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The Brambles 2020-10-20 Person 1 5 0

No practical information provided for how to specifically manage mealtimes, even after asking several times. Information regularly asked for, promised and never sent. Evidence of staff not reading our initial notes (i.e. asking questions about issues already provided and making statements of fact about things that were incorrect and had already been advised). This happened repeatedly which suggested they were not taking notes during/after meetings, or that there were not reading notes of prior meetings. No minutes or any other follow up notes after official meetings (possibly linked to the issue above. (Some did arrive after chasing many times over several months and when they arrived they were factually incorrect). No care plan created (see also above). When we eventually received the 'plan' it proved only to be a series of notes, there was no plan. Meetings cancelled at short notice. Meeting dates offered and then withdrawn. Little coordination between staff members. - On one occasion a phone call was made to us due to a mix up between staff, the person calling was rude and insistent about an issue that had already been agreed - this led to them hanging up mid conversation. No apology was made, rather their line manager later was asked to be sympathetic as they had "felt unwell" that day. Regularly asked to have sympathy for the issues facing the team, to the extent that it more often felt that we were the ones who should be in the role of sympathetic care provider. Poorly managed review meetings which have been disorganised (ie. no agenda/notes supplied in advance for us to understand what was actually being reviewed). The meeting itself was disorganised and only consisted of being asked "Well, how do you think things are going?) Passive-aggressive correspondence and comments during meetings (for instance, being told that staff had "to get home to see their families", even though we'd already agreed to meet when only it was convenient for staff). Direct questions not being answered, rather an attitude of obfuscation. After many months of asking, eventually being referred to a charity (rather than NHS) for advice only to read that the advice provided (ie therapy such as CBT) was something that the team said would not be effective (see below). Constantly mis-referencing the Minnesota Starvation Experiment as a reason for not providing any level of therapeutic support, despite the recommended charity (BEAT) website advising that some types of therapy are relevant and helpful suitable. While understanding the limitations suggested by the Minnesota Starvation Experiment, I'm not convinced the team fully understand the context or wider academic reservations and qualifications about the blanket efficacy of the study. Not answering any questions about how an approach to treating eating disorders might (or might not) change when the sufferer is autistic. This question has been asked repeatedly, the response is to ignore and hope we go away.

See above. All of these issues have been raised. No one has seemed ready to offer a genuine apology, or desire to engage and address issues beyond a sense of "we're sorry if you feel that way, we're only human". I'm concerned that the basic function of the unit is limited to health monitoring (blood, weight, bone density). As extremely welcome as these things are, they fall far short of mental health support which is supposed to be the specialism of the team.