Welcome to Cotswold House

An estimated 1.25 million people in the UK suffer from an Eating Disorder (ED) at any one time, most of whom will have families, friends, carers, and others who will be affected by their loved one having an ED.

Evidence suggests there is a positive impact on treatment outcomes for someone with an Eating Disorder if their family are fully informed and engaged in treatment (Beat 2019).

Cotswold House believes that families, friends and carers play a crucial role in recovery from an eating disorder, however we are aware that supporting someone with an eating disorder can have a huge impact on your own emotional and physical well-being.

We encourage our patients to involve their families, friends and carers, as we believe that families can be a source of support and encouragement.

However, your loved ones may worry about upsetting or letting their families down, they may want to try and sort things out for themselves, or they may not be ready for treatment.

In our experience family, friends and carers are important in helping their loved one recover.
They are a resource; supporting their loved ones make changes and regain their lives.

The focus is on moving forwards, increasing understanding and identifying helpful approaches rather than apportioning blame.

We are fully committed to providing support for families, friends and carers and wherever possible involving you in the treatment of your loved one.

The National Institute for Health and Clinical Excellence (NICE) Eating Disorder Guidelines (2017) makes the following recommendation:

‘It is good practice for families of patients of all ages to be involved in the assessment and treatment of patients suffering with an Eating Disorder, and to be kept informed about risks and progress’, which is supported by Best Practice on the Engagement and Empowerment of Families and Carers affected by Eating Disorders (Beat 2019).

However, the focus of treatment is on the individual, who is seen as responsible for their own recovery.

Information about an individual’s health status is not shared with parents/carers without their consent, unless there is a concern that they are a risk to themselves or others.

About the service

Cotswold House and Wiltshire Community Eating Disorder Service are a specialist eating disorder service based in Savernake Hospital in Marlborough.

The service is for adults who have Eating Disorders including anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders.

We offer in-patient, day patient and community-based treatment.

The team

We are a multidisciplinary team, which includes Administrators, Community Psychiatric Nurses, Dieticians, Family Therapists, Occupational Therapists, Psychiatrists, Psychologists and Support Workers.

What to expect

Once we have received a referral, we will triage the referral to ensure we are the most appropriate service to meet your loved ones needs.

An assessment appointment will be arranged to gather information about the presenting issues and to agree a care / treatment plan.

The service aims to restore physical health and psychological wellbeing in a safe and collaborative way.

Waiting list

People on the waiting list are offered regular telephone reviews.

Their GP will be asked to monitor their physical health (this may include: bloods, ECG and weight) and to let us know if there is any deterioration.

If you are worried that there is deterioration in their presentation, please encourage your loved one to arrange a review with their GP or contact Cotswold House.

Treatment

The inpatient, day patient and community services offer a range of treatments including:

• Individual and group treatments and family therapy.

More detailed information is available from our website. www.oxfordhealth.nhs.uk

Care Planning Approach (CPA)

CPA is a framework, which aims to support your loved one’s recovery and is used to assess their needs and ensure they have appropriate support for their needs.

Confidentiality

Confidentiality is often cited as a barrier to why carers can’t be involved in their loved one’s treatment.

Although we recognise the importance of confidentiality and maintaining a trusting relationship between clinician and patient it doesn’t mean we can’t provide carers with general information the risks associated with it, what treatment involves and advice on managing the ED.

About eating disorders

Eating disorders such as Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder are mental health problems.

They involve an unhealthy relationship with food (such as restricting one’s food intake, bingeing on large amounts of food, sticking to strict dietary rules).

They also typically involve a poor or distorted body image and/or a fear of gaining weight.
There is no one cause for eating disorders and no one type of person gets them.

For further information Beat is the national eating disorder charity on b-eat.co.uk or our website www.oxfordhealth.nhs.uk

Looking after yourself

Supporting and caring for a loved one who is suffering from an eating disorder is not an easy task and can have a huge impact on family, friends and carers.

We believe it is important that carers are supported in this difficult and sometimes over-whelming task.

Friends and family meeting

This meeting is held monthly on a Saturday morning between 10-11.30.

The meeting is available for any families and carers of current inpatient, day-patient and outpatients and carers of those currently on our waiting list.

Clinicians from Cotswold House and Wiltshire Community Eating Disorder Service facilitate the meeting.

The aim is to provide a safe environment to talk about the impact the eating disorder has had on you and your family and an opportunity to meet other carers, share ideas and resources and look after your own well-being.

Some sessions will cover a specific topic such as cycle of change

.
Questions can be submitted in advance of the meeting and questions for presentations can be made.

The group aims to

• Provide specialist support and advice about caring for someone with an eating disorder
• Provide useful information and resources about eating disorders
• Provide a supportive space for sharing experiences.

