham.

I am sure you will agree that Elizabeth has the right to a family life under Art 8 and she is asking to see me.  I was visiting on a weekly basis and since you have placed my daughter far away from home yet again I would like to know what measures you have in place for families like myself.

I tried to telephone your office today but was told you do not have phone numbers.  

I look forward to hearing from you the procedures to claim expenses since you are responsible for the funding and I have been guided to yourselves by Cygnet.

Yours sincerely

Susan Bevis    

DEPRIVAL OF CONTACT

“It is unlikely this will be permanent as there is case law preventing the exclusion of family but they will certainly want to exercise close control since rehabilitation involves far more intensive involvement between staff and patients.”

“The major problem is the loss of the NR status which means they do not have to communicate with you regarding Elizabeth’s care.  The MHA 1983 negates the medical provisions of any POA so you cannot invoke that.”

Elizabeth has not had her phone since 28 June and that was the last time she picked up WhatsApp messages yet staff say she has her phone and then contradict themselves by stating it is charging in the office. It has been obvious for some time now that contact has been deliberately denied and that contact should be via her phone which the family pay a contract for.

I did have a call from RC Dr Khalli Memon who promised a meeting to discuss contact with me. Today I have been through several members of staff until finally the ward manager namely Keeley who I had a lengthy conversation with and who promised to look into giving the phone to Elizabeth but despite promises nothing was done.

Here is the message I received:

“It is Elizabeth here. I am not doing well today please can you call me back” so I did. Had the phone put down on me by a member of staff then called back a second time and asked to speak to Elizabeth – the outcome I did not get to speak to her.

I have today phoned the Bed Management Team of LPFT whose Head of Services is namely Gareth Price who have sent my daughter so far away most probably with approval of the MDT of Ash Villa as a leading nurse said about me not having contact for six months from Ash Villa discussed with the NR who displaced me. It seems like this is the plan because the phone is not with Elizabeth that we pay a contract on. With the short three line letter from Bed Management is a lot of carer’s information.

“What is a carers assessment?” Never had one and Enfield have not carried one out. I thought Hannah Kajue from Enfield Community Rehab Team was supposed to be carrying out this assessment but nothing has been done.

The booklet goes on to list the Carer’s Charter and it is important that all carers read this charter. It is all too easy for professionals to disregard carers and treat them like they were invisible and play on confidentiality but I had the phone put down on me when I explained what information could be shared. “carers are encouraged to ask questions and time must be made available by the team to answer”

Professionals will involve carers in treatment plans and in major decisions about the service users care as far as they can.

There is a good practice checklist.

To go and visit Elizabeth needs a lot of planning and also the risk of a lengthy journey and stay overnight only to be refused a visit. I discussed this today with Ward Manager Keeley.