We believe strongly in the benefits of a multi-disciplinary approach to care which includes our clinical and management teams.
Our clinical teams are made up doctors, nurses, psychologists, occupational therapists, social workers, pharmacists, physiotherapists, sports therapists and educators. We also have involvement from chaplaincy, advocacy and carers workers.
Working closely together, they ensure that we offer the right interventions at the right time, with a personalised care plan centred around a person's individual needs and goals.
Everything we do is aimed at improving and maintaining mental and physical wellbeing and encouraging empowerment and involvement so that people can be assisted in their recovery and in making a positive contribution to society.
We also work very closely with carers, families and friends. We are committed to forming real partnerships and provide opportunities for carers to share their experiences and to get involved in helping us to develop and improve the services we offer.
The medical staff at Langdon are organised into teams. Each team is led by a consultant psychiatrist but has many other members.
Some of these are known as speciality doctors, who are experienced doctors but not in training. Other members of the team are training to be consultant psychiatrists and are either core trainees, who are junior trainees, or speciality registrars, who are nearing their appointment as consultants.
Consultant psychiatrists are medical doctors who have completed their medical training and then decided to specialise in psychiatry. Forensic psychiatry is the branch that deals with mentally disordered offenders or those with similar needs, most of whom have come into contact with the courts of law or the prison service.
Patients are likely to see different members of their medical team on a day-to-day basis. They can ask to see a member of the medical team by speaking to their Primary Nurse or another member of staff. A General Practitioner also visits the site weekly to help meet physical health needs.
Psychiatrists work closely with other members of the multidisciplinary team and the most important part of care is provided by the team as a whole.
Nursing at Langdon is very much focused on empowering people, helping them to achieve their potential and recovering and maintaining their independence. Nursing care is always based upon relevant clinical evidence and our nurses will provide advice and support about physical health and wellbeing as well as mental health issues.
Nurses are employed in a number of different roles at Langdon to support people’s recovery and to involve their carers and families in the process. Our Registered Mental Nurses (RMNs) and Registered Learning Disability Nurses (RNLDs) are trained specialists and they are assisted by a team of support workers. All of our nurses work closely with professionals in other fields, including doctors, psychologists, occupational therapists and social workers.
When someone is admitted to Langdon Hospital, a Primary Nurse will be allocated to work closely with them, as well as a named support worker. They are encouraged to talk through their concerns, problems, needs and goals. Their care, support and treatment will then be planned and agreed with them and other professionals.
Clinical psychologists are trained to understand why people think, feel and behave in ways that may cause them difficulties. They use this training to help people understand themselves and to change. They do this mainly through talking with people about their difficulties, although they may also give them homework or ask them to do practical exercises.
There is a clinical psychologist in every multidisciplinary team. They attend the regular meetings to review care and treatment and have an important input into making decisions.
Psychologists may offer to meet with patients to offer them an assessment, or patients may ask to see them if they think it will be of help. During an assessment, a psychologist will talk with someone to find out about their life before the admission to hospital, the reasons for their admission, any difficulties or problems they feel they may have and goals that they would like to work towards. They may also ask for questionnaires to be completed or do tests. Once they have finished the assessment, they will usually discuss their evaluation and talk through
what kind of work can be done to help move forwards. They will usually write a report for the consultant psychiatrist concerned. The work done with a psychologist will depend on what has been discussed in the assessment and what people feel comfortable with. An agreement will be made about when to meet, for how long and whether there should be a fixed number of sessions or ongoing meetings until it is felt that the time is right to stop. Generally, a psychologist will ask about thoughts and feelings, and help look for patterns in thinking and behaviour. They may also suggest strategies to help cope with thoughts and feelings that people find difficult or upsetting.
Psychologists can work with people to help address many different issues. These include:
Occupational therapy is a process that encourages the ‘doing’ side of our lives and uses activity to help people get the most out of life and make changes in the way they feel about themselves and how they get on with others. The team consists of occupational therapists, physiotherpaists and sports therapists. They work closely with doctors, nurses, psychologists, physiotherapists, social workers, education tutors and others. The team also provides a vocational rehabilitation service, which focuses specifically on work skills and activities. Members of the team meet with people who use the service and work with them to explore their strengths, needs, interests and priorities.