Carers assessment

If your own health is suffering, as a carer you are entitled to a carer’s assessment.

This is not to assess your ability to care, but to think with you about what can be done to help you.

A carers assessment can be a chance to discuss what help you need to help you maintain your own health and to balance caring with other aspects of your life.

You can register as a carer at your GP surgery; carers.org.uk can be accessed online for further information and signposting.

Carer liaison

Carers are always welcome to raise concerns with us if they feel that their loved one is deteriorating, and they have serious concerns about their physical or mental health and/or if a patient has disengaged and is no longer in treatment.

In this case we may advise you to contact their GP for new referral.

If your loved one has agreed for you to be involved in their treatment and are admitted to our inpatient unit or day programme, we offer weekly carers liaison contact.

Family therapy

Sessions are offered in our clinic base in Savernake Hospital, Marlborough.

This can be offered to families, parents / carers, couples and individuals.

Participation

We welcome carers participation in the shaping of the service we provide, please contact us if you have feedback on ways in which we can improve the service we provide.

What do people say about Cotswold House?

‘Cotswold House is more than just a place where treatment is given; it provides a very caring community that goes beyond being supportive.’

‘It’s very difficult to describe what a special place Cotswold House is, having your loved one in some sort of psychiatric unit can be frightening, however Cotswold House offers a warm and friendly environment.’

‘I was treated with fantastic care and respect by the whole team especially the help I got after COVID-19 hit. I can only thank them with everything they supported me with, I wouldn’t know where I would be without the help I received.’

Suggested reading materials

• Skills-based learning for caring for a loved one with an eating disorder: The new Maudsley method. Janet Treasure, Grainne Smith, and Anna Crane (2017)
• The Succeed Foundation has developed a DVD based on the above book which has been written, produced, and directed by carers, patients, and clinicians http://www.succeedfoundation.org/
• Anorexia Nervosa; A Recovery Guide for Families, Friends and Sufferers. Janet Treasure (2013)
• Biting the Hand that Starves You: Inspiring resistance to anorexia/bulimia. Richard Maisel, David Epston and Alisa Borden (2004)
• Getting Better Bit(e) by Bit(e) – A survival kit for sufferers of bulimia nervosa and binge eating disorders. Schmidt and Treasure (2015)
• Overcoming Binge Eating. Dr Christopher Fairburn (2013).
• Anorexia Nervosa: The Wish to Change, Crisp, Joughin, Halek & Bowyer.
• National Institute for Health and Clinical Excellence (NICE): Eating disorders treatment guidelines for England and Wales. Available online at www.NICE.org.uk

Resources

• B-eat: Beat is the world’s largest eating disorders charity. It provides support and information to anyone affected by eating disorders, including sufferers, their family members and friends, professionals and anyone who wants to find out more about eating disorders. Website: www.b-eat.co.uk

• Beat Carers’ Forum: The Beat Carers’ Forum is an online community dedicated to carers, where you can find information and access support, talking to other people who have supported someone with an eating disorder. By registering on the forum you can access the dedicated message boards, participate in live chats with other carers and download a range of information to help you provide the best possible support. Website: www.b-eat-carers.co.uk

• Carers Trust: Carers Trust works to improve support, services and recognition for anyone living with the challenges of caring, unpaid, for a family member or friend who is ill, frail, disabled or has mental health or addiction problems. Website: http://www.carers.org/

Helplines:

• Beat Adult Helpline 0845 634 1414 (Monday to Friday, 10.30am-8.30pm; Saturday, 1.00pm-4.30pm) or email help@b-eat.co.uk

• Beat Youthline (for those aged 25 or under) 0845 634 7650 (Monday to Friday, 4.30pm-8.30pm; Saturday, 1.00pm-4.30pm) or email: fyp@b-eat.co.uk Beat offers a callback service, so that you can save the cost of the call. The Youthline also offers a text service – text ‘call back’ to 07786 201820 for a free callback. They aim to return calls within 24 hours and during Youthline opening hours.

• The New Maudsley Approach: This website provides parents and carers of people with eating disorders with a toolkit to help educate, empower and equip them to deal more effectively with the stressful caring role. Website: http://www.thenewmaudsleyapproach.co.uk

• Overcoming Anorexia for Carers www.overcominganorexiaonline.com

There are a range of resources out there that you can use to support you.

We recommend that you seek appropriate medical advice from your GP if you feel you need further support.

Beat is the UK’s leading eating disorder charity. Through their website you can find local support in your area, information on eating disorders, how you can support yourself and how others can support you.

You can email BEAT for more information on onlineservices@beateatingdisorders.org.uk or access their website at: https://www.beateatingdisorders.org.uk