Gardening

Gardening

Introduction

The Friends has a long history of assisting and supporting the important role that gardens play in aiding patients’ recovery and providing a peaceful environment for the ward staff. Set out below are descriptions of some recent projects in which the Friends have played a role as well as a brief history of earlier involvement.

Denbigh Ward – digging your scene

The following is a CPFT press release from February 2018 when the staff of Denbigh ward were preparing to unveil their new-look gardens following a huge makeover.
The gardens at Denbigh Ward at Fulbourn Hospital, Cambridge, are being transformed thanks to donations from businesses and local charity Friends of Fulbourn.

In the grounds of the 14-bed older people’s ward will be a cottage garden for patients and staff to enjoy, a sensory garden with wind chimes and plants that stimulate the senses, and a kitchen garden with raised beds where patients will be able grow salads, herbs, fruits and vegetables.
Work to landscape the gardens and smooth the pathways began in January and planting is now underway ahead of the grand opening which will take place on Sunday, 25 February when a special lunch will be put on for patients and their friends and family.

TOOLED UP Denbigh Ward Manager Sue Richardson and Modern Matron Ramesh Subbiah

Modern Matron Ramesh Subbiah, pictured about with Ward Manager Sue Richardson said: “We wanted to give the gardens at Denbigh Ward a makeover – and we’re delighted with how they are coming together. It’s all hands to the pump now to ensure they are ready for the big day.
 “Lots of people have helped us get this far, particularly the Friends of Fulbourn, along with many other local businesses who have donated plants, flowers, bird boxes and other lovely things.

“When they are complete they are going to be a massive benefit both for the patients and for the staff who work on the ward.”

Sue added: “The gardens at the ward are really important to the care we give to patients. They provide a relaxing open space and can be hugely beneficial in helping staff and families to interact with patients where they can plant vegetables or just enjoy the many sights, smells and sounds the gardens will contain.”

Denbigh Ward is a purpose-built assessment unit for people with dementia.

Springbank Ward – a sensory/mindfulness garden

The Friends made a donation in 2019 to help transform the garden in Springbank into a sensory/mindfulness garden that can be enjoyed by patients and staff. Karen Hogan, the ward’s Occupational Therapist,  reports as follows on how the have progressed so far:

We wanted to make the garden a peaceful space that everyone on the ward can go to and explore calming sensory plants and engage in mindfulness practices. The garden at Springbank was quite neglected before the work started and rarely used unless in hot weather.  Here are a few pictures of the garden before the work was started.

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AFTER

Paul Herrington from Grow Places kindly worked with us to create a planting plan and we have nearly finished the first stage.  In addition to plants and flowers we have left an area to grow fruits and vegetables.  We had a successful crop of tomatoes this year and are hoping to grow a wider variety in the Spring.

We have plants some strong smelling herbs in our newly painted raised beds and part of our focus next year will be developing these beds further to include a variety of plants that appeal to all the senses.

Another aim for next year is to add peaceful places to sit and other sensory inputs such as wind chimes, mosaics and lights.

One final highlight from the garden has been the opportunity to work with Sandie Cain from the Botanic Garden in Cambridge, we were lucky to go to a training course on basic horticulture skills and Sandie also visited our garden to see how we were doing and offer advice.  Sandie has agreed to return next year to continue to support us.  We got a lot of great ideas from visiting her schools garden at the Botanics.

Here are a few pictures of the garden during the development.  We look forward to updating you in the Spring 2020 when the garden is completed.

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On the next sunny day I will take a few more photos so you can see exactly what the garden looks like now.