Together, they create a treatment plan that aims to address these issues and build on existing skills. A number of sessions are usually offered and these may be as individuals or as part of a group, depending on need. Different people will be involved in different activities depending on what areas of their life they want to concentrate on.
The activities may include relaxation skills training, social and creative sessions, independent living skills training and community activities. Work skills include computing, shop work and picture framing. Sessions can be aimed at encouraging people to get along with others and gaining a better understanding of their own behaviour. The team also helps run various ‘closed’ groups. These include anger and anxiety management sessions, drug and alcohol groups, social skills training, personal relationships groups and problem solving sessions. These offer structure and give a sense of responsibility. They encourage people to set their own goals in order to increase motivation.
They help people regain confidence in their own abilities, live more independently and move towards recovery and discharge from hospital.
Our Medicines Optimisation Team at Langdon includes technicians, pharmacists and a Clozapine support worker.
They work to ensure that medication at Langdon Hospital is safe and effective, but also appropriate for the correct person, at the correct time. They promote safe and effective prescribing by working closely with medical colleagues and where possible offer expert advise following evidence based prescribing guidelines. They also promote a shared decision making approach so that patients and healthcare professionals work together with a common goal of identifying the most appropriate treatment for each person.
The team also deliver training to a range of professions and patients within the hospital, ranging from basic awareness of medications and how to find quality sources of information, to specific training around certain types of medications and how they work.
They aim to learn from things that go well, and also the things that could be done better, so that they are constantly improving their service around the management of medication.
Our forensic social workers are an important part of our multidisciplinary teams. They play an active role in maintaining contact with friends, family and local agencies on behalf of our patients and are also closely involved in making onward plans and arrangements for people when they are ready to be discharged from Langdon.
All people using the service have a nominated social worker, who plays an active part in promoting their best interests. They work closely with medical and other staff at the hospital, as well as with external agencies. Social workers have a key role to play in helping Mental Health Tribunals and others to decide whether or not people should continue to be detained under the Mental Health Act.
Where appropriate, they will liaise with family members and others about the care and treatment people are receiving in hospital. Social workers also have a role in advising clinical teams on matters relating to Child Protection. This includes the evaluation of requests made to visit, or receive visits, from family or friends who are under the age of 18.
People using our service can ask their Primary Nurse or any other member of staff to get in touch with members of the social care team, at any time.
Our Chaplain provides religious, spiritual and ‘pastoral’ support to people who use our service, carers, family members and staff. Their work is not confined to those people with a religious or spiritual belief, nor is it restricted to any particular religious denomination. Our Chaplain can help to put people in touch with representatives of other faiths.
The work of the Chaplain can vary depending on the nature of the help and support that is sought. In some cases, it may be something as simple as someone wanting to attend a church or other religious service. More
generally, a good deal of the Chaplain’s time is spent listening to people, hearing about what is worrying them and talking about the issues in their lives. Sometimes, conversations can have a spiritual or religious
basis and, in other cases, the Chaplain is simply a supportive listener.
The Chaplain tries to spend a little time with all newcomers to the hospital soon after their arrival. They will try to get to know people a little better to find out if and how they can support them. Some people just want someone to talk to who won’t judge what they say. Others may want religious services, private prayers or Communion, or to have an anniversary marked. An agreement is made as to how much information, if any, is written down and a simple ‘spiritual needs’ form is placed in people’s notes. All conversations with the Chaplain remain confidential unless express permission is given to share information with others.
The only exception to this is in extreme circumstances where someone may be putting themselves or others at risk of serious harm.
People using our service have a right to be represented by an advocate - someone to support them, represent their interests and speak on their behalf.
Advocates can provide help and advice throughout someone’s stay at the hospital, participating in care review meetings, liaising with the multidisciplinary team, playing a role in mediation, providing guidance and information and generally helping people to express their views and resolve their concerns. Information about how to contact an advocate is available on all wards or by speaking to a member of our team.