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Hafan Y Coed Wards
Ash: Neuropsychiatry (Acquired Brain Injury)
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The client group are aged between seventeen and sixty-five years of age and are individuals
with moderate to severe cognitive, behavioural and emotional difficulties rising from
Acquired Brain injury.
An Acquired Brain Injury can occur from many possible causes including a fall, a road
accident or a stroke. It is always an injury caused to the brain since birth.
This ward specialise in the assessment and management of neuropsychiatric complications
following an Acquired Brain Injury including:
· Psychosis
· Emotional difficulties
· Personality change
· Psychological complication
· Challenging and impulsive behaviour
· Post traumatic and complex epilepsy
The ward has capacity for 2 female patients and 9 male patients. This gender difference is a
reflection of the fact that males, especially young males, are at a far higher risk of brain
injury than females.
The duration of stay for each patient is varied and therefore discharge plans are
continuously assessed by the multi-disciplinary team.
Patients on this ward will display disinhibited behaviours due to the area of the brain which
is damaged. This may include swearing and being sexually inappropriate. If you feel
uncomfortable at any point gentle remind the patient that their behaviour is not
appropriate. If this continues remove yourself and speak to a staff member.
Patients on this ward can also display physically challenging behaviour. At times this may
require physical interventions from staff. Please do not be alarmed as the ward is heavily
staff and all staff are trained to restrain in a safe and humane way. If this was to happen
either remove yourself from the area if required or continue with the activity and reassure
worried patients.
Hazel: Supported Recovery Service
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The Hazel ward provides high dependency rehabilitations for the patients. The purpose of
specialist rehabilitation services is to deliver effective rehabilitation and recovery to people
whose needs cannot be met by less intensive mainstream adult mental health services.
The focus is on the treatment and care of persons with complex and challenging enduring
mental health needs. The patients are likely to have a history of previous frequent
admissions or substantial service intervention.
The aim is to promote personal recovery, to regain confidence and skills in everyday
activities, a process which can take months or even years. The length of admission is
expected to be 1 to 3 years. Eventually, patients will follow a pathway of care to other
rehabilitation facilities or community placements, e.g. Park Road.
Patients are given the opportunity to develop skills needed to help move on and prepare for
discharge. These skills could be practical things such as how to plan, shop and cook, or it
could be about developing confidence again. The staff help to structure an individual's day
which helps with their overall wellbeing – you’re visits will be part of this structure.
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It is a relaxed environment, where people are friendly and supportive.
Your role: facilitate activities to encourage and develop the patients’ skill set. You will create
a poster prior to your session advertising the activity you will be facilitating. You are
responsible for ensuring you have the correct resources. Speak to your project coordinator
regarding budget and equipment in the office you can use.
Cedar: Crisis Assessment
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The aim of the Crisis Assessment Ward is for a multi-disciplinary team to provide timely
assessment, treatment and formulation of a Care and Treatment Plan in support of a brief
inpatient stay, or if necessary, a transfer to one of the Locality Wards (Willow, Beech or
Oak).
A patients’ hospital is based on the location of their registered GP. Therefore all patients
with mental health conditions aged 18-65 who require hospital admission within Cardiff and
The Vale of Glamorgan will get admitted to the Crisis Assessment Ward at Hafan Y Coed. The
only patients that will not get admitted to the Cedar ward are those who are open to
forensic mental health service or those whose risks suggest they may be more suitable
admitted to the Psychiatric Intensive Care Unit (PICU) which is the Alder ward.
Patients are admitted to Cedar ward for a period of up to a maximum of 14 days for a
comprehensive assessment. By the end of the assessment the multidisciplinary team will
decide if the patient has a mental health condition which requires treatment, and if so
where this the treatment will take place.
If a patient requires a longer hospital admission for treatment they will be transferred to
their locality or treatment ward for ongoing inpatient treatment. The location of their
treatment wards are determined by their registered GP.
The patients admitted to Cedar may have already been diagnosed as having a severe mental
health condition (e.g. schizophrenia & bipolar disorder) or may be having their first episode
of a diagnosable mental health conditions.
A mental health crises include: suicidal behaviour or intention, panic attacks/extreme
anxiety, psychotic episodes (loss of sense of reality, hallucinations, hearing voices) and other
behaviours that may seem out of control or irrational and that might endanger others. These
types of situations can also be described as ‘acute’ and require access to ‘acute’ services.
Patients are at their most vulnerable on this ward and as such the staff ratio is higher than
other wards. Please take this is account.
Locality wards - Acute Admission
These wards provide a safe, supportive environment for the assessment of individual need, and the
planning and delivery of treatment to facilitate recovery and successful discharge into the
community. Care is centred on achieving a therapeutic relationship.
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When individuals are admitted to an in-patient setting, they are allocated a ward based on
the area of their GP. This helps the NHS re-locate them back into the community as swiftly
and safely as possible. Unfortunately there are occasions where patients are admitted to
wards where there is a bed available, but it may not be the ward that covers the area of
their GP.
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The wards provide a 24 hour, 7 day a week service. They are staffed by a multi-disciplinary
team offering support, care and treatment for individuals who cannot be safely and
effectively treated at home.
Acute services are for people experiencing severe symptoms of psychosis. The word
psychosis describes a set of symptoms that include delusions (believing something that is
unlikely to be true e.g. that a group of unknown people are conspiring to hurt them)
hallucinations (e.g. hearing voices) and confused and disturbed thinking. When people
experience these symptoms, mental health professionals define this as a psychotic episode.
Psychotic episodes can vary in length - they can last for a few days; they can continue
indefinitely until they are treated; they can come and go.
