Description of Placement
Inpatient work is based on an 8 bedded ward (Marshaw) providing rehabilitation to women with complex disorders. Women needing a more acute approach/assessment are admitted to a second Ward, Elmridge. Care pathways from Marshaw link to the non-secure Cottages in the grounds of Guild Park, back into the patient’s local district rehabilitation service or into local partnership projects in the community as part of the Enhanced CPA process. There is a weekly multi-disciplinary team meeting and 6 monthly Effective Care Coordination meeting with the patient at the centre of the process (supported by an advocate if they wish). Care planning involves structured assessment, prioritisation of strengths and needs with risk management balanced by therapeutic risk taking. A full range of psychological treatments and rehabilitation activities are available within the secure site. There is also the opportunity to assess referred women in prison, high security or in secondary services. A range of other special interest options are available at Guild Lodge (forensic special interests) or within district services (Assertive Outreach as a special interest or psychotherapy).

The role of the trainee
The trainee will work under supervision as part of the multi-disciplinary teams on Marshaw and Elmridge ward with involvement in structured assessment, risk management and care planning. The trainee will also be expected to participate in the review of rehabilitation services across Lancashire. The aim is to identify gaps and to plan new recovery services. The trainee will also be involved in the assessment of Lancashire women in prison who may need inpatient diversion. Finally, the trainee will be involved in the pan regional forensic on-call rota which is currently 1 in 7.

Details of multidisciplinary team
There is a full multidisciplinary team structure within the inpatient services. Dr Lorna Jellicoe-Jones leads the forensic clinical psychological service. There is a well-resourced occupational therapy department and two dedicated OT’s working across Marshaw and Elmridge. There is full nursing establishment with a Modern Matron providing support to two G grade Ward Managers and 4 F grade Staff Nurses. The Women’s Service has a dedicated Staff Grade Psychiatrist with cross-cover from 4 other Staff Grade posts and 1 SHO post. One or two forensic SpR’s are generally attached to Guild Lodge Secure Services.

Comments from the current SpR
In my opinion this is an excellent opportunity for a Rehabilitation SpR to learn not only about rehabilitation but also gain experience in Forensic Psychiatry. Amongst the many attracting points about this job is the high quality of the supervision and excellent support which you will receive from Dr Davenport. I would highly recommend this post to my colleagues.

Opportunities for teaching
There are many opportunities for teaching medical students with the recent intake of 4th year medical students to Lancashire Care Trust. There are also opportunities to participate in the in-service training and to provide training on medical psychiatric perspectives to the multi-disciplinary team at Guild Lodge Medium Secure Services.

Safety Considerations
The new unit conforms to modern Medium Security criteria with the provision of personal pinpoint alarms for all personnel. High levels of relational security are provided on site to manage the risk of violence in the inpatient setting. There is a safe visiting policy for professionals working in district services and the facilities conform to College requirements for training status for SHO and SpR. The trainee is expected to have participated in the yearly breakaway programme and will be provided with a personal alarm and mobile phone as required. There is also a general induction to SpR’s working within the forensic setting on a regular basis at Ashworth Hospital. Local induction is organised by Dr Simon Plunkett, Lead Consultant for Forensic Services for the Guild Lodge site.

Core Placement: No. Specialist placement leading to an endorsement in rehabilitation.