We recognise that discharge from hospital can be a vulnerable time for individuals suffering from eating disorders, in light of this we endeavour to prepare for discharge from the point of admission.
In order to properly prepare for a safe discharge we recommend that anyone involved in care and treatment is included in the discussions for discharge.
We recognise the important role family, carers and friends play in supporting the recovery of patients with eating disorders as such we provide opportunities for family and friends to participate in treatment and leisure activities from the ward; including self-catering, meal planning and support for snacks and meals out. We invite families to avail of Family therapy, Occupational Therapy and Nursing joint meetings to discuss concerns and troubleshoot. We also work on the basis of increasing periods of home leave in order for both the patient and family to test out different strategies to support recovery.
We encourage family, friends and Carers to avail of the Carers skills groups and Carers support groups that are available within the service. These services are provided by skilled clinicians within the service and include the use of evidence based research and care to provide valuable support and skills in caring for a loved one with an eating disorder. At times patients may not provide permission for staff to share specific information on their care to their carers , we of course respect the confidentiality of our patients however there may be incidents of high risk/concern whereby carers, specifically next of kin need to be contacted.
We are always be able to share the ethos and expectations of the treatment program and provide general advise to all.
We use the Care Programme Approach (CPA) format to make sure that an appropriate after care package is in place and that inpatient and day patient care prepares patients and their families as effectively as possible for the level of after care available. We tailor the timing and frequency of CPA review meetings to individual need, but typically, this will involve at least one review in the first six weeks of admission, and another close to the point of discharge. We aim to facilitate attendance of local services, families and others in the support network whenever possible, making use of remote access through teleconferencing when necessary.
The service can offer further treatment in the day patient and outpatient setting following discharge from inpatient or day-patient care when appropriate (depending on feasibility of travel and availability of funding for further treatment). When appropriate, necessary and agreed with local services, we can provide ongoing Responsible Clinician (RC) role for patients treated under a Community Treatment Order (CTO) following discharge. In these circumstances, funding is required for monthly outpatient review with the RC; agreement for funding for Tribunal and Manager’s hearing work as required; and funding agreement for a minimum of two weeks' readmission to hospital if recall is required. Further funding for admission will be negotiated and agreed after the initial assessment following recall to hospital is completed.
Following discharge, we provide:
- Follow up within seven days of discharge from a member of the team to check in
- A discharge summary and CPA care plan
- Clinical support to the local team: typically, monthly phone contact with a lead professional for a period of months equal to the duration of inpatient and day patient treatment with the service (up to six months)
- Ongoing access to the Carers' Support Group for up to three months
- Access to the Carer Skills Workshop, if not already completed
The day patient treatment programme functions as an intensive outpatient treatment; we can support 12 day patients at one time. It can be as a step up from outpatient sessions or a step down from inpatient care.
The day programme is integrated into our inpatient setting and allows people to attend between one and seven days between 8am and 7pm depending on their specific needs. This allows us to offer flexibility and least restrictive form of treatment for people with an eating disorder. Each individual will have a graded timetable for attendance and the multidisciplinary team will provide nutritional, medical, psychological, occupational and social components of care through a combination of individual, group and family work with an emphasis upon community care and rehabilitation. The length of treatment varies dependant on the individual’s treatment goals.
We offer a two week assessment on admission, this allows us to explore and support the individual on whether this is the right intensity of treatment. We accept referral from males and females from the age of 17.5 years and over.
The Therapeutic Group Programme is group based therapy and is an integral part of eating disorder treatment we offer at Vincent Square. It is designed to target and support the individual to develop new strategies around the factors which maintain the eating disorder. The therapeutic group programme is available to both inpatients and day patients seven days a week and is led from a multidisciplinary approach.
Following multidisciplinary assessment each individual will have a staged programme of groups, which is developed and reviewed during the course of their admission in collaboration with their Keyworker and Occupational Therapist.
Individuals engaging in the timetable are encouraged to take an active role in reviewing the groups, to make sure it is diverse and is meeting the core needs of the patient group.