Psychosis is a symptom of schizophrenia, bipolar disorder and schizoaffective disorder. It can
also be a symptom of dementia, some forms of personality disorder and Parkinson’s disease.
People who abuse drugs and alcohol sometimes experience symptoms of psychosis, and
psychosis can occur as a side effect of some types of medication. Psychotic experiences can
be triggered by severe stress or anxiety, severe depression or sleep deprivation. Bear in
mind that people experiencing psychosis are often unaware that they are unwell.
It can be difficult at times on these wards as the patients are at a difficult stage of their
condition. Often patients have come straight from the crisis ward so they can still be very
unwell. You will observe a range of severities on these wards.
You will act the same on this ward as you would on any of the others, this information is just
so you’re aware of the differences and the type of conditions the patients might have.
Patients on Acute wards can be voluntary (informal), or are detained under the Mental
Health Act (formal).
Your role: facilitate activities to encourage and develop the patients’ skill set. You will create
a poster prior to your session advertising the activity you will be facilitating. You are
responsible for ensuring you have the correct resources. Speak to your project coordinator
regarding budget and equipment in the office you can use.
Oak: Locality Acute Admission
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This ward takes patients who are aligned to the Eastern Vale of Glamorgan Crisis Team
which covers Barry and Penarth.
The patient population tend to have mental health conditions comorbid with drug and
alcohol problems.
Beech: Locality Acute Admission
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This ward takes patients who are aligned to the South West Crisis Team which covers Cardiff
Bay, Grangetown and Riverside area.
The patient population is of a very different cultural background, most commonly Somali.
Willow: Locality Acute Admission
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This ward takes patients who are aligned to the North Crisis Team which covers areas such
as Whitchurch, Rhiwbina, Thornhill and the Heath.
The patient population is a mixed gender ward. Patients are experiencing varying levels of
psychosis.
Low Secure Wards
Elm: Forensic Psychiatry and Maple: Forensic Rehabilitation
This service is specifically designed to meet the needs of service users who have committed a serious
crime or are at risk of harm to others. Service users are admitted from medium secure hospitals,
local psychiatric hospitals, prisons and the courts.
 There are three levels of security within forensic units – high, medium and low. There are
three high secure hospitals – Ashworth, Broadmoor and Rampton. People referred to one of
these hospitals are detained under mental health legislation because they are thought to
pose a ‘grave and immediate danger to the public.’ Each of these hospitals is part of an NHS
Trust. Medium secure hospitals/units are for people who are detained under mental health
legislation and pose a serious danger to the public. They are run by either the NHS or private
healthcare organisations. There are special women-only medium secure forensic units. Most
people transferred from court or prison are initially sent to medium or high secure units.
Low secure units are run by either the NHS or private healthcare organisations. These are
mostly used for patients detained under mental health legislation as an involuntary
patient, or for people who have already spent time in a medium secure unit. Voluntary
patients are sometimes admitted to low secure units.
 Elm and Maple wards provide service provision at a low secure level in conjunction with
other criminal justice agencies. Treatment is flexible and aims attend psychological and
social needs, whilst maximising patient’s abilities to function safely within the community.
 Due to our policy, only volunteers over the aged of 21 or have a great deal of experience can
volunteer on the forensic wards. These wards are well managed, and staff keep a close eye
on you. All the same, be prepared for some intimidating and verbally aggressive behaviour.
As a precaution, staff will provide you with an attack alarm upon arrival. If they don’t, ask for
one. Don’t build these wards up in your head as scary places, they’re not! They are low
secure so challenging behaviours are at a minimum.
 Sometimes the patients will have 2 to 1 observations which means one member of staff will
always be with that individual due to their challenging behaviour. This can affect the safety
and busyness of the ward so SVC staff will check weekly the state of the forensic wards (the
day of the session) to confirm it’s ok for volunteers to go and I will be in touch if volunteers
weren’t able to attend a session.
 Patients may first of all be admitted to Elm and progress to Maple as their mental health
condition becomes more stable. Maple has a built in flat available for two patients who are
working towards discharge. The self-contained flat also includes cooking facilities. Patients
may go between wards depending on their condition.
 Your role: facilitate activities to encourage and develop the patients’ skill set. You will create
a poster prior to your session advertising the activity you will be facilitating. You are
responsible for ensuring you have the correct resources. Speak to your project coordinator
regarding budget and equipment in the office you can use. On Elm there is a cinema room
which could be used for a session.
All Wards
There can be challenging behaviours both verbal and physical on all wards and this is due to the
patients’ conditions. It is best to expect different kinds of challenging behaviours like swearing,
insulting phrases. This doesn’t always happen but it is best to prepare yourself just encase. If this
were to happen then you should remove yourself from the situation by making an excuse like you
need the toilet or a drink of water, and tell a member of staff so they’re aware.
Most patients can communicate well if they are willing to. However, often their conditions are
chronic and they have been in the hospital environment for a long time and so might be frustrated
with this. Patients can apply for leave from the hospital and are granted it by Psychiatrists
dependent on their care plan.
Wards can vary in business as it depends on patients and their day to day behaviours. Before
entering the ward you will go into an ‘air locker’ and will be greeted by staff. You should always
introduce yourself to staff and ask who can or can’t join your activity. Staff may want to check the
resources you are bringing onto the ward.
Don’t be alarmed if you see someone being restrained on any of the wards as this is ok and the staff
do this in the most humane way. If this were to happen you should remove yourselves from
situation and area and let the staff do their job. You can continue doing whatever you were doing
with patients and try to reassure other patients if they’re worried. Staff are always around on every
ward and will be able to help you with any problems. If you did have any problems you should
always tell staff, the lead volunteers and your project coordinator at SVC (Charlotte Watson).