Willow Ward – facilitating recovery service award development project

Hannah Lilly, the ward’s Occupational Therapist, explains how the development of the ward courtyard space has provided a significant improvement to the ward environment and an opportunity to support patient recovery through engagement in meaningful occupations
Willow ward is an acute unit for older people with functional mental health difficulties, such as depression, anxiety and psychosis. Over the last year, we have been developing a small, overgrown and unusable courtyard garden in the centre of the ward. We wanted to create a calming space with planting and art work, and with this vision in mind our goal was to enable our patients to participate in the project throughout. Over a number of months this has been incredibly successful, with patients becoming involved in a wide range of activities, from group planning to planting the garden, designing and painting a large mural and, in colder months, sanding, painting and varnishing bird boxes.
Reflecting on the project, it has been fantastic to recognise the wide range of ways this has supported the recovery of the people we work with, particularly in building motivation and self-efficacy through strategies identified within the re-motivation process. The variety of tasks involved enabled us to use patients’ different strengths and interests, to set up appropriate roles and responsibilities and work towards individual goals.
Collaborative planning
Paul Herrington, from Grow Places, and Lucy-Rose Andrews, social recovery project manager, brought skills and expert knowledge to our project. With each of them we ran open group planning sessions on the ward, with the occupational therapy team enabling engagement and communication, having developed rapport and understanding of individual patient needs. The re-motivation process discusses the benefits of involving people in collaborative projects so as to develop self-validation and self-efficacy.
Patients reflected that garden space to be ‘peaceful.’ Being in an area of the ward that is communal, but away from the busier dining area, it often provides a safe space to begin to build confidence on the ward, take first steps away from self-isolation, and sometimes an area to eat and drink, with less risk of over-stimulation and related agitation.
Patients suggested pastel colours, grasses that could gently move in the wind, spring bulbs and scented herbs. We also planned a large painted tile willow tree to add to a big blank wall in a mix of colours to suit across the seasons.
Involving patients from the early stages gave a sense of belonging and responsibility within the project.
As professionals we are expert in supporting patient recovery, but not expert in the tasks themselves, and this led us to working more collaboratively, with a reliance on the skills and knowledge of the patients within the group, some of whom luckily were quite expert gardeners.
The group also ensured that our plans captured what the patients felt was needed from this environment at each stage of their recovery on the ward.
Facilitating participation
For many people on the ward motivation at the most basic level can be a challenge. Through facilitating groups in communal areas we enabled people to observe, and through this, invited their participation.
During the initial stages, completing meaningful occupations alongside a person can help to prompt curiosity, interest and occasional engagement. Often patients with low motivation and confidence declined to join in, but soon called suggestions across the room or stopped to have a look at what we were doing as they passed.
The project also provided a starting point for some one-to-one conversations to explore life history and personal interests. Patients were invited to take on individual roles that were personally meaningful to them at each stage, enabling us to provide recognition of their individual skills and interests and develop a sense of capacity.
As an example, a keen gardener with Parkinson’s did not yet feel able to join us in the garden, but spent much time sanding a bird box, which he shared with pride.
One group of ladies spontaneously began working together to interpret our garden plants and direct where plants should go. Another lady, who had declined to engage in anything on the ward, began telling us about her past work as a stained-glass window designer and agreed to go and look at the artwork we had been painting.
Taking on these responsibilities within the project could be seen as facilitating motivation; activities were set up to be achievable and patients gained positive experiences.
Through the volitional process this then supported the development of self-confidence and therefore motivation towards other tasks.
Moving forward
When moving towards discharge, a significant aspect of the occupational therapy role on the ward is to work with patients to identify plans and strategies to meet functional goals at home.
This often involves home assessments; however, for one patient her goal was to build her confidence in reintegrating into a local community. A trip to the garden centre, following a home assessment, give purpose to exploring the wider community while out of hospital, to explore her expectation of overwhelming anxiety and an inability to cope. With support she was able to reflect on the experience positively, developing her self-confidence, and a couple of weeks later she returned independently to do her own shopping and from there identified a number of local social groups to try.
Other patients also began integrating their skills and confidence into their daily lives on discharge. One lady began pruning the plants in her conservatory during weekend home leave, which she reported gave her a sense of purpose and achievement, having previously believed she would be unable to return to gardening due to having had a fall.
Two patients returned to the ward after discharge to donate plants that they felt would add to the space, demonstrating a sense of inclusion and an ability to reflect on the positive aspects of their recovery on the ward.
Supporting recovery through engagement in occupation
Overall, while the project has involved a lot of work, it has also provided a significant improvement to the ward environment; an opportunity to develop relationships with the wider multidisciplinary team; and, most importantly, numerous opportunities to support patient recovery through engagement in meaningful occupations.
It has left me keen to identify what project we could work on next to continue to provide these opportunities.
With thanks to the Friends of Fulbourn (whose contribution came from part of a grant from Tesco’s Bags of Help scheme); Head to Toe charity; Paul Herrington; Grow Places; Lucy Rose Andrews; all of the patients involved; and everyone in the wider team who has provided support and advice.
Article reproduced by kind permission of OT News

The Chapel Garden

By 2015, the Chapel Garden, which is in regular use by patients, was suffering from neglect, apart from a clear up in that year by a Friends’ party of volunteers. Accordingly the Friends sought the advice of Christoph Keate, the head gardener at Emmanuel College, on how to put not only the Chapel garden but also those in several of the wards into good order such that they might benefit patients not only visually but also as a focus for ward gardening activities. Armed with Christoph’s advice on the maintenance needed and possibilities for future planting, the Friends recruited Paul Herrington, CEO of Grow Places Ltd, a social enterprise a social enterprise focussed on gardening work with adults with disabilities including mental health. It was agreed that the priority was to restore the Chapel garden first before looking at Denbigh and other wards.

After preliminary planning Paul liaised with: the chaplain, John Nicholson; the staff and patients on George Mackenzie House, who had gardening activities. Th result was a much improved garden.

History of the Gardening projects

A gardening group was one of the Millennium Arts Projects started by the Friends funding a professional gardener as artist-in-residence, with help from the late Bronwen Loder, a member of the management committee of the Friends. They led a small group of male young-onset dementia patients who met weekly. Christina Rowland-Jones, former chair of the Friends, recollects its great success: “One patient never spoke as a result of his illness, and I well remember Bronwen telling me, in great excitement, that he had started to use words for the plants etc.  He must have enjoyed gardening before becoming ill.  The first garden to benefit from the group’s attention was to the left of the internal hospital road leading up to George Mackenzie ward, which was just grass.   With permission the group dug out a large square of the grass, planted it and provided a part-hidden central area with seating which was appreciated by patients who wished to isolate themselves outside during the summer.  The MAP textile group made very tall, colourful flags for each corner of the plot.  We had terrible trouble with rabbits eating the shrubs. Next was the chapel garden.  The group cleared the plot, dug it out and planted it with a range of interesting shrubs and a small mulberry tree, and again with seating for the patients. It looked lovely. From the outset the hospital managers made it clear that their contract gardeners only cut the grass – in fact half-cut it and left it lying over the top – and they would not maintain the two gardens.  Initially the gardening group maintained both, but our professional gardener decided to give up and we had nobody to lead it and couldn’t find a successor so had to stop the work.   At one point I was contacted by the head of a big firm on the Science Park who ran ‘away days’ for his senior staff where they carried out voluntary work in the locality, and they spent a day tidying both gardens, with a lot of time spent on the chapel area.   They really enjoyed themselves.   After that we were unable to provide regular maintenance and the latter garden in particular suffered badly”.