Specialities
	Services for Older People
	Where people matter A unique specialist service is available at St Andrew’s for older people with mental health problems who require assessment and management in secure conditions. This service comprises two secure units for older men and care pathways that include a mixed gender ward for people with dementia, a mixed gender open rehabilitation ward and locked ward for those requiring high physical nursing needs. The service is primarily available to those over the age of 60 although younger people who would benefit will also be considered on an individual basis. Direct admission to any of these services is determined by the clinical team following receipt of a clinical referral and an assessment of clinical need and suitability. The knowledge and experience of our comprehensive multi-disciplinary teams mean that the needs of individuals with challenging behaviour who require a secure environment can be met. The Care Programme Approach/Single Assessment Process enables co-ordinated and effective management of symptoms and risk. This is part of the team’s collective aim to maintain the best possible quality of life for our service users and, where possible, to reduce risk enabling a move to lower security. An important feature of this service is its range of care pathways. Many service users progress from the secure service through to the open rehabilitation unit and are then able to return back to the community in their home area. Alternatively, some may need to remain in the Hospital and care is focussed on maintaining quality of life in a homely (but secure) environment. Those who become frailer can move to the ward that specialises in providing high quality care for individuals who require higher levels of physical and palliative care. Secure Service for Older Men Foster Unit is an assessment, treatment and rehabilitation forensic unit for older men (60+) with mental disorder who have committed or are suspected of having committed serious offences. Service users typically have psychotic illness and/or personality disorders but little or no cognitive impairment. O’Connell Unit is an assessment, treatment and rehabilitation unit for older men (60+) with mental disorder who may have some cognitive impairment and a history of challenging or offending behaviour. Integrated Care Pathways Althorp Ward is a mixed gender service in an open ward that allows service users to develop their skills and to live as independently as possible Compton Ward is a mixed gender service for older people who require high physical nursing input in addition to their mental health needs Secure Service for Dementia and Challenging Behaviour Rambaut Ward is a mixed gender service for older people with advanced cognitive impairment and challenging behaviour Secure Service for Older Women It is possible to meet the needs of older women on any of the above mixed gender wards. However it is recognised that there is a need to develop appropriate services for older women with challenging behaviour and it is planned that this new service will be available in early 2008. Further details will be posted on the website in due course. Environment and Facilities Bright, spacious and attractive accommodation with appropriate furniture and equipment is situated at ground and first floor level with access to safe gardens. Beyond that there are the impressive grounds of St Andrew’s and other leisure and recreational facilities including a swimming pool, Jacuzzi and gymnasium. Treatment Approach The ethos of the service is person-centred. The aim is to provide treatment that is structured, respectful and caring within a safe environment. Care is delivered by highly trained and experienced nursing staff and other members of the extensive multi-disciplinary team. A comprehensive and holistic assessment of each individual’s mental and physical health is undertaken. This includes a thorough assessment of risk comprising behavioural risks, forensic risks, mental health risks as well as those risks that are particularly relevant to the older person, such as falls, exploitation, abuse and nutritional problems. For those who have committed offences this will include a thorough assessment of their forensic risk. There is a commitment to maintaining and supporting contact between service users and their families where this is appropriate. The dedicated Social Workers are responsible for liaising with relatives to ensure that they are involved fully and that their needs are also taken into account. Individual service user progress and outcome is assessed and monitored by a range of validated measures specific to the particular service and service user need. In those units that have a number of people with dementia, Dementia Care Mapping is used both to ensure positive interactions between staff and service users and to provide feedback to staff. There is an active research and training programme and we maintain professional contacts with other workers in the field. Enquiries For general information please contact us by telephone or email. Freephone enquiries on 0800 434 6690 or email enquiries@standrew.co.uk For more specific information about this service and referrals, please contact the Operational Manager on 01604 616095 or email townsend@standrew.co.uk Art work is courtesy of St Andrew's Healthcare service users