A digital place for people who access services, carers, staff and partner agencies, to share ideas around care co-ordination & care planning in mental health

Archive for the ‘Training and learning’ Category

New Mental Health Recovery Group

Here, Elaine Wilkes, Carers Education Worker writes about a new group to support people in Leeds:

I am really excited this morning along with my colleague Lokhi Roy!  We both work as part of Leeds Carers and stated a new group last night based on Mental Health Recovery!

recovery header

The group runs at Vale Circles once every two weeks from 5.30pm-7pm.  It is based on a group that has been running at Lovell Park for five years. Click here for the dates and venue details.

So why the excitement?  Well I experience depression and this is a group where anyone can come along if they have an interest in mental recovery.  This is:

  • Workers
  • People who have mental health problems
  • Carers
  • Anyone who is a combination of all the above

The group focuses on:

  • Hope that recovery can happen
  • Looking at things in a positive way
  • Knowing we experience negative things but looking at the type of things we do to overcome these

My dad died last March and I went to the Lovell Park  group  the week after his funeral.  I was ok but still at times tearful.  A member of the group mentioned railways (which my Dad loved) and I could feel myself becoming tearful.  I did not feel the need to hide the tears but talked about being upset by his death.  This led to other people talking about how they had overcome difficult things including deaths of people close to them.  I went away from that group feeling supported and more positive.  We also talked about techniques that can help all us cope at tough times

My hope for the Vale Circles Recovery Group is that we can develop a safe place where anyone feels comfortable to talk about things that are emotional and hard.  For me the key thing is we don’t stop there but focus on hope, how we can overcome pain and techniques to help all us of do this.

I don’t think it matters whether someone is a service user, carer or worker or all of these.  What matters to me is that we are people  and we all have things that are hard.  This group is about overcoming these things but also have fun and humour along the way.

If you would like further information about these sessions or to book yourself a place please contact 0113 85 54445 and ask for Elaine Wilkes or Lokhi Roy.

EQUIP training reflections…….

Last week I was fortunate enough receive training delivered as part of the EQUIP trial – EQUIP stands for Enhancing the Quality of User Involved Care Planning in Mental Health Services, you can read more about it here. Anyway, I was a bit of a cuckoo in the community teams’ nest and I have to say they were very welcoming (I know it can be disconcerting to have a non-team member present at a team event!).

Having been involved in bringing the trial to the attention of Leeds and York Partnerships NHS Foundation Trust (LYPFT)  I was curious as to what the training content would be – and anxious that it was on similar lines to the existing training provided within the LYPFT. I don’t want to blog the entirety of the training but I am happy to share some key reflections:

  • Training was delivered by Lauren, Lindsey and Karina – experts by experience of using services, being a carer and an academic. This worked very well and brought the theoretical points to life, making the learning ‘real’; so helpful in understanding the impact that professionals way of being, interventions and ‘rules’ have on people.
  • Role play can work – the trainers pushed some difficult conversations that served to highlight some of the stickier areas that we work within – confidentiality, information sharing, truth-telling versus saying a lot of words but saying nothing.
  • People can’t be involved in shared decision-making if they don’t have the information upon which to make the decision.
  • There is disconnection between what the research found to be important to service users and carers (engagement and delivery of the care plan) and what the professional found to be important (production of care plan, targets met). Noted that there are professional and organisational drivers, but to provide care support and treatment that is going to make a difference, we have to prioritise the person’s goals.
  • Aspirational goals are the future – we can ditch SMART (hurrah, permission granted!). People’s goals are not always SMART and they don’t have to be. They need to be heard, understood and drive the care plan.
  • Care plans are an output of working together with people to agree a plan but the journey to get to this point is where the value lies – involving the person, understanding priorities and being prepared to hear them even if they are in conflict to professional/organisational priorities, being flexible and responding to changing needs. It’s the process not the product.
  • The role that an organisation takes in setting local ‘targets’ can work against improving quality of involvement and inhibit shared decision
  • The trainers mentioned that they found the Trusts care plan to be the most service user focused amongst the Trusts they have worked with; that they found working with LYPFT to be a positive experience, that the staff have been positive, motivated and caring. Lindsey said that it gave her hope that care coordinators can and do support people very well in the community.

Delighted to have had the opportunity to participate, looking forward to thinking about what this learning means for LYPFT, community teams and most importantly for the difference this makes to people and carers.

Donna Kemp | Care Programme Approach Development Manager

Assessing spiritual needs in mental health

I was delighted to meet with Rev Melodie Timball last week to talk about Spirituality and mental health. Melodie has a specific goal: that everyone accessing mental health services at Leeds and York Partnerships NHS Foundation Trust has an assessment of their spiritual needs.

keeping the faithNot sure about what Spirituality and mental health have to do with each other? You can read about it here (The Royal College of Psychiatrists) and here (Mental Health Foundation).

