Friday, 18 May 2018

The Temporary Closure of The Phoenix Centre Eating Disorder Unit | MHAW18

Eating disorders aren't something that I have touched on within my posts simply because I don't have much experience surrounding Eating Disorders and I feel like sometimes it is best to stick to what you know however, Eating Disorders are a very common and serious Mental Health Condition and within the UK, it is believed that 1.25 million people suffers from an Eating Disorder and it is estimated that only 11% of them are male. One of the most common Eating Disorders is Anorexia Nervosa which has the highest mortality rate of any psychiatric disorder.

Over the past couple of years, I have seen many Psychiatric Inpatient Units being closed down but the Phoenix Centre in Cambridge really hit home. I know many different people who have been an inpatient at the Eating Disorder Unit, I have been inside to visit friends and it was also right next door to the Psychiatric Unit that I was an inpatient in.

The Phoenix Centre is based on the Ida Darwin hospital site in Cambridge which provides 14 Inpatient beds as well as day-patient and outreach specialist treatment for young people aged between 13-18 years old with complex Eating Disorders.


What shocked me the most about the closure of this unit is that the reason was due to a lack of qualified staff. According to Cambridgeshire & Peterborough NHS Foundation Trust and NHS England's Specialised Commissioning Team, the unit has had to shut as it would have problems providing 'a safe staffing level'.

The unit is only temporarily closed with the "intention to reopen in October when newly qualified staff will be available but in the mean time, teenagers with Eating Disorders who may have qualified for specialist help will have to be treated at home," according to Cambridge News. I understand how there is a safety concern surrounding a lack of workers but what about the poor individuals who are suffering from Eating Disorders but who now can't go into hospital where they'd get the treatment they require? What hope does that leave them? Especially considering that many admissions to hospital are of people who struggle to manage their illness at home and in the community.

At the time the decision was made to close the unit, there were only three young people on the unit, two were discharged and one was transferred to another unit. Were the two young people who got discharged actually ready to be discharged or was it due to lack of beds? Being transferred to another unit can be daunting to anybody, but when you're unwell and have gotten used to your surroundings, change can be even more difficult because in some aspects, you have to start again with meeting new people and getting used to your environment.

Like any Psychiatric or Eating Disorder based Inpatient Units, I have heard very mixed reviews of the Phoenix Centre, but I feel that this unit in particular has quite a high reputation. When CQC Inspected CPFT Eating Disorder Services in October 2015, they did not give an Overall rating as they only inspected part of the service. According to the CQC Inspection summery, they found that within the Phoenix Centre;

  • Parts of the ward couple not easily be seen. However, staff tried to mitigate and manage this by ensuring they were well positioned, enabling them to monitor and observe patients.
  • Most staff confirmed that they had received mandatory training and 24 of the 28 Staff members were up to date with their training.
  • Medicines were stored appropriately in the clinic room on both wards. Both clinic rooms were well stocked, clean and well equipped with resuscitation equipment and emergency drugs.
  • Physical health checks were completed at the point of admission and were comprehensive. Risk assessment and care plans were very detailed. They had been updated and reviewed. Care assessments had been completed and uploaded onto the electronic system.
  • All eating disorder services had good links with Addenbrooke’s Hospital for physical healthcare, including access to paediatrics for young people at the Phoenix Centre.
  • Patients told us that staff were kind, caring and supportive when they were experiencing difficulties. Patients were involved in their care and treatment and attended meetings to discuss decisions about their treatment and dietary plans. Patients told us that their families were involved too. On admission to the wards patients and families were given an admission pack which had information on treatments, patient rights and how to complain.
However,
  • The Phoenix Centre had difficulty when using bank or agency staff because of the special needs of the patients and the support required at meal times.
  • The Phoenix Centre only had two staff on duty at night and there was no evidence of a patient acuity tool being used to plan staffing levels.
  • At the Phoenix Centre we saw that capacity and consent had not been assessed and recorded on admission in line with the code of practice.
  • In order to maintain patients’ safety the Phoenix Centre, as a temporary measure, only admitted one patient per week. This was because of the staffing levels and the acuity of patients.
In regards to safe staffing, CQC "were provided with data that showed that the Phoenix Centre from November 2014 to April 2015 requested 133 shifts for registered nurses to be covered, 85% were covered by bank and 5% were covered by agency; 10% were unfilled. There were 142 requests for unregistered nurses; 84% were covered by bank, 5% were covered by agency and 11% were unfilled."

