New unit at mental health hospital will reduce risk of injury to patients

The Redwoods Centre, in Shrewsbury, currently lacks the facility, meaning agitated patients have to be handled in “unsuitable” rooms where they can kick the doors open.

In a report for the Midlands Partnership Foundation NHS Trust board, Safety and Risk Management Head Duncan Kett writes that funding for the new, purpose-built seclusion unit has now been secured, and a planning application has been submitted to Shropshire Council.

Writing for the board in March, Mr Kett said the absence of the facility at the 112-bed mental health unit “creates a risk to staff safety”.

“Current seclusion and non-seclusion rooms are not suitable,” he said.

“The doors can be kicked open and staff do not have the ability to withdraw and this intensifies the risk to them and the patients and can raise the stimulation levels of patients being nursed in the rooms.

“This raises the potential for severe injury to patients and to staff.”

But, in his update for the board’s September 30 meeting, he writes: “Plans have been developed and approved with key care group leads and the scheme will progress to formal planning application and tender, with work anticipated to start in the autumn.

“Existing controls are maintained in place whilst the scheme is being progressed, from enhanced observations and bespoke care plans and controls for the delivery of seclusion in non-seclusion areas.”

Application documents submitted on the trust’s behalf describe Redwoods – which stands to the west of the Royal Shrewsbury Hospital site – as “a purpose-built inpatient facility for adults with acute mental health problems, dementia and rehabilitation needs”.

A design statement by Lancashire-based Gilling Dod Architects says the current system, where patients in need of de-escalation are taken off-ward, “has a number of negative effects, including: increased state of despair to the service user; increase safety risk to staff members whilst escorting to and from distant seclusion spaces; reduced staff numbers on the wards as a result of transfer off-ward; and Covid-19 -related safety issues”.

Mental Health Act guidelines require patients to be secluded in areas that are used for no other purpose, and the architect’s statement says they are typically “robust enough to withstand determined attack” and “away from the main patient areas and bedrooms” with a bed that “should not be moveable and should have padding which cannot be removed, is robust and easily cleaned”.

The planned single-storey Redwoods facility would be placed at the corner of the Oak and Laurel wards, in the southwest of the site. It would include a bedroom, lounge, bathroom and 20-square-metre fenced garden for the secluded patient, and a windowed observation room for staff.

Shropshire Council will decide on the application at a later date.