Royal College of Nursing have published a handbook, Spirituality in Nursing Care.  Guidelines for nursing staff are relevant to mental health nursing and are practical too, for example:

“Just as you would assess your patients’ physical needs, an initial assessment of their spiritual concerns is also important. You may find questions such as these helpful:

do you have a way of making sense of the things that happen to you?

• what sources of support/help do you look to when life is difficult?

• would you like to see someone who can help you?

• would you like to see someone who can help you talk or think through the impact of this illness/life event? (You don’t have to be religious to talk to them).”

With everything jostling for a place on the ‘must do’ list, what is the mandate for assessing spiritual needs? Nice have a quality statement: Quality Statement 6: End of life care for adults – People approaching the end of life are offered spiritual and religious support appropriate to their needs and preferences.

But what about everyone else? And when I say everyone, I mean everyone – staff included!

I’m not sure there has to be a stick for this. I think the carrot is tasty enough.

spirituality

 

 

So what do pharmacy staff at LYPFT do all day – count tablets?? No

elaine westonThis guest blog by Elaine Weston, Chief Pharmacist at Leeds and York Partnership NHS Foundation Trust, is about the role that pharmacy has in a persons care, support and treatment.

Q. What do pharmacy staff do all day? A. Count tablets into bottles? X No

Dispensing prescriptions is only a small part of the daily activity of pharmacy staff. The Pharmacists and Pharmacy technicians’ role is to ensure that service users get the best out of their medicines (Medicines Optimisation).

This means service users understanding their medication, how it works, when they should take it, what side effects may be experienced and how to minimise them.

On admission to hospital the pharmacy technicians will contact, with the person’s permission, the service user’s GP or look at the ‘Summary Care Record’ in order to find out  the current medication that the service user is prescribed. This is then checked with the service user or carer to ensure it is correct. Sometimes people are prescribed medication but for various reasons do not take it. The pharmacy staff will explore with the service user why they decide not to take a medication and if it is because of side effects then they can advise on ways to minimise these.

Mistakes are often made around medication when people move from one care setting to another ie from home to hospital or on discharge back home or when transferred to different hospitals. This is why it is very important to bring your medicines into hospital with you if you are admitted or have an outpatient appointment. This means the Dr, nurse or pharmacist can check that the medication is correct.

Giving information about medication is an essential role for Pharmacy staff and helping service users make a decision about their choice of medication where appropriate. The website www.choiceandmedication.org/leedsandyorkpft/ can help in making these decisions. The website has all the common psychiatric conditions and medication used to treat them. The format of the website is user-friendly and can be used by service users or carers on their own or in discussion with their healthcare professional. Leaflets about the medication can also be printed off.

choice and medication

The pharmacy department operates a ‘Telephone Help Line’  9am to 5am Monday to Friday (0113 8555534 for Leeds and 0113 8550591 for York)  for service users, carers, GPs and community pharmacists to contact a pharmacist for advice about medication.

The pharmacy staff  also check that relevant blood tests have been carried out for example for Lithium and Clozapine. We check that other tests have been done like ECGs if a service user is prescribed an antipsychotic. The pharmacy staff will also ask you about whether you smoke, this is because some medication is affected by smoking and blood levels of medication can be changed depending on how many cigarettes you smoke each day, or if you stop smoking.

A service user’s physical health is as important as their mental health and so the pharmacy staff will ask you if you have had relevant physical health checks, like weight, cholesterol levels, blood pressure checks either at your GP or in a LYPFT clinic.

Sometimes a doctor will ask a pharmacist to help advise them regarding a service user’s medication. This might be because the current medication is not working well, or side effects are troublesome. The pharmacy staff will collate a drug history using all the past and current medical and nursing notes, maybe from many years before in order to get a picture of previous therapy and how well or not it worked. The pharmacist would then give advice to the doctor on the best options for future treatment.

In summary, Pharmacy staff are here to help you get the best out of your medicines, do not hesitate to use them.

Elaine Weston, Chief Pharmacist 

August 2015

New Care Act – key points for mental health

In this post, Jenny Titcombe, Senior Mental Health Social Worker, explains about the new Care Act and what it means for people accessing mental health services, carers and for people working in mental health………

What do people need to know about the new Care Act ?

• The government says the new Care Act (2014) is the biggest social care reform in the UK for over half a century. The Care Act aims to simplify all other laws and tries to make it clear exactly what people who need social care advice/ support can expect from their council.
• The wellbeing of people is at the centre of the new Care Act. Councils now have a duty to think about the physical, mental and emotional wellbeing of people who need care. Councils also have a new duty to provide preventative services to keep people healthy in the first place. Council’s must also provide better information to help people access good care.
• For the first time the care system will be built around each individual person and what care they each need and want. Personal Budget’s are part of the new law which give people the power to spend allocated money on care that meets their needs and suits them best.
• The Care Act also introduces a cap on care costs for which an individual is liable (April, 2016)

More information is available here

What does The Care Act mean for carers?