Other information that came from the CQC report includes how 'the Phoenix Centre reported difficulty when using bank staff due to the specialised needs of patients. The manager told us that if the bank or agency staff did not know how to support meal times the patients would not eat and this increased the risk to the patients. Staffing sickness figures for the Phoenix Centre showed that there were 3.9% and 3.3 days lost per month, staff shared sickness records that highlighted that four staff nurses were off on long term sick leave. It was discussed how the Phoenix Centre was running on two staff at night and breaks were not being taken. In the last six months, there had been 26 incidents of restraint at the Phoenix Centre, of which none were prone. It was noted on the files that the practice of 'safe holds' had been used to move patients when distressed or to reinsert feeding tubes and to 'hold a patient down' if required whilst their feed was completed. We were told this could be for up to 30 minutes. Staff said how they were only trained in safe holds and not full restraint. The Phoenix Centre had bed occupancy of more than 85% and over the past six months, the highest occupancy was 96% and the lowest was 82%. Records showed that there were a total of eight complaints made in the last 12 months across the Eating Disorder service. Two for the Phoenix Centre were still under investigation. Young people at the Phoenix Centre said they had raised complaints and felt that staff listened to them and their issues were resolved.'

Overall, it sounds that the care received within the Phoenix Centre was to a high standard with very few mistakes. It is such a shame that there is a shortage of staff and that the unit has been closed for the safety of its patients, because it appears that this particular unit was a very promising and beneficial service for young people struggling with an eating disorder. 

I have spoken to a few people that I know who have previously been an inpatient at the Phoenix Centre to see what they have had to say, Stacey, who has her own blog which can be found here explained how "I'm a bit heartbroken that it's come to the temporary closure. This unit saved my life on two occasions. The staff and support I got there was second to none and I met some of the greatest people in there. It's hard, not only because of what that place means to me, but to the others who are in need of a bed. I have no doubt in my mind that when they reopen again in October, that the care and service they provide will continue to be incredible. It just really hits home when it's something close to your heart."

Sophie says how "I was in the Phoenix in 2012 for six months, it really helped me being in there, and the fact that it was so close to home made it easier for me to recover because I knew my family were close and now it's closing despite being the only eating disorder unit within miles which can be so detrimental to young people's lives and can effect their recovery. That place saved my life and it is so sad to see it close."


"That place was amazing when I was there, it taught me so much and although it took a lot more time and professionals to recover, it definitely helped me. I'm worried for the people who need a bed as that is one of the few specialised eating disorder units for adolescents and it angers me that the government decides to close everywhere. I'm scared that people aren't getting the help they need and the situation is getting worse. Now that I work in services, I have seen it from both sides and neither is pretty, the whole system is in shambles and things like this just further reduce my hope that mental health is being taking seriously by commissioners, the Phoenix will always hold a special place for me, I have lots of memories with lots of people there" says Chloe, a former inpatient.

Another former patient Sky explained how "I am not sure whether they are closing down permanently or whether it's just for refurbishment but to be honest I don't think they really know either as it was on such short notice! I was supposed to do a family day this summer and now they won't even be open! I feel awful for all of the people who needs those beds and all the staff who need those jobs! Honestly I don't believe I would have learned to manage as fast as I have, had I gone to another unit! It's one of the best."

It seems that many people, especially former patients are devastated about the closure, but hopefully the unit will reopen in October when newly qualified staff are available, what are your thoughts?

Thank-you for reading, Tay x

Sources:
BEAT Eating Disorder Statistics
CPFT - The Phoenix Centre
Cambridge News Article
CQC Inspection Summery - CPFT Eating Disorder Services
CQC Inspection Report - CPFT Eating Disorder Service Findings

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