• The Care Act also introduces new rights for carers. Now anyone who provides unpaid care or support to an adult family member or friend can arrange to have a carer’s assessment, irrespective of whether the person they care for has eligible needs. Previously only carers providing regular and substantial care were entitled to a carer’s assessment.
• For the first time, if a Carer has eligible needs of their own, they will have the right to support from the council.
More information is available at Carers UK herehere is a link to Carers Leeds and this link is to York Carers Forum.

What does this mean for people working in mental health?
• Social workers in Community Mental Health Teams have recently undergone training in The Care Act and have embraced changes to practice, process and paperwork.
• As a result of The Care Act, working age adults with mental health problems and professional referrers should find it easier to access funded support as assessments are based on an individual’s needs (rather than available services) and more flexible responses to meeting eligible needs should be available.
• The Care Act now makes integration, cooperation and partnership a legal requirement on local authorities and on all agencies involved in public care the NHS including independent or private sector organisations and housing. Those working in Mental Health Services should expect further moves towards integrated services over the coming years.
• The Care Act makes offering Personal Budgets to people with eligible social care need law. Although under separate legislation – there is likely to be a rise in personal health budgets and mixed (health and social care) budgets over coming years. Recently introduced regulations now makes it law that those eligible for NHS Continuing Health Care have a right to a Personal Health Budget.
Watch this space …

Jenny Titcombe
Senior Mental Health Social Worker

One page profiles in mental health

A recent conversation with Stuart Lane about personal health budgets got me to thinking about one page profiles and how they might support creative working in teams and in collaborative working with people accessing services. We had a discussion about what it might be like if staff had a one page profile that was available to service users; would this be a good thing? Would it enhance engagement? Would it encourage more critical thinking about choice of worker? Would it be ‘too much information’? Would it make any difference to how staff relate to each other? Lots of questions to ponder over. My instincts are that it would be a good thing but thats only my view……….

Helen Sanderson Associates do a lot of work on one page profiles and are currently offering a free webinar, click here for info on how to book on: Person Centred Practices in Mental Health, 29th January 2 -3pm

Main topics are:-

1. Using One Page Profiles, both with people with Mental Health needs and in the teams supporting them working in Clinical settings and in the Community.

2. How Person Centred Thinking Tools can be used to analyse and solve common problems in Mental Health services.

3. An introduction to improving reviews and CPA through Person Centred Practice.

So what do personal health budgets and one page profiles have to do with each other? Well, they both require some creative thinking; some letting go of existing ways of viewing and doing things; and both could contribute to a person’s wellbeing and recovery.

Already looking forward to seeing how personal health budgets in Mental Health will work…………….

Integrated Care Pathways in Mental Health

Jo Fryer and Emma Metcalf explain what Integrated Care Pathways are and how these are being developed at Leeds and York Partnership NHS Foundation Trust (LYPFT):

Hi there, the trust is developing pathways that set out minimum standards of what people should expect and receive during their care. We thought it would be useful to outline work done so far, and what we are doing next. Below is some information that will hopefully be useful: 

What is an Integrated Care Pathway (ICP)?

An Integrated Care Pathway:

  • maps what should be done, when and by whom
  • sets a minimum standard of care
  • incorporates relevant guidelines, standards and protocols

Why have LYPFT developed ICP’s?

ICP’s identify:

  • the right people
  • doing the right things
  • in the right order
  • at the right time
  • in the right place

all with the attention to the individuals journey.

They also reduce unnecessary duplication and variation and are outcome and wellbeing / recovery focussed.

The trust has developed a ‘Core’ ICP that builds upon the information gathered at the assessment.  Areas of need anyone may experience regardless of ‘diagnosis’ will help develop individual care plans; other areas of need may include:

  • Mental health and/or Learning Difficulties
  • Physical health
  • Social, Occupational & Vocational
  • Medication
  • Discharge planning
  • Carers and Family interventions
  • Finances
  • Housing
  • Supporting and Safeguarding children
  • Safeguarding adults
  • Engagement
  • Advocacy
  • Diversity
  • Safety & Risk
  • Advanced decisions
  • Substance Use
  • Mental Health Act
  • Mental Capacity Act

In addition to these, specific needs based interventions describe the specific, expert interventions recommended by NICE and other best practice guidance for people with specific needs around Cognitive Impairment / Dementia, Psychosis and Common Mental Health issues.

We are currently working on how we can make the information meaningful and accessible for all and the best way of doing this eg the Trust web site. We will also be undertaking consultations with people who use our services.

Thank you for taking the time to read this and we hope you found it a useful introduction to ICP’s.

If you have any comments or questions please feel free to post them on here or email planningcarelypft@nhs.net

Jo, ICP Development Manager & Emma, ICP Developer

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